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Sample records for left inferior colliculus

  1. Enhanced Modiolar Stimulation Effects in the Inferior Colliculus

    National Research Council Canada - National Science Library

    Lithgow, Brian

    2001-01-01

    This preliminary study quantifies and provides one explanation for the extent of modiolar stimulation observed as a function of current level as recorded in a population of Inferior Colliculus units...

  2. Dopaminergic Input to the Inferior Colliculus in Mice

    Directory of Open Access Journals (Sweden)

    Alexander A Nevue

    2016-01-01

    Full Text Available The response of sensory neurons to stimuli can be modulated by a variety of factors including attention, emotion, behavioral context, and disorders involving neuromodulatory systems. For example, patients with Parkinson’s disease have disordered speech processing, suggesting that dopamine alters normal representation of these salient sounds. Understanding the mechanisms by which dopamine modulates auditory processing is thus an important goal. The principal auditory midbrain nucleus, the inferior colliculus (IC, is a likely location for dopaminergic modulation of auditory processing because it contains dopamine receptors and nerve terminals immunoreactive for tyrosine hydroxylase (TH, the rate-limiting enzyme in dopamine synthesis. However, the sources of dopaminergic input to the IC are unknown. In this study, we iontophoretically injected a retrograde tracer into the IC of mice and then stained the tissue for TH. We also immunostained for dopamine beta-hydroxylase (DBH, an enzyme critical for the conversion of dopamine to norepinephrine, to differentiate between dopaminergic and noradrenergic inputs. Retrogradely labeled neurons that were positive for TH were seen bilaterally, with strong ipsilateral dominance, in the subparafascicular thalamic nucleus (SPF. All retrogradely labeled neurons that we observed in other brain regions were TH-negative. Projections from the SPF were confirmed using an anterograde tracer, revealing TH-positive and DBH-negative anterogradely labeled fibers and terminals in the IC. While the functional role of this dopaminergic input to the IC is not yet known, it provides a potential mechanism for context dependent modulation of auditory processing.

  3. Diffusion tensor imaging of the inferior colliculus and brainstem auditory-evoked potentials in preterm infants

    International Nuclear Information System (INIS)

    Reiman, Milla; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Johansson, Reijo; Jaeaeskelaeinen, Satu K.; Kujari, Harry; Haataja, Leena

    2009-01-01

    Preterm and low-birth-weight infants have an increased risk of sensorineural hearing loss. Brainstem auditory-evoked potentials (BAEP) are an effective method to detect subtle deficits in impulse conduction in the auditory pathway. Abnormalities on diffusion tensor imaging (DTI) have been shown to be associated with perinatal white-matter injury and reduced fractional anisotropy (FA) has been reported in patients with sensorineural hearing loss. To evaluate the possibility of a correlation between BAEP and DTI of the inferior colliculus in preterm infants. DTI at term age and BAEP measurements were performed on all very-low-birth-weight or very preterm study infants (n=56). FA and apparent diffusion coefficient (ADC) of the inferior colliculus were measured from the DTI. Shorter BAEP wave I, III, and V latencies and I-III and I-V intervals and higher wave V amplitude correlated with higher FA of the inferior colliculus. The association between the DTI findings of the inferior colliculus and BAEP responses suggests that DTI can be used to assess the integrity of the auditory pathway in preterm infants. (orig.)

  4. Diffusion tensor imaging of the inferior colliculus and brainstem auditory-evoked potentials in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, Milla; Lehtonen, Liisa; Lapinleimu, Helena [Turku University Central Hospital, Department of Paediatrics, Turku (Finland); Parkkola, Riitta [Turku University Central Hospital, Department of Radiology and Turku PET Centre, Turku (Finland); Johansson, Reijo [Turku University Central Hospital, Department of Otorhinolaryngology, Turku (Finland); Jaeaeskelaeinen, Satu K. [Turku University Central Hospital, Department of Clinical Neurophysiology, Turku (Finland); Kujari, Harry [Turku University Central Hospital, Department of Pathology, Turku (Finland); Haataja, Leena [Turku University Central Hospital, Department of Paediatric Neurology, Turku (Finland)

    2009-08-15

    Preterm and low-birth-weight infants have an increased risk of sensorineural hearing loss. Brainstem auditory-evoked potentials (BAEP) are an effective method to detect subtle deficits in impulse conduction in the auditory pathway. Abnormalities on diffusion tensor imaging (DTI) have been shown to be associated with perinatal white-matter injury and reduced fractional anisotropy (FA) has been reported in patients with sensorineural hearing loss. To evaluate the possibility of a correlation between BAEP and DTI of the inferior colliculus in preterm infants. DTI at term age and BAEP measurements were performed on all very-low-birth-weight or very preterm study infants (n=56). FA and apparent diffusion coefficient (ADC) of the inferior colliculus were measured from the DTI. Shorter BAEP wave I, III, and V latencies and I-III and I-V intervals and higher wave V amplitude correlated with higher FA of the inferior colliculus. The association between the DTI findings of the inferior colliculus and BAEP responses suggests that DTI can be used to assess the integrity of the auditory pathway in preterm infants. (orig.)

  5. HISTOLOGICAL STUDIES OF THE EFFECTS OF MONOSODIUM GLUTAMATE ON THE INFERIOR COLLICULUS OF ADULT WISTAR RATS.

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    A.O. Eweka.

    2008-01-01

    Full Text Available Histological effects of Monosodium glutamate (MSG commonly used as food additive on the inferior colliculus (IC of adult Wistar rats were carefully studied. The rats of both sexes (n=24, average weight of 185g were randomly assigned into two treatments (n=16 and control (n=8 groups. The rats in the treatment groups received 3g and 6g of MSG thoroughly mixed with their feeds for fourteen days, while the control rats received equal amounts of feeds without MSG added. The rats were fed with growers' mash purchased from Edo Feeds and Flour Mill Ltd, Ewu, Edo State and were given water liberally. The rats were sacrificed on day fifteen of the experiment. The inferior colliculus was carefully dissected out and quickly fixed in 10% formal saline for routine histological study after H&E method.The histological findings after H&E methods indicated that the treated sections of the inferior colliculus showed some cellular degenerative changes, cellular hypertrophy, and autophagic vacuoles with some intercellular vacuolations appearing in the stroma, and some degree of neuronal hypertrophy when compared to the control sections.These findings indicate that MSG consumption may have a deleterious effect on the neurons of the inferior colliculus (IC. MSG may probably have adverse effects on the auditory sensibilities by its deleterious effects on the nerve cells of the IC of adult Wistar rats. It is recommended that further studies aimed at corroborating these observations be carried out.

  6. Negative temporal summation of the responses to pairs of tone bursts in albino mice inferior colliculus

    Science.gov (United States)

    Bibikov, Nikolay G.; Cai, Chen Qi; Jie, Tang

    2003-10-01

    The extracellular activities of single units in an inferior colliculus of narcotized albino mice have been studied. As a stimuli pairs of best frequency (BF) tone bursts with different duration have been used and forward masking has been studied. The test tone usually has a 40 ms duration at intensity 5 dB above threshold. The intensity and duration of the masker could be changed. It was shown that the forward masking essentially depends upon the duration of the first burst. In many cases, the negative temporal summation can be seen. The increase in the duration of first burst (or masker) leads to the decrease in the whole response. Moreover, the BF tone burst which did not evoke any spike response could inhibit the response to the second (test) tone in some cases. Therefore in many units the inhibitory threshold was lower than the excitatory threshold even at the best frequency. The local application of bicuculline through a multibarrel-electrode increased the pulse activity considerably. However, the effect of forward masking usually left even after an inhibitory antagonist (bicuculline) application. [Work supported by grants 39970251 from NSFC, T010360056 from the Foreign Expert Bureau of the State Council of China, and 02-04-3900 from RFBR-NSFC.

  7. Classification of frequency response areas in the inferior colliculus reveals continua not discrete classes

    OpenAIRE

    Palmer, Alan R; Shackleton, Trevor M; Sumner, Christian J; Zobay, Oliver; Rees, Adrian

    2013-01-01

    A differential response to sound frequency is a fundamental property of auditory neurons. Frequency analysis in the cochlea gives rise to V-shaped tuning functions in auditory nerve fibres, but by the level of the inferior colliculus (IC), the midbrain nucleus of the auditory pathway, neuronal receptive fields display diverse shapes that reflect the interplay of excitation and inhibition. The origin and nature of these frequency receptive field types is still open to question. One proposed hy...

  8. Immunocytochemical profiles of inferior colliculus neurons in the rat and their changes with aging

    Czech Academy of Sciences Publication Activity Database

    Ouda, Ladislav; Syka, Josef

    2012-01-01

    Roč. 6, č. 68 (2012), s. 1-14 ISSN 1662-5110 R&D Projects: GA ČR(CZ) GAP304/12/1342; GA ČR(CZ) GBP304/12/G069 Institutional research plan: CEZ:AV0Z50390703 Institutional support: RVO:68378041 Keywords : inferior colliculus * GABA * parvalbumin Subject RIV: FH - Neurology Impact factor: 3.333, year: 2012

  9. Intracellular responses to frequency modulated tones in the dorsal cortex of the mouse inferior colliculus

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    Ruediger eGeis

    2013-01-01

    Full Text Available Frequency modulations occur in many natural sounds, including vocalizations. The neuronal response to frequency modulated (FM stimuli has been studied extensively in different brain areas, with an emphasis on the auditory cortex and the central nucleus of the inferior colliculus. Here, we measured the responses to FM sweeps in whole-cell recordings from neurons in the dorsal cortex of the mouse inferior colliculus. Both up- and downward logarithmic FM sweeps were presented at two different speeds to both the ipsi- and the contralateral ear. Based on the number of action potentials that were fired, between 10-24% of cells were selective for rate or direction of the FM sweeps. A somewhat lower percentage of cells, 6-21%, showed selectivity based on EPSP size. To study the mechanisms underlying the generation of FM selectivity, we compared FM responses with responses to simple tones in the same cells. We found that if pairs of neurons responded in a similar way to simple tones, they generally also responded in a similar way to FM sweeps. Further evidence that FM selectivity can be generated within the dorsal cortex was obtained by reconstructing FM sweeps from the response to simple tones using three different models. In about half of the direction selective neurons the selectivity was generated by spectrally asymmetric synaptic inhibition. In addition, evidence for direction selectivity based on the timing of excitatory responses was also obtained in some cells. No clear evidence for the local generation of rate selectivity was obtained. We conclude that FM direction selectivity can be generated within the dorsal cortex of the mouse inferior colliculus by multiple mechanisms.

  10. Auditory fear conditioning modifies steady-state evoked potentials in the rat inferior colliculus.

    Science.gov (United States)

    Lockmann, André Luiz Vieira; Mourão, Flávio Afonso Gonçalves; Moraes, Marcio Flávio Dutra

    2017-08-01

    The rat inferior colliculus (IC) is a major midbrain relay for ascending inputs from the auditory brain stem and has been suggested to play a key role in the processing of aversive sounds. Previous studies have demonstrated that auditory fear conditioning (AFC) potentiates transient responses to brief tones in the IC, but it remains unexplored whether AFC modifies responses to sustained periodic acoustic stimulation-a type of response called the steady-state evoked potential (SSEP). Here we used an amplitude-modulated tone-a 10-kHz tone with a sinusoidal amplitude modulation of 53.7 Hz-as the conditioning stimulus (CS) in an AFC protocol (5 CSs per day in 3 consecutive days) while recording local field potentials (LFPs) from the IC. In the preconditioning session ( day 1 ), the CS elicited prominent 53.7-Hz SSEPs. In the training session ( day 2 ), foot shocks occurred at the end of each CS (paired group) or randomized in the inter-CS interval (unpaired group). In the test session ( day 3 ), SSEPs markedly differed from preconditioning in the paired group: in the first two trials the phase to which the SSEP coupled to the CS amplitude envelope shifted ~90°; in the last two trials the SSEP power and the coherence of SSEP with the CS amplitude envelope increased. LFP power decreased in frequency bands other than 53.7 Hz. In the unpaired group, SSEPs did not change in the test compared with preconditioning. Our results show that AFC causes dissociated changes in the phase and power of SSEP in the IC. NEW & NOTEWORTHY Local field potential oscillations in the inferior colliculus follow the amplitude envelope of an amplitude-modulated tone, originating a neural response called the steady-state evoked potential. We show that auditory fear conditioning of an amplitude-modulated tone modifies two parameters of the steady-state evoked potentials in the inferior colliculus: first the phase to which the evoked oscillation couples to the amplitude-modulated tone shifts

  11. Alignment of sound localization cues in the nucleus of the brachium of the inferior colliculus

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    Young, Eric D.

    2014-01-01

    Accurate sound localization is based on three acoustic cues (interaural time and intensity difference and spectral cues from directional filtering by the pinna). In natural listening conditions, every spatial position of a sound source provides a unique combination of these three cues in “natural alignment.” Although neurons in the central nucleus (ICC) of the inferior colliculus (IC) are sensitive to multiple cues, they do not favor their natural spatial alignment. We tested for sensitivity to cue alignment in the nucleus of the brachium of the IC (BIN) in unanesthetized marmoset monkeys. The BIN receives its predominant auditory input from ICC and projects to the topographic auditory space map in the superior colliculus. Sound localization cues measured in each monkey were used to synthesize broadband stimuli with aligned and misaligned cues; spike responses to these stimuli were recorded in the BIN. We computed mutual information (MI) between the set of spike rates and the stimuli containing either aligned or misaligned cues. The results can be summarized as follows: 1) BIN neurons encode more information about auditory space when cues are aligned compared with misaligned. 2) Significantly more units prefer aligned cues in the BIN than in ICC. 3) An additive model based on summing the responses to stimuli with the localization cues varying individually accurately predicts the alignment preference with all cues varying. Overall, the results suggest that the BIN is the first site in the ascending mammalian auditory system that is tuned to natural combinations of sound localization cues. PMID:24671535

  12. Responses to amplitude modulated infrared stimuli in the guinea pig inferior colliculus

    Science.gov (United States)

    Richter, Claus-Peter; Young, Hunter

    2013-03-01

    Responses of units in the central nucleus of the inferior colliculus of the guinea pig were recorded with tungsten electrodes. The set of data presented here is limited to high stimulus levels. The effect of changing the modulation frequency and the modulation depth was explored for acoustic and laser stimuli. The selected units responded to sinusoidal amplitude modulated (AM) tones, AM trains of clicks, and AM trains of laser pulses with a modulation of their spike discharge. At modulation frequencies of 20 Hz, some units tended to respond with 40 Hz to the acoustic stimuli, but only at 20 Hz for the trains of laser pulses. For all modes of stimulation the responses revealed a dominant response to the first cycle of the modulation, with decreasing number of action potential during successive cycles. While amplitude modulated tone bursts and amplitude modulated trains of acoustic clicks showed similar patterns, the response to trains of laser pulses was different.

  13. Interaural time sensitivity of high-frequency neurons in the inferior colliculus.

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    Yin, T C; Kuwada, S; Sujaku, Y

    1984-11-01

    Recent psychoacoustic experiments have shown that interaural time differences provide adequate cues for lateralizing high-frequency sounds, provided the stimuli are complex and not pure tones. We present here physiological evidence in support of these findings. Neurons of high best frequency in the cat inferior colliculus respond to interaural phase differences of amplitude modulated waveforms, and this response depends upon preservation of phase information of the modulating signal. Interaural phase differences were introduced in two ways: by interaural delays of the entire waveform and by binaural beats in which there was an interaural frequency difference in the modulating waveform. Results obtained with these two methods are similar. Our results show that high-frequency cells can respond to interaural time differences of amplitude modulated signals and that they do so by a sensitivity to interaural phase differences of the modulating waveform.

  14. Human inferior colliculus activity relates to individual differences in spoken language learning.

    Science.gov (United States)

    Chandrasekaran, Bharath; Kraus, Nina; Wong, Patrick C M

    2012-03-01

    A challenge to learning words of a foreign language is encoding nonnative phonemes, a process typically attributed to cortical circuitry. Using multimodal imaging methods [functional magnetic resonance imaging-adaptation (fMRI-A) and auditory brain stem responses (ABR)], we examined the extent to which pretraining pitch encoding in the inferior colliculus (IC), a primary midbrain structure, related to individual variability in learning to successfully use nonnative pitch patterns to distinguish words in American English-speaking adults. fMRI-A indexed the efficiency of pitch representation localized to the IC, whereas ABR quantified midbrain pitch-related activity with millisecond precision. In line with neural "sharpening" models, we found that efficient IC pitch pattern representation (indexed by fMRI) related to superior neural representation of pitch patterns (indexed by ABR), and consequently more successful word learning following sound-to-meaning training. Our results establish a critical role for the IC in speech-sound representation, consistent with the established role for the IC in the representation of communication signals in other animal models.

  15. Variability of the Time Course of Stimulus-Specific Adaptation in the Inferior Colliculus

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    David ePérez-González

    2012-12-01

    Full Text Available Stimulus-specific adaptation (SSA is the ability of some neurons to respond better to rare than to frequent, repetitive stimuli. In the auditory system, it has been found at the level of the midbrain, thalamus and cortex. While previous studies have used the whole overall neuronal response to characterize SSA, here we present a detailed analysis on the variations within the time course of the evoked responses. The extracellular activity of well isolated single neurons from the inferior colliculus (IC was recorded during stimulation using an oddball paradigm, which is able to elicit SSA. At the same time, these responses were evaluated before, during and after the microiontophoretic application of gabazine, a specific antagonist of GABA-A receptors, to study the contribution of inhibition to the responses of these neurons. We then analyzed the difference signal (DS, which is the difference in the PSTH in response to rare and frequent stimuli. We found that, even in a sample of neurons showing strong SSA (i.e., showing larger preference for rare stimuli, the DS was variable and one third of the neurons contained portions that responded significantly better to the frequent stimuli than to the rare. This variability is not observed when averaging the responses of multiple cells. Furthermore, the blockade of GABA-A receptors increased the number of neurons showing portions that responded better to the frequent stimuli, indicating that inhibition in the IC refines and sharpens SSA in the neural responses. 

  16. Sensitivity to Interaural Time Differences in the Inferior Colliculus with Bilateral Cochlear Implants

    Science.gov (United States)

    Smith, Zachary M.; Delgutte, Bertrand

    2007-01-01

    Bilateral cochlear implantation attempts to increase performance over a monaural prosthesis by harnessing the binaural processing of the auditory system. Although many bilaterally implanted human subjects discriminate interaural time differences (ITDs), a major cue for sound localization and signal detection in noise, their performance is typically poorer than that of normal-hearing listeners. We developed an animal model of bilateral cochlear implantation to study neural ITD sensitivity for trains of electric current pulses delivered via bilaterally implanted intracochlear electrodes. We found that a majority of single units in the inferior colliculus of acutely deafened, anesthetized cats are sensitive to ITD and that electric ITD tuning is as sharp as found for acoustic stimulation with broadband noise in normal-hearing animals. However, the sharpness and shape of ITD tuning often depended strongly on stimulus intensity; some neurons had dynamic ranges of ITD sensitivity as low as 1 dB. We also found that neural ITD sensitivity was best at pulse rates below 100 Hz and decreased with increasing pulse rate. This rate limitation parallels behavioral ITD discrimination in bilaterally implanted individuals. The sharp neural ITD sensitivity found with electric stimulation at the appropriate intensity is encouraging for the prospect of restoring the functional benefits of binaural hearing in bilaterally implanted human subjects and suggests that neural plasticity resulting from previous deafness and deprivation of binaural experience may play a role in the poor ITD discrimination with current bilateral implants. PMID:17581961

  17. Classification of frequency response areas in the inferior colliculus reveals continua not discrete classes.

    Science.gov (United States)

    Palmer, Alan R; Shackleton, Trevor M; Sumner, Christian J; Zobay, Oliver; Rees, Adrian

    2013-08-15

    A differential response to sound frequency is a fundamental property of auditory neurons. Frequency analysis in the cochlea gives rise to V-shaped tuning functions in auditory nerve fibres, but by the level of the inferior colliculus (IC), the midbrain nucleus of the auditory pathway, neuronal receptive fields display diverse shapes that reflect the interplay of excitation and inhibition. The origin and nature of these frequency receptive field types is still open to question. One proposed hypothesis is that the frequency response class of any given neuron in the IC is predominantly inherited from one of three major afferent pathways projecting to the IC, giving rise to three distinct receptive field classes. Here, we applied subjective classification, principal component analysis, cluster analysis, and other objective statistical measures, to a large population (2826) of frequency response areas from single neurons recorded in the IC of the anaesthetised guinea pig. Subjectively, we recognised seven frequency response classes (V-shaped, non-monotonic Vs, narrow, closed, tilt down, tilt up and double-peaked), that were represented at all frequencies. We could identify similar classes using our objective classification tools. Importantly, however, many neurons exhibited properties intermediate between these classes, and none of the objective methods used here showed evidence of discrete response classes. Thus receptive field shapes in the IC form continua rather than discrete classes, a finding consistent with the integration of afferent inputs in the generation of frequency response areas. The frequency disposition of inhibition in the response areas of some neurons suggests that across-frequency inputs originating at or below the level of the IC are involved in their generation.

  18. Effect of background noise on neuronal coding of interaural level difference cues in rat inferior colliculus

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    Mokri, Yasamin; Worland, Kate; Ford, Mark; Rajan, Ramesh

    2015-01-01

    Humans can accurately localize sounds even in unfavourable signal-to-noise conditions. To investigate the neural mechanisms underlying this, we studied the effect of background wide-band noise on neural sensitivity to variations in interaural level difference (ILD), the predominant cue for sound localization in azimuth for high-frequency sounds, at the characteristic frequency of cells in rat inferior colliculus (IC). Binaural noise at high levels generally resulted in suppression of responses (55.8%), but at lower levels resulted in enhancement (34.8%) as well as suppression (30.3%). When recording conditions permitted, we then examined if any binaural noise effects were related to selective noise effects at each of the two ears, which we interpreted in light of well-known differences in input type (excitation and inhibition) from each ear shaping particular forms of ILD sensitivity in the IC. At high signal-to-noise ratios (SNR), in most ILD functions (41%), the effect of background noise appeared to be due to effects on inputs from both ears, while for a large percentage (35.8%) appeared to be accounted for by effects on excitatory input. However, as SNR decreased, change in excitation became the dominant contributor to the change due to binaural background noise (63.6%). These novel findings shed light on the IC neural mechanisms for sound localization in the presence of continuous background noise. They also suggest that some effects of background noise on encoding of sound location reported to be emergent in upstream auditory areas can also be observed at the level of the midbrain. PMID:25865218

  19. Convergent input from brainstem coincidence detectors onto delay-sensitive neurons in the inferior colliculus.

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    McAlpine, D; Jiang, D; Shackleton, T M; Palmer, A R

    1998-08-01

    Responses of low-frequency neurons in the inferior colliculus (IC) of anesthetized guinea pigs were studied with binaural beats to assess their mean best interaural phase (BP) to a range of stimulating frequencies. Phase plots (stimulating frequency vs BP) were produced, from which measures of characteristic delay (CD) and characteristic phase (CP) for each neuron were obtained. The CD provides an estimate of the difference in travel time from each ear to coincidence-detector neurons in the brainstem. The CP indicates the mechanism underpinning the coincidence detector responses. A linear phase plot indicates a single, constant delay between the coincidence-detector inputs from the two ears. In more than half (54 of 90) of the neurons, the phase plot was not linear. We hypothesized that neurons with nonlinear phase plots received convergent input from brainstem coincidence detectors with different CDs. Presentation of a second tone with a fixed, unfavorable delay suppressed the response of one input, linearizing the phase plot and revealing other inputs to be relatively simple coincidence detectors. For some neurons with highly complex phase plots, the suppressor tone altered BP values, but did not resolve the nature of the inputs. For neurons with linear phase plots, the suppressor tone either completely abolished their responses or reduced their discharge rate with no change in BP. By selectively suppressing inputs with a second tone, we are able to reveal the nature of underlying binaural inputs to IC neurons, confirming the hypothesis that the complex phase plots of many IC neurons are a result of convergence from simple brainstem coincidence detectors.

  20. Dynamic temporal signal processing in the inferior colliculus of echolocating bats

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    Philip eJen

    2012-05-01

    Full Text Available In nature, communication sounds among animal species including humans are typical complex sounds that occur in sequence and vary with time in several parameters including amplitude, frequency, duration as well as separation and order of individual sounds. Among these multiple parameters, sound duration is a simple but important one that contributes to the distinct spectral and temporal attributes of individual biological sounds. Likewise, the separation of individual sounds is an important temporal attribute that determines an animal’s ability in distinguishing individual sounds. Whereas duration selectivity of auditory neurons underlies an animal’s ability in recognition of sound duration, the recovery cycle of auditory neurons determines a neuron’s ability in responding to closely spaced sound pulses and therefore it underlies the animal’s ability in analyzing the order of individual sounds. Since the multiple parameters of naturally occurring communication sounds vary with time, the analysis of a specific sound parameter by an animal would be inevitably affected by other co-varying sound parameters. This is particularly obvious in insectivorous bats which rely on analysis of returning echoes for prey capture when they systematically vary the multiple pulse parameters throughout a target approach sequence. In this review article, we present our studies of dynamic variation of duration selectivity and recovery cycle of neurons in the central nucleus of the inferior colliculus of the frequency-modulated bats to highlight the dynamic temporal signal processing of central auditory neurons. These studies use single pulses and three biologically relevant pulse-echo (P-E pairs with varied duration, gap and amplitude difference similar to that occurring during search, approach and terminal phases of hunting by bats. These studies show that most collicular neurons respond maximally to a best tuned sound duration (BD. The sound to which these

  1. Developmental PCB Exposure Increases Audiogenic Seizures and Decreases Glutamic Acid Decarboxylase in the Inferior Colliculus.

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    Bandara, Suren B; Eubig, Paul A; Sadowski, Renee N; Schantz, Susan L

    2016-02-01

    Previously, we observed that developmental polychlorinated biphenyl (PCB) exposure resulted in an increase in audiogenic seizures (AGSs) in rats. However, the rats were exposed to loud noise in adulthood, and were not tested for AGS until after 1 year of age, either of which could have interacted with early PCB exposure to increase AGS susceptibility. This study assessed susceptibility to AGS in young adult rats following developmental PCB exposure alone (without loud noise exposure) and investigated whether there was a decrease in GABA inhibitory neurotransmission in the inferior colliculus (IC) that could potentially explain this effect. Female Long-Evans rats were dosed orally with 0 or 6 mg/kg/day of an environmentally relevant PCB mixture from 28 days prior to breeding until the pups were weaned at postnatal day 21. One male-female pair from each litter was retained for the AGS study whilst another was retained for Western blot analysis of glutamic acid decarboxylase (GAD) and GABAAα1 receptor in the IC, the site in the auditory midbrain where AGS are initiated. There was a significant increase in the number and severity of AGSs in the PCB groups, with females somewhat more affected than males. GAD65 was decreased but there was no change in GAD67 or GABAAα1 in the IC indicating decreased inhibitory regulation in the PCB group. These results confirm that developmental PCB exposure alone is sufficient to increase susceptibility to AGS, and provide the first evidence for a possible mechanism of action at the level of the IC. © The Author 2015. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Descending and tonotopic projection patterns from the auditory cortex to the inferior colliculus.

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    Straka, M M; Hughes, R; Lee, P; Lim, H H

    2015-08-06

    The inferior colliculus (IC) receives many corticofugal projections, which can mediate plastic changes such as shifts in frequency tuning or excitability of IC neurons. While the densest projections are found in the IC's external cortices, fibers originating from the primary auditory cortex (AI) have been observed throughout the IC's central nucleus (ICC), and these projections have shown to be organized tonotopically. Some studies have also found projections from other core and non-core cortical regions, though the organization and function of these projections are less known. In guinea pig, there exists a non-core ventrorostral belt (VRB) region that has primary-like properties and has often been mistaken for AI, with the clearest differentiating characteristic being VRB's longer response latencies. To better understand the auditory corticofugal descending system beyond AI, we investigated if there are projections from VRB to the ICC and if they exhibit a different projection pattern than those from AI. In this study, we performed experiments in ketamine-anesthetized guinea pigs, in which we positioned 32-site electrode arrays within AI, VRB, and ICC. We identified the monosynaptic connections between AI-to-ICC and VRB-to-ICC using an antidromic stimulation method, and we analyzed their locations across the midbrain using three-dimensional histological techniques. Compared to the corticocollicular projections to the ICC from AI, there were fewer projections to the ICC from VRB, and these projections had a weaker tonotopic organization. The majority of VRB projections were observed in the caudal-medial versus the rostral-lateral region along an isofrequency lamina of the ICC, which is in contrast to the AI projections that were scattered throughout an ICC lamina. These findings suggest that the VRB directly modulates sound information within the ascending lemniscal pathway with a different or complementary role compared to the modulatory effects of AI, which may

  3. Subcollicular projections to the auditory thalamus and collateral projections to the inferior colliculus

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    Brett R Schofield

    2014-07-01

    Full Text Available Experiments in several species have identified direct projections to the medial geniculate nucleus (MG from cells in subcollicular auditory nuclei. Moreover, many cochlear nucleus cells that project to the MG send collateral projections to the inferior colliculus (IC (Schofield et al., 2014, Front. Neuroanat. 8:10. We conducted 3 experiments to characterize projections to the MG from the superior olivary and the lateral lemniscal regions in guinea pigs. For experiment 1, we made large injections of retrograde tracer into the MG. Labeled cells were most numerous in the superior paraolivary nucleus, ventral nucleus of the trapezoid body, lateral superior olivary nucleus, ventral nucleus of the lateral lemniscus, ventrolateral tegmental nucleus, paralemniscal region and sagulum. Additional sources include other periolivary nuclei and the medial superior olivary nucleus. The projections are bilateral with an ipsilateral dominance (66%. For experiment 2, we injected tracer into individual MG subdivisions. The results show that the subcollicular projections terminate primarily in the medial MG, with the dorsal MG a secondary target. The variety of projecting nuclei suggest a range of functions, including monaural and binaural aspects of hearing. These direct projections could provide the thalamus with some of the earliest (i.e., fastest information regarding acoustic stimuli.For experiment 3, we made large injections of different retrograde tracers into one MG and the homolateral IC to identify cells that project to both targets. Such cells were numerous and distributed across many of the nuclei listed above, mostly ipsilateral to the injections. The prominence of the collateral projections suggests that the same information is delivered to both the IC and the MG, or perhaps that a common signal is being delivered as a preparatory indicator or temporal reference point. The results are discussed from functional and evolutionary perspectives.

  4. Mechanisms of spectral and temporal integration in the mustached bat inferior colliculus

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    Jeffrey James Wenstrup

    2012-10-01

    Full Text Available This review describes mechanisms and circuitry underlying combination-sensitive response properties in the auditory brainstem and midbrain. Combination-sensitive neurons, performing a type of auditory spectro-temporal integration, respond to specific, properly timed combinations of spectral elements in vocal signals and other acoustic stimuli. While these neurons are known to occur in the auditory forebrain of many vertebrate species, the work described here establishes their origin in the auditory brainstem and midbrain. Focusing on the mustached bat, we review several major findings: 1 Combination-sensitive responses involve facilitatory interactions, inhibitory interactions, or both when activated by distinct spectral elements in complex sounds. 2 Combination-sensitive responses are created in distinct stages: inhibition arises mainly in lateral lemniscal nuclei of the auditory brainstem, while facilitation arises in the inferior colliculus (IC of the midbrain. 3 Spectral integration underlying combination-sensitive responses requires a low frequency input tuned well below a neuron’s characteristic frequency (ChF. Low-ChF neurons in the auditory brainstem project to high-ChF regions in brainstem or IC to create combination sensitivity. 4 At their sites of origin, both facilitatory and inhibitory combination-sensitive interactions depend on glycinergic inputs and are eliminated by glycine receptor blockade. Surprisingly, facilitatory interactions in IC depend almost exclusively on glycinergic inputs and are largely independent of glutamatergic and GABAergic inputs. 5 The medial nucleus of the trapezoid body, the lateral lemniscal nuclei, and the IC play critical roles in creating combination-sensitive responses. We propose that these mechanisms, based on work in the mustached bat, apply to a broad range of mammals and other vertebrates that depend on temporally sensitive integration of information across the audible spectrum.

  5. Immunocytochemical profiles of inferior colliculus neurons in the rat and their changes with aging

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    Ladislav eOuda

    2012-09-01

    Full Text Available The inferior colliculus (IC plays a strategic role in the central auditory system in relaying and processing acoustical information, and therefore its age-related changes may significantly influence the quality of the auditory function. A very complex processing of acoustical stimuli occurs in the IC, as supported also by the fact that the rat IC contains more neurons than all other subcortical auditory structures combined. GABAergic neurons, which predominantly co-express parvalbumin, are present in the central nucleus of the IC in large numbers and to a lesser extent in the dorsal and external/lateral cortices of the IC. On the other hand, calbindin and calretinin are prevalent in the dorsal and external cortices of the IC, with only a few positive neurons in the central nucleus. The relationship between calbindin and calretinin expression in the IC and any neurotransmitter system has not yet been well established, but the distribution and morphology of the immunoreactive neurons suggest that they are at least partially non-GABAergic cells. The expression of glutamate decarboxylase (a key enzyme for GABA synthesis and calcium binding proteins in the IC of rats undergoes pronounced changes with aging that involve mostly a decline in protein expression and a decline in the number of immunoreactive neurons. Similar age-related changes in glutamate decarboxylase, calbindin and calretinin expression are present in the IC of two rat strains with differently preserved inner ear function up to late senescence (Long-Evans and Fischer 344, which suggests that these changes do not depend exclusively on peripheral deafferentation but are, at least partially, of central origin. These changes may be associated with the age-related deterioration in the processing of the temporal parameters of acoustical stimuli, which is not correlated with hearing threshold shifts, and therefore may contribute to central presbycusis.

  6. Low-threshold potassium currents stabilize IID-sensitivity in the inferior colliculus.

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    Anita eKarcz

    2012-08-01

    Full Text Available The inferior colliculus (IC is a midbrain nucleus that exhibits sensitivity to differences in interaural time and intensity (ITDs and IIDs and integrates information from the auditory brainstem to provide an unambiguous representation of sound location across the azimuth. Further upstream, in the lateral superior olive (LSO, absence of low-threshold potassium currents in Kcna1-/- mice interfered with response onset timing and restricted IID-sensitivity to the hemifield of the excitatory ear. Assuming the IID-sensitivity in the IC to be at least partly inherited from LSO neurons, the IC IID-encoding was compared between wild-type (Kcna1+/+ and Kcna1-/- mice. We asked whether the effect observed in the Kcna1-/- LSO was (I simply propagated into the IC, (II is enhanced and amplified or, (III alternatively, was compensated and so no longer detectable. Our results show that general IC response properties as well as the distribution of IID-functions were comparable in Kcna1-/- and Kcna1+/+ mice. In agreement with the literature IC neurons exhibited a higher level-invariance of IID-sensitivity compared to LSO neurons. However, manipulating the timing between the inputs of the two ears caused significantly larger shifts of IID-sensitivity in Kcna1-/- mice, whereas in the wild-type IC the IID functions were stable and less sensitive to changes of the temporal relationship between the binaural inputs. We conclude that the IC not only inherits IID-sensitivity from the LSO, but that the convergence with other, non-olivary inputs in the wild-type IC acts to quality-control, consolidate and stabilize IID representation; this necessary integration of inputs is impaired in the absence of the low-threshold potassium currents mediated by Kv1.1.

  7. Information conveyed by inferior colliculus neurons about stimuli with aligned and misaligned sound localization cues

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    Young, Eric D.

    2011-01-01

    Previous studies have demonstrated that single neurons in the central nucleus of the inferior colliculus (ICC) are sensitive to multiple sound localization cues. We investigated the hypothesis that ICC neurons are specialized to encode multiple sound localization cues that are aligned in space (as would naturally occur from a single broadband sound source). Sound localization cues including interaural time differences (ITDs), interaural level differences (ILDs), and spectral shapes (SSs) were measured in a marmoset monkey. Virtual space methods were used to generate stimuli with aligned and misaligned combinations of cues while recording in the ICC of the same monkey. Mutual information (MI) between spike rates and stimuli for aligned versus misaligned cues were compared. Neurons with best frequencies (BFs) less than ∼11 kHz mostly encoded information about a single sound localization cue, ITD or ILD depending on frequency, consistent with the dominance of ear acoustics by either ITD or ILD at those frequencies. Most neurons with BFs >11 kHz encoded information about multiple sound localization cues, usually ILD and SS, and were sensitive to their alignment. In some neurons MI between stimuli and spike responses was greater for aligned cues, while in others it was greater for misaligned cues. If SS cues were shifted to lower frequencies in the virtual space stimuli, a similar result was found for neurons with BFs cue interaction reflects the spectra of the stimuli and not a specialization for representing SS cues. In general the results show that ICC neurons are sensitive to multiple localization cues if they are simultaneously present in the frequency response area of the neuron. However, the representation is diffuse in that there is not a specialization in the ICC for encoding aligned sound localization cues. PMID:21653729

  8. EFFECTS OF CHRONIC ADMINISTRATION OF EFAVIRENZ ON THE BRAIN AND INFERIOR COLLICULUS WEIGHTS OF ADULT WISTAR RATS

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    J. O. Adjene

    2009-01-01

    Full Text Available The effects of chronic administration of Efavirenz commonly used as part of highly active antiretroviral therapy (HAART for the treatment of Human Immunodeficiency Virus (HIV type-1 on the weight of the brain and inferior colliculus of adult wistar rats was carefully studied. The rats of both sexes (n=16, with an average weight of 200g were randomly assigned into treatment (n=8 and control (n=8 groups. The rats in the treatment group received 600 mg/70 kg body weight of Efavirenz dissolved in distilled water daily for 30 days (thirty days through the orogastric tube. The control group received equal volume of distilled water daily for 30 days through the same route. The rats were fed with grower's mash obtained from Edo Feeds and Flour Mill Limited, Ewu, Edo state, Nigeria and given water liberally. The rats were sacrificed by cervical dislocation method on the thirty-first day of the experiment and the brains were carefully dissected out, dried, weighed and recorded using the Mettler Toledo weighing balance. The findings indicate that there was a significant decrease (P < 0.05 in the dry brain weight and an increase in the relative dry brain weight of the treatment group as compared with the control group in this experiment. There was also a significant increase (P < 0.05 in the weight of the dry inferior colliculus per total dry brain weight in the treatment group when compared with the control group. However, the relative dry inferior colliculus weight was significantly higher (P < 0.05 in the treatment group also than that of the control group in this experiment

  9. Inferior colliculus contributions to phase encoding of stop consonants in an animal model.

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    Warrier, Catherine M; Abrams, Daniel A; Nicol, Trent G; Kraus, Nina

    2011-12-01

    The human auditory brainstem is known to be exquisitely sensitive to fine-grained spectro-temporal differences between speech sound contrasts, and the ability of the brainstem to discriminate between these contrasts is important for speech perception. Recent work has described a novel method for translating brainstem timing differences in response to speech contrasts into frequency-specific phase differentials. Results from this method have shown that the human brainstem response is surprisingly sensitive to phase differences inherent to the stimuli across a wide extent of the spectrum. Here we use an animal model of the auditory brainstem to examine whether the stimulus-specific phase signatures measured in human brainstem responses represent an epiphenomenon associated with far-field (i.e., scalp-recorded) measurement of neural activity, or alternatively whether these specific activity patterns are also evident in auditory nuclei that contribute to the scalp-recorded response, thereby representing a more fundamental temporal processing phenomenon. Responses in anaesthetized guinea pigs to three minimally-contrasting consonant-vowel stimuli were collected simultaneously from the cortical surface vertex and directly from central nucleus of the inferior colliculus (ICc), measuring volume conducted neural activity and multiunit, near-field activity, respectively. Guinea pig surface responses were similar to human scalp-recorded responses to identical stimuli in gross morphology as well as phase characteristics. Moreover, surface-recorded potentials shared many phase characteristics with near-field ICc activity. Response phase differences were prominent during formant transition periods, reflecting spectro-temporal differences between syllables, and showed more subtle differences during the identical steady state periods. ICc encoded stimulus distinctions over a broader frequency range, with differences apparent in the highest frequency ranges analyzed, up to 3000

  10. Hyperexcitability of inferior colliculus and acoustic startle reflex with age-related hearing loss.

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    Xiong, Binbin; Alkharabsheh, Ana'am; Manohar, Senthilvelan; Chen, Guang-Di; Yu, Ning; Zhao, Xiaoming; Salvi, Richard; Sun, Wei

    2017-07-01

    Chronic tinnitus and hyperacusis often develop with age-related hearing loss presumably due to aberrant neural activity in the central auditory system (CAS) induced by cochlear pathologies. However, the full spectrum of physiological changes that occur in the CAS as a result age-related hearing loss are still poorly understood. To address this issue, neurophysiological measures were obtained from the cochlea and the inferior colliculus (IC) of 2, 6 and 12 month old C57BL/6J mice, a mouse model for early age-related hearing loss. Thresholds of the compound action potentials (CAP) in 6 and 12 month old mice were significantly higher than in 2 month old mice. The sound driven and spontaneous firing rates of IC neurons, recorded with 16 channel electrodes, revealed mean IC thresholds of 22.8 ± 6.5 dB (n = 167) at 2 months, 37.9 ± 6.2 dB (n = 132) at 6 months and 47.1 ± 15.3 dB (n = 151) at 12 months of age consistent with the rise in CAP thresholds. The characteristic frequencies (CF) of IC neurons ranged from 3 to 32 kHz in 2 month old mice; the upper CF ranged decreased to 26 kHz and 16 kHz in 6 and 12 month old mice respectively. The percentage of IC neurons with CFs between 8 and 12 kHz increased from 36.5% in 2 month old mice, to 48.8% and 76.2% in 6 and 12 month old mice, respectively, suggesting a downshift of IC CFs due to the high-frequency hearing loss. The average spontaneous firing rate (SFRs) of all recorded neurons in 2 month old mice was 3.2 ± 2.5 Hz (n = 167). For 6 and 12 month old mice, the SFRs of low CF neurons ( 8 kHz increased to 13.0 ± 15.4 (n = 68) Hz at 6 months of age and then declined to 4.8 ± 7.4 (n = 110) spikes/s at 12 months of age. In addition, sound-evoked activity at suprathreshold levels at 6 months of age was much higher than at 2 and 12 months of age. To evaluate the behavioral consequences of sound evoked hyperactivity in the IC, the amplitude of the acoustic startle reflex was measured at 4

  11. Effects of electrical stimulation of the inferior colliculus on 2f1-f2 distortion product otoacoustic emissions in anesthetized guinea pigs

    Czech Academy of Sciences Publication Activity Database

    Popelář, Jiří; Mazelová, Jana; Syka, Josef

    č. 170 (2002), s. 116-126 ISSN 0378-5955 R&D Projects: GA MZd NK6454 Institutional research plan: CEZ:AV0Z5039906 Keywords : inferior colliculus Subject RIV: FH - Neurology Impact factor: 1.969, year: 2002

  12. [Effect of Electroacupuncture on Expression of Catechol-O-methyltransferase in the Inferior Colliculus and Auditory Cortex in Age-related Hearing Loss Guinea Pigs].

    Science.gov (United States)

    Liu, Shu-Yun; Deng, Li-Qiang; Yang, Ye; Yin, Ze-Deng

    2017-04-25

    To observe the expression of catechol-O-methyltransferase (COMT) in inferior colliculus and auditory cortex of guinea pigs with age-related hearing loss(AHL) induced by D-galactose, so as to explore the possible mechanism of electroacupuncture(EA) underlying preventing AHL. Thirty 3-month-old guinea pigs were randomly divided into control group, model group and EA group( n =10 in each group), and ten 18-month-old guinea pigs were allocated as elderly group. The AHL model was established by subcutaneous injection of D-galactose. EA was applied to bilateral "Yifeng"(SJ 17) and "Tinggong"(SI 19) for 15 min in the EA group while modeling, once daily for 6 weeks. After treatment, the latency of auditory brainstem response(ABR) Ⅲ wave was measured by a brain-stem evoked potentiometer. The expressions of COMT in the inferior colliculus and auditory cortex were detected by Western blot. Compared with the control group, the latencies of ABR Ⅲ wave were significantly prolonged and the expressions of COMT in the inferior colliculus and auditory cortex were significantly decreased in the model group and the elderly group( P guinea pigs, which may contribute to its effect in up-regulating the expression of COMT in the inferior colliculus and auditory cortex.

  13. Roentgenologic appearance of left-sided inferior vena cava

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira; Saitoh, Takashi

    1985-01-01

    2 Cases of left-sided inferior vena cava, and 2 cases of left-sided inferior vena cava with azygos and hemiazygos continuation were evaluated with computed tomography and other roentgenologic procedures and discussed thier clinical and radiological significance. Left-sided inferior vena cava with azygos (hemiazygos) continuation is often associated with cyanotic or acyanotic congenital heart disease and abnormalities of cardiovascular position, abdominal situs and polysplenia. But, single left-sided inferior vena cavas have little tendency having associated anomalies. Both venous anomalies also shuld be embryologically differentiated, namely, failure of development of the lower portion of the supracardinal veins results in infrahepatic interruption of inferior vena cava with azygos continuation, persistence of the left cardinal system and atrophy of the right system lead to the left-side inferior vena cava. Knowledge of inferior vena cava anomalies is important to the radiologist in order to differentiate between venous anomalies and an enlarged lymph nodes in a patient with malignant tumor. (author)

  14. Expression of immediate-early genes in the inferior colliculus and auditory cortex in salicylate-induced tinnitus in rat

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    S.S. Hu

    2014-03-01

    Full Text Available Tinnitus could be associated with neuronal hyperactivity in the auditory center. As a neuronal activity marker, immediate-early gene (IEG expression is considered part of a general neuronal response to natural stimuli. Some IEGs, especially the activity-dependent cytoskeletal protein (Arc and the early growth response gene-1 (Egr-1, appear to be highly correlated with sensory-evoked neuronal activity. We hypothesize, therefore, an increase of Arc and Egr-1 will be observed in a tinnitus model. In our study, we used the gap prepulse inhibition of acoustic startle (GPIAS paradigm to confirm that salicylate induces tinnitus-like behavior in rats. However, expression of the Arc gene and Egr-1 gene were decreased in the inferior colliculus (IC and auditory cortex (AC, in contradiction of our hypothesis. Expression of N-methyl d-aspartate receptor subunit 2B (NR2B was increased and all of these changes returned to normal 14 days after treatment with salicylate ceased. These data revealed long-time administration of salicylate induced tinnitus markedly but reversibly and caused neural plasticity changes in the IC and the AC. Decreased expression of Arc and Egr-1 might be involved with instability of synaptic plasticity in tinnitus.

  15. Nonlinear processing of a multicomponent communication signal by combination-sensitive neurons in the anuran inferior colliculus.

    Science.gov (United States)

    Lee, Norman; Schrode, Katrina M; Bee, Mark A

    2017-09-01

    Diverse animals communicate using multicomponent signals. How a receiver's central nervous system integrates multiple signal components remains largely unknown. We investigated how female green treefrogs (Hyla cinerea) integrate the multiple spectral components present in male advertisement calls. Typical calls have a bimodal spectrum consisting of formant-like low-frequency (~0.9 kHz) and high-frequency (~2.7 kHz) components that are transduced by different sensory organs in the inner ear. In behavioral experiments, only bimodal calls reliably elicited phonotaxis in no-choice tests, and they were selectively chosen over unimodal calls in two-alternative choice tests. Single neurons in the inferior colliculus of awake, passively listening subjects were classified as combination-insensitive units (27.9%) or combination-sensitive units (72.1%) based on patterns of relative responses to the same bimodal and unimodal calls. Combination-insensitive units responded similarly to the bimodal call and one or both unimodal calls. In contrast, combination-sensitive units exhibited both linear responses (i.e., linear summation) and, more commonly, nonlinear responses (e.g., facilitation, compressive summation, or suppression) to the spectral combination in the bimodal call. These results are consistent with the hypothesis that nonlinearities play potentially critical roles in spectral integration and in the neural processing of multicomponent communication signals.

  16. Hearing assessment during deep brain stimulation of the central nucleus of the inferior colliculus and dentate cerebellar nucleus in rat

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    Jasper V. Smit

    2017-10-01

    Full Text Available Background Recently it has been shown in animal studies that deep brain stimulation (DBS of auditory structures was able to reduce tinnitus-like behavior. However, the question arises whether hearing might be impaired when interfering in auditory-related network loops with DBS. Methods The auditory brainstem response (ABR was measured in rats during high frequency stimulation (HFS and low frequency stimulation (LFS in the central nucleus of the inferior colliculus (CIC, n = 5 or dentate cerebellar nucleus (DCBN, n = 5. Besides hearing thresholds using ABR, relative measures of latency and amplitude can be extracted from the ABR. In this study ABR thresholds, interpeak latencies (I–III, III–V, I–V and V/I amplitude ratio were measured during off-stimulation state and during LFS and HFS. Results In both the CIC and the CNBN groups, no significant differences were observed for all outcome measures. Discussion DBS in both the CIC and the CNBN did not have adverse effects on hearing measurements. These findings suggest that DBS does not hamper physiological processing in the auditory circuitry.

  17. Sensitivity of inferior colliculus neurons to interaural time differences in the envelope versus the fine structure with bilateral cochlear implants.

    Science.gov (United States)

    Smith, Zachary M; Delgutte, Bertrand

    2008-05-01

    Bilateral cochlear implantation seeks to improve hearing by taking advantage of the binaural processing of the central auditory system. Cochlear implants typically encode sound in each spectral channel by amplitude modulating (AM) a fixed-rate pulse train, thus interaural time differences (ITD) are only delivered in the envelope. We investigated the ITD sensitivity of inferior colliculus (IC) neurons with sinusoidally AM pulse trains. ITD was introduced independently to the AM and/or carrier pulses to measure the relative efficacy of envelope and fine structure for delivering ITD information. We found that many IC cells are sensitive to ITD in both the envelope (ITD(env)) and fine structure (ITD(fs)) for appropriate modulation frequencies and carrier rates. ITD(env) sensitivity was generally similar to that seen in normal-hearing animals with AM tones. ITD(env) tuning generally improved with increasing modulation frequency up to the maximum modulation frequency that elicited a sustained response in a neuron (tested pulse/s (pps) carriers and was nonexistent at 5,000 pps. The neurons that were sensitive to ITD(fs) at 1,000 pps were those that showed the best ITD sensitivity to low-rate pulse trains. Overall, the best ITD sensitivity was found for ITD contained in the fine structure of a moderate rate AM pulse train (1,000 pps). These results suggest that the interaural timing of current pulses should be accurately controlled in a bilateral cochlear implant processing strategy that provides salient ITD cues.

  18. Target representation of naturalistic echolocation sequences in single unit responses from the inferior colliculus of big brown bats

    Science.gov (United States)

    Sanderson, Mark I.; Simmons, James A.

    2005-11-01

    Echolocating big brown bats (Eptesicus fuscus) emit trains of frequency-modulated (FM) biosonar signals whose duration, repetition rate, and sweep structure change systematically during interception of prey. When stimulated with a 2.5-s sequence of 54 FM pulse-echo pairs that mimic sounds received during search, approach, and terminal stages of pursuit, single neurons (N=116) in the bat's inferior colliculus (IC) register the occurrence of a pulse or echo with an average of <1 spike/sound. Individual IC neurons typically respond to only a segment of the search or approach stage of pursuit, with fewer neurons persisting to respond in the terminal stage. Composite peristimulus-time-histogram plots of responses assembled across the whole recorded population of IC neurons depict the delay of echoes and, hence, the existence and distance of the simulated biosonar target, entirely as on-response latencies distributed across time. Correlated changes in pulse duration, repetition rate, and pulse or echo amplitude do modulate the strength of responses (probability of the single spike actually occurring for each sound), but registration of the target itself remains confined exclusively to the latencies of single spikes across cells. Modeling of echo processing in FM biosonar should emphasize spike-time algorithms to explain the content of biosonar images.

  19. Wisteria Floribunda Agglutinin-Labeled Perineuronal Nets in the Mouse Inferior Colliculus, Thalamic Reticular Nucleus and Auditory Cortex

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    Sarah M. Fader

    2016-04-01

    Full Text Available Perineuronal nets (PNNs are specialized extracellular matrix molecules that are associated with the closing of the critical period, among other functions. In the adult brain, PNNs surround specific types of neurons, however the expression of PNNs in the auditory system of the mouse, particularly at the level of the midbrain and forebrain, has not been fully described. In addition, the association of PNNs with excitatory and inhibitory cell types in these structures remains unknown. Therefore, we sought to investigate the expression of PNNs in the inferior colliculus (IC, thalamic reticular nucleus (TRN and primary auditory cortex (A1 of the mouse brain by labeling with wisteria floribunda agglutinin (WFA. To aid in the identification of inhibitory neurons in these structures, we employed the vesicular GABA transporter (VGAT-Venus transgenic mouse strain, which robustly expresses an enhanced yellow-fluorescent protein (Venus natively in nearly all gamma-amino butyric acid (GABA-ergic inhibitory neurons, thus enabling a rapid and unambiguous assessment of inhibitory neurons throughout the nervous system. Our results demonstrate that PNNs are expressed throughout the auditory midbrain and forebrain, but vary in their local distribution. PNNs are most dense in the TRN and least dense in A1. Furthermore, PNNs are preferentially associated with inhibitory neurons in A1 and the TRN, but not in the IC of the mouse. These data suggest regionally specific roles for PNNs in auditory information processing.

  20. The dissimilar time course of temporary threshold shifts and reduction of inhibition in the inferior colliculus following intense sound exposure.

    Science.gov (United States)

    Heeringa, A N; van Dijk, P

    2014-06-01

    Excessive noise exposure is known to produce an auditory threshold shift, which can be permanent or transient in nature. Recent studies showed that noise-induced temporary threshold shifts are associated with loss of synaptic connections to the inner hair cells and with cochlear nerve degeneration, which is reflected in a decreased amplitude of wave I of the auditory brainstem response (ABR). This suggests that, despite normal auditory thresholds, central auditory processing may be abnormal. We recorded changes in central auditory processing following a sound-induced temporary threshold shift. Anesthetized guinea pigs were exposed for 1 h to a pure tone of 11 kHz (124 dB sound pressure level). Hearing thresholds, amplitudes of ABR waves I and IV, and spontaneous and tone-evoked firing rates in the inferior colliculus (IC) were assessed immediately, one week, two weeks, and four weeks post exposure. Hearing thresholds were elevated immediately following overexposure, but recovered within one week. The amplitude of the ABR wave I was decreased in all sound-exposed animals for all test periods. In contrast, the ABR wave IV amplitude was only decreased immediately after overexposure and recovered within a week. The proportion of IC units that show inhibitory responses to pure tones decreased substantially up to two weeks after overexposure, especially when stimulated with high frequencies. The proportion of excitatory responses to low frequencies was increased. Spontaneous activity was unaffected by the overexposure. Despite rapid normalization of auditory thresholds, our results suggest an increased central gain following sound exposure and an abnormal balance between excitatory and inhibitory responses in the midbrain up to two weeks after overexposure. These findings may be associated with hyperacusis after a sound-induced temporary threshold shift. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Adaptation and inhibition underlie responses to time-varying interaural phase cues in a model of inferior colliculus neurons.

    Science.gov (United States)

    Borisyuk, Alla; Semple, Malcolm N; Rinzel, John

    2002-10-01

    A mathematical model was developed for exploring the sensitivity of low-frequency inferior colliculus (IC) neurons to interaural phase disparity (IPD). The formulation involves a firing-rate-type model that does not include spikes per se. The model IC neuron receives IPD-tuned excitatory and inhibitory inputs (viewed as the output of a collection of cells in the medial superior olive). The model cell possesses cellular properties of firing rate adaptation and postinhibitory rebound (PIR). The descriptions of these mechanisms are biophysically reasonable, but only semi-quantitative. We seek to explain within a minimal model the experimentally observed mismatch between responses to IPD stimuli delivered dynamically and those delivered statically (McAlpine et al. 2000; Spitzer and Semple 1993). The model reproduces many features of the responses to static IPD presentations, binaural beat, and partial range sweep stimuli. These features include differences in responses to a stimulus presented in static or dynamic context: sharper tuning and phase shifts in response to binaural beats, and hysteresis and "rise-from-nowhere" in response to partial range sweeps. Our results suggest that dynamic response features are due to the structure of inputs and the presence of firing rate adaptation and PIR mechanism in IC cells, but do not depend on a specific biophysical mechanism. We demonstrate how the model's various components contribute to shaping the observed phenomena. For example, adaptation, PIR, and transmission delay shape phase advances and delays in responses to binaural beats, adaptation and PIR shape hysteresis in different ranges of IPD, and tuned inhibition underlies asymmetry in dynamic tuning properties. We also suggest experiments to test our modeling predictions: in vitro simulation of the binaural beat (phase advance at low beat frequencies, its dependence on firing rate), in vivo partial range sweep experiments (dependence of the hysteresis curve on

  2. Processing of Natural Echolocation Sequences in the Inferior Colliculus of Seba’s Fruit Eating Bat, Carollia perspicillata

    Science.gov (United States)

    Kordes, Sebastian; Kössl, Manfred

    2017-01-01

    Abstract For the purpose of orientation, echolocating bats emit highly repetitive and spatially directed sonar calls. Echoes arising from call reflections are used to create an acoustic image of the environment. The inferior colliculus (IC) represents an important auditory stage for initial processing of echolocation signals. The present study addresses the following questions: (1) how does the temporal context of an echolocation sequence mimicking an approach flight of an animal affect neuronal processing of distance information to echo delays? (2) how does the IC process complex echolocation sequences containing echo information from multiple objects (multiobject sequence)? Here, we conducted neurophysiological recordings from the IC of ketamine-anaesthetized bats of the species Carollia perspicillata and compared the results from the IC with the ones from the auditory cortex (AC). Neuronal responses to an echolocation sequence was suppressed when compared to the responses to temporally isolated and randomized segments of the sequence. The neuronal suppression was weaker in the IC than in the AC. In contrast to the cortex, the time course of the acoustic events is reflected by IC activity. In the IC, suppression sharpens the neuronal tuning to specific call-echo elements and increases the signal-to-noise ratio in the units’ responses. When presenting multiple-object sequences, despite collicular suppression, the neurons responded to each object-specific echo. The latter allows parallel processing of multiple echolocation streams at the IC level. Altogether, our data suggests that temporally-precise neuronal responses in the IC could allow fast and parallel processing of multiple acoustic streams. PMID:29242823

  3. Monaural and binaural response properties of neurons in the inferior colliculus of the rabbit: effects of sodium pentobarbital.

    Science.gov (United States)

    Kuwada, S; Batra, R; Stanford, T R

    1989-02-01

    1. We studied the effects of sodium pentobarbital on 22 neurons in the inferior colliculus (IC) of the rabbit. We recorded changes in the sensitivity of these neurons to monaural stimulation and to ongoing interaural time differences (ITDs). Monaural stimuli were tone bursts at or near the neuron's best frequency. The ITD was varied by delivering tones that differed by 1 Hz to the two ears, resulting in a 1-Hz binaural beat. 2. We assessed a neuron's ITD sensitivity by calculating three measures from the responses to binaural beats: composite delay, characteristic delay (CD), and characteristic phase (CP). To obtain the composite delay, we first derived period histograms by averaging, showing the response at each stimulating frequency over one period of the beat frequency. Second, the period histograms were replotted as a function of their equivalent interaural delay and then averaged together to yield the composite delay curve. Last, we calculated the composite peak or trough delay by fitting a parabola to the peak or trough of this composite curve. The composite delay curve represents the average response to all frequencies within the neuron's responsive range, and the peak reflects the interaural delay that produces the maximum response. The CD and CP were estimated from a weighted fit of a regression line to the plot of the mean interaural phase of the response versus the stimulating frequency. The slope and phase intercept of this regression line yielded estimates of CD and CP, respectively. These two quantities are thought to reflect the mechanism of ITD sensitivity, which involves the convergence of phase-locked inputs on a binaural cell. The CD estimates the difference in the time required for the two inputs to travel from either ear to this cell, whereas the CP reflects the interaural phase difference of the inputs at this cell. 3. Injections of sodium pentobarbital at subsurgical dosages (less than 25 mg/kg) almost invariably altered the neuron's response

  4. The role of left posterior inferior temporal cortex in spelling.

    Science.gov (United States)

    Rapcsak, Steven Z; Beeson, Pélagie M

    2004-06-22

    To determine whether damage to left posterior inferior temporal cortex (PITC) is associated with agraphia and to characterize the nature of the spelling impairment. Left angular gyrus may play a critical role in spelling. However, this traditional view is challenged by reports of agraphia after left temporo-occipital lesions and by functional imaging studies demonstrating activation of left PITC during writing in normal individuals. Patients with focal damage to the left temporo-occipital cortex and normal control subjects were administered a comprehensive spelling battery that included regular words, irregular words, and nonwords as stimuli. Although patients performed worse than control subjects in all experimental conditions, the spelling deficit was particularly severe for irregular words, whereas regular word and nonword spelling were less impaired. Additional analyses indicated that orthographic regularity and word frequency had a much more pronounced effect on spelling accuracy in patients compared with control subjects. Most errors on irregular words were phonologically plausible, consistent with reliance on a sublexical phonologic spelling strategy (i.e., phoneme-grapheme conversion). Overall, the spelling impairment of the patients showed the characteristic profile of lexical agraphia. Lesion analyses indicated that the damage in the majority of patients encompassed an area within the left PITC (BA 37/20) where the authors previously obtained evidence of activation in a functional imaging study of writing in normal participants. The behavioral and neuroanatomic observations in the patients are consistent with functional imaging studies of writing in neurologically intact individuals and provide converging evidence for the role of left PITC in spelling. Together, these findings implicate left PITC as a possible neural substrate of the putative orthographic lexicon that contains stored memory representations for the written forms of familiar words.

  5. Specific immediate early gene expression induced by high doses of salicylate in the cochlear nucleus and inferior colliculus of the rat.

    Science.gov (United States)

    Santos, Paula; da Silva, Lilian Eslaine Costa Mendes; Leão, Ricardo Maurício

    Salicylate at high doses induces tinnitus in humans and experimental animals. However, the mechanisms and loci of action of salicylate in inducing tinnitus are still not well known. The expression of Immediate Early Genes (IEG) is traditionally associated with long-term neuronal modifications but it is still not clear how and where IEGs are activated in animal models of tinnitus. Here we investigated the expression of c-fos and Egr-1, two IEGs, in the Dorsal Cochlear Nucleus (DCN), the Inferior Colliculus (IC), and the Posterior Ventral Cochlear Nucleus (pVCN) of rats. Rats were treated with doses known to induce tinnitus in rats (300mg/kg i.p. daily, for 3 days), and c-fos and Egr-1 protein expressions were analyzed using western blot and immunocytochemistry. After administration of salicylate, c-fos protein expression increased significantly in the DCN, pVCN and IC when assayed by western blot. Immunohistochemistry staining showed a more intense labeling of c-fos in the DCN, pVCN and IC and a significant increase in c-fos positive nuclei in the pVCN and IC. We did not detect increased Egr-1 expression in any of these areas. Our data show that a high dose of salicylate activates neurons in the DCN, pVCN and IC. The expression of these genes by high doses of salicylate strongly suggests that plastic changes in these areas are involved in the genesis of tinnitus. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  6. Organization and trade-off of spectro-temporal tuning properties of duration-tuned neurons in the mammalian inferior colliculus.

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    Morrison, James A; Farzan, Faranak; Fremouw, Thane; Sayegh, Riziq; Covey, Ellen; Faure, Paul A

    2014-05-01

    Neurons throughout the mammalian central auditory pathway respond selectively to stimulus frequency and amplitude, and some are also selective for stimulus duration. First found in the auditory midbrain or inferior colliculus (IC), these duration-tuned neurons (DTNs) provide a potential neural mechanism for encoding temporal features of sound. In this study, we investigated how having an additional neural response filter, one selective to the duration of an auditory stimulus, influences frequency tuning and neural organization by recording single-unit responses and measuring the dorsal-ventral position and spectral-temporal tuning properties of auditory DTNs from the IC of the awake big brown bat (Eptesicus fuscus). Like other IC neurons, DTNs were tonotopically organized and had either V-shaped, U-shaped, or O-shaped frequency tuning curves (excitatory frequency response areas). We hypothesized there would be an interaction between frequency and duration tuning in DTNs, as electrical engineering theory for resonant filters dictates a trade-off in spectral-temporal resolution: sharp tuning in the frequency domain results in poorer resolution in the time domain and vice versa. While the IC is a more complex signal analyzer than an electrical filter, a similar operational trade-off could exist in the responses of DTNs. Our data revealed two patterns of spectro-temporal sensitivity and spatial organization within the IC: DTNs with sharp frequency tuning and broad duration tuning were located in the dorsal IC, whereas cells with wide spectral tuning and narrow temporal tuning were found in the ventral IC. Copyright © 2014 the American Physiological Society.

  7. Interaural delay sensitivity and the classification of low best-frequency binaural responses in the inferior colliculus of the guinea pig.

    Science.gov (United States)

    McAlpine, D; Jiang, D; Palmer, A R

    1996-08-01

    Monaural and binaural response properties of single units in the inferior colliculus (IC) of the guinea pig were investigated. Neurones were classified according to the effect of monaural stimulation of either ear alone and the effect of binaural stimulation. The majority (309/334) of IC units were excited (E) by stimulation of the contralateral ear, of which 41% (127/309) were also excited by monaural ipsilateral stimulation (EE), and the remainder (182/309) were unresponsive to monaural ipsilateral stimulation (EO). For units with best frequencies (BF) up to 3 kHz, similar proportions of EE and EO units were observed. Above 3 kHz, however, significantly more EO than EE units were observed. Units were also classified as either facilitated (F), suppressed (S), or unaffected (O) by binaural stimulation. More EO than EE units were suppressed or unaffected by binaural stimulation, and more EE than EO units were facilitated. There were more EO/S units above 1.5 kHz than below. Binaural beats were used to examine the interaural delay sensitivity of low-BF (BF binaural facilitation, whilst those with larger BPs generally showed binaural suppression. The classification of units based upon binaural stimulation with BF tones was consistent with their interaural-delay sensitivity. Characteristic delays (CD) were examined for 96 low-BF units. A clear relationship between BF and CD was observed. CDs of units with very low BFs (binaural processing in the guinea pig at low frequencies is similar to that reported in all other species studied. However, the dependence of CD on BF would suggest that the delay line system that sets up the interaural-delay sensitivity in the lower brainstem varies across frequency as well as within each frequency band.

  8. Noise Trauma-Induced Behavioral Gap Detection Deficits Correlate with Reorganization of Excitatory and Inhibitory Local Circuits in the Inferior Colliculus and Are Prevented by Acoustic Enrichment.

    Science.gov (United States)

    Sturm, Joshua J; Zhang-Hooks, Ying-Xin; Roos, Hannah; Nguyen, Tuan; Kandler, Karl

    2017-06-28

    Hearing loss leads to a host of cellular and synaptic changes in auditory brain areas that are thought to give rise to auditory perception deficits such as temporal processing impairments, hyperacusis, and tinnitus. However, little is known about possible changes in synaptic circuit connectivity that may underlie these hearing deficits. Here, we show that mild hearing loss as a result of brief noise exposure leads to a pronounced reorganization of local excitatory and inhibitory circuits in the mouse inferior colliculus. The exact nature of these reorganizations correlated with the presence or absence of the animals' impairments in detecting brief sound gaps, a commonly used behavioral sign for tinnitus in animal models. Mice with gap detection deficits (GDDs) showed a shift in the balance of synaptic excitation and inhibition that was present in both glutamatergic and GABAergic neurons, whereas mice without GDDs showed stable excitation-inhibition balances. Acoustic enrichment (AE) with moderate intensity, pulsed white noise immediately after noise trauma prevented both circuit reorganization and GDDs, raising the possibility of using AE immediately after cochlear damage to prevent or alleviate the emergence of central auditory processing deficits. SIGNIFICANCE STATEMENT Noise overexposure is a major cause of central auditory processing disorders, including tinnitus, yet the changes in synaptic connectivity underlying these disorders remain poorly understood. Here, we find that brief noise overexposure leads to distinct reorganizations of excitatory and inhibitory synaptic inputs onto glutamatergic and GABAergic neurons and that the nature of these reorganizations correlates with animals' impairments in detecting brief sound gaps, which is often considered a sign of tinnitus. Acoustic enrichment immediately after noise trauma prevents circuit reorganizations and gap detection deficits, highlighting the potential for using sound therapy soon after cochlear damage

  9. Expression of tumor necrosis factor-α and interleukin-1β genes in the cochlea and inferior colliculus in salicylate-induced tinnitus

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    Chen Jin-Cherng

    2011-04-01

    Full Text Available Abstract Background Changes in the gene expressions for tumor necrosis factor-α (TNF-α and/or interleukin-1β (IL-1β during tinnitus have not been previously reported. We evaluated tinnitus and mRNA expression levels of TNF-α, IL-1β, and N-methyl D-aspartate receptor subunit 2B (NR2B genes in cochlea and inferior colliculus (IC of mice after intraperitoneal injections of salicylate. Methods Forty-eight 3-month-old male SAMP8 mice were randomly and equally divided into two groups: salicylate-treated and saline-treated. All mice were trained to perform an active avoidance task for 5 days. Once conditioned, an active avoidance task was performed 2 hours after daily intraperitoneal injections of saline, either alone or containing 300 mg/kg sodium salicylate. Total numbers of times (tinnitus score the mice climbed during the inter-trial silent period for 10 trials were recorded daily for 4 days (days 7 to 10, and then mice were euthanized for determination of mRNA expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC at day 10. Results Tinnitus scores increased in response to daily salicylate treatments. The mRNA expression levels of TNF-α increased significantly for the salicylate-treated group compared to the control group in both cochlea (1.89 ± 0.22 vs. 0.87 ± 0.07, P p = 0.0040. mRNA expression levels for the IL-1β gene also increased significantly in the salicylate group compared to the control group in both cochlea (3.50 ± 1.05 vs. 2.80 ± 0.28, p versus 1.24 ± 0.52, p = 0.0013. Linear regression analysis revealed a significant positive association between tinnitus scores and expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC. In addition, expression levels of the TNF-α gene were positively correlated with those of the NR2Bgene in both cochlea and IC; whereas, the expression levels of the IL-1β gene was positively correlated with that of the NR2B gene in IC, but not in cochlea. Conclusion We

  10. Encoding of the amplitude modulation of pulsatile electrical stimulation in the feline cochlear nucleus by neurons in the inferior colliculus; effects of stimulus pulse rate

    Science.gov (United States)

    McCreery, Douglas; Han, Martin; Pikov, Victor; Yadav, Kamal; Pannu, Satinderpall

    2013-10-01

    Objectives. Persons without a functional auditory nerve cannot benefit from cochlear implants, but some hearing can be restored by an auditory brainstem implant (ABI) with stimulating electrodes implanted on the surface of the cochlear nucleus (CN). Most users benefit from their ABI, but speech recognition tends to be poorer than for users of cochlear implants. Psychophysical studies suggest that poor modulation detection may contribute to the limited performance of ABI users. In a cat model, we determined how the pulse rate of the electrical stimulus applied within or on the CN affects temporal and rate encoding of amplitude modulation (AM) by neurons in the central nucleus of the inferior colliculus (ICC). Approach. Stimulating microelectrodes were implanted chronically in and on the cats' CN, and multi-site recording microelectrodes were implanted chronically into the ICC. Encoding of AM pulse trains by neurons in the ICC was characterized as vector strength (VS), the synchrony of neural activity with the AM, and as the mean rate of neuronal action potentials (neuronal spike rate (NSR)). Main results. For intranuclear microstimulation, encoding of AM as VS was up to 3 dB greater when stimulus pulse rate was increased from 250 to 500 pps, but only for neuronal units with low best acoustic frequencies, and when the electrical stimulation was modulated at low frequencies (10-20 Hz). For stimulation on the surface of the CN, VS was similar at 250 and 500 pps, and the dynamic range of the VS was reduced for pulse rates greater than 250 pps. Modulation depth was encoded strongly as VS when the maximum stimulus amplitude was held constant across a range of modulation depth. This ‘constant maximum’ protocol allows enhancement of modulation depth while preserving overall dynamic range. However, modulation depth was not encoded as strongly as NSR. Significance. The findings have implications for improved sound processors for present and future ABIs. The performance of

  11. Binaural interaction in low-frequency neurons in inferior colliculus of the cat. II. Effects of changing rate and direction of interaural phase.

    Science.gov (United States)

    Yin, T C; Kuwada, S

    1983-10-01

    We used the binaural beat stimulus to study the interaural phase sensitivity of inferior colliculus (IC) neurons in the cat. The binaural beat, produced by delivering tones of slightly different frequencies to the two ears, generates continuous and graded changes in interaural phase. Over 90% of the cells that exhibit a sensitivity to changes in the interaural delay also show a sensitivity to interaural phase disparities with the binaural beat. Cells respond with a burst of impulses with each complete cycle of the beat frequency. The period histogram obtained by binning the poststimulus time histogram on the beat frequency gives a measure of the interaural phase sensitivity of the cell. In general, there is good correspondence in the shapes of the period histograms generated from binaural beats and the interaural phase curves derived from interaural delays and in the mean interaural phase angle calculated from them. The magnitude of the beat frequency determines the rate of change of interaural phase and the sign determines the direction of phase change. While most cells respond in a phase-locked manner up to beat frequencies of 10 Hz, there are some cells tht will phase lock up to 80 Hz. Beat frequency and mean interaural phase angle are linearly related for most cells. Most cells respond equally in the two directions of phase change and with different rates of change, at least up to 10 Hz. However, some IC cells exhibit marked sensitivity to the speed of phase change, either responding more vigorously at low beat frequencies or at high beat frequencies. In addition, other cells demonstrate a clear directional sensitivity. The cells that show sensitivity to the direction and speed of phase changes would be expected to demonstrate a sensitivity to moving sound sources in the free field. Changes in the mean interaural phase of the binaural beat period histograms are used to determine the effects of changes in average and interaural intensity on the phase sensitivity

  12. Individual structural differences in left inferior parietal area are associated with schoolchildrens’ arithmetic scores

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

    Full Text Available Arithmetic skill is of critical importance for academic achievement, professional success and everyday life, and childhood is the key period to acquire this skill. Neuroimaging studies have identified that left parietal regions are a key neural substrate for representing arithmetic skill. Although the relationship between functional brain activity in left parietal regions and arithmetic skill has been studied in detail, it remains unclear about the relationship between arithmetic achievement and structural properties in left inferior parietal area in schoolchildren. The current study employed a combination of voxel-based morphometry (VBM for high-resolution T1-weighted images and fiber tracking on diffusion tensor imaging (DTI to examine the relationship between structural properties in the inferior parietal area and arithmetic achievement in 10-year-old schoolchildren. VBM of the T1-weighted images revealed that individual differences in arithmetic scores were significantly and positively correlated with the grey matter (GM volume in the left intraparietal sulcus (IPS. Fiber tracking analysis revealed that the forceps major, left superior longitudinal fasciculus (SLF, bilateral inferior longitudinal fasciculus (ILF and inferior fronto-occipital fasciculus (IFOF were the primary pathways connecting the left IPS with other brain areas. Furthermore, the regression analysis of the probabilistic pathways revealed a significant and positive correlation between the fractional anisotropy (FA values in the left SLF, ILF and bilateral IFOF and arithmetic scores. The brain structure-behavior correlation analyses indicated that the GM volumes in the left IPS and the FA values in the tract pathways connecting left IPS were both related to children’s arithmetic achievement. The present findings provide evidence that individual structural differences in the left IPS are associated with arithmetic scores in schoolchildren.

  13. Aberrant Left Inferior Bronchial Artery Originating from the Left Gastric Artery in a Patient with Acute Massive Hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Sen, E-mail: jasfly77@vip.163.com; Sun, Xi-Wen, E-mail: xwsun@citiz.net; Yu, Dong, E-mail: yudong_mail@126.com; Jie, Bing, E-mail: jbshh@163.com [Shanghai Pulmonary Hospital, Tongji University School of Medicine, Department of Radiology (China)

    2013-10-15

    Massive hemoptysis is a life-threatening condition, and the major source of bleeding in this condition is the bronchial circulation. Bronchial artery embolization is a safe and effective treatment for controlling hemoptysis. However, the sites of origin of the bronchial arteries (BAs) have numerous anatomical variations, which can result in a technical challenge to identify a bleeding artery. We present a rare case of a left inferior BA that originated from the left gastric artery in a patient with recurrent massive hemoptysis caused by bronchiectasis. The aberrant BA was embolized, and hemoptysis has been controlled for 8 months.

  14. Memory of music: roles of right hippocampus and left inferior frontal gyrus.

    Science.gov (United States)

    Watanabe, Takamitsu; Yagishita, Sho; Kikyo, Hideyuki

    2008-01-01

    We investigated neural correlates of retrieval success for music memory using event-related functional magnetic resonance imaging. To minimize the interference from MRI scan noise, we used sparse temporal sampling technique. Newly composed music materials were employed as stimuli, which enabled us to detect regions in absence of effects of experience with the music stimuli in this study. Whole brain analyses demonstrated significant retrieval success activities in the right hippocampus, bilateral lateral temporal regions, left inferior frontal gyrus and left precuneus. Anatomically defined region-of-interests analyses showed that the activity of the right hippocampus was stronger than that of the left, while the activities of the inferior frontal gyri showed the reverse pattern. Furthermore, performance-based analyses demonstrated that the retrieval success activity of the right hippocampus was positively correlated with the corrected recognition rate, suggesting that the right hippocampus contributes to the accuracy of music retrieval outcome.

  15. Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Kaufman, John A.; Lakin, Paul L.

    2004-01-01

    Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach

  16. Distinct roles of left inferior frontal regions that explain individual differences in second language acquisition.

    Science.gov (United States)

    Sakai, Kuniyoshi L; Nauchi, Arihito; Tatsuno, Yoshinori; Hirano, Kazuyoshi; Muraishi, Yukimasa; Kimura, Masakazu; Bostwick, Mike; Yusa, Noriaki

    2009-08-01

    Second language (L2) acquisition is more susceptible to environmental and idiosyncratic factors than first language acquisition. Here, we used functional magnetic resonance imaging for L2 learners of different ages of first exposure (mean: 12.6 and 5.6 years) in a formal school environment, and compared the cortical activations involved in processing English sentences containing either syntactic or spelling errors, where the testing ages and task performances of both groups were matched. We found novel activation patterns in two regions of the left inferior frontal gyrus (IFG) that correlated differentially with the performances of the late and early learners. Specifically, activations of the dorsal and ventral triangular part (F3t) of the left IFG correlated positively with the accuracy of the syntactic task for the late learners, whereas activations of the left ventral F3t correlated negatively with the accuracy for the early learners. In contrast, other cortical regions exhibited differential correlation patterns with the reaction times (RTs) of the syntactic task. Namely, activations of the orbital part (F3O) of the left IFG, as well as those of the left angular gyrus, correlated positively with the RTs for the late learners, whereas those activations correlated negatively with the RTs for the early learners. Moreover, the task-selective activation of the left F3O was maintained for both the late and early learners. These results explain individual differences in L2 acquisition, such that the acquisition of linguistic knowledge in L2 is subserved by at least two distinct inferior frontal regions of the left F3t and F3O. (c) 2008 Wiley-Liss, Inc.

  17. Dysregulated left inferior parietal activity in schizophrenia and depression: functional connectivity and characterization

    Directory of Open Access Journals (Sweden)

    Veronika I. Müller

    2013-06-01

    Full Text Available The inferior parietal cortex (IPC is a heterogeneous region that is known to be involved in a multitude of diverse different tasks and processes, though its contribution to these often-complex functions is yet poorly understood. In a previous study we demonstrated that patients with depression failed to deactivate the left IPC during processing of congruent audiovisual information. We now found the same dysregulation (same region and condition in schizophrenia. By using task-independent (resting state and task-dependent (MACM analyses we aimed at characterizing this particular region with regard to its connectivity and function. Across both approaches, results revealed functional connectivity of the left inferior parietal seed region with bilateral IPC, precuneus and posterior cingulate cortex (PrC/PCC, medial orbitofrontal cortex (mOFC, left middle frontal (MFG as well as inferior frontal (IFG gyrus. Network-level functional characterization further revealed that on the one hand, all interconnected regions are part of a network involved in memory processes. On the other hand, sub-networks are formed when emotion, language, social cognition and reasoning processes are required. Thus, the IPC-region that is dysregulated in both depression and schizophrenia is functionally connected to a network of regions which, depending on task demands may form sub-networks. These results therefore indicate that dysregulation of left IPC in depression and schizophrenia might not only be connected to deficits in audiovisual integration, but is possibly also associated to impaired memory and deficits in emotion processing in these patient groups.

  18. [Postero'inferior aneurysm of the left ventricle following myocardial infarction. Diagnosis and surgical treatment].

    Science.gov (United States)

    Flores Covarrubias, S E; Acoltzin Vidal, C; Nava Lopez, G; Palacios Macedo, X

    1979-01-01

    This is a report of the first four cases of left ventricle aneurysm of the posterior and inferior segments successfully treated surgically in the Hospital de Cardiología y Neumología del Centro Médico Nacional, México D. F., and represent the twelve per cent of all realized aneurysmectomies. The patients were all men with 57 years mean age, and a previous history of posteroinferior myocardial infarction, complicated in three of them with angor and severe ventricle arrythmias; chest X ray in lateral view showed a bump of the posteroinferior border of the cardiac silhouette; the echocardiography increase in the ventricular diameter below the mitral valve; the ventriculography made evident a diastolic bulging with systolic expansion of posterior and inferior segments of the left ventricle and no mitral regurgitation; selective coronary arteriography showed a dominant right pattern with 100 per cent proximal occlusion. Aneurysmectomy was done in all four cases and aortocoronary by-pass in two. The posteromedial papilar muscle was found respected in all cases and in two cases a mural thrombus was detected.

  19. Left-sided and duplicate inferior vena cava: a case series and review.

    Science.gov (United States)

    Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

    2013-11-01

    Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Copyright © 2012 Wiley Periodicals, Inc.

  20. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii. © The Author(s) 2014.

  1. Generating predictions: lesion evidence on the role of left inferior frontal cortex in rapid syntactic analysis.

    Science.gov (United States)

    Jakuszeit, Maria; Kotz, Sonja A; Hasting, Anna S

    2013-01-01

    A well-documented phenomenon in event-related electroencephalography (EEG) and magnetoencephalography (MEG) studies on language processing is that syntactic violations of different types elicit negativities as early as 100 msec after the violation point. Recently, these responses have been associated with activations in or very close to sensory cortices, suggesting the involvement of basic sensory mechanisms in the detection of syntactic violations. The present study investigated whether intact auditory cortices and adjacent temporal regions are sufficient to generate early syntactic negativities in the auditory event-related potential (ERP). We tested ten clinically non-aphasic patients with left inferior frontal lesions, but intact temporal cortices in a passive auditory ERP paradigm that had reliably elicited early negativities in response to violations of subject-verb agreement and word category in the past. Subject-verb agreement violations failed to elicit early grammaticality effects in these patients, whereas a group of ten age-matched controls showed a reliable early negativity. This finding supports the idea that sensory aspects of syntactic analysis as reflected in early syntactic negativities critically depend on top-down predictions generated by the left inferior frontal cortex. In contrast, word category violations elicited a small, marginally significant early negativity both in controls and patients, suggesting an additional involvement of temporal regions in early phrase structure processing. In an additional auditory oddball experiment patients showed a regular P300, but no N2b component in response to deviant tones, indicating that their deficit in generating sensory predictions extends beyond the language domain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Left inferior frontal gyrus mediates morphosyntax: ERP evidence from verb processing in left-hemisphere damaged patients.

    Science.gov (United States)

    Regel, Stefanie; Kotz, Sonja A; Henseler, Ilona; Friederici, Angela D

    2017-01-01

    Neurocognitive models of language comprehension have proposed different mechanisms with different neural substrates mediating human language processing. Whether the left inferior frontal gyrus (LIFG) is engaged in morpho-syntactic information processing is currently still controversially debated. The present study addresses this issue by examining the processing of irregular verb inflection in real words (e.g., swim > swum > swam) and pseudowords (e.g., frim > frum > fram) by using event-related brain potentials (ERPs) in neurological patients with lesions in the LIFG involving Broca's area as well as healthy controls. Different ERP patterns in response to the grammatical violations were observed in both groups. Controls showed a biphasic negativity-P600 pattern in response to incorrect verb inflections whereas patients with LIFG lesions displayed a N400. For incorrect pseudoword inflections, a late positivity was found in controls, while no ERP effects were obtained in patients. These findings of different ERP patterns in the two groups strongly indicate an involvement of LIFG in morphosyntactic processing, thereby suggesting brain regions' specialization for different language functions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

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    Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2016-06-15

    A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

  4. Early-latency categorical speech sound representations in the left inferior frontal gyrus.

    Science.gov (United States)

    Alho, Jussi; Green, Brannon M; May, Patrick J C; Sams, Mikko; Tiitinen, Hannu; Rauschecker, Josef P; Jääskeläinen, Iiro P

    2016-04-01

    Efficient speech perception requires the mapping of highly variable acoustic signals to distinct phonetic categories. How the brain overcomes this many-to-one mapping problem has remained unresolved. To infer the cortical location, latency, and dependency on attention of categorical speech sound representations in the human brain, we measured stimulus-specific adaptation of neuromagnetic responses to sounds from a phonetic continuum. The participants attended to the sounds while performing a non-phonetic listening task and, in a separate recording condition, ignored the sounds while watching a silent film. Neural adaptation indicative of phoneme category selectivity was found only during the attentive condition in the pars opercularis (POp) of the left inferior frontal gyrus, where the degree of selectivity correlated with the ability of the participants to categorize the phonetic stimuli. Importantly, these category-specific representations were activated at an early latency of 115-140 ms, which is compatible with the speed of perceptual phonetic categorization. Further, concurrent functional connectivity was observed between POp and posterior auditory cortical areas. These novel findings suggest that when humans attend to speech, the left POp mediates phonetic categorization through integration of auditory and motor information via the dorsal auditory stream. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Transcranial Magnetic Stimulation over Left Inferior Frontal and Posterior Temporal Cortex Disrupts Gesture-Speech Integration.

    Science.gov (United States)

    Zhao, Wanying; Riggs, Kevin; Schindler, Igor; Holle, Henning

    2018-02-21

    Language and action naturally occur together in the form of cospeech gestures, and there is now convincing evidence that listeners display a strong tendency to integrate semantic information from both domains during comprehension. A contentious question, however, has been which brain areas are causally involved in this integration process. In previous neuroimaging studies, left inferior frontal gyrus (IFG) and posterior middle temporal gyrus (pMTG) have emerged as candidate areas; however, it is currently not clear whether these areas are causally or merely epiphenomenally involved in gesture-speech integration. In the present series of experiments, we directly tested for a potential critical role of IFG and pMTG by observing the effect of disrupting activity in these areas using transcranial magnetic stimulation in a mixed gender sample of healthy human volunteers. The outcome measure was performance on a Stroop-like gesture task (Kelly et al., 2010a), which provides a behavioral index of gesture-speech integration. Our results provide clear evidence that disrupting activity in IFG and pMTG selectively impairs gesture-speech integration, suggesting that both areas are causally involved in the process. These findings are consistent with the idea that these areas play a joint role in gesture-speech integration, with IFG regulating strategic semantic access via top-down signals acting upon temporal storage areas. SIGNIFICANCE STATEMENT Previous neuroimaging studies suggest an involvement of inferior frontal gyrus and posterior middle temporal gyrus in gesture-speech integration, but findings have been mixed and due to methodological constraints did not allow inferences of causality. By adopting a virtual lesion approach involving transcranial magnetic stimulation, the present study provides clear evidence that both areas are causally involved in combining semantic information arising from gesture and speech. These findings support the view that, rather than being

  6. Percutaneous closure of a hemodynamically significant connection between the inferior vena cava and the left atrium.

    Science.gov (United States)

    Wiebe, Jens; Rixe, Johannes; Nef, Holger

    2015-10-01

    A connection between the inferior vena cava (IVC) and the left atrium (LA) can occur as a rare complication after surgical atrial septum defect (ASD) repair. We demonstrate the first case of a percutaneous closure of this connection. A 67-year-old female was admitted to hospital due to exertional dyspnea. A history of a surgical ASD repair in 1960 and 1966 with a residual shunt was already known. Transesophageal echocardiography and a CT scan revealed a hemodynamically significant drainage of the IVC into the LA. This connection was successfully closed percutaneously with an AMPLATEZR Duct Occluder I (St. Jude Medical, St. Paul, MN). Post-procedural CT-scan and transthoracic echocardiography demonstrated a stable position and there was also no evidence of a residual shunt. The patient reported a significant reduction of exertional dyspnea. Percutaneous closure of an IVC to LA connection in this case was safe and feasible. The decision about which device is optimal must be made on an individual basis. © 2015 Wiley Periodicals, Inc.

  7. The left inferior frontal gyrus: A neural crossroads between abstract and concrete knowledge.

    Science.gov (United States)

    Della Rosa, Pasquale Anthony; Catricalà, Eleonora; Canini, Matteo; Vigliocco, Gabriella; Cappa, Stefano F

    2018-04-12

    Evidence from both neuropsychology and neuroimaging suggests that different types of information are necessary for representing and processing concrete and abstract word meanings. Both abstract and concrete concepts, however, conjointly rely on perceptual, verbal and contextual knowledge, with abstract concepts characterized by low values of imageability (IMG) (low sensory-motor grounding) and low context availability (CA) (more difficult to contextualize). Imaging studies supporting differences between abstract and concrete concepts show a greater recruitment of the left inferior frontal gyrus (LIFG) for abstract concepts, which has been attributed either to the representation of abstract-specific semantic knowledge or to the request for more executive control than in the case of concrete concepts. We conducted an fMRI study on 27 participants, using a lexical decision task involving both abstract and concrete words, whose IMG and CA values were explicitly modelled in separate parametric analyses. The LIFG was significantly more activated for abstract than for concrete words, and a conjunction analysis showed a common activation for words with low IMG or low CA only in the LIFG, in the same area reported for abstract words. A regional template map of brain activations was then traced for words with low IMG or low CA, and BOLD regional time-series were extracted and correlated with the specific LIFG neural activity elicited for abstract words. The regions associated to low IMG, which were functionally correlated with LIFG, were mainly in the left hemisphere, while those associated with low CA were in the right hemisphere. Finally, in order to reveal which LIFG-related network increased its connectivity with decreases of IMG or CA, we conducted generalized psychophysiological interaction analyses. The connectivity strength values extracted from each region connected with the LIFG were correlated with specific LIFG neural activity for abstract words, and a regression

  8. Effect of eye rotation on visual-field map onto superior colliculus and visual cortex.

    Science.gov (United States)

    Gordon, B; Moran, J; Presson, J

    1983-09-01

    We used multiunit recording to assess the effect of rotating one eye approximately 90 degrees at about the time of normal eye opening. Rotation of the eye did not alter the topography of the retinal maps onto visual cortex or superior colliculus. The intorted eye drove cells at most recording points in the contralateral visual cortex and superior colliculus. In its ipsilateral colliculus the intorted eye drove cells at about 10% of the recording points; that is, the temporal retina of this eye was quite ineffective in driving collicular cells. In its ipsilateral cortex the intorted eye drove cells at about 30% of the recording sites. The unoperated eye drove cells at all locations in both colliculus and cortex on both sides of the brain. The effects of extorsion were studied only in the superior colliculus. Extorsion and intorsion produced similar results except that extorsion produced a less severe deficit in the ability of the temporal retina to drive cells in its ipsilateral colliculus. Cutting all the extraocular muscles without eye rotation was studied only in the colliculus and produced results similar to those produced by intorsion and extorsion. However, the temporal retina of the operated eye was more effective after muscle cut alone than after intorsion or extorsion. Forcing the animal to use the rotated right eye alone on alternate days during the first 3 mo of life did not decrease the deficits. Almost all recording sites in the right colliculus were driven only by the unoperated left eye. If the left eye was sutured when the right eye was rotated, only the right eye drove cells in the left colliculus, but the two eyes were about equally effective in the right colliculus; however, rather few sites in the right colliculus were binocularly driven. We conclude that both extraocular muscle section and eye rotation reduce the effectiveness of the uncrossed input from the operated eye to the superior colliculus and visual cortex. The effects on the superior

  9. Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

    International Nuclear Information System (INIS)

    Maeshima, S.; Matsumoto, T.; Ueyoshi, A.; Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H.; Roger, P.

    2002-01-01

    We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

  10. Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

    Energy Technology Data Exchange (ETDEWEB)

    Maeshima, S.; Matsumoto, T.; Ueyoshi, A. [Department of Physical Medicine and Rehabilitation, Wakayama Medical University, Wakayama (Japan); Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H. [Department of Neurological Surgery, Hidaka General Hospital, Wakayama (Japan); Roger, P. [School of Communication Sciences and Disorders, University of Sydney, Sydney, NSW (Australia)

    2002-02-01

    We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

  11. Enhancing verbal creativity: modulating creativity by altering the balance between right and left inferior frontal gyrus with tDCS.

    Science.gov (United States)

    Mayseless, N; Shamay-Tsoory, S G

    2015-04-16

    Creativity is the production of novel ideas that have value. Previous research indicated that while regions in the right hemisphere are implicated in the production of new ideas, damage to the left inferior frontal gyrus (IFG) is associated with increased creativity, indicating that the left IFG damage may have a "releasing" effect on creativity. To examine this, in the present study we used transcranial direct current stimulation (tDCS) to modulate activity of the right and the left IFG. In the first experiment we show that whereas anodal tDCS over the right IFG coupled with cathodal tDCS over the left IFG increases creativity as measured by a verbal divergent thinking task, the reverse stimulation does not affect creative production. To further confirm that only altering the balance between the two hemispheres is crucial in modulating creativity, in the second experiment we show that stimulation targeting separately the left IFG (cathodal stimulation) or the right IFG (anodal stimulation) did not result in changes in creativity as measured by verbal divergent thinking. These findings support the balance hypothesis, according to which verbal creativity requires a balance of activation between the right and the left frontal lobes, and more specifically, between the right and the left IFG. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  12. Subacute sclerosing panencephalitis with bilateral inferior collicular hyperintensity on magnetic resonance imaging brain

    Directory of Open Access Journals (Sweden)

    Maya Thomas

    2012-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is chronic encephalitis occurring after infection with measles virus. An 8-year-old boy presented with progressive behavioral changes, cognitive decline and myoclonic jerks, progressing to a bed bound state over 2 months. Magnetic resonance imaging (MRI brain showed T2-weighted hyperintensities in the subcortical areas of the left occipital lobe and brachium of the inferior colliculus on both sides. EEG showed bilateral, synchronous periodic discharges. Serum/cerebrospinal fluid measles IgG titer was significantly positive. The overall features were suggestive of SSPE. MRI finding of bilateral inferior colliculus changes on MRI without significant involvement of other commonly involved areas suggests an uncommon/rare imaging pattern of SSPE.

  13. Rare case of left adrenal cortical carcinoma with level 3 inferior vena ...

    African Journals Online (AJOL)

    Observation: A 21-year-old male, incidentally detected with left supra renal tumor invading the left renal vein and the thrombus extending into the supra diaphragmatic IVC, underwent laparotomy with simultaneous median sternotomy on total cardiac bypass for removal of IVC tumor thrombus and radical excision of the ...

  14. Facial colliculus syndrome

    Directory of Open Access Journals (Sweden)

    Rupinderjeet Kaur

    2016-01-01

    Full Text Available A male patient presented with horizontal diplopia and conjugate gaze palsy. Magnetic resonance imaging (MRI revealed acute infarct in right facial colliculus which is an anatomical elevation on the dorsal aspect of Pons. This elevation is due the 6th cranial nerve nucleus and the motor fibres of facial nerve which loop dorsal to this nucleus. Anatomical correlation of the clinical symptoms is also depicted in this report.

  15. Surgical skills acquisition among left-handed trainees-true inferiority or unfair assessment: a preliminary study.

    Science.gov (United States)

    Lee, Jason Y; Mucksavage, Phillip; McDougall, Elspeth M

    2013-01-01

    Studies involving the formal assessment of surgical skills have often reported inferior abilities among left-handed surgical trainees (LHT). Most surgical training curricula and assessment methods, however, are inherently geared toward right-handed trainees (RHT); potentially placing LHT at both a training and assessment disadvantage. We evaluated the effect of a hand dominance-based curriculum for acquisition of basic suturing and knot tying skills among medical students. After Institutional Review Board approval, first- and second-year medical students from the University of California, Irvine School of Medicine were recruited to participate in a basic suturing and knot tying skills course. Consenting students were randomized to either a left-handed curriculum or a right-handed curriculum consisting of (1) a 30-minute introductory video and (2) a 2-hour instructor-led, hands-on training session on basic suturing and knot tying. All instructional methods, instruments, and instructors were exclusively right-handed or left-handed for the right-handed curriculum or left-handed curriculum, respectively. Students were assessed on the performance of 2 suturing tasks, continuous running suturing and instrument knot tying, and performance assessments were conducted both immediately and 2 weeks posttraining. A total of 19 students completed the training course and both assessments (8 LHT, 11 RHT). Students randomized to a curriculum "concordant" with their hand dominance performed significantly better than those randomized to a "discordant" curriculum on both tasks (p hand dominance might have inferior acquisition of basic suturing and knot tying skills. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. A fractured inferior vena cava filter strut migrating to the left pulmonary artery

    Directory of Open Access Journals (Sweden)

    Tamer Hudali

    2015-01-01

    Full Text Available Inferior vena cava filters are increasingly used in patients with recurrent venous thromboembolism who are contraindicated to anticoagulation. Migration of a broken strut to the pulmonary artery is a very rare complication of these filters. We report the case of an 83-year-old female who experienced this complication with the migratory strut remaining in the same position for years. This case provides evidence that such filters probably have higher rates of complications than what has been thought that remain asymptomatic. The indications and the management of complications of such devices need to be studied further.

  17. The role of the left inferior parietal lobule in second language learning: An intensive language training fMRI study.

    Science.gov (United States)

    Barbeau, Elise B; Chai, Xiaoqian J; Chen, Jen-Kai; Soles, Jennika; Berken, Jonathan; Baum, Shari; Watkins, Kate E; Klein, Denise

    2017-04-01

    Research to date suggests that second language acquisition results in functional and structural changes in the bilingual brain, however, in what way and how quickly these changes occur remains unclear. To address these questions, we studied fourteen English-speaking monolingual adults enrolled in a 12-week intensive French language-training program in Montreal. Using functional MRI, we investigated the neural changes associated with new language acquisition. The participants were scanned before the start of the immersion program and at the end of the 12 weeks. The fMRI scan aimed to investigate the brain regions recruited in a sentence reading task both in English, their first language (L1), and in French, their second language (L2). For the L1, fMRI patterns did not change from Time 1 to Time 2, while for the L2, the brain response changed between Time 1 and Time 2 in language-related areas. Of note, for the L2, there was higher activation at Time 2 compared to Time 1 in the left inferior parietal lobule (IPL) including the supramarginal gyrus. At Time 2 this higher activation in the IPL correlated with faster L2 reading speed. Moreover, higher activation in the left IPL at Time 1 predicted improvement in L2 reading speed from Time 1 to Time 2. Our results suggest that learning-induced plasticity occurred as early as 12 weeks into immersive second-language training, and that the IPL appears to play a special role in language learning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Leiomyosarcoma of inferior vena cava involving bilateral renal veins: Surgical challenges and reconstruction with upfront saphenous vein interposition graft for left renal vein outflow

    Directory of Open Access Journals (Sweden)

    Rishi Nayyar

    2010-01-01

    Full Text Available Leiomyosarcoma of inferior vena cava (IVC involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.

  19. Left Inferior Frontal Gyrus Sensitivity to Phonetic Competition in Receptive Language Processing: A Comparison of Clear and Conversational Speech.

    Science.gov (United States)

    Xie, Xin; Myers, Emily

    2018-03-01

    The speech signal is rife with variations in phonetic ambiguity. For instance, when talkers speak in a conversational register, they demonstrate less articulatory precision, leading to greater potential for confusability at the phonetic level compared with a clear speech register. Current psycholinguistic models assume that ambiguous speech sounds activate more than one phonological category and that competition at prelexical levels cascades to lexical levels of processing. Imaging studies have shown that the left inferior frontal gyrus (LIFG) is modulated by phonetic competition between simultaneously activated categories, with increases in activation for more ambiguous tokens. Yet, these studies have often used artificially manipulated speech and/or metalinguistic tasks, which arguably may recruit neural regions that are not critical for natural speech recognition. Indeed, a prominent model of speech processing, the dual-stream model, posits that the LIFG is not involved in prelexical processing in receptive language processing. In the current study, we exploited natural variation in phonetic competition in the speech signal to investigate the neural systems sensitive to phonetic competition as listeners engage in a receptive language task. Participants heard nonsense sentences spoken in either a clear or conversational register as neural activity was monitored using fMRI. Conversational sentences contained greater phonetic competition, as estimated by measures of vowel confusability, and these sentences also elicited greater activation in a region in the LIFG. Sentence-level phonetic competition metrics uniquely correlated with LIFG activity as well. This finding is consistent with the hypothesis that the LIFG responds to competition at multiple levels of language processing and that recruitment of this region does not require an explicit phonological judgment.

  20. Fracture of the anterior colliculus.

    Science.gov (United States)

    Skie, M C; Ebraheim, N A; Woldenberg, L; Randall, K

    1995-04-01

    The authors retrospectively reviewed 33 cases of fracture involving the anterior colliculus of the medial malleolus to examine clinical results of operative treatment for these fractures. Although this injury appears innocuous, it can be difficult to obtain stable fixation of the fragment intraoperatively, and painful nonunion can result. A simple reduction maneuver and method of tension band fixation are described.

  1. Differential activity in left inferior frontal gyrus for pseudo and real words: an event-related functional MRI study on auditory lexical decision

    International Nuclear Information System (INIS)

    Xiao Zhuangwei; Xu Weixiong; Zhang Xuexin; Wang Xiaoyi; Weng Xuchu; Wu Renhua; Wu Xiaoping

    2006-01-01

    Objective: To study lexical processing of pseudo words and real words by using a fast event-related functional MRI (ER-fMRI) design. Methods: Participants did an auditory lexical decision task on a list of pseudo-randomly intermixed real and pseudo Chinese two-character (or two-syllable) words. Pseudo words were constructed by recombining constituent characters of the real words to control for sublexical codes properties. Results: The behavioral performance of fourteen participants indicated that response to pseudowords was significantly slower and less accurate than to real words (mean error rate: 9.9% versus 3.9%, mean reaction time: 1618 ms versus 1143 ms). Processing of pseudo words and real words activated a highly comparable network of brain regions, including bilateral inferior frontal gyrus, superior, middle temporal gyrus, calcarine and lingual gyrus, and left supramarginal gyrus. Mirroring a behavioral lexical effect, left inferior frontal gyrus (IFG) was significantly more activated for pseudo words than for real words. Conclusion: The results indicate that the processing of left inferior frontal gyrus in judging pseudo words and real words is not related to grapheme-to-phoneme conversion, but rather to making positive versus negative responses in decision making. (authors)

  2. Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Saur, Dorothee; Price, Cathy J

    2013-01-01

    The role of the right hemisphere in aphasia recovery after left hemisphere damage remains unclear. Increased activation of the right hemisphere has been observed after left hemisphere damage. This may simply reflect a release from transcallosal inhibition that does not contribute to language...... hemisphere lesion. Our findings lend further support to the notion that increased activation of homologous right hemisphere areas supports aphasia recovery after left hemisphere damage....

  3. Greater pre-stimulus effective connectivity from the left inferior frontal area to other areas is associated with better phonological decoding in dyslexic readers

    Directory of Open Access Journals (Sweden)

    Richard E Frye

    2010-12-01

    Full Text Available Functional neuroimaging studies suggest that neural networks that subserve reading are organized differently in dyslexic readers (DRs and typical readers (TRs, yet the hierarchical structure of these networks has not been well studied. We used Granger Causality (GC to examine the effective connectivity of the preparatory network that occurs prior to viewing a non-word stimulus that requires phonological decoding in 7 DRs and 10 TRs who were young adults. The neuromagnetic activity that occurred 500 ms prior to each rhyme trial was analyzed from sensors overlying the left and right inferior frontal areas (IFA, temporoparietal areas (TPA, and ventral occipitotemporal areas (VOTA within the low, medium, and high beta and gamma sub-bands. A mixed-model analysis determined whether connectivity to or from the left and right IFAs differed across connectivity direction (into vs. out of the IFAs, brain areas, reading group, and/or performance. Results indicated that greater connectivity in the low beta sub-band from the left IFA to other cortical areas was significantly related to better non-word rhyme discrimination in DRs but not TRs. This suggests that the left IFA is an important cortical area involved in compensating for poor phonological function in DRs. We suggest that the left IFA activates a wider-than usual network prior to each trial in the service of supporting otherwise effortful phonological decoding in DRs. The fact that the left IFA provides top-down activation to both posterior left hemispheres areas used by typical readers for phonological decoding and homologous right hemisphere areas is discussed. In contrast, within the high gamma sub-band, better performance was associated with decreased connectivity between the left IFA and other brain areas, in both reading groups. Overly strong gamma connectivity during the pre-stimulus period may interfere with subsequent transient activation and deactivation of sub-networks once the non

  4. Bilateral inferior frontal language-related activation correlates with verbal recall in patients with left temporal lobe epilepsy and typical language distribution.

    Science.gov (United States)

    Sanjuán, Ana; Bustamante, Juan Carlos; García-Porcar, María; Rodríguez-Pujadas, Aina; Forn, Cristina; Martínez, Juan Carlos; Campos, Anabel; Palau, Juan; Gutiérrez, Antonio; Villanueva, Vicente; Avila, César

    2013-03-01

    Language fMRI has been used in the presurgical evaluation of drug-resistant temporal lobe epilepsy patients. Previous studies have demonstrated that left temporal lobe epilepsy (LTLE) patients with atypical language lateralization are at lower risk of postsurgical verbal memory decline, hypothesizing co-occurrence of verbal memory and language reorganization presurgically. Furthermore, it has been proposed that the recruitment of right frontal language-related areas is associated with the preservation of verbal memory performance in these patients. However, less is known about the correlation between these functions specifically in LTLE patients with left language dominance, although they are more prone to postsurgical verbal memory decline. The aim of the present study was to investigate whether the relationship between verbal memory scores and frontal language activation is also observed in LTLE patients with typical language dominance. Eighteen healthy controls, 12 right temporal lobe epilepsy patients and 12 LTLE patients with typical language distribution as assessed by an fMRI verbal fluency task were selected. Verbal memory scores were obtained from the patients' neuropsychological presurgical evaluation. Our results showed a positive correlation between verbal recall and activation of bilateral inferior frontal areas in LTLE patients. These results support the hypothesis of a link between language representation in inferior frontal areas and hippocampal functioning, and indicate that both hemispheres are related to the preservation of verbal memory in patients with hippocampal damage and typical language dominance. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Activation and Functional Connectivity of the Left Inferior Temporal Gyrus during Visual Speech Priming in Healthy Listeners and Listeners with Schizophrenia.

    Science.gov (United States)

    Wu, Chao; Zheng, Yingjun; Li, Juanhua; Zhang, Bei; Li, Ruikeng; Wu, Haibo; She, Shenglin; Liu, Sha; Peng, Hongjun; Ning, Yuping; Li, Liang

    2017-01-01

    Under a "cocktail-party" listening condition with multiple-people talking, compared to healthy people, people with schizophrenia benefit less from the use of visual-speech (lipreading) priming (VSP) cues to improve speech recognition. The neural mechanisms underlying the unmasking effect of VSP remain unknown. This study investigated the brain substrates underlying the unmasking effect of VSP in healthy listeners and the schizophrenia-induced changes in the brain substrates. Using functional magnetic resonance imaging, brain activation and functional connectivity for the contrasts of the VSP listening condition vs. the visual non-speech priming (VNSP) condition were examined in 16 healthy listeners (27.4 ± 8.6 years old, 9 females and 7 males) and 22 listeners with schizophrenia (29.0 ± 8.1 years old, 8 females and 14 males). The results showed that in healthy listeners, but not listeners with schizophrenia, the VSP-induced activation (against the VNSP condition) of the left posterior inferior temporal gyrus (pITG) was significantly correlated with the VSP-induced improvement in target-speech recognition against speech masking. Compared to healthy listeners, listeners with schizophrenia showed significantly lower VSP-induced activation of the left pITG and reduced functional connectivity of the left pITG with the bilateral Rolandic operculum, bilateral STG, and left insular. Thus, the left pITG and its functional connectivity may be the brain substrates related to the unmasking effect of VSP, assumedly through enhancing both the processing of target visual-speech signals and the inhibition of masking-speech signals. In people with schizophrenia, the reduced unmasking effect of VSP on speech recognition may be associated with a schizophrenia-related reduction of VSP-induced activation and functional connectivity of the left pITG.

  6. Neurophysiological investigations in the colliculus inferior of Rhinolophus ferrumequinum

    NARCIS (Netherlands)

    Neuweiler, Gerhard

    1970-01-01

    The horseshoe-bat Rhinolophus ferrumequinum is the best known representative of those bats using constant frequency sounds for echolocation. Schnitzler (1968) has shown, that horseshoe-bats compensate Dopplershifts during flight by lowering the emitted constant frequency so that the heard

  7. Neuronal Correlates of Pitch in the Inferior Colliculus

    National Research Council Canada - National Science Library

    Depireux, Didier A; Klein, David J; Simon, Jonathan Z; Shamma, Shihab A

    2006-01-01

    ...) in the barbiturate- or ketamine-anesthetized ferret were recorded with single tungsten electrodes. Single-unit action potentials were recorded using glassinsulated tungsten microelectrodes with 5 to 6 megohm impedance...

  8. The Left Superior Longitudinal Fasciculus within the Primary Sensory Area of Inferior Parietal Lobe Plays a Role in Dysgraphia of Kana Omission within Sentences

    Directory of Open Access Journals (Sweden)

    Nobusada Shinoura

    2012-01-01

    Full Text Available Functional neurological changes after surgery combined with diffusion tensor imaging (DTI tractography can directly provide evidence of anatomical localization of brain function. Using these techniques, a patient with dysgraphia before surgery was analyzed at our hospital in 2011. The patient showed omission of kana within sentences before surgery, which improved after surgery. The brain tumor was relatively small and was located within the primary sensory area (S1 of the inferior parietal lobe (IPL. DTI tractography before surgery revealed compression of the branch of the superior longitudinal fasciculus (SLF by the brain tumor. These results suggest that the left SLF within the S1 of IPL plays a role in the development of dysgraphia of kana omission within sentences.

  9. Bihemispheric stimulation over left and right inferior frontal region enhances recovery from apraxia of speech in chronic aphasia.

    Science.gov (United States)

    Marangolo, Paola; Fiori, Valentina; Cipollari, Susanna; Campana, Serena; Razzano, Carmelina; Di Paola, Margherita; Koch, Giacomo; Caltagirone, Carlo

    2013-11-01

    Several studies have already shown that transcranial direct current stimulation (tDCS) is a useful tool for enhancing recovery in aphasia. However, all tDCS studies have previously investigated the effects using unihemisperic stimulation. No reports to date have examined the role of bihemispheric tDCS on aphasia recovery. Here, eight aphasic persons with apraxia of speech underwent intensive language therapy in two different conditions: real bihemispheric anodic ipsilesional stimulation over the left Broca's area and cathodic contralesional stimulation over the right homologue of Broca's area, and a sham condition. In both conditions, patients underwent concurrent language therapy for their apraxia of speech. The language treatment lasted 10 days (Monday to Friday, then weekend off, then Monday to Friday). There was a 14-day intersession interval between the real and the sham conditions. In all patients, language measures were collected before (T0), at the end of (T10) and 1 week after the end of (F/U) treatment. Results showed that after simultaneous excitatory stimulation to the left frontal hemisphere and inhibitory stimulation to the right frontal hemisphere regions, patients exhibited a significant recovery not only in terms of better accuracy and speed in articulating the treated stimuli but also in other language tasks (picture description, noun and verb naming, word repetition, word reading) which persisted in the follow-up session. Taken together, these data suggest that bihemispheric anodic ipsilesional and cathodic contralesional stimulation in chronic aphasia patients may affect the treated function, resulting in a positive influence on different language tasks. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  10. Surgery for gliomas involving the left inferior parietal lobule: new insights into the functional anatomy provided by stimulation mapping in awake patients.

    Science.gov (United States)

    Maldonado, Igor Lima; Moritz-Gasser, Sylvie; de Champfleur, Nicolas Menjot; Bertram, Luc; Moulinié, Gérard; Duffau, Hugues

    2011-10-01

    Surgery in the left dominant inferior parietal lobule (IPL) is challenging because of a high density of somatosensory and language structures, both in the cortex and white matter. In the present study, on the basis of the results provided by direct cerebral stimulation in awake patients, the authors revisit the anatomofunctional aspects of surgery within the left IPL. Fourteen consecutive patients underwent awake craniotomy for a glioma involving the left IPL. Intraoperative motor, sensory, and language mapping was performed before and during the tumor removal, at both the cortical and subcortical levels, to optimize the extent of resection, which was determined based on functional boundaries. Anatomofunctional correlations were performed by combining the results of intraoperative mapping and those provided by pre- and postoperative MR imaging. At the cortical level, the primary somatosensory area (retrocentral gyrus) limited the resection anteriorly in all cases, at least partially. Less frequently, speech arrest or articulatory problems were observed within the parietal operculum (4 cases). The lateral limit was determined by language sites that were variably distributed. Anomia was the most frequent response (9 cases) at the posterior third of the superior (and/or middle) temporal gyrus. Posteriorly, less reproducible reorganized language sites were seldom observed in the posterior portion of the angular gyrus (2 cases). At the subcortical level, in addition to somatosensory responses due to stimulation of the thalamocortical pathways, articulatory disturbances were induced by stimulation of white matter in the anterior and lateral part of the surgical cavity (11 cases). This tract anatomically corresponds to the horizontal portion of the lateral segment of the superior longitudinal fascicle (SLF III). Deeper and superiorly, phonemic paraphasia was the main language disturbance (12 cases), elicited by stimulation of the posterosuperior portion of the arcuate

  11. Tell it to a child! A brain stimulation study of the role of left inferior frontal gyrus in emotion regulation during storytelling.

    Science.gov (United States)

    Urgesi, Cosimo; Mattiassi, Alan D A; Buiatti, Tania; Marini, Andrea

    2016-08-01

    In everyday life we need to continuously regulate our emotional responses according to their social context. Strategies of emotion regulation allow individuals to control time, intensity, nature and expression of emotional responses to environmental stimuli. The left inferior frontal gyrus (LIFG) is involved in the cognitive control of the selection of semantic content. We hypothesized that it might also be involved in the regulation of emotional feelings and expressions. We applied continuous theta burst stimulation (cTBS) over LIFG or a control site before a newly-developed ecological regulation task that required participants to produce storytelling of pictures with negative or neutral valence to either a peer (unregulated condition) or a child (regulated condition). Linguistic, expressive, and physiological responses were analyzed in order to assess the effects of LIFG-cTBS on emotion regulation. Results showed that the emotion regulation context modulated the emotional content of narrative productions, but not the physiologic orienting response or the early expressive behavior to negative stimuli. Furthermore, LIFG-cTBS disrupted the text-level structuring of negative picture storytelling and the early cardiac and muscular response to negative pictures; however, it did not affect the contextual emotional regulation of storytelling. These results may suggest that LIFG is involved in the initial detection of the affective arousal of emotional stimuli. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. TMS interferes with lexical-semantic retrieval in left inferior frontal gyrus and posterior middle temporal gyrus: Evidence from cyclical picture naming.

    Science.gov (United States)

    Krieger-Redwood, Katya; Jefferies, Elizabeth

    2014-11-01

    We used TMS to investigate the contribution of left inferior frontal gyrus (LIFG) and posterior middle temporal gyrus (pMTG) to lexical/semantic selection and retrieval processes using a cyclical naming paradigm. Participants named pictures that were presented repeatedly across six cycles, either in semantically related or unrelated sets. Previous research has suggested that selection demands are higher for related sets, especially after repetition, since participants experience competition from the activation of semantic neighbours. In contrast, retrieval demands are greater for unrelated sets in the absence of semantic priming, particularly on the first cycle when the target names have not been previously activated. Therefore, this paradigm can reveal independent effects of (i) retrieval demands (i.e., the ease of accessing picture names from visual input) and (ii) selection/competition. We found that rTMS to LIFG and pMTG produced similar behavioural effects: stimulation of both sites disrupted picture naming performance on early cycles (when participants were less practised at producing the picture names) and for semantically-related sets (when there was the potential for increased competition and yet also facilitation from semantic neighbours). There were no effects of TMS when either retrieval or selection requirements were maximal on their own. The data therefore support the view that both LIFG and pMTG contribute to picture name retrieval, with both sites playing a critical role in mediating the semantic facilitation of naming when retrieval demands are high. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Context-dependent lexical ambiguity resolution: MEG evidence for the time-course of activity in left inferior frontal gyrus and posterior middle temporal gyrus.

    Science.gov (United States)

    Mollo, Giovanna; Jefferies, Elizabeth; Cornelissen, Piers; Gennari, Silvia P

    An MEG study investigated the role of context in semantic interpretation by examining the comprehension of ambiguous words in contexts leading to different interpretations. We compared high-ambiguity words in minimally different contexts (to bowl, the bowl) to low-ambiguity counterparts (the tray, to flog). Whole brain beamforming revealed the engagement of left inferior frontal gyrus (LIFG) and posterior middle temporal gyrus (LPMTG). Points of interest analyses showed that both these sites showed a stronger response to verb-contexts by 200 ms post-stimulus and displayed overlapping ambiguity effects that were sustained from 300 ms onwards. The effect of context was stronger for high-ambiguity words than for low-ambiguity words at several different time points, including within the first 100 ms post-stimulus. Unlike LIFG, LPMTG also showed stronger responses to verb than noun contexts in low-ambiguity trials. We argue that different functional roles previously attributed to LIFG and LPMTG are in fact played out at different periods during processing. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  14. Non-perceptual Regions in the Left Inferior Parietal Lobe Support Phonological Short-term Memory: Evidence for a Buffer Account?

    Science.gov (United States)

    Yue, Qiuhai; Martin, Randi C; Hamilton, A Cris; Rose, Nathan S

    2018-03-07

    Buffer versus embedded processes accounts of short-term memory (STM) for phonological information were addressed by testing subjects' perception and memory for speech and non-speech auditory stimuli. Univariate and multivariate (MVPA) approaches were used to assess whether brain regions recruited in recognizing speech were involved in maintaining speech representations over a delay. As expected, a left superior temporal region was found to support speech perception. However, contrary to the embedded processes approach, this region failed to show a load effect, or any sustained activation, during a maintenance delay. Moreover, MVPA decoding during the maintenance stage was unsuccessful in this region by a perception classifier or an encoding classifier. In contrast, the left supramarginal gyrus showed both sustained activation and a load effect. Using MVPA, stimulus decoding was successful during the delay period. In addition, a functional connectivity analysis showed that, as memory load increased, the left temporal lobe involved in perception became more strongly connected with the parietal region involved in maintenance. Taken together, the findings provide greater support for a buffer than embedded processes account of phonological STM.

  15. T'ain't what you say, it's the way that you say it--left insula and inferior frontal cortex work in interaction with superior temporal regions to control the performance of vocal impersonations.

    Science.gov (United States)

    McGettigan, Carolyn; Eisner, Frank; Agnew, Zarinah K; Manly, Tom; Wisbey, Duncan; Scott, Sophie K

    2013-11-01

    Historically, the study of human identity perception has focused on faces, but the voice is also central to our expressions and experiences of identity [Belin, P., Fecteau, S., & Bedard, C. Thinking the voice: Neural correlates of voice perception. Trends in Cognitive Sciences, 8, 129-135, 2004]. Our voices are highly flexible and dynamic; talkers speak differently, depending on their health, emotional state, and the social setting, as well as extrinsic factors such as background noise. However, to date, there have been no studies of the neural correlates of identity modulation in speech production. In the current fMRI experiment, we measured the neural activity supporting controlled voice change in adult participants performing spoken impressions. We reveal that deliberate modulation of vocal identity recruits the left anterior insula and inferior frontal gyrus, supporting the planning of novel articulations. Bilateral sites in posterior superior temporal/inferior parietal cortex and a region in right middle/anterior STS showed greater responses during the emulation of specific vocal identities than for impressions of generic accents. Using functional connectivity analyses, we describe roles for these three sites in their interactions with the brain regions supporting speech planning and production. Our findings mark a significant step toward understanding the neural control of vocal identity, with wider implications for the cognitive control of voluntary motor acts.

  16. Left Lobe Mobilization Strategy of Right-Sided Major Hepatectomy for Treatment of a Tumor Causing Severe Inferior Vena Cava Compression: A Novel Strategy Using the Modified Liver-Hanging Maneuver.

    Science.gov (United States)

    Araki, Kenichiro; Kubo, Norio; Ishii, Norihiro; Tsukagoshi, Mariko; Igarashi, Takamichi; Watanabe, Akira; Kuwano, Hiroyuki; Shirabe, Ken

    2018-02-14

    Massive bleeding during major hepatectomy is associated with greater mortality and morbidity.1 Our previous study shows that inferior vena cava (IVC) compression by tumor and an anterior approach without the liver-hanging maneuver (LHM) are risk factors for massive bleeding.2 The LHM is useful for controlling bleeding in deeper parenchymal transection planes.3 However, severe compression of the IVC by tumor makes it difficult to insert a hanging tape.4 The study shows a novel modified LHM strategy for severe IVC compression to minimize intraoperative bleeding. The procedure was disassembled into six steps: (1) the glissonian bifurcation is encircled using an extrahepatic approach (2) the hepatic ligaments are dissected, and the root of each hepatic vein trunk is exposed (3) the left lobe is fully mobilized, and the short hepatic veins are carefully dissected with a systematic procedure established from hemi-left lobe procurement in living donor liver transplantation5 (4) the tape is inserted from the space between the right and middle hepatic vein trunks into the glissonian bifurcation along the anterior surface of the IVC (5) liver parenchymal transection is performed with upward pulling of the tape (6) the right hepatic vein is dissected, and the right lobe is dissected from the diaphragm and the right hepatic ligaments. Right hepatectomy with this procedure was performed for two patients with IVC compressed by hepatocellular carcinoma. The operative times were respectively 483 and 396 min. The respective estimated blood losses were 1195 and 485 ml, without transfusion. Both patients had acceptable outcomes without complications. The novel modified LHM strategy ensured minimal bleeding in the resection of a huge liver tumor causing severe IVC compression.

  17. Proposal for a new classification of variations in the iliac venous system based on internal iliac veins: a case series and a review of double and left inferior vena cava.

    Science.gov (United States)

    Hayashi, Shogo; Naito, Munekazu; Hirai, Shuichi; Terayama, Hayato; Miyaki, Takayoshi; Itoh, Masahiro; Fukuzawa, Yoshitaka; Nakano, Takashi

    2013-09-01

    There are many reports on variations in the inferior vena cava (IVC), particularly double IVC (DIVC) and left IVC (LIVC). However, no systematic report has recorded iliac vein (IV) flow patterns in the DIVC and LIVC. In this study, we examined IV flow patterns in both DIVC and LIVC observed during gross anatomy courses conducted for medical students and in previously reported cases. During the gross anatomy courses, three cases of DIVC and one case of LIVC were found in 618 cadavers. The IV flow pattern from these four cases and all other previously reported cases can be classified into one of the following three types according to the vein into which the internal iliac vein drained: the ipsilateral external IV; confluence of the ipsilateral external IV and IVC; and the communicating vein, which connects the IVC and the contralateral IVC or its iliac branch. This classification, which is based on the internal IV course, is considered to be useful because IV variations have the potential to cause clinical problems during related retroperitoneal surgery, venous interventional radiology, and diagnostic procedures for pelvic cancer.

  18. Morphological evaluation of the superior colliculus of young Wistar ...

    African Journals Online (AJOL)

    Morphological evaluation of the superior colliculus of young Wistar rats following prenatal exposure to Carica papaya leaf extract. ... 9 and 10 of gestation (Group A); days 16 and 17 (Group B); and on days 9, 10, 16 and 17 (Group C); while Group D represented the control, and received distilled water throughout gestation.

  19. Response of cat inferior colliculus neurons to binaural beat stimuli: possible mechanisms for sound localization.

    Science.gov (United States)

    Kuwada, S; Yin, T C; Wickesberg, R E

    1979-11-02

    The interaural phase sensitivity of neurons was studied through the use of binaural beat stimuli. The response of most cells was phase-locked to the beat frequency, which provides a possible neural correlate to the human sensation of binaural beats. In addition, this stimulus allowed the direction and rate of interaural phase change to be varied. Some neurons in our sample responded selectively to manipulations of these two variables, which suggests a sensitivity to direction or speed of movement.

  20. Acoustical enrichment during early postnatal development changes response properties of inferior colliculus neurons in rats

    Czech Academy of Sciences Publication Activity Database

    Bureš, Zbyněk; Bartošová, Jolana; Lindovský, Jiří; Chumak, Tetyana; Popelář, Jiří; Syka, Josef

    2014-01-01

    Roč. 40, č. 11 (2014), s. 3674-3683 ISSN 0953-816X R&D Projects: GA ČR(CZ) GAP303/12/1347; GA ČR(CZ) GBP304/12/G069; GA MŠk EE2.3.30.0018 Institutional support: RVO:68378041 Keywords : attention-dependent plasticity * auditory system * critical period Subject RIV: FH - Neurology Impact factor: 3.181, year: 2014

  1. Cooling of the auditory cortex modifies neuronal activity in the inferior colliculus in rats

    Czech Academy of Sciences Publication Activity Database

    Popelář, Jiří; Šuta, Daniel; Lindovský, Jiří; Bureš, Zbyněk; Pysaněnko, Kateryna; Chumak, Tetyana; Syka, Josef

    2016-01-01

    Roč. 332, feb (2016), s. 7-16 ISSN 0378-5955 R&D Projects: GA ČR(CZ) GBP304/12/G069; GA ČR(CZ) GAP303/12/1347 Institutional support: RVO:68378041 Keywords : auditory cortex * cooling * cortical inactivation * efferent system Subject RIV: ED - Physiology Impact factor: 2.906, year: 2016

  2. Functional Identification of a Pulvinar Path from Superior Colliculus to MT

    Science.gov (United States)

    Berman, Rebecca A.; Wurtz, Robert H.

    2010-01-01

    The idea of a second visual pathway, in which visual signals travel from brainstem to cortex via the pulvinar thalamus, has had considerable influence as an alternative to the primary geniculo-striate pathway. Existence of this second pathway in primates, however, is not well established. A major question centers on whether the pulvinar acts as a relay, particularly in the path from the superior colliculus (SC) to the motion area in middle temporal (MT) cortex. We used physiological microstimulation to identify pulvinar neurons belonging to the path from SC to MT in the macaque. We made three salient observations. First, we identified many neurons in the visual pulvinar that received input from SC or projected to MT, as well as a largely separate set of neurons that received input from MT. Second, and more importantly, we identified a subset of neurons as relay neurons that both received SC input and projected to MT. The identification of these relay neurons demonstrates a continuous functional path from SC to MT through the pulvinar in primates. Third, we histologically localized a subset of SC-MT relay neurons to the subdivision of inferior pulvinar known to project densely to MT, but also localized SC-MT relay neurons to an adjacent subdivision. This pattern indicates that the pulvinar pathway is not limited to a single anatomically-defined region. These findings bring new perspective to the functional organization of the pulvinar and its role in conveying signals to the cerebral cortex. PMID:20445060

  3. Anomalies of the vena cava inferior

    International Nuclear Information System (INIS)

    Koen, F.R.; Bouwer, A.J.; Bornman, M.S.; Du Plessis, D.J.

    1986-01-01

    Two cases of anomalous inferior vena cava are presented, with the emphasis on embryology. The firts patient was investigated by venography for a clinically proven varicocele as a probable cause of infertility. A double inferior vena cava was found during venography, and was confirmed by computed tomography (CT). In the second case a left-sided inferior vena cava was an incidental finding when a CT scan was done as a diagnostic procedure in a case of Hodgkin's disease. A short summary of the embryology and the significance of the variants is presented

  4. Superior colliculus connections with visual thalamus in gray squirrels (Sciurus carolinensis): evidence for four subdivisions within the pulvinar complex.

    Science.gov (United States)

    Baldwin, Mary K L; Wong, Peiyan; Reed, Jamie L; Kaas, Jon H

    2011-04-15

    As diurnal rodents with a well-developed visual system, squirrels provide a useful comparison of visual system organization with other highly visual mammals such as tree shrews and primates. Here, we describe the projection pattern of gray squirrel superior colliculus (SC) with the large and well-differentiated pulvinar complex. Our anatomical results support the conclusion that the pulvinar complex of squirrels consists of four distinct nuclei. The caudal (C) nucleus, distinct in cytochrome oxidase (CO), acetylcholinesterase (AChE), and vesicular glutamate transporter-2 (VGluT2) preparations, received widespread projections from the ipsilateral SC, although a crude retinotopic organization was suggested. The caudal nucleus also received weaker projections from the contralateral SC. The caudal nucleus also projects back to the ipsilateral SC. Lateral (RLl) and medial (RLm) parts of the previously defined rostral lateral pulvinar (RL) were architectonically distinct, and each nucleus received its own retinotopic pattern of focused ipsilateral SC projections. The SC did not project to the rostral medial (RM) nucleus of the pulvinar. SC injections also revealed ipsilateral connections with the dorsal and ventral lateral geniculate nuclei, nuclei of the pretectum, and nucleus of the brachium of the inferior colliculus and bilateral connections with the parabigeminal nuclei. Comparisons with other rodents suggest that a variously named caudal nucleus, which relays visual inputs from the SC to temporal visual cortex, is common to all rodents and possibly most mammals. RM and RL divisions of the pulvinar complex also appear to have homologues in other rodents. Copyright © 2011 Wiley-Liss, Inc.

  5. Computed tomographic evaluation of the renal vein and inferior vena cava in renal cell carcinoma

    International Nuclear Information System (INIS)

    Masuda, Fujio; Nakada, Gyojiro; Onishi, Tetsuo; Higashi, Yoichiro; Machida, Toyohei

    1980-01-01

    Renal cell carcinoma not rarely invades the renal vein and inferior vena cava with formation of tumor thrombus. On the other hand, congenital anomalies of these venous channels are occasionally encountered. At the time of surgery of renal cell carcinoma, therefore, preoperative evaluation of the renal vein and inferior vena cava is desirable. In 22 cases of renal cell carcinoma treated at the Jikei University Hospital during 16 months period from Jan. 1979 to apr. 1980, the ranal vein and inferior vena cava were examined by computed tomography (CT). Intravenous tumor thrombus was diagnosed in 4, double inferior vena cava in one and retroaortic left renal vein in one. All these CT diagnosis were confirmed to be correct by surgery. Three of tumor thrombus cases showed involvement of inferior vena cava. CT findings included dilated vein in 4 and filling defect after contrast enhancement in 2. In double inferior vena cava, CT at the level of the upper pole of kidney showed the left inferior vena cava traversing in front of the aorta and conjoining the left inferior vena cava, CT at the level of renal vein the left renal vein draining into the left inferior vena cava and CT at the lower level two round inferior vena cava with the aorta between them. It was a diagnostically useful finding that the left inferior vena cava was markedly stained in CT after contrast enhancement jestas the aorta and the right inferior vena cava. In retroaortic left renal vein, CT showed the left renal vein running behind the aorta and draining into the inferior vena cava. Preoperative information on congenital anomalies of the renal vein and inferior vena cava or tumor thrombus and its extension are very important particularly for radical surgery to be conducted safely without postoperative complications. Computed tomography is quite useful in evaluation of morbid state of the renal vein and inferior vena cava. (author)

  6. Retinal origin of direction selectivity in the superior colliculus.

    Science.gov (United States)

    Shi, Xuefeng; Barchini, Jad; Ledesma, Hector Acaron; Koren, David; Jin, Yanjiao; Liu, Xiaorong; Wei, Wei; Cang, Jianhua

    2017-04-01

    Detecting visual features in the environment, such as motion direction, is crucial for survival. The circuit mechanisms that give rise to direction selectivity in a major visual center, the superior colliculus (SC), are entirely unknown. We optogenetically isolate the retinal inputs that individual direction-selective SC neurons receive and find that they are already selective as a result of precisely converging inputs from similarly tuned retinal ganglion cells. The direction-selective retinal input is linearly amplified by intracollicular circuits without changing its preferred direction or level of selectivity. Finally, using two-photon calcium imaging, we show that SC direction selectivity is dramatically reduced in transgenic mice that have decreased retinal selectivity. Together, our studies demonstrate a retinal origin of direction selectivity in the SC and reveal a central visual deficit as a consequence of altered feature selectivity in the retina.

  7. [Inferior vestibular neuritis].

    Science.gov (United States)

    Alzuphar, Stephen Jacques; Maire, Raphaël

    2017-10-04

    Inferior vestibular neuritis is a rare form of acute peripheral vestibular loss that only implies the lesion of the inferior vestibular nerve. The diagnosis is based on the observation of a spontaneous downbeating nystagmus, pathological head impulse test for the posterior semicircular canal and abnormal cervical vestibular-evoked myogenic potentials. Bithermal caloric testing and head impulse test for horizontal and anterior canals are normal, as well as the ocular vestibular-evoked myogenic potentials. The differential diagnosis of inferior vestibular neuritis includes the various central lesions that produce vertical down beating nystagmus (posterior fossa) and a cerebral magnetic resonance imaging is mandatory.

  8. Cortical projections to the superior colliculus in grey squirrels (Sciurus carolinensis).

    Science.gov (United States)

    Baldwin, Mary K L; Young, Nicole A; Matrov, Denis; Kaas, Jon H

    2018-02-16

    The superior colliculus is an important midbrain structure involved with integrating information from varying sensory modalities and sending motor signals to produce orienting movements towards environmental stimuli. Because of this role, the superior colliculus receives a multitude of sensory inputs from a wide variety of subcortical and cortical structures. Proportionately, the superior colliculus of grey squirrels is among the largest in size of all studied mammals, suggesting the importance of this structure in the behavioural characteristics of grey squirrels. Yet, our understanding of the connections of the superior colliculus in grey squirrels is lacking, especially with respect to possible cortical influences. In this study, we placed anatomical tracer injections within the medial aspect of the superior colliculus of five grey squirrels (Sciurus carolinensis) and analysed the areal distribution of corticotectal projecting cells in flattened cortex. V1 projections to the superior colliculus were studied in two additional animals. Our results indicate that the superior colliculus receives cortical projections from visual, higher order somatosensory, and higher order auditory regions, as well as limbic, retrosplenial and anterior cingulate cortex. Few, if any, corticotectal projections originate from primary motor, primary somatosensory or parietal cortical regions. This distribution of inputs is similar to the distribution of inputs described in other rodents such as rats and mice, yet the lack of inputs from primary somatosensory and motor cortex is features of corticotectal inputs more similar to those observed in tree shrews and primates, possibly reflecting a behavioural shift from somatosensory (vibrissae) to visual navigation. © 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  9. Spectral and temporal auditory processing in the superior colliculus of aged rats.

    Science.gov (United States)

    Costa, Margarida; Lepore, Franco; Guillemot, Jean-Paul

    2017-09-01

    Presbyacusis reflects dysfunctions present along the central auditory pathway. Given that the topographic representation of the auditory directional spatial map is deteriorated in the superior colliculus of aged animals, therefore, are spectral and temporal auditory processes altered with aging in the rat's superior colliculus? Extracellular single-unit recordings were conducted in the superior colliculus of anesthetized Sprague-Dawley adult (10 months) and aged (22 months) rats. In the spectral domain, level thresholds in aged rats were significantly increased when superior colliculus auditory neurons were stimulated with pure tones or Gaussian noise bursts. The sharpness of the frequency response tuning curve at 10 dB SPL above threshold was also significantly broader among the aged rats. Furthermore, in the temporal domain, the minimal silent gap thresholds to Gaussian noises were significantly longer in aged rats. Hence, these results highlight that spectral and temporal auditory processing in the superior colliculus are impaired during aging. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Modeling the value of strategic actions in the superior colliculus

    Directory of Open Access Journals (Sweden)

    Dhushan Thevarajah

    2010-02-01

    Full Text Available In learning models of strategic game play, an agent constructs a valuation (action value over possible future choices as a function of past actions and rewards. Choices are then stochastic functions of these action values. Our goal is to uncover a neural signal that correlates with the action value posited by behavioral learning models. We measured activity from neurons in the superior colliculus (SC, a midbrain region involved in planning saccadic eye movements, in monkeys while they performed two saccade tasks. In the strategic task, monkeys competed against a computer in a saccade version of the mixed-strategy game “matching-pennies”. In the instructed task, stochastic saccades were elicited through explicit instruction rather than free choices. In both tasks, neuronal activity and behavior were shaped by past actions and rewards with more recent events exerting a larger influence. Further, SC activity predicted upcoming choices during the strategic task and upcoming reaction times during the instructed task. Finally, we found that neuronal activity in both tasks correlated with an established learning model, the Experience Weighted Attraction model of action valuation (Ho, Camerer, and Chong, 2007. Collectively, our results provide evidence that action values hypothesized by learning models are represented in the motor planning regions of the brain in a manner that could be used to select strategic actions.

  11. The superior colliculus is sensitive to gestalt-like stimulus configuration in hemispherectomy patients.

    Science.gov (United States)

    Georgy, Loraine; Celeghin, Alessia; Marzi, Carlo A; Tamietto, Marco; Ptito, Alain

    2016-08-01

    Patients with cortical blindness following a lesion to the primary visual cortex (V1) may retain nonconscious visual abilities (blindsight). One intriguing, though largely unexplored question, is whether nonconscious vision in the blind hemifield of hemianopic patients can be sensitive to higher-order perceptual organization, and which V1-independent structure underlies such effect. To answer this question, we tested two rare hemianopic patients who had undergone hemispherectomy, and in whom the only post-chiasmatic visual structure left intact in the same side of the otherwise damaged hemisphere was the superior colliculus (SC). By using a variant of the redundant target effect (RTE), we presented single dots, patterns composed by the same dots organized in quadruple gestalt-like configurations, or patterns of four dots arranged in random configurations, either singly to the intact visual hemifield or bilaterally to both hemifields. As reported in a number of prior studies on blindsight patients, we found that bilateral stimulation yielded faster reaction times (RTs) than single stimulation of the intact field for all conditions (i.e., there was an implicit RTE). In addition to this effect, both patients showed a further speeding up of RTs when the gestalt-like, but not the random shape, quadruple patterns were projected to their blind hemifield during bilateral stimulation. Because other retino-recipient subcortical and cortical structures in the damaged hemisphere are absent, the SC on the lesioned side seems solely responsible for such an effect. The present results provide initial support to the notion that nonconscious vision might be sensitive to perceptual organization and stimulus configuration through the pivotal contribution of the SC, which can enhance the processing of gestalt-like or structured stimuli over meaningless or randomly assembled ones and translate them into facilitatory motor outputs. Copyright © 2016 The Authors. Published by Elsevier

  12. Superior colliculus resting state networks in post-traumatic stress disorder and its dissociative subtype.

    Science.gov (United States)

    Olivé, Isadora; Densmore, Maria; Harricharan, Sherain; Théberge, Jean; McKinnon, Margaret C; Lanius, Ruth

    2018-01-01

    The innate alarm system (IAS) models the neurocircuitry involved in threat processing in posttraumatic stress disorder (PTSD). Here, we investigate a primary subcortical structure of the IAS model, the superior colliculus (SC), where the SC is thought to contribute to the mechanisms underlying threat-detection in PTSD. Critically, the functional connectivity between the SC and other nodes of the IAS remains unexplored. We conducted a resting-state fMRI study to investigate the functional architecture of the IAS, focusing on connectivity of the SC in PTSD (n = 67), its dissociative subtype (n = 41), and healthy controls (n = 50) using region-of-interest seed-based analysis. We observed group-specific resting state functional connectivity between the SC for both PTSD and its dissociative subtype, indicative of dedicated IAS collicular pathways in each group of patients. When comparing PTSD to its dissociative subtype, we observed increased resting state functional connectivity between the left SC and the right dorsolateral prefrontal cortex (DLPFC) in PTSD. The DLPFC is involved in modulation of emotional processes associated with active defensive responses characterising PTSD. Moreover, when comparing PTSD to its dissociative subtype, increased resting state functional connectivity was observed between the right SC and the right temporoparietal junction in the dissociative subtype. The temporoparietal junction is involved in depersonalization responses associated with passive defensive responses typical of the dissociative subtype. Our findings suggest that unique resting state functional connectivity of the SC parallels the unique symptom profile and defensive responses observed in PTSD and its dissociative subtype. Hum Brain Mapp 39:563-574, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. Inferior vestibular neuritis.

    Science.gov (United States)

    Kim, Ji-Soo; Kim, Hyo Jung

    2012-08-01

    Vestibular neuritis (VN) mostly involves the superior portion of the vestibular nerve and labyrinth. This study aimed to describe the clinical features of VN involving the inferior vestibular labyrinth and its afferents only. Of the 703 patients with a diagnosis of VN or labyrinthitis at Seoul National University Bundang Hospital from 2004 to 2010, we retrospectively recruited 9 patients (6 women, age range 15-75) with a diagnosis of isolated inferior VN. Diagnosis of isolated inferior VN was based on torsional downbeating spontaneous nystagmus, abnormal head-impulse test (HIT) for the posterior semicircular canal (PC), and abnormal cervical vestibular-evoked myogenic potentials (VEMP) in the presence of normally functioning horizontal and anterior semicircular canals, as determined by normal HIT and bithermal caloric tests. All patients presented with acute vertigo with nausea, vomiting, and imbalance. Three patients also had tinnitus and hearing loss in the involved side. The rotation axis of torsional downbeating spontaneous nystagmus was best aligned with that of the involved PC. HIT was also positive only for the involved PC. Cervical VEMP was abnormal in seven patients, and ocular VEMP was normal in all four patients tested. Ocular torsion and subjective visual vertical tests were mostly within the normal range. Since isolated inferior VN lacks the typical findings of much more prevalent superior VN, it may be mistaken for a central vestibular disorder. Recognition of this rare disorder may help avoid unnecessary workups in patients with acute vestibulopathy.

  14. Inferiority is compex

    Science.gov (United States)

    Wade, Jess

    2017-07-01

    In Inferior: How Science Got Women Wrong and the New Research That's Rewriting the Story, author Angela Saini puts forward the idea that bad science has been used to endorse the cultural prejudice that women are both biologically and psychologically second rate to men.

  15. Prenatal VPA exposure and changes in sensory processing by the superior colliculus

    Directory of Open Access Journals (Sweden)

    Georgia eDendrinos

    2011-10-01

    Full Text Available Disorders involving dysfunctional sensory processing are characterized by an inability to filter sensory information, particularly simultaneously arriving multimodal inputs. We examined the effects of prenatal exposure to valproic acid (VPA, a teratogen linked to sensory dysfunction, on the behavior of juvenile and adult rats, and on the anatomy of the superior colliculus, a critical multisensory integration center in the brain. VPA-exposed rats showed deficits in colliculus-dependent behaviors including startle response, prepulse inhibition and nociceptive responses. Some deficits reversed with age. Stereological analyses revealed that colliculi of VPA-treated rats had significantly fewer parvalbumin-positive neurons, a subset of GABAergic cells. These results suggest that prenatal VPA treatment affects the development of the superior colliculus and leads to persistent anatomical changes evidenced by aberrant behavior in tasks that require sensory processing.

  16. Flattened facial colliculus on magnetic resonance imaging in Machado-Joseph disease.

    Science.gov (United States)

    Ogawa, Yoshitsugu; Ito, Shoichi; Makino, Takahiro; Kanai, Kazuaki; Arai, Kimihito; Kuwabara, Satoshi

    2012-07-01

    Atrophy of the pontine tegmentum and facial colliculus is a characteristic pathological feature of Machado-Joseph disease. We assessed whether this finding can be detected by conventional brain magnetic resonance imaging. A total of 17 patients with genetically confirmed Machado-Joseph disease, 15 disease controls (spinocerebellar ataxia type 6 and dentatorubral-pallidoluysian atrophy), and 17 normal subjects were examined using a 1.5-Tesla magnetic resonance imaging scanner. The widths of the facial colliculus, pontine tegmentum, and pontine base and the area of the fourth ventricle were measured on axial T2-weighted imaging. Pathological examination was performed in 9 Machado-Joseph disease patients. In addition, visual inspection of the facial colliculus was evaluated by receiver operating characteristic analysis. The width of the facial colliculus was significantly smaller in Machado-Joseph disease patients (0.37 ± 0.16 mm; mean ± standard deviation) than in normal subjects (0.73 ± 0.30 mm; P Machado-Joseph disease (4.85 ± 0.58 mm) and dentatorubral-pallidoluysian atrophy (4.72 ± 0.59) patients than in normal subjects (6.35 ± 0.74 mm; P Machado-Joseph disease from dentatorubral-pallidoluysian atrophy (0.78) and spinocerebellar ataxia type 6 (0.87). Pathological evaluation showed significant atrophy of the facial colliculus in all Machado-Joseph disease patients. Atrophy of the facial colliculus is a feasible magnetic resonance imaging finding for diagnosing Machado-Joseph disease, and it is easily found as a flattening of the fourth ventricular floor. Copyright © 2012 Movement Disorder Society.

  17. The immediate effects of acoustic trauma on excitation and inhibition in the inferior colliculus : A Wiener-kernel analysis

    NARCIS (Netherlands)

    Heeringa, Amarins Nieske; van Dijk, Pim

    Noise-induced tinnitus and hyperacusis are thought to correspond to a disrupted balance between excitation and inhibition in the central auditory system. Excitation and inhibition are often studied using pure tones; however, these responses do not reveal inhibition within the excitatory pass band.

  18. Neuronal activity in the inferior colliculus and auditory cortex in rats with noise-induced altered gap detection ability

    Czech Academy of Sciences Publication Activity Database

    Profant, Oliver; Burianová, Jana; Popelář, Jiří; Syka, Josef

    -, - (2006), s. 170-170 [Symposium on Hearing Rehabilitation and Innovative Inner Ear Therapies. 18.09.2006-20.09.2006, Montpellier] R&D Projects: GA ČR GA309/04/1074; GA MZd NR8113; GA MŠk LC554 Institutional research plan: CEZ:AV0Z50390512 Keywords : GDT Subject RIV: FH - Neurology

  19. Brief noise exposure in juvenile rats causes a deterioration in the frequency selectivity of inferior colliculus neurons in adulthood

    Czech Academy of Sciences Publication Activity Database

    Popelář, Jiří; Šuta, Daniel; Syka, Josef

    -, - (2006), s. 72-72 [Symposium on Hearing Rehabilitation and Innovative Inner Ear Therapies. 18.09.2006-20.09.2006, Montpellier] R&D Projects: GA ČR GA309/04/1074; GA MZd NR8113; GA MŠk LC554 Institutional research plan: CEZ:AV0Z50390512 Keywords : Neurons Subject RIV: FH - Neurology

  20. Rare occurrence of the left maxillary horizontal third molar impaction ...

    African Journals Online (AJOL)

    Rare occurrence of the left maxillary horizontal third molar impaction, the right maxillary third molar vertical impaction and the left mandibular third molar vertical impaction with inferior alveolar nerve proximity in a 30 year old female: a case report.

  1. Colliculus atlantis: an insufficiently considered anatomic structure in open-mouth radiography of the cervical spine; Der Colliculus atlantis - eine wenig beachtete anatomische Struktur - im transoralen Roentgenbild der Halswirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Schmidberger, H.R. [Universitaetsklinik fuer Radiologie, Graz (Austria); Weiglein, A.H. [Graz Univ. (Austria). Anatomisches Inst.

    1998-12-01

    Purpose: To study the time and mode of the development of the colliculus atlantis, the rate of its occurrence, the causes for its absence, and the radiological-clinical importance in the analysis of open-mouth-view radiographs. Material and Methods: Retrospective analysis of standardized radiographs of the cervical spine in more than 20 000 adults and 100 children. Study of 234 human skeletons of different ages and of 38 isolated adult atlases. Cadaveric dissection of 42 adults (age 48-87). Axial radiographs of isolated atlases and analysis of the bony structures of the colliculus atlantis. Results: The colliculus atlantis develops between age 10 and 13 years. It is always present after age 13 years. For the development of the colliculus atlantis a normal function of the craniocervical joints is necessary. In congenital dysmorphias of the craniocervical region with dysfunction of the craniocervical joints and in fractures of the dens axis before age 10 years with instable healing the colliculus atlantis is absent. Conclusions: The colliculus atlantis is developed at age 13 years apart from some rare exceptions as mentioned. Changes of the site and the structure of the colliculus atlantis allow an early diagnosis of certain traumatically and inflammatory diseases of this region. Furthermore, it serves as an additional parameter in functional analysis of the craniocervical joints. (orig.) [Deutsch] Ziel: Untersuchungen ueber den Zeitpunkt und die Art der Entstehung des Colliculus atlantis, die Haeufigkeit des Vorkommens, die Ursachen seines Fehlens und seine radiologisch-klinische Bedeutung bei der Analyse transoraler Roentgenaufnahmen. Methode: Retrospektive Analyse streng standardisierter Roentgenaufnahmen der Halswirbelsaeule von mehr als 20 000 Erwachsenen und 100 Kindern. Untersuchungen von 234 menschlichen Skeletten verschiedenen Alters und 38 isolierten Atlanten von Erwachsenen. Frische Sektionen von 42 Erwachsenen (48-87 Jahre). Axiale Roentgenaufnahmen

  2. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

    Directory of Open Access Journals (Sweden)

    G Raghavendra Prasad

    2013-01-01

    Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

  3. Hepatic and postrenal segment anomalies of inferior vena cava

    International Nuclear Information System (INIS)

    Choe, Yeon Hyeon; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1986-01-01

    Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferior vena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitoneal operations such as procedures for prevention of venous embolism, splenorenal shunt operation and aortic prosthetic replacement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter. We analyzed 16 cases of postrenal segment anomalies diagnosed by CT, vena cavography, retrograde pyelography and ultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed by cardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8 cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases of left-sided IVC were accompanied by malignant tumors, but caval veins could be discriminated from enlarged nodes because of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Two cases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segment anomalies were 6 cases. Five cases of IVC on left side of vertebra crossed midline at live to enter right-sided right atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases of complex cardiac anomalies, 4 cases of annapolis and 2 cases of situs ambiguous were associated with these anomalies.

  4. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  5. Transhepatic approach for extracardiac inferior cavopulmonary connection stent fenestration.

    LENUS (Irish Health Repository)

    Kenny, Damien

    2012-02-01

    We report on a 3-year-old male who underwent transcatheter stent fenestration of the inferior portion of an extracardiac total cavopulmonary connection in the setting of hypoplastic left heart syndrome. Transhepatic approach, following an unsuccessful attempt from the femoral vein facilitated delivery of a diabolo-shaped stent.

  6. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.

    1986-01-01

    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% [mean +/- S.E.M.] vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury

  7. Collateral circulations in inferior vena cava obstruction

    International Nuclear Information System (INIS)

    Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

    1985-01-01

    Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

  8. CT findings of bilateral inferior vena cava: Differentiation from dilated retroperitoneal veins

    International Nuclear Information System (INIS)

    Park, Kyung Joo; Lee, Si Kyung; Lee, Joo Hyuk

    1993-01-01

    We experience five cases of bilateral inferior vena cava for recent one year. We evaluated the CT findings of the cases and of dilated veins located in the left retroperitoneum (seven left gonadal, seven inferior mesenteric, and two left ascending lumber veins) in the viewpoints of the size, location and relation with the surrounding structures. Bilateral inferior vena cava (IVC) may be asymmetric and the left IVC may be smaller than other retroperitoneal veins with a round contour. The left IVC was located anterior to the spinal body and corresponded with contralateral vena cava in the anteroposterior plane. The gonadal vein was located anterio or anterolateral side of the psoas and always crossed the ureter. Most of the inferior mesenteric vein showed similar location to the opposite site of the vena cava in the anterolateral side of the muscle, medial to the left ureter without crossing. The left ascending lumbar vein was similarly located to the left vena cava but dilated in a short segment. It is required to trace the vessel upward and downward and observe its continuity for correct differentiation. If it is impossible, some differential points suggested in the results of our study will be helpful for distinguishing them

  9. [MASSIVE HEMORRHAGE FROM THE FISTULA FORMATION BETWEEN CUTANEOUS URETEROSTOMY AND INFERIOR EPIGASTRIC ARTERY: A CASE REPORT].

    Science.gov (United States)

    Fujinami, Hiroyuki; Shibuya, Tadamasa; Mori, Kenichi; Shin, Toshitaka; Sumino, Yasuhiro; Sato, Fuminori; Mimata, Hiromitsu; Sato, Yoshiyasu; Matsubara, Takanori; Sakamoto, Sadaaki; Kamei, Noritaka; Hongo, Tetsuo

    2015-04-01

    A 87-year-old man received radical nephroureterectomy for right renal pelvic cancer in 2009 and left cutaneous ureterostomy after radical cystectomy for bladder cancer in 2013. He visited the hospital for exchanging a 7 or 8 Fr single-J catheter every 2 to 4 weeks. Eleven months after the 2nd operation, massive bleeding from the stoma occurred when ureteral catheter was exchanged. Contrast-enhanced computed tomography showed that left inferior epigastric artery was located close to left ureter. Angiography of the left inferior epigastric artery didn't show an obvious fistula, but revealed the stoma was surrounded by ramified new blood vessels from left inferior epigastric artery. We suspected a rupture of the vessels and performed embolization for the branch of inferior epigastric artery to left ureter. This embolization made it possible for the bleeding to be controlled. Massive bleeding from the branch of inferior epigastric artery is very rare, and we report the case and review the literature.

  10. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion.

    Science.gov (United States)

    Onesti, Maria Giuseppina; Troccola, Antonietta; Maruccia, Michele; Conversi, Andrea; Scuderi, Gianluca

    2013-01-01

    Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion.

  11. Developmental dyslexia: dysfunction of a left hemisphere reading network

    Directory of Open Access Journals (Sweden)

    Fabio eRichlan

    2012-05-01

    Full Text Available This mini-review summarizes and integrates findings from recent meta-analyses and original neuroimaging studies on functional brain abnormalities in dyslexic readers. Surprisingly, there is little empirical support for the standard neuroanatomical model of developmental dyslexia, which localizes the primary phonological decoding deficit in left temporo-parietal regions. Rather, recent evidence points to a dysfunction of a left hemisphere reading network, which includes occipito-temporal, inferior frontal, and inferior parietal regions.

  12. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  13. The curious case of the disappearing IVC: A case report and review of the aetiology of Inferior Vena Cava Agenesis

    Science.gov (United States)

    Paddock, Michael; Robson, Nicola

    2014-01-01

    We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth. PMID:24967034

  14. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    OpenAIRE

    Yang, Catherine; Trad, Henrique Simão; Mendonça, Silvana Machado; Trad, Clovis Simão

    2013-01-01

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return fro...

  15. The Efferent Connections Of The Nucleus Of The Optic Tract And The Superior Colliculus In The Rabbit

    NARCIS (Netherlands)

    Holstege, Gert; Collewijn, Han

    1982-01-01

    3H-leucine injections were made in tectal and pretectal areas in the rabbit. After injections in the nucleus of the optic tract (NOT) labeled fibers were distributed bilaterally to the superior colliculus, the dorsal part of the medial geniculate nucleus (MGd), and the pulvinar nucleus, and

  16. The mechanism of saccade motor pattern generation investigated by a large-scale spiking neuron model of the superior colliculus.

    Directory of Open Access Journals (Sweden)

    Jan Morén

    Full Text Available The subcortical saccade-generating system consists of the retina, superior colliculus, cerebellum and brainstem motoneuron areas. The superior colliculus is the site of sensory-motor convergence within this basic visuomotor loop preserved throughout the vertebrates. While the system has been extensively studied, there are still several outstanding questions regarding how and where the saccade eye movement profile is generated and the contribution of respective parts within this system. Here we construct a spiking neuron model of the whole intermediate layer of the superior colliculus based on the latest anatomy and physiology data. The model consists of conductance-based spiking neurons with quasi-visual, burst, buildup, local inhibitory, and deep layer inhibitory neurons. The visual input is given from the superficial superior colliculus and the burst neurons send the output to the brainstem oculomotor nuclei. Gating input from the basal ganglia and an integral feedback from the reticular formation are also included.We implement the model in the NEST simulator and show that the activity profile of bursting neurons can be reproduced by a combination of NMDA-type and cholinergic excitatory synaptic inputs and integrative inhibitory feedback. The model shows that the spreading neural activity observed in vivo can keep track of the collicular output over time and reset the system at the end of a saccade through activation of deep layer inhibitory neurons. We identify the model parameters according to neural recording data and show that the resulting model recreates the saccade size-velocity curves known as the saccadic main sequence in behavioral studies. The present model is consistent with theories that the superior colliculus takes a principal role in generating the temporal profiles of saccadic eye movements, rather than just specifying the end points of eye movements.

  17. Leiomyosarcoma of the inferior turbinate

    Directory of Open Access Journals (Sweden)

    Christopher W. Harper, Jr., MD

    2017-09-01

    Full Text Available We report a case of leiomyosarcoma of the inferior nasal turbinate. The patient, a 68-year-old Caucasian male, presented with 4–6 weeks of epistaxis that was resistant to nasal packing and septal cautery. Upon inspection in the operating room, a small mass was excised from the inferior turbinate. High-power H&E-stained microscopy demonstrated bundles of malignant smooth muscle cells, and immunohistochemical stains were strongly positive for desmin, smooth muscle actin and vimentin, while negative for pankeratin EA1/EA3 and CaM 5.2, suggesting leiomyosarcoma as the diagnosis. Clear margins were obtained at a second surgery. At the time of this writing it is 8 months since his last surgery and he has remained symptom free.

  18. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Tahvanainen, Minna; Nikus, Kjell C; Holmvang, Lene

    2011-01-01

    Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.......Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored....

  19. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed.

  20. [Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].

    Science.gov (United States)

    Peces, R; Gil, F; Costero, O; Pobes, A

    2002-01-01

    We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment.

  1. Endogenous attention signals evoked by threshold contrast detection in human superior colliculus.

    Science.gov (United States)

    Katyal, Sucharit; Ress, David

    2014-01-15

    Human superior colliculus (SC) responds in a retinotopically selective manner when attention is deployed on a high-contrast visual stimulus using a discrimination task. To further elucidate the role of SC in endogenous visual attention, high-resolution fMRI was used to demonstrate that SC also exhibits a retinotopically selective response for covert attention in the absence of significant visual stimulation using a threshold-contrast detection task. SC neurons have a laminar organization according to their function, with visually responsive neurons present in the superficial layers and visuomotor neurons in the intermediate layers. The results show that the response evoked by the threshold-contrast detection task is significantly deeper than the response evoked by the high-contrast speed discrimination task, reflecting a functional dissociation of the attentional enhancement of visuomotor and visual neurons, respectively. Such a functional dissociation of attention within SC laminae provides a subcortical basis for the oculomotor theory of attention.

  2. [Organization of the receptive fields of the superior colliculus neurons of the squirrel Sciurus vulgaris].

    Science.gov (United States)

    Mass, A M

    1976-01-01

    Studies have been made on the reaction of single neurons of the superior colliculus to stationary and moving visual stimuli in immobilized squirrels. The main bulk of collicular units (59%) is not directionally selective, 11%--exhibit high directional selectivity and 30%--were found to be relatively selective. Most of the cells (85%) "prefer" high speed of stimulus motion. Optimal speed for these neurons is equal to 30--100 degree/sec. Testing by a stationary light spot (0.5degree in diameter), reveals different structure of the receptive fields with various types of "on"-and "off"-inputs. Lateral inhibition was observed in the receptive fields with both uniform organization and separated "on" and "off" areas.

  3. Single Unit Recordings of Cells Responsive to Visual, Somatic, Acoustic, and Noxious Stimuli in the Superior Colliculus of the Golden Hamster.

    Science.gov (United States)

    1978-08-01

    NUMBER 79-191T t; __ _ _ _ _ _ 4. TITLE (and Subtitle) 5. TYPE OF REPORT & PERIOD COVERED Single Unit Recordings of Cells Responsive to Visul , Somatic...8217I:I . .A The information in this thesis has been published: J. Comp. Neur. 183:269-284, "Properties of Superior Colliculus Neurons in the Golden...axons from both eyes reach both sides of the central nervous system and provide binocular information to the 6 superior colliculus and, via the

  4. Electrical stimulation of superior colliculus affects strabismus angle in monkey models for strabismus.

    Science.gov (United States)

    Upadhyaya, Suraj; Meng, Hui; Das, Vallabh E

    2017-03-01

    Disruption of binocular vision during the critical period for development leads to eye misalignment in humans and in monkey models. We have previously suggested that disruption within a vergence circuit could be the neural basis for strabismus. Electrical stimulation in the rostral superior colliculus (rSC) leads to vergence eye movements in normal monkeys. Therefore, the purpose of this study was to investigate the effect of SC stimulation on eye misalignment in strabismic monkeys. Electrical stimulation was delivered to 51 sites in the intermediate and deep layers of the SC (400 Hz, 0.5-s duration, 10-40 μA) in 3 adult optical prism-reared strabismic monkeys. Scleral search coils were used to measure movements of both eyes during a fixation task. Staircase saccades with horizontal and vertical components were elicited by stimulation as predicted from the SC topographic map. Electrical stimulation also resulted in significant changes in horizontal strabismus angle, i.e., a shift toward exotropia/esotropia depending on stimulation site. Electrically evoked saccade vector amplitude in the two eyes was not significantly different ( P > 0.05; paired t -test) but saccade direction differed. However, saccade disconjugacy accounted for only ~50% of the change in horizontal misalignment while disconjugate postsaccadic movements accounted for the other ~50% of the change in misalignment due to electrical stimulation. In summary, our data suggest that electrical stimulation of the SC of strabismic monkeys produces a change in horizontal eye alignment that is due to a combination of disconjugate saccadic eye movements and disconjugate postsaccadic movements. NEW & NOTEWORTHY Electrical stimulation of the superior colliculus in strabismic monkeys results in a change in eye misalignment. These data support the notion of developmental disruption of vergence circuits leading to maintenance of eye misalignment in strabismus. Copyright © 2017 the American Physiological Society.

  5. Electrical stimulation of superior colliculus affects strabismus angle in monkey models for strabismus

    Science.gov (United States)

    Upadhyaya, Suraj; Meng, Hui

    2017-01-01

    Disruption of binocular vision during the critical period for development leads to eye misalignment in humans and in monkey models. We have previously suggested that disruption within a vergence circuit could be the neural basis for strabismus. Electrical stimulation in the rostral superior colliculus (rSC) leads to vergence eye movements in normal monkeys. Therefore, the purpose of this study was to investigate the effect of SC stimulation on eye misalignment in strabismic monkeys. Electrical stimulation was delivered to 51 sites in the intermediate and deep layers of the SC (400 Hz, 0.5-s duration, 10–40 μA) in 3 adult optical prism-reared strabismic monkeys. Scleral search coils were used to measure movements of both eyes during a fixation task. Staircase saccades with horizontal and vertical components were elicited by stimulation as predicted from the SC topographic map. Electrical stimulation also resulted in significant changes in horizontal strabismus angle, i.e., a shift toward exotropia/esotropia depending on stimulation site. Electrically evoked saccade vector amplitude in the two eyes was not significantly different (P > 0.05; paired t-test) but saccade direction differed. However, saccade disconjugacy accounted for only ~50% of the change in horizontal misalignment while disconjugate postsaccadic movements accounted for the other ~50% of the change in misalignment due to electrical stimulation. In summary, our data suggest that electrical stimulation of the SC of strabismic monkeys produces a change in horizontal eye alignment that is due to a combination of disconjugate saccadic eye movements and disconjugate postsaccadic movements. NEW & NOTEWORTHY Electrical stimulation of the superior colliculus in strabismic monkeys results in a change in eye misalignment. These data support the notion of developmental disruption of vergence circuits leading to maintenance of eye misalignment in strabismus. PMID:28031397

  6. Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-06-01

    Full Text Available Background: Unlike left ventricular function, less attention has been paid to Right Ventricular (RV function after Myocardial Infarction (MI. Objectives: The current study aimed to compare RV function in patients with inferior and anterior MI. Patients and Methods: During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group and 35 ones had anterior MI (AMI group. Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P < 0.05 was considered to be statistically significant.

  7. Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava

    International Nuclear Information System (INIS)

    Takayasu, K.; Moriyama, N.; Muramatsu, Y.

    1985-01-01

    When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (acessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals

  8. Head-dipping by rats with lesions of superior colliculus during extended testing in hole-board.

    Science.gov (United States)

    Dean, P; Redgrave, P

    1983-06-01

    It has previously been shown that rats with large lesions of the superior colliculus fail to head-dip during a 5 min hole-board test. To investigate whether this was a permanent deficit in exploratory behaviour arising from inability to produce the appropriate responses, collicular rats were tested in a hole-board for 60 min or more. The period before their first head-dip (mean 27 min 40 sec) was much longer than for unoperated animals (mean 22 sec), but subsequently the collicular rats showed a pattern of head-dipping that was similar (although not identical) to that of the control rats. It appears that rats with lesions of the superior colliculus are not permanently prevented from exploring the hole-board by inability to produce the required response, but rather that they may have difficulty in discovering certain features of novel environments.

  9. Inferior Vena Cava Duplication: Incidental Case in a Young Woman

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    Danilo Coco

    2016-01-01

    Full Text Available A case of a double inferior vena cava (IVC with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT, which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures.

  10. Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction

    International Nuclear Information System (INIS)

    Croft, C.H.; Woodward, W.; Nicod, P.; Corbett, J.R.; Lewis, S.E.; Willerson, J.T.; Rude, R.E.

    1982-01-01

    To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such reciprocal changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms

  11. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  12. [The effect of weakening inferior oblique muscles on the status of ocular torsion].

    Science.gov (United States)

    Mai, Guang-Huan; Yu, Xin-Ping; Yu, Huan-Yun; Chen, Jing-Chang; Deng, Da-Ming; Lin, Xiao-Ming; Kang, Ying; Wu, He-Ping

    2004-04-01

    To understand the clinical significance of subjective and objective examination of cyclodeviations and investigate the effect of weakening inferior oblique muscles on the status of ocular torsion. Twenty patients (40 eyes) with overacting inferior oblique muscles underwent bilateral myotomy or partial myectomy of inferior oblique muscles. Subjective cyclodeviations were measured before surgery as well as one week, two months after surgery by double maddox rod test (DMRT). Objective cyclodeviations were assessed by fundus photography before and 7 days after surgery in 15 cases. The photograph was transferred to a computer, and the fovea-disc angle was measured by means of drawing picture software. Nine patients with primary overaction of inferior oblique muscles were negative with DMRT before surgery, and only one case revealed incyclotropia 5.0 degrees tested two months after surgery. Four out of 11 patients with secondary overaction of inferior oblique muscles showed excyclotropia 2.5 degrees - 5.0 degrees with DMRT before surgery, and all patients indicated no subjective cyclotropia with DMRT two months after surgery. Fundus photography determination of the right eye revealed extorsion 16.83 degrees +/- 6.39 degrees, the left eye 14.92 degrees +/- 4.51 degrees before surgery. The reduction of the cyclodeviations by weakening inferior oblique muscle for the right and left eye was 13.07 degrees +/- 3.38 degrees and 10.54 degrees +/- 3.75 degrees respectively. The comparison of objective ocular torsion for both eyes showed high significant differences (P < 0.01) pre- and post-operatively. The results of subjective and objective examination of cyclodeviations in patients with primary or secondary overacting inferior oblique muscle early after birth were not consistent. Weakening inferior oblique muscle could correct excyclodeviation. There exist complicated compensatory mechanisms for subjective change of ocular torsion after surgery. The changes of subjective and

  13. Superior colliculus responses to attended, unattended, and remembered saccade targets during smooth pursuit eye movements.

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    Suryadeep eDash

    2016-04-01

    Full Text Available In realistic environments, keeping track of multiple visual targets during eye movements likely involves an interaction between vision,top-down spatial attention, memory, and self-motion information. Recently we found that the superior colliculus (SC visual memory response is attention-sensitive and continuously updated relative to gaze direction. In that study,animals were trained to remember the location of a saccade target across an intervening smooth pursuit (SP eye movement (Dash et al. 2015. Here, we modified this paradigm to directly compare the properties of visual and memory updating responsesto attended and unattended targets.Our analysis shows that during SP, active SC visual vs. memory updating responses share similar gaze-centered spatio-temporal profiles (suggesting a common mechanism, but updating was weaker by ~25%, delayed by ~55ms, and far more dependent on attention. Further, during SP the sum of passive visual responses (to distracter stimuli and memory updating responses (to saccade targets closely resembled the responses for active attentional tracking of visible saccade targets. These results suggest that SP updating signals provide a damped, delayed estimate of attended location that contributes to the gaze-centered tracking of both remembered and visible saccade targets.

  14. Superior colliculus neuronal ensemble activity signals optimal rather than subjective confidence.

    Science.gov (United States)

    Odegaard, Brian; Grimaldi, Piercesare; Cho, Seong Hah; Peters, Megan A K; Lau, Hakwan; Basso, Michele A

    2018-02-13

    Recent studies suggest that neurons in sensorimotor circuits involved in perceptual decision-making also play a role in decision confidence. In these studies, confidence is often considered to be an optimal readout of the probability that a decision is correct. However, the information leading to decision accuracy and the report of confidence often covaried, leaving open the possibility that there are actually two dissociable signal types in the brain: signals that correlate with decision accuracy (optimal confidence) and signals that correlate with subjects' behavioral reports of confidence (subjective confidence). We recorded neuronal activity from a sensorimotor decision area, the superior colliculus (SC) of monkeys, while they performed two different tasks. In our first task, decision accuracy and confidence covaried, as in previous studies. In our second task, we implemented a motion discrimination task with stimuli that were matched for decision accuracy but produced different levels of confidence, as reflected by behavioral reports. We used a multivariate decoder to predict monkeys' choices from neuronal population activity. As in previous studies on perceptual decision-making mechanisms, we found that neuronal decoding performance increased as decision accuracy increased. However, when decision accuracy was matched, performance of the decoder was similar between high and low subjective confidence conditions. These results show that the SC likely signals optimal decision confidence similar to previously reported cortical mechanisms, but is unlikely to play a critical role in subjective confidence. The results also motivate future investigations to determine where in the brain signals related to subjective confidence reside.

  15. Connections of the superior colliculus to shoulder muscles of the rat: a dual tracing study.

    Science.gov (United States)

    Rubelowski, J M; Menge, M; Distler, C; Rothermel, M; Hoffmann, K-P

    2013-01-01

    Previous investigations indicate that the superior colliculus (SC) is involved in the initiation and execution of forelimb movements. In the present study we investigated the tectofugal, in particular the tecto-reticulo-spinal projections to the shoulder and arm muscles in the rat. We simultaneously retrogradely labeled the premotor neurons in the brainstem by injection of the pseudorabies virus PrV Bartha 614 into the m. rhomboideus minor and m. acromiodeltoideus, and anterogradely visualized the tectofugal projections by intracollicular injection of the tracer FITC dextrane. Our results demonstrate that the connection of the SC to the skeletal muscles of the forelimb is at least trisynaptic. This was confirmed by long survival times after virus injections into the muscles (98-101 h) after which numerous neurons in the deep layers of the SC were labeled. Transsynaptically retrogradely labeled brainstem neurons connected disynaptically to the injected muscles with adjacent tectal terminals were predominantly located in the gigantocellular nuclear complex of the reticular formation. In addition, putative relay neurons were found in the caudal part of the pontine reticular nucleus. Both tectal projections to the nucleus gigantocellularis and the pontine reticular nucleus were bilateral but ipsilaterally biased. We suggest this projection to be involved in more global functions in motivated behavior like general arousal allowing fast voluntary motor activity.

  16. Connections of the superior colliculus to shoulder muscles of the rat: a dual tracing study

    Directory of Open Access Journals (Sweden)

    Johanna M Rubelowski

    2013-06-01

    Full Text Available AbstractPrevious investigations indicate that the superior colliculus (SC is involved in the initiation and execution of forelimb movements. In the present study we investigated the tectofugal, in particular the tecto-reticulo-spinal projections to the shoulder and arm muscles in the rat. We simultaneously retrogradely labelled the premotor neurons in the brainstem by injection of the pseudorabies virus PrV Bartha 614 into the m. rhomboideus minor and m. acromiodeltoideus, and anterogradely visualized the tectofugal projections by intracollicular injection of the tracer FITC dextrane. Our results demonstrate that the connection of the SC to the skeletal muscles of the forelimb is at least trisynaptic. This was confirmed by long survival times after virus injections into the muscles (98-101h after which numerous neurons in the deep layers of the SC were labelled. Transsynaptically retrogradely labelled brainstem neurons connected disynaptically to the injected muscles with adjacent tectal terminals were predominantly located in the gigantocellular nuclear complex of the reticular formation. In addition, putative relay neurons were found in the caudal part of the pontine reticular nucleus. Both tectal projections to the nucleus gigantocellularis and the pontine reticular nucleus were bilateral but ipsilaterally biased. We suggest this projection to be involved in more global functions in motivated behaviour like general arousal allowing fast voluntary motor activity.

  17. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. © 2016 The authors.

  18. Bilateral inferior petrosal sinus sampling

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    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  19. Endovascular treatment for ruptured distal anterior inferior cerebellar artery aneurysm.

    Science.gov (United States)

    Oh, Jae-Sang; Yoon, Seok-Mann; Shim, Jai-Joon; Bae, Hack-Gun; Yoon, Il-Gyu

    2014-03-01

    A 42-year-old woman presented with Hunt and Hess grade (HHG) III subarachnoid hemorrhage (SAH) caused by a ruptured left distal anterior inferior cerebellar artery (AICA) aneurysm. Computed tomography showed a thin SAH on the cerebellopontine angle cistern, and small vermian intracerebral hemorrhage and intraventricular hemorrhage in the fourth ventricle. Digital subtraction angiography revealed the aneurysm on the postmeatal segment of left distal AICA, a branching point of rostrolateral and caudomedial branch of the left distal AICA. Despite thin caliber, tortuous running course and far distal location, the AICA aneurysm was obliterated successfully with endovascular coils without compromising AICA flow. However, the patient developed left side sensorineural hearing loss postoperatively, in spite of definite patency of distal AICA on the final angiogram. She was discharged home without neurologic sequela except hearing loss and tinnitus. Endovascular treatment of distal AICA aneurysm, beyond the meatal loop, is feasible while preserving the AICA flow. However, because the cochlear hair cell is vulnerable to ischemia, unilateral hearing loss can occur, possibly caused by the temporary occlusion of AICA flow by microcatheter during endovascular treatment.

  20. Tuberculosis pulmonar de campos inferiores

    Directory of Open Access Journals (Sweden)

    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p < 0.001, presencia de condensación (p < 0.001 y compromiso unilateral (p < 0.001 en la radiografía de tórax, junto con mayor número de internaciones (p = 0.02. Cabe destacar que sólo16 de los 42 pacientes con TBCI (38% tenían alguna comorbilidad demostrada. La TBCI puede presentarse aun sin comorbilidades asociadas y debe sospecharse en neumonías de evolución tórpida independientemente de su localización.

  1. Peritoneal fluid causing inferior attenuation on SPECT thallium-201 myocardial imaging in women

    Energy Technology Data Exchange (ETDEWEB)

    Rab, S.T.; Alazraki, N.P.; Guertler-Krawczynska, E.

    1988-11-01

    On SPECT thallium images, myocardial left ventricular (LV) anterior wall attenuation due to breast tissue is common in women. In contrast, in men, inferior wall counts are normally decreased compared to anterior counts. The purpose of this report is to describe cases of inferior wall attenuation of counts in women caused by peritoneal fluid, not myocardial disease. Twelve consecutive SPECT thallium myocardial studies performed in women on peritoneal dialysis, being evaluated for kidney transplant, were included in this study. For all studies, 3.5 mCi 201Tl were injected intravenously. Thirty-two images were acquired over 180 degrees (45 degrees RAO progressing to 45 degrees LPO) at 40 sec per stop. SPECT images were reviewed in short axis, horizontal long and vertical long axes. Data were also displayed in bullseye format with quantitative comparison to gender-matched normal files. Ten of 12 female patients studied had inferior wall defects on images, confirmed by bullseye display. All patients had approximately 2 liters of peritoneal fluid. Review of planar rotational views showed diaphragm elevation and fluid margin attenuations affecting left ventricular inferior wall. Thus, peritoneal fluid is a cause of inferior attenuation on 201Tl cardiac imaging.

  2. Traumatismos de veia cava inferior

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    Cleinaldo de Almeida Costa

    Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI. MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI, achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65% doentes sofreram lesão por arma branca, 26 (34% por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54% doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica < 70mmHg. O índice de trauma abdominal penetrante (PATI médio foi maior que 40. À laparotomia, todos demonstraram sangramento retroperitoneal ativo ou hematoma retroperitoneal em expansão. Vinte e um pacientes possuíam lesão de VCI retro-hepática, enquanto nos outros 55 a lesão era infra-hepática. O reparo operatório predominante foi a venorrafia lateral em 65 doentes. Houve necessidade de tóraco-freno-laparotomia em quatro doentes do total de oito doentes que foram à toracotomia direita por lesão retro-hepática. Foram realizados shunts átrio-cavais em seis doentes, dos quais três sobreviveram. CONCLUSÕES: O ferimento de VCI é uma lesão de alta letalidade e possui uma relação intrínseca com a violência urbana. A sobrevivência depende de uma imediata e vigorosa reposição de volume, um manejo operatório adequado e todo esforço em evitar-se hipotermia.

  3. A sodium afterdepolarization in rat superior colliculus neurons and its contribution to population activity.

    Science.gov (United States)

    Ghitani, Nima; Bayguinov, Peter O; Basso, Michele A; Jackson, Meyer B

    2016-07-01

    The mammalian superior colliculus (SC) is a midbrain structure that integrates multimodal sensory inputs and computes commands to initiate rapid eye movements. SC neurons burst with the sudden onset of a visual stimulus, followed by persistent activity that may underlie shifts of attention and decision making. Experiments in vitro suggest that circuit reverberations play a role in the burst activity in the SC, but the origin of persistent activity is unclear. In the present study we characterized an afterdepolarization (ADP) that follows action potentials in slices of rat SC. Population responses seen with voltage-sensitive dye imaging consisted of rapid spikes followed immediately by a second distinct depolarization of lower amplitude and longer duration. Patch-clamp recordings showed qualitatively similar behavior: in nearly all neurons throughout the SC, rapid spikes were followed by an ADP. Ionic and pharmacological manipulations along with experiments with current and voltage steps indicated that the ADP of SC neurons arises from Na(+) current that either persists or resurges following Na(+) channel inactivation at the end of an action potential. Comparisons of pharmacological properties and frequency dependence revealed a clear parallel between patch-clamp recordings and voltage imaging experiments, indicating a common underlying membrane mechanism for the ADP in both single neurons and populations. The ADP can initiate repetitive spiking at intervals consistent with the frequency of persistent activity in the SC. These results indicate that SC neurons have intrinsic membrane properties that can contribute to electrical activity that underlies shifts of attention and decision making. Copyright © 2016 the American Physiological Society.

  4. Electrical stimulation of the superior colliculus induces non- topographically organized perturbation of reaching movements in cats

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    Jean-Hubert eCourjon

    2015-07-01

    Full Text Available Besides its well-known contribution to orienting behaviors, the superior colliculus (SC might also play a role in controlling visually-guided reaching movements. This view has been inferred from studies in monkeys showing that some tectal cells located in the deep layers are active prior to reaching movements; it was corroborated by functional imaging studies performed in humans. Likewise, our group has already demonstrated that, in cats, that SC electrical stimulation can modify the trajectory of goal-directed forelimb movements without necessarily affecting the gaze position. However, as in monkeys, we could not establish any congruence between the usual retinotopic SC map and direction of evoked forelimb movements, albeit only a small portion of the collicular map was investigated. Therefore, the aim of the current study was to further ascertain the causal contribution of SC to reaching movement by exploring the whole collicular map. Our results confirmed that SC electrical stimulation deflected the trajectory of reaching movements, but this deviation was always directed downward and backward, irrespective of the location of the stimulation site. The lack of a complete map of reach directions in the SC and the absence of congruence between the direction of evoked forelimb movements and the collicular oculomotor map challenge the view that, in the cat, the SC causally contributes to coding forelimb movements. Interestingly, the very short latencies of the effect argue also against the interruption of reaching movements being driven by a disruption of the early visual processing. Our results rather suggest that the SC might contribute to the reach target selection process. Alternatively, SC stimulation might have triggered a postural adjustment anticipating an upcoming orienting reaction, leading to an interruption of the on-going reaching movement.

  5. Detailed anatomy of a left accessory aberrant colic artery.

    Science.gov (United States)

    Rusu, M C; Vlad, M; Voinea, L M; Curcă, G C; Sişu, A M

    2008-10-01

    In an aged human female cadaver a left accessory aberrant colic artery (LAACA) was observed and studied. It originated from the superior mesenteric artery at 3 cm proximal to the middle colic artery, at the inferior border of pancreas, passing over Treitz's muscle and continued covered by the superior duodenal fold where it crossed the inferior mesenteric vein. Further, it continued with a satellite vein anterior to the left renal vein and the anterior branch of the renal artery. The LAACA divided into an ascending branch and a descending one, anastomosed with the middle colic and proper left colic arteries; between its two primary branches and the splenic flexure of colon, a hypovascular area was observed. The surgical relevance of the LAACA detailed anatomy mainly relates to specific procedures performed in left colectomies and nephrectomies.

  6. [Inferior vestibular neuritis: diagnosis using VEMP].

    Science.gov (United States)

    Walther, L E; Repik, I

    2012-02-01

    Vestibular evoked myogenic potentials (VEMP) are a new method to establish the functional status of the otolith organs. The sacculocollic reflex of the cervical VEMP to air conduction (AC) reflects predominantly saccular function due to saccular afferents to the inferior vestibular nerve. We describe a case of inferior vestibular neuritis as a rare differential diagnosis of vestibular neuritis. Clinical signs were a normal caloric response, unilaterally absent AC cVEMPs and bilaterally preserved ocular VEMPs (AC oVEMPs).

  7. Sarcoma of the vena cava inferior

    International Nuclear Information System (INIS)

    Leon Alvarez, Jorge Luis; Rosello Silva, Nelson; Llorens Nunnez, Martha; Ochoa Montes, Luis Alberto

    2010-01-01

    Authors present an infrequent case of a female patient with abdominal tumor a great superficial collateral circulation type cava-cava, the abdominal ultrasound, the transthoracic and transesophageal echocardiogram and the computerized axial tomography (CAT) identified a tumor of the vena cava inferior. The fine-needle aspiration cytology of lesion confirmed the presence of primary fusopleomorphous sarcoma of high degree of malignancy of vena cava inferior

  8. Direct evidence for the contribution of the superior colliculus in the control of visually guided reaching movements in the cat.

    Science.gov (United States)

    Courjon, Jean-Hubert; Olivier, Etienne; Pélisson, Denis

    2004-05-01

    The production of visually guided reaching movements relies on a large neural network. Based on indirect experimental evidence, it has been suggested that the superior colliculus, a subcortical centre known for its key role in controlling rapid orienting gaze shifts, also belongs to this network. The aim of the present study was to investigate the role of the cat superior colliculus (SC) in the control of visually guided reaching movements. To address this issue, we studied the effect of SC electrical stimulation on forelimb reaching movements in two cats trained to catch a piece of food. Electrical stimulation delivered just after the movement onset yielded a consistent perturbation of the movement trajectory of the forelimb extremity. This perturbation followed stimulation onset by 56 +/- 11 ms on average, and consisted of a deviation of the spatial path and a deceleration of the movement. The forelimb perturbation was elicited in the absence of concomitant gaze or head displacement in 52% of the stimulation trials. Forelimb perturbations were followed by in-flight adjustments so that reaching movements reliably ended on the target. The present results constitute the first behavioural evidence for a contribution of the cat SC to the control of visually guided forelimb movements.

  9. Dyscalculia, dysgraphia, and left-right confusion from a left posterior peri-insular infarct.

    Science.gov (United States)

    Bhattacharyya, S; Cai, X; Klein, J P

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

  10. Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct

    Directory of Open Access Journals (Sweden)

    S. Bhattacharyya

    2014-01-01

    Full Text Available The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

  11. Assessment of cardiac exposure in left-tangential breast irradiation

    International Nuclear Information System (INIS)

    Vees, H.; Bigler, R.; Gruber, G.; Bieri, S.

    2011-01-01

    Purpose. - To assess the value of treatment-planning related parameters namely, the breast volume; the distance of the inferior field border to diaphragm; and the cardio-thoracic ratio for left-tangential breast irradiation. Patients and methods. - Treatment plans of 27 consecutively left-sided breast cancer patients after breast conserving surgery were evaluated for several parameters concerning heart-irradiation. We measured the heart distance respective to the cardio-thoracic ratio and the distance of the inferior field border to diaphragm, as well as the breast volume in correlation with the irradiated heart volume. Results. - The mean heart and left breast volumes were 504 cm 3 and 672.8 cm 3 , respectively. The mean heart diameter was 13.4 cm; the mean cardio-thoracic ratio 0.51 and the mean distance of the inferior field border to diaphragm was 1.4 cm. Cardio-thoracic ratio (p = 0.01), breast volume (p = 0.0002), distance of the inferior field border to diaphragm (p = 0.02) and central lung distance (p = 0.02) were significantly correlated with the measured heart distance. A significant correlation was also found between cardio-thoracic ratio, breast volume and distance of the inferior field border to diaphragm with the irradiated heart volume measured by V10, V20 and V40. Conclusion. - The verification of parameters like cardio-thoracic ratio, distance of the inferior field border to diaphragm and breast volume in left-sided breast cancer patients may help in determining which patients could benefit from more complex planning techniques such as intensity-modulated radiotherapy to reduced risk of late cardiac injury. (authors)

  12. The reflection of retinal light response information onto the superior colliculus in the rat.

    Science.gov (United States)

    Valjakka, Antti

    2007-08-01

    The functional principles of mediation of retina-encoded visual information through the optic nerve to the superior colliculus (SC) of the contralateral brain hemisphere were investigated in non-drugged and unrestrained albino rats by considering the following issues: (1) the type of information transmitted, (2) the response components of the retina and SC involved in encoding the transmitted information, and (3) the timing of related processes. The field potential responses for different intensities of flashes, under different background illuminations, were simultaneously recorded from the sclera area of the eye and the optic layer of the contralateral SC. It was found that the b-wave crest of the retinal electroretinogram (ERG) and the peak-1 or peak-2 of the SC correlate by their amplitude, while the a-wave trough of the retinal ERG and the peak-1 of the SC correlate by their latency. The values of these mutually correlating response components were invariably determined by the given light response bias of the retina (photoreceptors), the change in the photon flux of the light stimulus and, obviously, the change in the wavelength of the light stimulus. The a-wave trough, peak-1, b-wave crest and peak-2 were invariably induced in this time-order. The data suggest that the information properties of (a) intensity, (b) presentation time and, obviously, (c) colour of the light stimulus, such as are shed on the retina, and information about the light response bias of the retina are mediated correlatively and quantitatively to the cell network system of the SC through the optic nerve. These processes must happen during the a-to-b-wave phases of the ERG. The data indicate that the random-type variations in the activity of the related cellular systems may actually be harnessed in mediating the defined information properties of the visual stimulus from the retina to the SC of the brain through the optic nerve. This study shows a method of measuring the function of the

  13. Frontal eye field sends delay activity related to movement, memory, and vision to the superior colliculus.

    Science.gov (United States)

    Sommer, M A; Wurtz, R H

    2001-04-01

    Many neurons within prefrontal cortex exhibit a tonic discharge between visual stimulation and motor response. This delay activity may contribute to movement, memory, and vision. We studied delay activity sent from the frontal eye field (FEF) in prefrontal cortex to the superior colliculus (SC). We evaluated whether this efferent delay activity was related to movement, memory, or vision, to establish its possible functions. Using antidromic stimulation, we identified 66 FEF neurons projecting to the SC and we recorded from them while monkeys performed a Go/Nogo task. Early in every trial, a monkey was instructed as to whether it would have to make a saccade (Go) or not (Nogo) to a target location, which permitted identification of delay activity related to movement. In half of the trials (memory trials), the target disappeared, which permitted identification of delay activity related to memory. In the remaining trials (visual trials), the target remained visible, which permitted identification of delay activity related to vision. We found that 77% (51/66) of the FEF output neurons had delay activity. In 53% (27/51) of these neurons, delay activity was modulated by Go/Nogo instructions. The modulation preceded saccades made into only part of the visual field, indicating that the modulation was movement-related. In some neurons, delay activity was modulated by Go/Nogo instructions in both memory and visual trials and seemed to represent where to move in general. In other neurons, delay activity was modulated by Go/Nogo instructions only in memory trials, which suggested that it was a correlate of working memory, or only in visual trials, which suggested that it was a correlate of visual attention. In 47% (24/51) of FEF output neurons, delay activity was unaffected by Go/Nogo instructions, which indicated that the activity was related to the visual stimulus. In some of these neurons, delay activity occurred in both memory and visual trials and seemed to represent a

  14. BOLD temporal dynamics of rat superior colliculus and lateral geniculate nucleus following short duration visual stimulation.

    Directory of Open Access Journals (Sweden)

    Condon Lau

    Full Text Available BACKGROUND: The superior colliculus (SC and lateral geniculate nucleus (LGN are important subcortical structures for vision. Much of our understanding of vision was obtained using invasive and small field of view (FOV techniques. In this study, we use non-invasive, large FOV blood oxygenation level-dependent (BOLD fMRI to measure the SC and LGN's response temporal dynamics following short duration (1 s visual stimulation. METHODOLOGY/PRINCIPAL FINDINGS: Experiments are performed at 7 tesla on Sprague Dawley rats stimulated in one eye with flashing light. Gradient-echo and spin-echo sequences are used to provide complementary information. An anatomical image is acquired from one rat after injection of monocrystalline iron oxide nanoparticles (MION, a blood vessel contrast agent. BOLD responses are concentrated in the contralateral SC and LGN. The SC BOLD signal measured with gradient-echo rises to 50% of maximum amplitude (PEAK 0.2±0.2 s before the LGN signal (p<0.05. The LGN signal returns to 50% of PEAK 1.4±1.2 s before the SC signal (p<0.05. These results indicate the SC signal rises faster than the LGN signal but settles slower. Spin-echo results support these findings. The post-MION image shows the SC and LGN lie beneath large blood vessels. This subcortical vasculature is similar to that in the cortex, which also lies beneath large vessels. The LGN lies closer to the large vessels than much of the SC. CONCLUSIONS/SIGNIFICANCE: The differences in response timing between SC and LGN are very similar to those between deep and shallow cortical layers following electrical stimulation, which are related to depth-dependent blood vessel dilation rates. This combined with the similarities in vasculature between subcortex and cortex suggest the SC and LGN timing differences are also related to depth-dependent dilation rates. This study shows for the first time that BOLD responses in the rat SC and LGN following short duration visual stimulation are

  15. Aneurysm of Anterior Inferior Cerebellar Artery-posterior Inferior Cerebellar Artery Variant

    Science.gov (United States)

    Ansari, Khursheed Ahmad; Menon, Girish; Nair, Suresh; Abraham, Mathew

    2018-01-01

    Aneurysms arising from anterior inferior cerebellar artery-posterior inferior cerebellar artery (AICA-PICA) variant are extremely rare. They usually present with subarachnoid hemorrhage. This is probably the second case report of a large thrombosed AICA-PICA variant aneurysm presenting as a cerebellopontine angle mass lesion with cranial nerve palsy, managed successfully by surgical clipping. PMID:29492120

  16. [Vectorcardiographic manifestations of left intraventricular conduction disorders].

    Science.gov (United States)

    de Micheli, A; Medrano, G A

    1979-01-01

    Both, the vectorcardiographic changes produced by the various degrees of left bundle branch block and these observed with the different types of left distal block, are described. When a "wave jumping" phenomenon exists, the vectorcardiographic changes are more characteristic in the horizontal plane than in the frontal plane and can be interpreted satisfactorily in basis of the ventricular activation sequence. The normal counterclockwise rotation of the horizontal vectorcardiogram persists in the presence of left bundle branch block of slight and moderate degrees, since the electromotive forces of the free left ventricular wall are still predominant. In the majority of intermediate degree blocks, the middle portion of the RH loop develops with a clockwise rotation and general aspect with a clockwise rotation and the general aspect of the ventricular loop resembles an eight figure. This is due to the electromotive forces originated by the delayed depolarization of the left septal mass that starts to predominate. With advanced degrees of block, the largest portion of the RH loop shows a clockwise rotation, as well as marked notchings and slurrings. The initial anterior portion of the horizontal vectorcardiogram does not disappear, but is situated to the left of the anterior-posterior axis with a counterclockwise rotation (first right septal vector). Otherwise, the direct electrical sign of left distal block emphasized: evidence of delayed activation in a limited zone of the homolateral ventricle. This local delay gives rise to an asynchronism of the activation phenomenon between the upper and lower regions of the ventricle. The diagnosis of left bifascicular block is based essentially on the evidence of unequal delay of the activation sequence in the basal regions and in the inferior ones of the homolateral ventricle and also on the frequent persistence of the first left septal vector.

  17. The compression syndrome of the left renal vein

    International Nuclear Information System (INIS)

    Justich, E.

    1982-01-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed. (orig.) [de

  18. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Directory of Open Access Journals (Sweden)

    Angélica Castro Pimentel

    2016-01-01

    Full Text Available Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics.

  19. The diagnostic importance of the recognition of the inferior Vena cava abnormalities on CT-examinations

    International Nuclear Information System (INIS)

    Gouliamos, A.; Striggaris, K.; Haliasos, N.; Vlahos, N.; Pontifex, G.

    1981-01-01

    Two unusual variations of the Vena cava inferior, as shown by CT examinations, are reported and characteristic X-rays, as well as CT scans, are presented. The first case shows an IVC course to the left of the aorta and the second case absence of the intrahepatic portion of the IVC with azygos continuation. Difficulties in the differential diagnosis are analyzed and discussed, both demonstrated by plain X-rays and CT scans. (orig.) [de

  20. Reciprocal ST segment changes in acute inferior myocardial infarction: Clinical, hemodynamic and angiographic implications

    Directory of Open Access Journals (Sweden)

    Hatem El Atroush

    2012-09-01

    Conclusion: The significance of reciprocal ST depression on the electrocardiogram during the course of inferior MI remains uncertain, opinion is divided as to whether it is a benign electrical phenomenon or a sign of a greater myocardial necrosis and more frequent left coronary artery disease, from our study we support the latter opinion. This simple ECG finding may be used to differentiate high risk patients for a more aggressive approach.

  1. High Frequency rTMS over the Left Parietal Lobule Increases Non-Word Reading Accuracy

    Science.gov (United States)

    Costanzo, Floriana; Menghini, Deny; Caltagirone, Carlo; Oliveri, Massimiliano; Vicari, Stefano

    2012-01-01

    Increasing evidence in the literature supports the usefulness of Transcranial Magnetic Stimulation (TMS) in studying reading processes. Two brain regions are primarily involved in phonological decoding: the left superior temporal gyrus (STG), which is associated with the auditory representation of spoken words, and the left inferior parietal lobe…

  2. The right posterior inferior frontal gyrus contributes to phonological word decisions in the healthy brain

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Price, Cathy J; Baumgaertner, Annette

    2010-01-01

    There is consensus that the left hemisphere plays a dominant role in language processing, but functional imaging studies have shown that the right as well as the left posterior inferior frontal gyri (pIFG) are activated when healthy right-handed individuals make phonological word decisions. Here we...... used online transcranial magnetic stimulation (TMS) to examine the functional relevance of the right pIFG for auditory and visual phonological decisions. Healthy right-handed individuals made phonological or semantic word judgements on the same set of auditorily and visually presented words while...... they received stereotactically guided TMS over the left, right or bilateral pIFG (n=14) or the anterior left, right or bilateral IFG (n=14). TMS started 100ms after word onset and consisted of four stimuli given at a rate of 10Hz and intensity of 90% of active motor threshold. Compared to TMS of aIFG, TMS of p...

  3. [Scleral buckling for inferior rhegmatogenous retinal detachments].

    Science.gov (United States)

    Abdellaoui, M; Chraibi, F; Benatiya Andaloussi, I; Tahri, H

    2014-10-01

    To investigate the epidemiological, clinical, therapeutic and prognostic factors in cases of inferior rhegmatogenous retinal detachments (RD) treated by scleral buckling surgery. A retrospective chart review was performed on 45 patients (45 eyes) with inferior RD with only inferior tears (4:00-8:00), who had been treated by scleral buckling surgery over a 6-year period from 2006 to 2011. The parameters studied included patient demographics, refractive status, time until consultation, clinical exam data, treatment modalities and functional and anatomic results. Forty-five cases were included in this study (45 eyes), with an average patient age of 44.5 years (14 to 75 years) and a slight male predominance (56%). Myopia was observed in 60%. Mean time until consultation was 3.5 months. Visual acuity on admission was less than 1/10 in 53.33%. Macular detachment was found in 80%. Causative lesions were holes in 26 eyes. Proliferative vitreoretinopathy was essentially stage B in 48.9%. Scleral buckling surgery was performed in all patients, with drainage of subretinal fluid in 37.8%. Retinal reattachment was obtained in 36 eyes (80%) with a final visual acuity greater than or equal to 1/10 in 71.11%. The mean follow-up in our study was 6.62 months. Inferior retinal detachment has a predilection for young myopes. The time until consultation is often long, and extraocular surgery, although difficult, exhibits documented efficacy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Regional Pericarditis Mimicking Inferior Myocardial Infarction following Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Ahmad T. Alhammouri

    2014-01-01

    Full Text Available Acute pericarditis is common but illusive, often mimicking acute coronary syndrome in its clinical and electrocardiographic presentation. Regional pericarditis, though rare, presents further challenge with a paucity of published diagnostic criteria. We present a case of postoperative regional pericarditis and discuss helpful electrocardiographic findings. A 66-year-old male with history of open drainage of a liver abscess presented with abdominal pain and tenderness. CT of the abdomen was concerning for pneumatosis intestinalis of the distal descending colon. He underwent lysis of liver adhesions; exploration revealed only severe colonic impaction, for which he had manual disimpaction and peritoneal irrigation. Postoperatively, he developed sharp chest pain. Electrocardiogram revealed inferior ST elevation. Echocardiogram revealed normal left and right ventricular dimensions and systolic function without wall motion abnormalities. Emergent coronary angiography did not identify a culprit lesion, and left ventriculogram showed normal systolic function without wall motion abnormalities. He received no intervention, and the diagnosis of regional pericarditis was entertained. His cardiac troponin was 0.04 ng/dL and remained unchanged, with resolution of the ECG abnormalities in the following morning. Review of his preangiography ECG revealed PR depression, downsloping baseline between QRS complexes, and reciprocal changes in the anterior leads, suggestive of regional pericarditis.

  5. Increased functional connectivity between superior colliculus and brain regions implicated in bodily self-consciousness during the rubber hand illusion.

    Science.gov (United States)

    Olivé, Isadora; Tempelmann, Claus; Berthoz, Alain; Heinze, Hans-Joachim

    2015-02-01

    Bodily self-consciousness refers to bodily processes operating at personal, peripersonal, and extrapersonal spatial dimensions. Although the neural underpinnings of representations of personal and peripersonal space associated with bodily self-consciousness were thoroughly investigated, relatively few is known about the neural underpinnings of representations of extrapersonal space relevant for bodily self-consciousness. In the search to unravel brain structures generating a representation of the extrapersonal space relevant for bodily self-consciousness, we developed a functional magnetic resonance imaging (fMRI) study to investigate the implication of the superior colliculus (SC) in bodily illusions, and more specifically in the rubber hand illusion (RHi), which constitutes an established paradigm to study the neural underpinnings of bodily self-consciousness. We observed activation of the colliculus ipsilateral to the manipulated hand associated with eliciting of RHi. A generalized form of context-dependent psychophysiological interaction analysis unravelled increased illusion-dependent functional connectivity between the SC and some of the main brain areas previously involved in bodily self-consciousness: right temporoparietal junction (rTPJ), bilateral ventral premotor cortex (vPM), and bilateral postcentral gyrus. We hypothesize that the collicular map of the extrapersonal space interacts with maps of the peripersonal and personal space generated at rTPJ, vPM and the postcentral gyrus, producing a unified representation of space that is relevant for bodily self-consciousness. We suggest that processes of multisensory integration of bodily-related sensory inputs located in this unified representation of space constitute one main factor underpinning emergence of bodily self-consciousness. © 2014 Wiley Periodicals, Inc.

  6. Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

    Science.gov (United States)

    Brunetti, Natale D; Ieva, Riccardo; Correale, Michele; Cuculo, Andrea; Santoro, Francesco; Guaricci, Andrea I; De Gennaro, Luisa; Gaglione, Antonio; Di Biase, Matteo

    2016-01-01

    The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.

  7. Reconstrucción de extremidad inferior

    Directory of Open Access Journals (Sweden)

    M. Parrett Brian, M.D.

    2010-01-01

    Full Text Available La reconstrucción de la extremidad inferior es parte esencial de la cirugía plástica y se concentra en el tratamiento de heridas y defectos causados por trauma, cáncer, o procesos de enfermedades crónicas. Durante los últimos 25 años, los avances en técnicas de cirugía plástica tales como la transferencia libre de tejidos tecnologías más avanzadas de cuidado de heridas han revolucionado este campo, permitiendo salvar extremidades que de otro modo habrían sido amputadas. Este documento analizará el campo de la reconstrucción de extremidades inferiores concentrándose en la evaluación de defectos y heridas de pierna y las variadas opciones de tratamiento.

  8. Percutaneous placement of bird's nest inferior vena cava filter

    International Nuclear Information System (INIS)

    Lee, Seung Hoon; Sung, Kyu Bo; Yoon, Hyun Ki

    1999-01-01

    To describe clinical experiences of the use of Bird's Nest inferior vena cava(IVC) filter. Between August 1991 and August 1997, IVC filter was percutaneously inserted in 51 patients with pulmonary embolism(PE) and deep vein thrombosis of the lower extremities. Indications for the placement of this filter were contraindication to anticoagulation in 17 patients, prophylaxis of PE in 17, failed anticoagulation in 11, massive PE with residual floating thrombus in three and complications involving anticoagulation in 3. In order to delineate the location of renal vein and extension of deep vein thrombosis into the IVC, all patients under went inferior vena cavography before filter placement. Thirty filters were inserted through the right femoral vein, 19 through the right internal jugular vein and three through the left femoral vein. The patients involved were followed up for periods ranging from one week to six years (mean 10 months). A Bird's Nest IVC filter was placed in the infrarenal IVC in 44 patients and in the suprarenal IVC in 7. Certain complicatioins ensued. IVC penetration occurred in three patients(5.9%), and in seven(1.37%) the filter wire prolapsed. Except for transient pain, however, there were no serious IVC penetration-related complications and no evidence of recurrence of PE in the cases involving prolapse of the filter wire. During follow up, clinically suspected recurrent PE was noted in two patients(3.9%), but there was no evidence of newly developed occlusion of the IVC. In patients who under went follow up, Bird's Nest IVC filter effectively prevented the development and recurrence of PE, and there were no complications. To prevent of penetration of the IVC and prolapse of the filter, however, technical skill was needed

  9. How Left Inferior Frontal Cortex Participates in Syntactic Processing: Evidence from Aphasia

    Science.gov (United States)

    Love, Tracy; Swinney, David; Walenski, Matthew; Zurif, Edgar

    2008-01-01

    We report on three experiments that provide a real-time processing perspective on the poor comprehension of Broca's aphasic patients for non-canonically structured sentences. In the first experiment we presented sentences (via a Cross Modal Lexical Priming (CMLP) paradigm) to Broca's patients at a normal rate of speech. Unlike the pattern found…

  10. Rare case of left adrenal cortical carcinoma with level 3 inferior vena ...

    African Journals Online (AJOL)

    K. Jain

    2017-05-02

    May 2, 2017 ... On behalf of all the authors the corresponding author states that there is no conflict of interests. Source of funding. No source of funding to declare. References. [1] Kebebew E, Reiff E, Duh QY, Clark OH, McMillan A. Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made.

  11. Non-inferiority trials: are they inferior? A systematic review of reporting in major medical journals.

    Science.gov (United States)

    Rehal, Sunita; Morris, Tim P; Fielding, Katherine; Carpenter, James R; Phillips, Patrick P J

    2016-10-07

    To assess the adequacy of reporting of non-inferiority trials alongside the consistency and utility of current recommended analyses and guidelines. Review of randomised clinical trials that used a non-inferiority design published between January 2010 and May 2015 in medical journals that had an impact factor >10 (JAMA Internal Medicine, Archives Internal Medicine, PLOS Medicine, Annals of Internal Medicine, BMJ, JAMA, Lancet and New England Journal of Medicine). Ovid (MEDLINE). We searched for non-inferiority trials and assessed the following: choice of non-inferiority margin and justification of margin; power and significance level for sample size; patient population used and how this was defined; any missing data methods used and assumptions declared and any sensitivity analyses used. A total of 168 trial publications were included. Most trials concluded non-inferiority (132; 79%). The non-inferiority margin was reported for 98% (164), but less than half reported any justification for the margin (77; 46%). While most chose two different analyses (91; 54%) the most common being intention-to-treat (ITT) or modified ITT and per-protocol, a large number of articles only chose to conduct and report one analysis (65; 39%), most commonly the ITT analysis. There was lack of clarity or inconsistency between the type I error rate and corresponding CIs for 73 (43%) articles. Missing data were rarely considered with (99; 59%) not declaring whether imputation techniques were used. Reporting and conduct of non-inferiority trials is inconsistent and does not follow the recommendations in available statistical guidelines, which are not wholly consistent themselves. Authors should clearly describe the methods used and provide clear descriptions of and justifications for their design and primary analysis. Failure to do this risks misleading conclusions being drawn, with consequent effects on clinical practice. Published by the BMJ Publishing Group Limited. For permission to use

  12. Subcortical and cortical correlates of pitch discrimination: Evidence for two levels of neuroplasticity in musicians

    DEFF Research Database (Denmark)

    Bianchi, Federica; Hjortkjær, Jens; Santurette, Sébastien

    2017-01-01

    superior temporal gyrus, Heschl's gyrus, insular cortex, inferior frontal gyrus, and in the inferior colliculus. Both subcortical and cortical neural responses predicted the individual pitch-discrimination performance. However, functional activity in the inferior colliculus correlated with differences...

  13. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  14. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

    Full Text Available Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  15. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  16. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Yang, Catherine; Trad, Clovis Simao; Trad, Henrique Simao

    2013-01-01

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  17. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  18. Added clinical value of the inferior temporal EEG electrode chain

    DEFF Research Database (Denmark)

    Bach Justesen, Anders; Eskelund Johansen, Ann Berit; Martinussen, Noomi Ida

    2018-01-01

    Objective To investigate the diagnostic added value of supplementing the 10–20 EEG array with six electrodes in the inferior temporal chain. Methods EEGs were recorded with 25 electrodes: 19 positions of the 10–20 system, and six additional electrodes in the inferior temporal chain (F9/10, T9/10, P...... in the inferior chain) and 6% (only seen at the inferior chain). Conclusions Adding six electrodes in the inferior temporal electrode chain to the 10–20 array improves the localization and identification of EEG abnormalities, especially those located in the temporal region. Significance Our results suggest...

  19. The use of ice-cream to reduce inferior and liver uptake of 99mTc Sestamibi

    International Nuclear Information System (INIS)

    Williams, R.C.; Jost, G.M.

    2002-01-01

    Aim: To determine if ice-cream has any role in reducing the main drawback of sestamibi imaging namely inferior and liver uptake of sestamibi in myocardial imaging. This inferior uptake from, Stomach, Loops of Bowel and Left Lobe of liver can make interpretation difficult Can obscure a defect in the inferior margin of the heart and Hot inferior uptake can produce false adjacent cold defect when using a Fourier kernel. Material and Methods: To remove the confounding factor of various 'stress' regimes adenosine exercise and Dobutamine, only resting Sestamibi scans were examined. Patients where Given ice cream on a stick (ice covered) just prior to injection Imaged at 90 mins post injection of 500 Mbq Tc99m Sestamibi with > 90% purity, using eccentric non-elliptical non circular orbit to maximise resolution, for 18 mins with 2 heads. Processing: Reconstruct (for this purpose) with a butterworth filter of 0.4 and a power factor of 2. Sum all coronal views: Make a rectangular ROI covering the inferior 1/2 or the myocardium. Duplicate this ROI and place at same vertical position over highest activity region of liver. Duplicate region and place immediately underneath cardiac region. Create a BGD region of interest between heart and liver. Data: Ratios of heart to liver and inferior to heart are created with and without background correction. Results: Summary: Ice cream reduces the inferior uptake of Sestamibi by 30%. Ice cream reduces the liver uptake by 14%. Conclusion: Given: The low risk of an ice cream intervention. The high acceptance by patients. The low cost. The effect on inferior uptake. The possible effect on liver uptake. I would recommend the use of Ice Cream for all Myocardial Sestamibi Imaging

  20. Left ventricular noncompaction in a patient presenting with a left ventricular failure

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    Ristić-Anđelkov Anđelka

    2018-01-01

    Full Text Available Introduction. Left ventricular noncompaction (LVNC is a congenital disorder characterised by prominent trabeculations in the left ventricular myocardium. This heart condition very often goes completely undetected, or is mistaken for hypertrophic cardiomyopathy or coronary disease. Case report. A middle-aged female with a positive family history of coronary disease was admitted with chest pain, electrocardiography (ECG changes in the area of the inferolateral wall and elevation in cardiac specific enzymes. Initially, she was suspected of having acute coronary syndrome. However, in the left ventricular apex, especially alongside the lateral and inferior walls, cardiac ultrasound visualised hypertrabeculation with multiple trabeculae projecting inside the left ventricular cavity. A short-axis view of the heart above the papillary muscles revealed the presence of two layers of the myocardium: a compacted homogeneous layer adjacent to the epicardium and a spongy layer with trabeculae and sinusoids under the endocardium. The thickness ratio between the two layers was 2.2:1. The same abnormalities were corroborated by multislice computed tomography (MSCT of the heart. Conclusion. Left ventricular noncompaction is a rare, usually hereditary cardiomyopathy, which should be considered as a possibility in patients with myocardial hypertrophy. It is very often mistaken for coronary disease owing to ECG changes and elevated cardiac specific enzymes associated with myocardial hypertrophy and heart failure.

  1. Dyslexic children lack word selectivity gradients in occipito-temporal and inferior frontal cortex

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    O.A. Olulade

    2015-01-01

    Full Text Available fMRI studies using a region-of-interest approach have revealed that the ventral portion of the left occipito-temporal cortex, which is specialized for orthographic processing of visually presented words (and includes the so-called “visual word form area”, VWFA, is characterized by a posterior-to-anterior gradient of increasing selectivity for words in typically reading adults, adolescents, and children (e.g. Brem et al., 2006, 2009. Similarly, the left inferior frontal cortex (IFC has been shown to exhibit a medial-to-lateral gradient of print selectivity in typically reading adults (Vinckier et al., 2007. Functional brain imaging studies of dyslexia have reported relative underactivity in left hemisphere occipito-temporal and inferior frontal regions using whole-brain analyses during word processing tasks. Hence, the question arises whether gradient sensitivities in these regions are altered in dyslexia. Indeed, a region-of-interest analysis revealed the gradient-specific functional specialization in the occipito-temporal cortex to be disrupted in dyslexic children (van der Mark et al., 2009. Building on these studies, we here (1 investigate if a word-selective gradient exists in the inferior frontal cortex in addition to the occipito-temporal cortex in normally reading children, (2 compare typically reading with dyslexic children, and (3 examine functional connections between these regions in both groups. We replicated the previously reported anterior-to-posterior gradient of increasing selectivity for words in the left occipito-temporal cortex in typically reading children, and its absence in the dyslexic children. Our novel finding is the detection of a pattern of increasing selectivity for words along the medial-to-lateral axis of the left inferior frontal cortex in typically reading children and evidence of functional connectivity between the most lateral aspect of this area and the anterior aspects of the occipito-temporal cortex. We

  2. Inferior parietal lobule encodes visual temporal resolution processes contributing to the critical flicker frequency threshold in humans.

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    Andrea Nardella

    Full Text Available The measurement of the Critical Flicker Frequency threshold is used to study the visual temporal resolution in healthy subjects and in pathological conditions. To better understand the role played by different cortical areas in the Critical Flicker Frequency threshold perception we used continuous Theta Burst Stimulation (cTBS, an inhibitory plasticity-inducing protocol based on repetitive transcranial magnetic stimulation. The Critical Flicker Frequency threshold was measured in twelve healthy subjects before and after cTBS applied over different cortical areas in separate sessions. cTBS over the left inferior parietal lobule altered the Critical Flicker Frequency threshold, whereas cTBS over the left mediotemporal cortex, primary visual cortex and right inferior parietal lobule left the Critical Flicker Frequency threshold unchanged. No statistical difference was found when the red or blue lights were used. Our findings show that left inferior parietal lobule is causally involved in the conscious perception of Critical Flicker Frequency and that Critical Flicker Frequency threshold can be modulated by plasticity-inducing protocols.

  3. Inferior parietal lobule encodes visual temporal resolution processes contributing to the critical flicker frequency threshold in humans.

    Science.gov (United States)

    Nardella, Andrea; Rocchi, Lorenzo; Conte, Antonella; Bologna, Matteo; Suppa, Antonio; Berardelli, Alfredo

    2014-01-01

    The measurement of the Critical Flicker Frequency threshold is used to study the visual temporal resolution in healthy subjects and in pathological conditions. To better understand the role played by different cortical areas in the Critical Flicker Frequency threshold perception we used continuous Theta Burst Stimulation (cTBS), an inhibitory plasticity-inducing protocol based on repetitive transcranial magnetic stimulation. The Critical Flicker Frequency threshold was measured in twelve healthy subjects before and after cTBS applied over different cortical areas in separate sessions. cTBS over the left inferior parietal lobule altered the Critical Flicker Frequency threshold, whereas cTBS over the left mediotemporal cortex, primary visual cortex and right inferior parietal lobule left the Critical Flicker Frequency threshold unchanged. No statistical difference was found when the red or blue lights were used. Our findings show that left inferior parietal lobule is causally involved in the conscious perception of Critical Flicker Frequency and that Critical Flicker Frequency threshold can be modulated by plasticity-inducing protocols.

  4. A non-recurrent inferior laryngeal nerve in a man undergoing thyroidectomy: a case report

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    Sousa Daniel

    2010-11-01

    Full Text Available Abstract Introduction A non-recurrent variant of the inferior laryngeal nerve has been seldom reported. These reports are mostly based on cadaveric dissection studies or large chart review studies in which the emphasis is placed on the determination of the frequency of the variation, and not on the clinical appearance of this variant. We graphically describe the intraoperative identification of a non-recurrent inferior laryngeal nerve. Case Presentation A 44-year old Caucasian man was referred to the Head and Neck Surgery Outpatient Clinic with the diagnosis of a nodular mass in his left thyroid lobe that had been growing for one year. A fine needle aspiration puncture was compatible with thyroid papillary cancer. It was decided that the patient should undergo total thyroidectomy. During surgery, a non-recurrent right inferior laryngeal nerve was noted. This nerve emanated from the right vagus nerve, entering the larynx 3 cm after its origin. The nerve did not show a recurrent course. The nerve on the left side had a normal configuration. The surgery and post-operative period were uneventful, and the patient had no change in his voice. Conclusion This paper allows those interested to become acquainted with the normal intraoperative appearance of a non-recurrent inferior laryngeal nerve. This will undoubtedly be of significance for all of those performing invasive diagnostic and surgical procedures in the neck and upper thoracic regions, in order to minimize the risk of iatrogenic injury to this nerve. This is of extreme importance, since a unilateral lesion of this nerve may result in permanent hoarseness, and a bilateral lesion may lead to aphonia and life-threatening dyspnea.

  5. Inferior alveolar canal course: a radiographic study.

    Science.gov (United States)

    Liu, Tie; Xia, Bing; Gu, Zhiyuan

    2009-11-01

    To describe the morphology and course of the inferior alveolar canal (IAC) as it appears in digital panoramic radiographs. Three hundred and eighty-six digital rotational panoramic radiographs (OPG) were studied using the Clinview Software (6.1.3.7 version, Instrumentarium). Among the 386 radiographs, 86 radiographs with 5-mm steel balls were used to calculate the magnification. The average magnification of radiographs in this study was 7.24+/-7.55%. The course of IAC as seen in the panoramic radiograph may be classified into four types: (1) linear curve, 12.75%, (2) spoon-shaped curve, 29.25%, (3) elliptic-arc curve, 48.5%, and (4) turning curve, 9.5%. On panoramic radiographs, the IAC appeared closest to the inferior border of the mandible in the region of the first molar. In relation to the teeth, on panoramic radiographs, the IAC appeared closest to the distal root tip of the third molar and furthest from the mesial root tip of the first molar. In the OPG, there are four types of IAC: linear, spoon shape, elliptic-arc, and turning curve. The data found in the study may be useful for dental implant, mandibule surgery, and dental anesthesia. The limitations of the panoramic radiograph in depicting the true three-dimensional (3D) morphology of the IAC are recognized, computed tomography (CT) and cone beam (CB)3D imaging being more precise.

  6. Connectivity between the superior colliculus and the amygdala in humans and macaque monkeys: virtual dissection with probabilistic DTI tractography

    Science.gov (United States)

    Koller, Kristin; Bultitude, Janet H.; Mullins, Paul; Ward, Robert; Mitchell, Anna S.; Bell, Andrew H.

    2015-01-01

    It has been suggested that some cortically blind patients can process the emotional valence of visual stimuli via a fast, subcortical pathway from the superior colliculus (SC) that reaches the amygdala via the pulvinar. We provide in vivo evidence for connectivity between the SC and the amygdala via the pulvinar in both humans and rhesus macaques. Probabilistic diffusion tensor imaging tractography revealed a streamlined path that passes dorsolaterally through the pulvinar before arcing rostrally to traverse above the temporal horn of the lateral ventricle and connect to the lateral amygdala. To obviate artifactual connectivity with crossing fibers of the stria terminalis, the stria was also dissected. The putative streamline between the SC and amygdala traverses above the temporal horn dorsal to the stria terminalis and is positioned medial to it in humans and lateral to it in monkeys. The topography of the streamline was examined in relation to lesion anatomy in five patients who had previously participated in behavioral experiments studying the processing of emotionally valenced visual stimuli. The pulvinar lesion interrupted the streamline in two patients who had exhibited contralesional processing deficits and spared the streamline in three patients who had no deficit. Although not definitive, this evidence supports the existence of a subcortical pathway linking the SC with the amygdala in primates. It also provides a necessary bridge between behavioral data obtained in future studies of neurological patients, and any forthcoming evidence from more invasive techniques, such as anatomical tracing studies and electrophysiological investigations only possible in nonhuman species. PMID:26224780

  7. [Leiomyosarcoma of the inferior vena cava. Case report and literature review].

    Science.gov (United States)

    López-Ruiz, José Antonio; Tallón-Aguilar, Luis; Marenco-de la Cuadra, Beatriz; López-Pérez, José; Oliva-Mompeán, Fernando; Padillo-Ruiz, Javier

    Large vessel sarcomas are rare tumours. Leiomyosarcoma of the inferior vena cava is the most common. About 300 cases have been reported in the literature. They tend to be large, and not develop metastasis. The prognosis of these tumours is poor. An 81 year-old woman who complained of pain in the right flank, with no other symptoms. Abdominal computed tomography showed a large retroperitoneal mass, which affected the inferior vena cava, with signs of thrombosis inside. It also encompassed the right renal vein and the right kidney. Excision of the tumour was performed in block, performing an autologous saphenous vein bypass between left the renal vein and proximal segment of inferior vena cava. Leiomyosarcomas of the inferior vena cava are classified according to their relationship with adjacent structures. The clinical signs and symptoms are generally non-specific. Diagnosis is made using computed tomography or magnetic resonance imaging, and biopsy of the retroperitoneal mass. Surgery is the only treatment capable of providing prolonged survival. The surgical management is determined by: the level of involvement, the extension, and the presence or absence of collateral veins. The role of adjuvant therapy is controversial. Inferior vena cava leiomyosarcomas remain a challenge for surgeons. At present, radical resection with negative margins, offers the highest survival rate. The best results are obtained with a multidisciplinary approach by experienced teams in the management of these tumours. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  9. Added clinical value of the inferior temporal EEG electrode chain.

    Science.gov (United States)

    Bach Justesen, Anders; Eskelund Johansen, Ann Berit; Martinussen, Noomi Ida; Wasserman, Danielle; Terney, Daniella; Meritam, Pirgit; Gardella, Elena; Beniczky, Sándor

    2018-01-01

    To investigate the diagnostic added value of supplementing the 10-20 EEG array with six electrodes in the inferior temporal chain. EEGs were recorded with 25 electrodes: 19 positions of the 10-20 system, and six additional electrodes in the inferior temporal chain (F9/10, T9/10, P9/10). Five-hundred consecutive standard and sleep EEG recordings were reviewed using the 10-20 array and the extended array. We identified the recordings with EEG abnormalities that had peak negativities at the inferior temporal electrodes, and those that only were visible at the inferior temporal electrodes. From the 286 abnormal recordings, the peak negativity was at the inferior temporal electrodes in 81 cases (28.3%) and only visible at the inferior temporal electrodes in eight cases (2.8%). In the sub-group of patients with temporal abnormalities (n = 134), these represented 59% (peak in the inferior chain) and 6% (only seen at the inferior chain). Adding six electrodes in the inferior temporal electrode chain to the 10-20 array improves the localization and identification of EEG abnormalities, especially those located in the temporal region. Our results suggest that inferior temporal electrodes should be added to the EEG array, to increase the diagnostic yield of the recordings. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  10. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  11. Total laparoscopic retrieval of inferior vena cava filter.

    Science.gov (United States)

    Benrashid, Ehsan; Adkar, Shaunak Sanjay; Bennett, Kyla Megan; Zani, Sabino; Cox, Mitchell Wayne

    2015-01-01

    While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  12. Total laparoscopic retrieval of inferior vena cava filter

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    Ehsan Benrashid

    2015-08-01

    Full Text Available While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  13. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Science.gov (United States)

    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients' ages were 78, 62, 65, and 76. All patients' reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons. PMID:25883820

  14. Rare Inferior Shoulder Dislocation (Luxatio Erecta

    Directory of Open Access Journals (Sweden)

    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  15. Obstruction of the hepatic portion of the inferior vena cava

    International Nuclear Information System (INIS)

    Kim, Jong Deok; Choi, Han Chin

    1985-01-01

    Five patients with obstruction of the hepatic portion of the inferior vena cava diagnosed by digital subtraction inferior vena cavography were reported. All of these patients, aged from 38 to 52, were female who had never used the oral contraceptives. Main collateral pathway of these patients was the central channels through ascending lumbar veins, internal and external vertebral plexuses, azygos-hemiazygos complex, and inferior vena cava itself above the obstructed segment

  16. Leiomyosarcoma of the inferior vena cava: A case report

    International Nuclear Information System (INIS)

    Kim, Yong Soo; Kim, Jong Sung; Koh, Byung Hee; Seo, Heung Suk; Cho, On Koo

    1993-01-01

    A 29 year old woman with unresectable Leiomyosarcoma of the inferior vena cava extending into the right atrium of the heart was presented. The upper and middle inferior vena cava was involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided tumor biopsy. The clinical and radiological presenting features were reviewed

  17. Subcomponents and connectivity of the inferior fronto-occipital fasciculus revealed by diffusion spectrum imaging fiber tracking

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    Yupeng Wu

    2016-09-01

    Full Text Available The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF are still controversial. In this study, we aimed to investigate the connectivity, asymmetry and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI analysis was performed on ten healthy adults and a 90-subject DSI template (NTU-90 Atlas. In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous standard definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient

  18. Congenital Vitelline Band Causing Intestinal Obstruction in an Adult with a Double Inferior Vena Cava

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    Mihiri Wettasinghe

    2016-01-01

    Full Text Available Introduction. Vitelline artery remnants are rare causes of intra-abdominal bands leading to bowel obstruction. These bands may be associated with Meckel’s diverticulum. Double inferior vena cava (IVC is a rare presentation and is usually identified incidentally. Case Presentation. A sixty-year-old male presented with progressive vomiting for five days and he was clinically diagnosed with intestinal obstruction. Plain X-ray abdomen showed evidence of small bowel obstruction. CT scan of the abdomen revealed dilated small bowel loops with a small outpouching in the distal ileum with a band like structure attached to it. In the CT, left sided patent IVC draining into the left renal vein was identified. Left external iliac vein was in continuity with the left IVC. Left internal iliac vein was draining into the right IVC. Exploratory laparotomy revealed a Meckel’s diverticulum with a band identified as the vitelline remnant attached to its apex and inserting at the anterior abdominal wall near the umbilicus. Discussion. Meckel’s diverticulum with vitelline bands, although rare, should be borne in mind in adult patients with intestinal obstruction. Identification of this anomaly can be difficult in imaging studies. Presence of double IVC should be mentioned in the imaging findings to prevent possible catastrophic complications during surgery.

  19. Percutaneous insertion of the inferior vena cava filter

    International Nuclear Information System (INIS)

    Huang Lianjun; Jiang Shiliang; Zhao Shihua; Yang Jianguo; Dai Ruping

    2000-01-01

    Objective: To evaluate the effect of inferior vena cava filter for prevention of pulmonary embolus (PE) formation. Methods: Twenty-eight cases of deep venous thrombosis (DVT) were treated with insertion of the inferior vena cava filter. Results: The filter was implanted into inferior vena cava below the rena vein. There were no severe complications occurred in the group. Twenty-seven cases were followed up to 2-34 months, and no migration of the filters were found. And no pulmonary embolism were revealed in fifteen cases without pulmonary thromboembolism. Conclusions: The inferior vena cava filter implantation is a safe and effective method to prevent pulmonary thromboembolism

  20. Diferenças de força dos membros inferiores por preferencia lateral em futebolistas Sub-17

    OpenAIRE

    Forte, Pedro Miguel Gomes; Morais, J.E.; Reis, A.; Barbosa, Tiago M.

    2016-01-01

    A força dos músculos ântero-posteriores dos membros inferiores direitos nos esquerdinos e ambidestros deve ser tanto quanto possível, desenvolvida de forma equilateral. Antero-posterior muscles strength in right limbs should be developed in a similar way with left ones, intending to reduces differences as much as possible. info:eu-repo/semantics/publishedVersion

  1. Enhanced visual responses in the superior colliculus in an animal model of attention-deficit hyperactivity disorder and their suppression by D-amphetamine.

    Science.gov (United States)

    Clements, K M; Devonshire, I M; Reynolds, J N J; Overton, P G

    2014-08-22

    Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by overactivity, impulsiveness and attentional problems, including an increase in distractibility. A structure that is intimately linked with distractibility is the superior colliculus (SC), a midbrain sensory structure which plays a particular role in the production of eye and head movements. Although others have proposed the involvement of such diverse elements as the frontal cortex and forebrain noradrenaline in ADHD, given the role of the colliculus in distractibility and the increased distractibility in ADHD, we have proposed that distractibility in ADHD arises due to collicular sensory hyper-responsiveness. To further investigate this possibility, we recorded the extracellular activity (multi-unit (MUA) and local field potential (LFP)) in the superficial visual layers of the SC in an animal model of ADHD, the New Zealand genetically hypertensive (GH) rat, in response to wholefield light flashes. The MUA and LFP peak amplitude and summed activity within a one-second time window post-stimulus were both significantly greater in GH rats than in Wistar controls, across the full range of stimulus intensities. Given that baseline firing rate did not differ between the strains, this suggests that the signal-to-noise ratio is elevated in GH animals. D-Amphetamine reduced the peak amplitude and summed activity of the multi-unit response in Wistar animals. It also reduced the peak amplitude and summed activity of the multi-unit response in GH animals, at higher doses bringing it down to levels that were equivalent to those of Wistar animals at baseline. The present results provide convergent evidence that a collicular dysfunction (sensory hyper-responsiveness) is present in ADHD, and that it may underlie the enhanced distractibility. In addition, D-amphetamine - a widely used treatment in ADHD - may have one of its loci of therapeutic action at the level of the

  2. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  3. The influence of anatomic variance in the coronary artery on cardiac function with PCI after acute inferior wall myocardial infarction

    International Nuclear Information System (INIS)

    Zheng Hongming; Feng Jue; Fang Fengning; Wu Heping; Wang Fengqin; Ma Huili

    2006-01-01

    Objective: To analyze the influence in anatomic variance of coronary artery on function of left and right ventricles after acute inferior myocardial infarction (AIMI) treated with percutaneous coronary intervention therapy (PCI). Methods: Forty-seven inferior AIMI patients were divided into 2 groups: 12 left dominant group [including equipollent case, i.e. inferior wall of left ventricle supplied by left circumflex coronary artery (LCX), right ventricle by right coronary artery (RCA)] and 35 right dominant group (both inferior wall and right ventricle were supplied by RCA). Equilibrium radionuclide angiocardiography (ERNA) and myocardial perfusion imaging (MPI) were used for comparing the influence between different coronary artery flow patterns on biventricular hemodynamics, blood supply and prognosis of PCI after 3 months. Results: Comparison of ventricular function in left and right dominant coronal artery type groups discharged 7- 10 d after PCI, there were differences in left ventricular ejection fraction (LVEF) [(63.03 ± 5.64)% vs (57.67 ± 7.35)%, P=0.012], peak ejection rate (PER) [(3.52 ± 0.66) end-diastolic volume (EDV)/s vs (2.93 ± 0.73) EDV/s, P =0.011], peak filling rate (PFR) [(2.71 ± 0.88) EDV/s vs (2.11 ± 0.45 ) EDV/s, P=0.004], left free-wall regional ejection fraction [(81.94 ± 20.75)% vs (67.25 ± 16.54)%, P = O.032], and right free-wall regional ejection fraction [(57.86 ± 11.77)% vs (67.83 ± 10.38)%, P=0.012], right ventricular ejection fraction (RVEF) [(37.89 ± 3.86)% vs (41.67 ± 4.81)%, P=0.09]. After 3 months,there was difference only in RVEF [(44.60 ± 5.29)% vs (48.00 ± 3.30)%, P=0.043], but no difference in myocardial perfusion of left ventricle (P=0.357). Conclusions: In acute stage of AIMI right dominant group, there was more severe injury of right ventricle, in convalescent stage most of the right ventricular function resumed. The sustained right ventricular function in part of the patients can be demonstrated by ERNA

  4. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

    OpenAIRE

    Prakash B Billakanti

    2016-01-01

    La fosa infratemporal es un área anatómica clínicamente importante para la administración de agentes anestésicos locales en odontología y cirugía maxilofacial. Fueron estudiadas variaciones en la anatomía del nervio alveolar inferior y la arteria maxilar en la disección infratemporal. Durante la disección rutinaria de la cabeza en el cadáver de un varón adulto, fue observada una variación excepcional en el origen del nervio alveolar inferior y su relación con las estructuras circundantes. El ...

  5. Relação entre terceiros molares inferiores e nervo alveolar inferior (NAI)

    OpenAIRE

    Vidigal, Victor Laviola

    2017-01-01

    Exodontias de terceiros molares são procedimentos comuns realizados por médicos dentistas, e apesar de rotineiro podem causar transtornos ou complicações trans e/ou pós operatórias. Vários fatores estão ligados às possíveis complicações, como idade e o grau de impactação do dente, em casos de terceiros molares inferiores, a sua íntima relação com o nervo alveolar inferior. Existem exames imaginológicos como radiografias e tomografias computadorizadas que podem ser utilizadas no pré-operatório...

  6. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. LA PERFORACION DEL NERVIO ALVEOLAR INFERIOR POR LA ARTERIA MAXILAR

    OpenAIRE

    Vanishree S Nayak; Ramachandra Bhat K; Prakash Billakanti Babu

    2011-01-01

    Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originate...

  7. Superficial and deep vein thrombosis associated with congenital absence of the infrahepatic inferior vena cava in a young male patient.

    Science.gov (United States)

    O'Connor, Donal B; O'Brien, Noel; Khani, Tahir; Sheehan, Stephen

    2011-07-01

    Congenital absence of the inferior vena cava (AIVC) is a rare vascular anomaly that may be associated with deep vein thrombosis (DVT). It is underreported and may be present in up to 5% of young patients with DVT. We report a unique case of simultaneous thrombosis of both superficial and deep veins in a patient with AIVC. A 20-year-old man presented with a 2-week history of a swollen, painful, left lower limb. On examination, the left leg and thigh were found to be swollen and varicosities were present along the lower abdominal wall. Ultrasound showed extensive superficial and deep venous thrombosis of the entire left lower limb. Computed tomography venogram revealed an infrahepatic AIVC with lower limb drainage through enlarged intrathoracic continuations of the azygous and hemiazygous veins. The patient was put on oral anticoagulant therapy and was well at 6-month follow-up. The hypothesis for DVT in patients with AIVC is that venous drainage of the lower limbs is inadequate, leading to venous stasis and thrombosis. All young patients presenting with idiopathic DVT should be investigated for inferior vena cava anomalies with computed tomography if ultrasound does not visualize the inferior vena cava. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  8. Segregated anatomical input to sub-regions of the rodent superior colliculus associated with approach and defense

    Directory of Open Access Journals (Sweden)

    Eliane eComoli

    2012-04-01

    Full Text Available The superior colliculus (SC is responsible for sensorimotor transformations required to direct gaze towards or away from unexpected, biologically salient events. Significant changes in external world are signalled to SC through primary multisensory afferents, spatially organised according to a retinotopic topography. For animals, where an unexpected event could indicate the presence of either predator or prey, early decisions to approach or avoid are particularly important. Rodents' ecology dictates predators are most often detected initially as movements in upper visual field (mapped in medial SC, while appetitive stimuli are normally found in lower visual field (mapped in lateral SC. Our purpose was to exploit this functional segregation to reveal neural sites that can bias or modulate initial approach or avoidance responses. Small injections of Fluoro-Gold were made into medial or lateral sub-regions of intermediate and deep layers of SC (SCm/SCl. A remarkable segregation of input to these two functionally defined areas was found. (i There were structures that projected only to SCm (e.g. specific cortical areas, lateral geniculate and suprageniculate thalamic nuclei, ventromedial and premammillary hypothalamic nuclei and several brainstem areas or SCl (e.g. primary somatosensory cortex representing upper body parts and vibrissae and parvicellular reticular nucleus in the brainstem. (ii Other structures projected to both SCm and SCl but from topographically segregated populations of neurones (e.g. zona incerta and substantia nigra pars reticulata. (iii There were a few brainstem areas in which retrogradely labeled neurons were spatially overlapping (e.g. pedunculopontine nucleus and locus coreuleus. These results indicate significantly more structures across the rat neuraxis are in a position to modulate defense responses evoked from SCm, and that neural mechanisms modulating SC-mediated defense or appetitive behaviour are almost entirely

  9. Localization of choline acetyltransferase and tyrosine hydroxylase immunoreactivities in the superior colliculus of the microbat,Rhinolophus ferrumequinum.

    Science.gov (United States)

    Jeong, Se-Jin; Jeon, Chang-Jin

    2017-06-01

    The purpose of this study was to determine whether the superior colliculus (SC) of the microbat has the same neurochemical makeup as that of other mammals. We examined the organization of choline acetyltransferase (ChAT)- and tyrosine hydroxylase-immunoreactive (TH-IR) fibers/cells using standard immunohistochemistry with antibodies against ChAT and TH. ChAT-IR fibers observed in the superficial layers were denser than those in the deeper layers, and these fibers were classified into two types: small varicose fibers and large varicose fibers. ChAT-IR cells were predominantly located in the superficial layers with diverse morphologies. Among the well-known sources of cholinergic fibers in the mammalian SC, pedunculopontine tegmental nucleus (PPTN) and laterodorsal tegmental nucleus (LDTN) contained strongly labeled ChAT-IR cells, while no cholinergic structures were found in the parabigeminal nucleus (PBG) in the microbat brain. TH-immunoreactivity was found within fibers but not within cells. The density of TH-IR fibers was high in the zonal layer, moderate in the superficial gray and optic layers, and low in the deeper layers. Well-labeled TH-IR cells were also observed within area 13 and the locus coeruleus, known as the sources of catecholaminergic fibers in other mammalian SC. Although there are some cytoarchitectural variations among species, our results clearly showed elaborately organized ChAT-IR and TH-IR fibers/cells in the microbat SC. Our findings will contribute significantly to the understanding of actively constructed microbat visual systems.

  10. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

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    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  11. Development of Right-hemispheric Dominance of Inferior Parietal Lobule in Proprioceptive Illusion Task.

    Science.gov (United States)

    Naito, Eiichi; Morita, Tomoyo; Saito, Daisuke N; Ban, Midori; Shimada, Koji; Okamoto, Yuko; Kosaka, Hirotaka; Okazawa, Hidehiko; Asada, Minoru

    2017-11-01

    Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8-11 years), adolescents (12-15 years), and young adults (18-23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing. © The Author 2017. Published by Oxford University Press.

  12. Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins

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    Wang Quan

    2012-06-01

    Full Text Available Abstract Leiomyosarcoma of the inferior vena cava (IVCL is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.

  13. Inferior Prefrontal Cortex Mediates the Relationship between Phosphatidylcholine and Executive Functions in Healthy, Older Adults.

    Science.gov (United States)

    Zamroziewicz, Marta K; Zwilling, Chris E; Barbey, Aron K

    2016-01-01

    Objectives: This study examines the neural mechanisms that mediate the relationship between phosphatidylcholine and executive functions in cognitively intact older adults. We hypothesized that higher plasma levels of phosphatidylcholine are associated with better performance on a particular component of the executive functions, namely cognitive flexibility, and that this relationship is mediated by gray matter structure of regions within the prefrontal cortex (PFC) that have been implicated in cognitive flexibility. Methods: We examined 72 cognitively intact adults between the ages of 65 and 75 in an observational, cross-sectional study to investigate the relationship between blood biomarkers of phosphatidylcholine, tests of cognitive flexibility (measured by the Delis-Kaplan Executive Function System Trail Making Test), and gray matter structure of regions within the PFC. A three-step mediation analysis was implemented using multivariate linear regressions and we controlled for age, sex, education, income, depression status, and body mass index. Results: The mediation analysis revealed that gray matter thickness of one region within the PFC, the left inferior PFC (Brodmann's Area 45), mediates the relationship between phosphatidylcholine blood biomarkers and cognitive flexibility. Conclusion: These results suggest that particular nutrients may slow or prevent age-related cognitive decline by influencing specific structures within the brain. This report demonstrates a novel structural mediation between plasma phosphatidylcholine levels and cognitive flexibility. Future work should examine the potential mechanisms underlying this mediation, including phosphatidylcholine-dependent cell membrane integrity of the inferior PFC and phosphatidylcholine-dependent cholinergic projections to the inferior PFC.

  14. Retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart and causing inferior vena cava dissection

    International Nuclear Information System (INIS)

    Sung, Yon Mi; Choe, Yeon Hyeon; Park, Seung Woo; Park, Pyo Won; Sung, Chang Ohk

    2005-01-01

    We present a case of retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart, which was associated with dissection of the inferior vena cava in a 32-year-old female. Computed tomography and magnetic resonance imaging showed a double-lumen inferior vena cava and a rod-like solid component attached to a sac-like lesion in the right heart chambers. Digital subtraction angiography showed an arteriovenous malformation draining to the inner lumen of the inferior vena cava. (orig.)

  15. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  16. Clinico-anatomical correlations of left posterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

    1988-01-01

    The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.)

  17. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  18. Left atrio-vertebral ratio: A new computed-tomography measurement to identify left atrial dilation.

    Science.gov (United States)

    Baque-Juston, Marie; Volondat, Manuelle; Fontas, Eric; Roger, Coralie; Brunner, Philippe; Padovani, Bernard; Chevallier, Patrick

    2016-01-01

    Left cardiac chambers dilation, interstitial lung changes and pleural effusions are the characteristics of cardiogenic pulmonary oedema on computed tomography (CT) of the chest but mensuration of the left atrial size is not routinely performed. Cardiac chambers normal dimensions are known to be proportional to the patient's build and anthropomorphic data but adjustment of chambers dimensions to available elements seen on the axial CT images has never been evaluated before. Our objective was to use data easily available on axial images to directly scale the left atrium. We chose to divide the left atrial diameter by the thoracic vertebral diameter, using the latter as a body-mass indicator. As a preliminary study, we aimed to evaluate the range of values of this left atrio-vertebral ratio (LAVR) by comparing patients suffering from cardiogenic pulmonary oedema with patients free of cardiac disease. We hypothesized that if the difference of values in these two populations of patients was significant enough, this ratio would be relevant and could be used as a quick criterion in different clinical situations. Two radiologists reviewed CT scans of 32 of patients free of cardiac disease and 40 patients in acute cardiac failure. The maximum diameter of the left atrium at the level of the right inferior pulmonary vein was divided by the vertebral transverse diameter to generate a left atrio-vertebral ratio. Receiver operating characteristic curves identified the threshold associated with pulmonary oedema. The mean LAVR was 1.85 ± 0.27 in asymptomatic patients and 2.48 ± 0.35 in patients with pulmonary oedema. A LAVR of 2.1 yielded 85% sensitivity and 88% specificity for the diagnosis of cardiogenic pulmonary oedema. LAVR is a simple new measure directly scaling the left atrial diameter to the anthropomorphic characteristics of the patient. In our series, a ratio above 2.1 is strongly associated with cardiogenic pulmonary oedema indirectly suggesting left atrial dilation

  19. Effects of single-sided inferior turbinectomy on nasal function and airflow characteristics.

    Science.gov (United States)

    Na, Yang; Chung, Kang Soo; Chung, Seung-Kyu; Kim, Sung Kyun

    2012-03-15

    Knowledge of airflow characteristics in the nasal cavity is essential to understanding the physiologic and pathologic aspects of nasal breathing. Airflows inside post-surgery models were investigated both experimentally and numerically to simulate the inferior turbinectomy. The left cavities of all three models are normal and right cavity is modified by (1) excision of the head of the inferior turbinate, (2) resection of the lower fifth of the inferior turbinate, and (3) resection of almost the entire inferior turbinate. Thin-slice CT (computed tomography) data (0.6mm deep) and meticulous refinement of the model surface by over a decade-long collaboration between engineers and an experienced ENT doctor resulted in the creation of sophisticated nasal cavity models. After numerical experiments and validation by comparison with the PIV results, the CFD code using the Reynolds stress turbulent model and variable temperature boundary condition on the mucosal wall was chosen as the proper numerical framework. Both global quantities (pressure drop, flow rate ratio, total wall heat transfer) and local changes (velocity, temperature, humidity, pressure gradient, and wall shear stress) were numerically investigated. The turbinectomy obviously altered the main stream direction. The flow rate in the upper airway near the olfactory slit decreased in models (1) and (3). This may weaken the olfactory function of the nose. Fluid and thermal properties that are believed to be related with physiology and prognosis are dependent on turbinate resection volume, position, and manner. Widening of the inferior airway does not always result in decreased flow resistance or wall heat transfer. The gains and losses of inferior turbinectomy were considered by analysis of the post-surgery model results. Nasal resistance was increased in model (1) due to sudden airway expansion. Nasal resistance increased and the wall heat transfer decreased in model (3) due to sudden airway expansion and

  20. Clinical characteristics of inferior vestibular neuritis.

    Science.gov (United States)

    Chihara, Yasuhiro; Iwasaki, Shinichi; Murofushi, Toshihisa; Yagi, Masato; Inoue, Aki; Fujimoto, Chisato; Egami, Naoya; Ushio, Munetaka; Karino, Shotaro; Sugasawa, Keiko; Yamasoba, Tatsuya

    2012-12-01

    Inferior vestibular neuritis (IVN) is a relatively minor subtype of vestibular neuritis (VN) and its clinical characteristics are unique. To clarify clinical characteristics of IVN in comparison with conventional VN. This was a retrospective case series review. Caloric responses and cervical vestibular evoked myogenic potential (cVEMP) responses were measured in 71 patients with VN. The patients were classified into three groups: (1) IVN group, who showed only asymmetrical cVEMP responses; (2) superior VN (SVN) group, who showed only asymmetrical caloric responses; (3) total VN (TVN) group, who showed asymmetrical responses in both tests. The clinical records of time course of subjective symptoms (duration of attack, duration of hospitalization, and time to remission) were reviewed and other profiles (age, sex, affected side, acute symptoms, and sequelae) were evaluated. Of the 71 patients with VN, 13 (18%) were classified as having IVN. The mean age and time to remission of patients with IVN (44.2 ± 4.8 years, 0.9 ± 0.5 months) were significantly lower and shorter, respectively, than those of patients with TVN (57.3 ± 2.5 years, 4.9 ± 4.7 months). There were no significant differences in other symptoms and profiles among the three groups. No patients with IVN showed benign paroxysmal positional vertigo as a sequela.

  1. 'Pseudothrombus' of the inferior vena cava

    International Nuclear Information System (INIS)

    Takebayashi, Shigeo; Odagiri, Kunio; Matsui, Kengo; Hayano, Ikuo.

    1983-01-01

    Normal Inferior Vena Cava (IVC) of 15 cases were studies on CT with bolus injection in the foot vein.FWell dilated IVC were obtained on scan both at full-inspiration and full-expiration. As the normal findings of IVC, different opacification patterns which may be designate ''homogenous'', ''layered'' and ''pseudothrombus'' were obtained. The ''homogenous'' opacification was noted both at full-inspiration and full-expiration. In homogenous patterns as noted as ''layered'' and ''pseudothrombus'' were suspected to occur in the case of insufficient mixing of contrast agent with blood and/or insufficient amount of contrast agent. And both these patterns were observed in dilated IVC. The ''layered'' opacified IVC was shown on scan at full-inspiration at which respiratory phase the blood flow in IVC may decrease.FThe ''pseudothrombus'' pattern was generally noted at full-expiration at which the blood flow may increase.FAlthough bolus injection of contrast agent into foot vein is useful for evaluation of IVC, one shound be aware of normal opacification of IVC including ''pseudothrombus'' pattern. (author)

  2. Ultrasound evaluation of the inferior epigastric artery.

    Science.gov (United States)

    Petrossian, E; Menegus, M A; Issenberg, H J; Jones, A; Frame, R; Brodman, R F

    1994-04-01

    Color-flow Doppler ultrasound was used to assess the anatomic characteristics of the inferior epigastric artery (IEA) bilaterally in 20 nonatherosclerotic (group I; mean age, 28 years) and 20 atherosclerotic (group II; mean age, 57 years) subjects. Forty-nine percent of the IEAs were located laterally within the rectus sheath with 34% in a mid and 17% in a medial location. Seventeen percent had a large branch within 5 cm of the origin. Average length of the IEA was 10.7 +/- 3.2 cm. Average proximal and distal internal diameters were 3.0 +/- 0.45 and 1.9 +/- 0.35 mm, respectively. Neither length nor vessel diameter showed any correlation with age or body surface area. Sixty-two percent of the IEAs were greater than or equal to 9 cm in length and 1.5 mm in distal diameter. Stenosis of the vessel (more than 50% diameter) was noted at the proximal 1 cm segment in 20% of the IEAs in the atherosclerotic group but none of the IEAs in the nonatherosclerotic group. Beyond this proximal segment, there was freedom from atherosclerotic stenosis as demonstrated by the IEAs' similarity of length and diameter irrespective of age in these atherosclerotic and nonatherosclerotic populations.

  3. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)

    2015-06-15

    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  4. The clinical application of inferior vena caval CO2-DSA

    International Nuclear Information System (INIS)

    Guo Jinhe; Teng Gaojun; Zhu Guangyu; Li Guozhao; Fang Wen; He Shicheng; Deng Tang

    2007-01-01

    Objective: To explore the feasibility and safety of inferior vena caval CO 2 -DSA and evaluate the results of inferior vena cavography using CO 2 -DSA or iodinated contrast media. Methods: 25 patients diagnosed as deep venous thrombosis of lower limb were prepared to conceive the implantation of inferior vena caval filter. The inferior vena cava and right renal vein CO 2 -DSA and iodinated contrast media DSA were carried out through jugular or femoral vein approach in all patients. Results: The inferior vena caval angiography with CO 2 -DSA or iodinated contrast media were carried out successfully in all patients. The quality of the inferior vena caval angiogram showed: with CO 2 as contrast media, 14 cases obtained excellent images and 11 cases had good images; with iodinated contrast media the images of 18 cases were excellent and 7 cases were good. No thrombus and variation of inferior vena cava were found by the two kinds of angiography. The diameter of inferior vena cava showed: (20.01 ± 0.83) mm with CO 2 contrast media and (20.15 ± 0.92) mm with iodinated contrast media, (P=0.006); having statistical significance between them. The safety of angiography with CO 2 presented only 1 case with transient slight decrease of O 2 saturation. No abnormal changes were found in blood pressure, heart rate and so on. Conclusions: Inferior vena caval CO 2 -DSA is feasible and safe, with statistical significance in the measurement of inferior vena caval diameter comparing with iodinated contrast material but with no influence on the implantation of filter. (authors)

  5. Where is the exact origin of narrow premature ventricular contractions manifesting qR in inferior wall leads?

    Science.gov (United States)

    Zheng, Cheng; Li, Jin; Lin, Jia-Xuan; Wang, Lu-Ping; Lin, Jia-Feng

    2016-04-04

    In recent years, radiofrequency catheter ablation(RFCA) has been established as an effective therapy for idiopathic premature ventricular contractions (PVCs), however, its effect on the narrow PVCs (QRS duration qR pattern in inferior leads, may not been fully concluded. Characteristics of 12-lead electrocardiogram (ECG) and electrophysiologic recordings were analyzed in 40 patients with symptomatic PVCs manifesting narrow QRS complex with qR pattern in inferior leads. The procedure of RFCA was performed based on pace mapping and activation mapping. Among the 40 patients with narrow PVCs, complete elimination of PVCs was achieved by RFCA in 35 patients during a median follow-up period of 23 months. Successful ablation was achieved on 19 patients at the sites where earliest Purkinje potentials were recorded in left ventricular anterosuperior septum, thus PVCs arising from left anterior fascicle (LAF) were confirmed, for these PVCs, the QRS morphology were right bundle branch and left posterior fascicle block (RBBB + LPFB) with rightward axis, the average QRS duration 116.07 ± 7.96 ms, R or rsR'in lead V1,with transition zone ahead of lead V1 in precordial leads. Another 16 successful RFCA were achieved by energy delivery at interleaflet triangle(ILT) between right coronary cusp(RCC) and left coronary cusp(LCC) where no Purkinje potentials were recorded, for narrow PVCs arising from the L-RCC ILT, the QRS morphology were similar to the PVCs arising from LAF but much narrower in QRS duration (100.44 ± 3.49 vs. 116.07 ± 7.96 ms, p qR pattern in inferior leads can be cured by the procedure of RFCA. On the basis of our study, we proposed that for narrow PVCs presenting qR pattern in inferior leads, when the ablation procedure failed at proximity of LAF within left anterosuperior septum, mapping and ablation in L-RCC ILT can be tried. The present findings can be helpful for planning catheter ablation for narrow PVCs manifesting qR in inferior leads.

  6. Aneurisma da artéria cerebelar ântero-inferior: relato de caso Aneurysm of the anterior inferior cerebellar artery: case report

    Directory of Open Access Journals (Sweden)

    Juan Oscar Alarcón Adorno

    2002-12-01

    Full Text Available Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA are considered rare, can cause cerebello pontine angle (CPA syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  7. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  8. Deep Vein Thrombosis of the Left Leg: A Case of May-Thurner Syndrome

    Directory of Open Access Journals (Sweden)

    Jiten Desai

    2018-02-01

    Full Text Available A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May–Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization.

  9. The allocentric neglect due to injury of the inferior fronto-occipital fasciculus in a stroke patient: A case report.

    Science.gov (United States)

    Jang, Sung Ho; Jang, Woo Hyuk

    2018-01-01

    We report on a patient who developed allocentric neglect due to injury of the inferior fronto-occipital fasciculus (IFOF) following intracranial hemorrhage, diagnosed using diffusion tensor tractography (DTT). Her cognition seemed normal (A 17-year-old, right-handed female patient). However, in spite of a normal visual field, her perception was missing on the left side, and she had no awareness of her deficit. She was unable to perceive the left side in each of 2 objects, regardless of position of the 2 objects, and failed at detail exploration of the left side of 1 object. In addition, the line bisection test, the most representative neglect test, did not reveal any abnormality. She was diagnosed with an intracerebral hemorrhage (right thalamus), intraventricular hemorrhage, and subarachnoid hemorrhage due to arteriovenous malformation in the right thalamus. Seven weeks after onset, she began rehabilitation. Consequently, the apple cancellation test to discriminate between allocentric and egocentric neglect was performed, with the result of severe allocentric neglect. The right superior longitudinal fasciculus and inferior longitudinal fasciculus were well-reconstructed without definite injury compared with those of the left side. However, the right IFOF was discontinued in the anterior portion around the frontal lobe. Allocentric neglect due to injury of IFOF was demonstrated in a stroke patient using DTT. It appears that DTT would be helpful in demonstrating the neglect type and pathway in patients with neglect. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  10. The Left Atrio-Vertebral Ratio: a new simple means for assessing left atrial enlargement on Computed Tomography.

    Science.gov (United States)

    Montillet, Marie; Baqué-Juston, Marie; Tasu, Jean-Pierre; Bertrand, Sandra; Berthier, Frédéric; Zarqane, Naïma; Brunner, Philippe

    2018-03-01

    The purpose of this study is to describe a new method to quickly estimate left atrial enlargement (LAE) on Computed Tomography. Left atrial (LA) volume was assessed with a 3D-threshold Hounsfield unit detection technique, including left atrial appendage and excluding pulmonary venous confluence, in 201 patients with ECG-gated 128-slice dual-source CT and indexed to body surface area. LA and vertebral axial diameter and area were measured at the bottom level of the right inferior pulmonary vein ostium. Ratio of LA diameter and surface on vertebra (LAVD and LAVA) were compared to LA volume. In accordance with the literature, a cutoff value of 78 ml/m 2 was chosen for maximal normal LA volume. 18% of LA was enlarged. The best cutoff values for LAE assessment were 2.5 for LAVD (AUC: 0.65; 95% CI: 0.58-0.73; sensitivity: 57%; specificity: 71%), and 3 for LAVA (AUC: 0.78; 95% CI: 0.72-0.84; sensitivity: 67%; specificity: 79%), with higher accuracy for LAVA (P=0.015). Inter-observer and intra-observer variability were either good or excellent for LAVD and LAVA (respective intraclass coefficients: 0.792 and 0.910; 0.912 and 0.937). A left atrium area superior to three times the vertebral area indicates LAE with high specificity. • Left atrial enlargement is a frequent condition associated with poor cardiac outcome. • Left atrial enlargement is highly time-consuming to diagnose on CT. • The left atrio-vertebral ratio quickly assesses left atrial enlargement. • A left atrial area > three times vertebral area is highly specific.

  11. Fibrous dysplasia of inferior turbinate, middle turbinate, and frontal sinus.

    Science.gov (United States)

    Ozcan, K M; Akdogan, O; Gedikli, Y; Ozcan, I; Dere, H; Unal, T

    2007-01-01

    Fibrous dysplasia (FD) is a non-neoplastic fibro-osseous lesion. Paranasal sinus involvement is infrequent. Involvement of the frontal sinus, sphenoid sinus, and middle turbinate is rare, and only sporadic cases have been reported in the literature. Nasal turbinates and especially the inferior turbinate are the least involved bones of the craniofacial region. To the best of our knowledge, only one case with McCune-Albright syndrome had FD of the inferior turbinate. Here, we report a rare case with FD of inferior and middle turbinates and review literature concerning FD of the craniofacial region.

  12. Isquemia aguda de miembros inferiores secundaria a ergortismo

    OpenAIRE

    Franco J. Vallejo, MD; Juan F. Gómez, MD; Natalia Tamayo, MD

    2011-01-01

    Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasod...

  13. MDCT of inferior mesenteric vein: normal anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Akpinar, E.; Turkbey, B. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Karcaaltincaba, M. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)], E-mail: musturayk@yahoo.com; Karaosmanoglu, D.; Akata, D. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    2008-07-15

    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.

  14. MDCT of inferior mesenteric vein: normal anatomy and pathology

    International Nuclear Information System (INIS)

    Akpinar, E.; Turkbey, B.; Karcaaltincaba, M.; Karaosmanoglu, D.; Akata, D.

    2008-01-01

    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images

  15. Development of rostral inferior parietal lobule area functional connectivity from late childhood to early adulthood.

    Science.gov (United States)

    Wang, Mengxing; Zhang, Jilei; Dong, Guangheng; Zhang, Hui; Lu, Haifeng; Du, Xiaoxia

    2017-06-01

    Although the mirror neuron system (MNS) has been extensively studied in monkeys and adult humans, very little is known about its development. Previous studies suggest that the MNS is present by infancy and that the brain and MNS-related cognitive abilities (such as language, empathy, and imitation learning) continue to develop after childhood. In humans, the PFt area of the inferior parietal lobule (IPL) seems to particularly correlate with the functional properties of the PF area in primates, which contains mirror neurons. However, little is known about the functional connectivity (FC) of the PFt area with other brain areas and whether these networks change over time. Here, we investigated the FC development of the PFt area-based network in 59 healthy subjects aged 7-26 years at resting-state to study brain development from late childhood through adolescence to early adulthood. The bilateral PFt showed similar core FC networks, which included the frontal lobe, the cingulate gyri, the insula, the somatosensory cortex, the precuneus, the superior and inferior parietal lobules, the temporal lobe, and the cerebellum posterior lobes. Furthermore, the FC between the left PFt and the left IPL exhibited a significantly positive correlation with age, and the FC between the left PFt and the right postcentral gyrus exhibited a significantly negative correlation with age. In addition, the FC between the right PFt and the right putamen exhibited a significantly negative correlation with age. Our findings suggest that the PFt area-based network develops and is reorganized with age. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

  16. Auditory attention enhances processing of positive and negative words in inferior and superior prefrontal cortex.

    Science.gov (United States)

    Wegrzyn, Martin; Herbert, Cornelia; Ethofer, Thomas; Flaisch, Tobias; Kissler, Johanna

    2017-11-01

    Visually presented emotional words are processed preferentially and effects of emotional content are similar to those of explicit attention deployment in that both amplify visual processing. However, auditory processing of emotional words is less well characterized and interactions between emotional content and task-induced attention have not been fully understood. Here, we investigate auditory processing of emotional words, focussing on how auditory attention to positive and negative words impacts their cerebral processing. A Functional magnetic resonance imaging (fMRI) study manipulating word valence and attention allocation was performed. Participants heard negative, positive and neutral words to which they either listened passively or attended by counting negative or positive words, respectively. Regardless of valence, active processing compared to passive listening increased activity in primary auditory cortex, left intraparietal sulcus, and right superior frontal gyrus (SFG). The attended valence elicited stronger activity in left inferior frontal gyrus (IFG) and left SFG, in line with these regions' role in semantic retrieval and evaluative processing. No evidence for valence-specific attentional modulation in auditory regions or distinct valence-specific regional activations (i.e., negative > positive or positive > negative) was obtained. Thus, allocation of auditory attention to positive and negative words can substantially increase their processing in higher-order language and evaluative brain areas without modulating early stages of auditory processing. Inferior and superior frontal brain structures mediate interactions between emotional content, attention, and working memory when prosodically neutral speech is processed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

    Full Text Available Left ventricular pseudo-aneurysm is a rare complication of aneurysmectomy. We present a case of surgically-treated left ventricular pseudo-aneurysm which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation and surgical repair are described. [Cukurova Med J 2013; 38(1.000: 123-125

  18. Validation of semi-automatic segmentation of the left atrium

    Science.gov (United States)

    Rettmann, M. E.; Holmes, D. R., III; Camp, J. J.; Packer, D. L.; Robb, R. A.

    2008-03-01

    Catheter ablation therapy has become increasingly popular for the treatment of left atrial fibrillation. The effect of this treatment on left atrial morphology, however, has not yet been completely quantified. Initial studies have indicated a decrease in left atrial size with a concomitant decrease in pulmonary vein diameter. In order to effectively study if catheter based therapies affect left atrial geometry, robust segmentations with minimal user interaction are required. In this work, we validate a method to semi-automatically segment the left atrium from computed-tomography scans. The first step of the technique utilizes seeded region growing to extract the entire blood pool including the four chambers of the heart, the pulmonary veins, aorta, superior vena cava, inferior vena cava, and other surrounding structures. Next, the left atrium and pulmonary veins are separated from the rest of the blood pool using an algorithm that searches for thin connections between user defined points in the volumetric data or on a surface rendering. Finally, pulmonary veins are separated from the left atrium using a three dimensional tracing tool. A single user segmented three datasets three times using both the semi-automatic technique as well as manual tracing. The user interaction time for the semi-automatic technique was approximately forty-five minutes per dataset and the manual tracing required between four and eight hours per dataset depending on the number of slices. A truth model was generated using a simple voting scheme on the repeated manual segmentations. A second user segmented each of the nine datasets using the semi-automatic technique only. Several metrics were computed to assess the agreement between the semi-automatic technique and the truth model including percent differences in left atrial volume, DICE overlap, and mean distance between the boundaries of the segmented left atria. Overall, the semi-automatic approach was demonstrated to be repeatable within

  19. A follow-up MRI study of the fusiform gyrus and middle and inferior temporal gyri in schizophrenia spectrum.

    Science.gov (United States)

    Takahashi, Tsutomu; Zhou, Shi-Yu; Nakamura, Kazue; Tanino, Ryoichiro; Furuichi, Atsushi; Kido, Mikio; Kawasaki, Yasuhiro; Noguchi, Kyo; Seto, Hikaru; Kurachi, Masayoshi; Suzuki, Michio

    2011-12-01

    While longitudinal magnetic resonance imaging (MRI) studies have demonstrated progressive gray matter reduction of the superior temporal gyrus (STG) during the early phases of schizophrenia, it remains largely unknown whether other temporal lobe structures also exhibit similar progressive changes and whether these changes, if present, are specific to schizophrenia among the spectrum disorders. In this longitudinal MRI study, the gray matter volumes of the fusiform, middle temporal, and inferior temporal gyri were measured at baseline and follow-up scans (mean inter-scan interval=2.7 years) in 18 patients with first-episode schizophrenia, 13 patients with schizotypal disorder, and 20 healthy controls. Both schizophrenia and schizotypal patients had a smaller fusiform gyrus than controls bilaterally at both time points, whereas no group difference was found in the middle and inferior temporal gyri. In the longitudinal comparison, the schizophrenia patients showed significant fusiform gyrus reduction (left, -2.6%/year; right, -2.3%/year) compared with schizotypal patients (left: -0.4%/year; right: -0.2%/year) and controls (left: 0.1%/year; right: 0.0%/year). However, the middle and inferior temporal gyri did not exhibit significant progressive gray matter change in all diagnostic groups. In the schizophrenia patients, a higher cumulative dose of antipsychotics during follow-up was significantly correlated with less severe gray matter reduction in the left fusiform gyrus. The annual gray matter loss of the fusiform gyrus did not correlate with that of the STG previously reported in the same subjects. Our findings suggest regional specificity of the progressive gray matter reduction in the temporal lobe structures, which might be specific to overt schizophrenia within the schizophrenia spectrum. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Collateral veins in left renal vein stenosis demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.; Talle, K.

    1983-01-01

    Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. (orig.)

  1. Frustrative reward omission increases aggressive behaviour of inferior fighters

    DEFF Research Database (Denmark)

    Vindas, Marco A.; Johansen, Ida B.; Vela-Avitua, Sergio

    2014-01-01

    Animals use aggressive behaviour to gain access to resources, and individuals adjust their behaviour relative to resource value and own resource holding potential (RHP). Normally, smaller individuals have inferior fighting abilities compared with larger conspecifics. Affective and cognitive proce...

  2. Collateral veins in inferior caval vein occlusion demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.

    1983-01-01

    CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathway are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava. (orig.)

  3. The effect of shoulder position on inferior glenohumeral mobilization.

    Science.gov (United States)

    Witt, Dexter W; Talbott, Nancy R

    2017-03-09

    Cross-sectional clinical measurement study. Inferior mobilizations are used to treat patients with shoulder dysfunctions. Common positions recommended for promoting an inferior glide include: (1) an open-packed position (OPP) in which the shoulder is in 55° of abduction, 30° of horizontal adduction, and no rotation; (2) neutral position (NP) of the shoulder; and (3) position of 90° of shoulder abduction (ABDP). Studies comparing the impact of position on inferior mobilization are lacking. To determine the effect of shoulder position on humeral movement and mobilization force during inferior mobilizations. Twenty-three subjects were tested bilaterally. Subjects were placed in the OPP, and an ultrasound transducer placed over the superior glenohumeral joint. As inferior mobilization forces were applied through a dynamometer, ultrasound images were taken at rest and during 3 grades of inferior mobilization. This process was repeated in the NP and the ABDP. In the NP, movements during grade 1, 2, and 3 mobilizations were 1.8, 3.8, and 4.5 mm, respectively. Movements measured in the OPP (1.0, 2.4, and 3.6 mm, respectively) and in the ABDP (1.0, 2.2, and 2.3 mm, respectively) were less. Forces were higher in the NP during grade 1, 2, and 3 mobilizations (51.8, 138.7, and 202.1 N, respectively) than in the OPP (37.2, 91.2, and 139.9 N, respectively) and the ABPD (42.5, 115.3, and 165.5 N, respectively). Mobilization position altered the movement and force during inferior mobilizations. Shoulder position should be considered when utilizing inferior mobilizations. NA. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  4. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... critics, and not least by feminists. The aim of this paper is to point out the position Freud took toward his patient. Dora stands out as the one case among Freud’s 5 great case stories that has a female protagonist, and reading the case it becomes clear that Freud stumbled because of an unresolved...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  5. Role of the right inferior parietal cortex in auditory selective attention: An rTMS study.

    Science.gov (United States)

    Bareham, Corinne A; Georgieva, Stanimira D; Kamke, Marc R; Lloyd, David; Bekinschtein, Tristan A; Mattingley, Jason B

    2018-02-01

    Selective attention is the process of directing limited capacity resources to behaviourally relevant stimuli while ignoring competing stimuli that are currently irrelevant. Studies in healthy human participants and in individuals with focal brain lesions have suggested that the right parietal cortex is crucial for resolving competition for attention. Following right-hemisphere damage, for example, patients may have difficulty reporting a brief, left-sided stimulus if it occurs with a competitor on the right, even though the same left stimulus is reported normally when it occurs alone. Such "extinction" of contralesional stimuli has been documented for all the major sense modalities, but it remains unclear whether its occurrence reflects involvement of one or more specific subregions of the temporo-parietal cortex. Here we employed repetitive transcranial magnetic stimulation (rTMS) over the right hemisphere to examine the effect of disruption of two candidate regions - the supramarginal gyrus (SMG) and the superior temporal gyrus (STG) - on auditory selective attention. Eighteen neurologically normal, right-handed participants performed an auditory task, in which they had to detect target digits presented within simultaneous dichotic streams of spoken distractor letters in the left and right channels, both before and after 20 min of 1 Hz rTMS over the SMG, STG or a somatosensory control site (S1). Across blocks, participants were asked to report on auditory streams in the left, right, or both channels, which yielded focused and divided attention conditions. Performance was unchanged for the two focused attention conditions, regardless of stimulation site, but was selectively impaired for contralateral left-sided targets in the divided attention condition following stimulation of the right SMG, but not the STG or S1. Our findings suggest a causal role for the right inferior parietal cortex in auditory selective attention. Copyright © 2017 Elsevier Ltd. All rights

  6. Pelvic Venous Variations in Patients with Congenital Inferior Vena Cava Anomalies: Classification with Computed Tomography

    International Nuclear Information System (INIS)

    Morita, S.; Higuchi, M.; Saito, N.; Mitsuhashi, N.

    2007-01-01

    Background: Pelvic venous variations of congenital inferior vena cava (IVC) anomalies that have the potential to cause problems during related surgery and interventional radiology are not fully appreciated. Purpose: To classify pelvic venous variations of congenital IVC anomalies using computed tomography (CT). Material and Methods: CT images for 36 patients with congenital IVC anomalies were retrospectively reviewed. Pelvic venous variations were classified with regard to the relationship with the iliac veins and the presence of interiliac communication. Results: Pelvic venous variations were classified into eight types. One azygous continuation displayed normal connection with the bilateral common iliac veins (CIV) (type 1). Of 28 double IVCs, 11 (39.3%) displayed no interiliac communication (type 2a), five (17.9%) displayed interiliac communication from the left CIV (type 2b), one (3.6%) had communication from the right CIV (type 2c), six (21.4%) had communication from the left internal iliac vein (IIV) (type 2d), and five (17.9%) had communication from the right IIV (type 2e). Six left IVCs displayed symmetrical-to-normal connection with the bilateral CIV (type 3). One absence of infrarenal IVC displayed no connection with the CIV (type 4). Conclusion: Eight types of pelvic venous variations of congenital IVC anomalies were classified using CT

  7. Unusual Presentation of Testicular Cancer with Tumor Thrombus Extending to the Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Marie Dusaud

    2015-01-01

    Full Text Available A 45-year-old man with a left testis tumor with a 25 mm para-aortic lymph node swelling, multiple bilateral pulmonary metastases, bilateral pulmonary embolism, and inferior vena cava (IVC thrombus underwent a radical orchidectomy in our institution. The thrombus extended from the left gonadal vein to the left renal vein to the IVC. The fluorine-18 fluorodeoxyglucose (f-FDG positron emission tomography (PET computerized tomography (CT demonstrated a hypermetabolic focus in the retroperitoneum and in the IVC thrombus. Before orchidectomy only lactate dehydrogenase (LDH was high but all the serum tumor markers increased postoperatively. The tumor was staged pT1N2M1aS1, which was an intermediate prognosis, based on the International Germ Cell Cancer Collaborative Group consensus (IGCCCG. After 4 courses of bleomycin, etoposide, and cisplatin (BEP chemotherapy the patient’s tumor markers normalized and the thrombus disappeared. There was only one residual retroperitoneal lymph node M1. Retroperitoneal lymph node dissection was performed. The pathological examination revealed only necrotic tissues. The patient has been disease-free since surgery.

  8. Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves' orbitopathy.

    Science.gov (United States)

    Monteiro, Mário Luiz Ribeiro; Gonçalves, Allan Christian Pieroni; Bezerra, Alanna Mara Pinheiro Sobreira

    2016-01-01

    The diagnosis of Graves' orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves' orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves' orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves' orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves' orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. RESUMO O diagnóstico de orbitopatia de Graves usualmente é fácil de ser estabelecido. No entanto, doenças da órbita que simulam alguns sinais clínicos da orbitopatia de Graves podem levar à confusão diagnóstica, particularmente quando associada à alguma forma de disfunção tireoidiana. Relatamos a ocorrência rara de amiloidose localizada no músculo reto inferior em paciente com hipotireoidismo autoimune, que recebeu inicialmente o diagnóstico errôneo de orbitopatia de Graves. Paciente masculino, 48 anos, com queixa de proptose progressiva e indolor do lado esquerdo e diplopia vertical intermitente há 6 meses. O diagnóstico de orbitopatia de Graves foi

  9. Resonant cholinergic dynamics in cognitive and motor decision-making:Attention, category learning, and choice in neocortex, superior colliculus, and optic tectum

    Directory of Open Access Journals (Sweden)

    Stephen eGrossberg

    2016-01-01

    Full Text Available Freely behaving organisms need to rapidly calibrate their perceptual, cognitive, and motor decisions based on continuously changing environmental conditions. These plastic changes include sharpening or broadening of cognitive and motor attention and learning to match the behavioral demands that are imposed by changing environmental statistics. This article proposes that a shared circuit design for such flexible decision-making is used in specific cognitive and motor circuits, and that both types of circuits use acetylcholine to modulate choice selectivity. Such task-sensitive control is proposed to control thalamocortical choice of the critical features that are cognitively attended and that are incorporated through learning into prototypes of visual recognition categories. A cholinergically-modulated process of vigilance control determines if a recognition category and its attended features are abstract (low vigilance or concrete (high vigilance. Homologous neural mechanisms of cholinergic modulation are proposed to focus attention and learn a multimodal map within the deeper layers of superior colliculus. This map enables visual, auditory, and planned movement commands to compete for attention, leading to selection of a winning position that controls where the next saccadic eye movement will go. Such map learning may be viewed as a kind of attentive motor category learning. The article hereby explicates a link between attention, learning, and cholinergic modulation during decision making within both cognitive and motor systems. Homologs between the mammalian superior colliculus and the avian optic tectum lead to predictions about how multimodal map learning may occur in the avian brain and how such learning may be modulated by acetycholine.

  10. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  11. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  12. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  13. Inferior Frontal Cortex Contributions to the Recognition of Spoken Words and Their Constituent Speech Sounds.

    Science.gov (United States)

    Rogers, Jack C; Davis, Matthew H

    2017-05-01

    Speech perception and comprehension are often challenged by the need to recognize speech sounds that are degraded or ambiguous. Here, we explore the cognitive and neural mechanisms involved in resolving ambiguity in the identity of speech sounds using syllables that contain ambiguous phonetic segments (e.g., intermediate sounds between /b/ and /g/ as in "blade" and "glade"). We used an audio-morphing procedure to create a large set of natural sounding minimal pairs that contain phonetically ambiguous onset or offset consonants (differing in place, manner, or voicing). These ambiguous segments occurred in different lexical contexts (i.e., in words or pseudowords, such as blade-glade or blem-glem) and in different phonological environments (i.e., with neighboring syllables that differed in lexical status, such as blouse-glouse). These stimuli allowed us to explore the impact of phonetic ambiguity on the speed and accuracy of lexical decision responses (Experiment 1), semantic categorization responses (Experiment 2), and the magnitude of BOLD fMRI responses during attentive comprehension (Experiment 3). For both behavioral and neural measures, observed effects of phonetic ambiguity were influenced by lexical context leading to slower responses and increased activity in the left inferior frontal gyrus for high-ambiguity syllables that distinguish pairs of words, but not for equivalent pseudowords. These findings suggest lexical involvement in the resolution of phonetic ambiguity. Implications for speech perception and the role of inferior frontal regions are discussed.

  14. A case of angiographically occult, distal small anterior inferior cerebellar artery aneurysm

    Science.gov (United States)

    Kubota, Hisashi; Sanada, Yasuhiro; Nagatsuka, Kazuhiro; Kato, Amami

    2015-01-01

    Background: A small aneurysm at an unusual location, such as a distal anterior inferior cerebellar artery (AICA) aneurysm, may conceal as a computed tomography angiography (CTA) and digital subtraction angiography (DSA)-occult aneurysm. Case Description: We herein present the case of a patient suffering from a subarachnoid hemorrhage (SAH) with two aneurysms in which the AICA aneurysm was negative by CTA and DSA. CTA demonstrated a right anterior choroidal artery aneurysm, which was revealed to be an unruptured aneurysm after surgical exploration. A small distal AICA aneurysm was detected by 3D rotational angiography (3DRA). The patient fully recovered except for left-side hearing loss four months after the second operation. Conclusion: We recommend a meticulous diagnosis by 3DRA in patients with SAH in which the distribution is not coincident with a typical aneurysmal location. PMID:26110079

  15. Inferior vestibular neuritis: a novel subtype of vestibular neuritis.

    Science.gov (United States)

    Zhang, D; Fan, Z; Han, Y; Yu, G; Wang, H

    2010-05-01

    To report eight cases of inferior vestibular neuritis, in order to raise awareness of this new subtype of vestibular neuritis. We retrospectively analysed 216 patients (104 males and 112 females; age range 10-64 years; mean age 38.4 years) with full clinical documentation who had attended our hospital's vertigo clinic between May 2007 and December 2008. All patients underwent systematic investigation, including hearing tests, radiology, caloric testing and vestibular evoked myogenic potential testing. Of 216 patients with vestibular neuritis, eight cases were diagnosed as inferior vestibular neuritis, based on comprehensive analysis of test data. The clinical features of these eight patients were consistent with the characteristics of vestibular neuritis. The results of pure tone audiometry and caloric testing were normal, and the possibility of central lesions was excluded by cerebral computed tomography or magnetic resonance imaging on admission. Six cases had unilateral loss of vestibular evoked myogenic potentials, whereas two had a unilateral lower amplitude of vestibular evoked myogenic potentials. Inferior vestibular neuritis is a novel subtype of vestibular neuritis, which involves the inferior vestibular nerve alone. Vestibular evoked myogenic potential testing is a useful aid to the diagnosis of inferior vestibular neuritis.

  16. The effects of inferior olive lesion on strychnine seizure

    International Nuclear Information System (INIS)

    Anderson, M.C.; Chung, E.Y.; Van Woert, M.H.

    1990-01-01

    Bilateral inferior olive lesions, produced by systemic administration of the neurotoxin 3-acetylpyridine (3AP) produce a proconvulsant state specific for strychnine-induced seizures and myoclonus. We have proposed that these phenomena are mediated through increased excitation of cerebellar Purkinje cells, through activation of glutamate receptors, in response to climbing fiber deafferentation. An increase in quisqualic acid (QA)-displaceable [ 3 H]AMPA [(RS)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid] binding in cerebella from inferior olive-lesioned rats was observed, but no difference in [ 3 H]AMPA binding displaced by glutamate, kainic acid (KA) or glutamate diethylester (GDEE) was seen. The excitatory amino acid antagonists GDEE and MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclo-hepten-5,10 imine] were tested as anticonvulsants for strychnine-induced seizures in 3AP inferior olive-lesioned and control rats. Neither drug effected seizures in control rats, however, both GDEE and MK-801 produced a leftward shift in the strychnine-seizure dose-response curve in 3AP inferior olive-lesioned rats. GDEE also inhibited strychnine-induced myoclonus in the lesioned group, while MK-801 had no effect on myoclonus. The decreased threshold for strychnine-induced seizures and myoclonus in the 3AP-inferior olive-lesioned rats may be due to an increase in glutamate receptors as suggested by the [ 3 H]AMPA binding data

  17. Inferior oblique muscle injury from local anesthesia for cataract surgery.

    Science.gov (United States)

    Hunter, D G; Lam, G C; Guyton, D L

    1995-03-01

    Vertical rectus muscle injury is commonly cited as a cause of strabismus after cataract surgery. Injury to the inferior oblique muscle or nerve as a complication of cataract surgery has not been described previously. Four patients without pre-existing strabismus who had diplopia after cataract surgery were studied. Analysis included prism and cover testing, Lancaster red-green testing, and fundus torsion assessment. Three patients had a delayed-onset hypertropia with fundus extorsion in the eye that underwent surgery, which is consistent with inferior oblique muscle overaction secondary to presumed contracture. The fourth patient had an immediate-onset hypotropia with fundus intorsion in the eye that underwent surgery, which is consistent with inferior oblique muscle paresis. Damage to a vertical rectus muscle or "unmasking" of a pre-existing superior oblique muscle paresis could not explain the history and findings in this group of four patients. The inferior oblique muscle contracture observed in three patients may have been caused by local anesthetic myotoxicity, whereas the paresis observed in one patient may have been due to mechanical trauma or anesthetic toxicity directly to the nerve innervating the muscle. Inferior oblique muscle or nerve injury should be considered as another possible cause of postoperative strabismus, especially when significant fundus torsion accompanies a vertical deviation.

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

    Science.gov (United States)

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

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pgravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. VENOUS SAMPLING FOR CUSHING DISEASE: COMPARISON OF INTERNAL JUGULAR VEIN AND INFERIOR PETROSAL SINUS SAMPLING.

    Science.gov (United States)

    Radvany, Martin G; Quinones-Hinojosa, Alfredo; Gallia, Gary L; Wand, Gary S; Salvatori, Roberto

    2016-09-01

    Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams. Five sites were simultaneously sampled in each patient (right and left IPS, right and left IJV, and femoral vein) before and after the administration of corticotrophin-releasing hormone or desmopressin. The test was considered consistent with CD when the IPS to peripheral ratio was >2 at baseline or >3 after stimulus and the IJV to peripheral ratio was >1.7 at baseline or >2 after stimulus. In 27 of 30 patients, IPSS results were consistent with a central source of ACTH. Two of the other 3 patients had EAS (one lung carcinoid and one occult), and 1 patient had pathology-proven CD. The sensitivity of IPSS was 96.4%. Only 64.2% of these patients had results meeting criteria for a central source of ACTH by IJVS criteria. Twenty patients with centralizing IPPS have undergone pituitary surgery. Of these, the central origin of excessive ACTH was confirmed with certainty in 16 patients. Among these 16 patients, the IPSS sensitivity was 93.8%, whereas 5 patients had false-negative IJVS (68.7% sensitivity). These results do not support the routine use of IJVS in establishing if the pituitary is the source of excessive ACTH. ACTH = adrenocorticotropic hormone CD = Cushing disease CRH = corticotrophin-releasing hormone CS = Cushing syndrome DDAVP = desmopressin EAS = ectopic ACTH secretion IJVS = internal jugular vein sampling IPSS = inferior petrosal sinus sampling JVS = jugular venous sampling MRI = magnetic resonance imaging.

  20. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shao Chun; Li, Xue Hua; Sun, Can Hui; Feng, Shi Ting; Peng, Zhen Peng; Huang, Si Yun; Li, Zi Ping [Dept. of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China)

    2014-10-15

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  1. Symptomatic duodenal perforation by inferior vena cava filter.

    Science.gov (United States)

    Baptista Sincos, Anna Pw; Sincos, Igor R; Labropoulos, Nicos; Donegá, Bruno C; Klepacz, Andrea; Aun, Ricardo

    2017-01-01

    Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.

  2. Isquemia aguda de miembros inferiores secundaria a ergortismo

    Directory of Open Access Journals (Sweden)

    Franco J. Vallejo, MD

    2011-11-01

    Full Text Available Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasodilatadores y calcio-antagonistas, que resolvió los síntomas en su totalidad.

  3. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  4. [Surgery of inferior vena cava-associated urological tumor lesions].

    Science.gov (United States)

    Weber, M; Meyer, F; Liehr, U B; Halloul, Z

    2013-10-01

    Tumor lesions of the inferior vena cava are extremely challenging with regard to adequate therapeutic management also in advanced malignant urological tumor lesions which can be caused by malignant adhesion, impression and tumor infiltration from the surrounding tissue. This can be the case with metastases from a seminoma or testicular carcinoma (differential diagnosis: primary vena cava leiomyosarcoma), tumor-associated growth into and within the inferior vena cava originating from renal cell carcinoma or carcinoma of the pararenal gland. The aim of this overview was to summarize current clinical and operative experiences in the treatment of inferior vena cava-associated urological tumor lesions, perioperative management, individual-specific and finding-adapted surgical technique and possible outcome, including prognostic considerations from clinical daily practice and representative data found in the literature. The primary aim of the surgical approach is to achieve R0 resection with reconstruction of the inferior vena cava lumen providing a reasonable risk-benefit ratio, which comprises i) complete resection and substitution of the inferior vena cava by a prosthesis along the previous extent of tumor growth, ii) partial resection of the vena cava wall with subsequent patch-plasty or tangential resection with primary suture or iii) removal of the vena cava thrombus after cavotomy. Particular attention should be paid to tumor thrombi reaching the right atrium which need to be extracted after sternotomy and atriotomy using an extracorporeal circulation (cardiac surgeon). For surgical planning, subdivision of the inferior vena cava into three segments, infracardiac, infrahepatic and infrarenal third, has been proven and tested. The current development status and advances in surgical approaches as well as advances in medical technology allow the successful approach to such advanced stage urological tumor manifestations. A deciding factor is the abdominal and

  5. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop.

    Science.gov (United States)

    Velasco-Torres, M; Padial-Molina, M; Avila-Ortiz, G; García-Delgado, R; Catena, A; Galindo-Moreno, P

    2017-09-01

    Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL). In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined. Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p<0.001; right and left, respectively) and lateral (r=-0.274, p=0.001; r=-0.285, p<0.001; right and left, respectively), particularly at the level of the premolars. Additionally, the presence (r=-0.181, p=0.001; r=-0.163, p=0.002; right and left, respectively) and anterior extension (r=-0.180, p=0.009; r=-0.285, p=0.05; right and left, respectively) of the AL was found to be inversely correlated with the age of the patient. This analysis of a Caucasian population has found that the older the patient, the lower the incidence of the loop and the shorter its anterior extension.

  6. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop

    Science.gov (United States)

    Velasco-Torres, Miguel; Padial-Molina, Miguel; Avila-Ortiz, Gustavo; García-Delgado, Raúl; Catena, Andrés

    2017-01-01

    Background Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL). Study Design In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined. Results Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p<0.001; right and left, respectively) and lateral (r=-0.274, p=0.001; r=-0.285, p<0.001; right and left, respectively), particularly at the level of the premolars. Additionally, the presence (r=-0.181, p=0.001; r=-0.163, p=0.002; right and left, respectively) and anterior extension (r=-0.180, p=0.009; r=-0.285, p=0.05; right and left, respectively) of the AL was found to be inversely correlated with the age of the patient. Conclusions This analysis of a Caucasian population has found that the older the patient, the lower the incidence of the loop and the shorter its anterior extension. Key words:Cone-beam computed tomography, mandibular nerve, mental foramen. PMID:28809376

  7. Projecte constructiu d'un pas inferior entre andanes

    OpenAIRE

    Sabate Cots, Guerau

    2010-01-01

    El condicionante fundamental de la solución adoptada es la no afectación a la explotación de la línea de ferrocarril. La ejecución del paso inferior se resuelve mediante la construcción de una estructura tipo marco unicelular y su posterior empuje, bajo las vías del ferrocarril porque de este modo se disminuye la afección de las obras al tráfico ferroviario, evitando el corte de vías. El Sistema de Empuje consiste esencialmente en la construcción de la estructura del paso inferior fue...

  8. The value of attenuation correction by hybrid SPECT/CT imaging on infarct size quantification in male patients with previous inferior myocardial infarct.

    Science.gov (United States)

    Giubbini, Raffaele Mario Tarquinio; Gabanelli, Sara; Lucchini, Silvia; Merli, Giuseppe; Puta, Erinda; Rodella, Carlo; Motta, Federica; Paghera, Barbara; Rossini, Pierluigi; Terzi, Arturo; Bertagna, Francesco

    2011-11-01

    Attenuation correction (AC) has been shown to improve the accuracy of myocardial perfusion single photon emission computed tomography (SPECT) for the detection and evaluation of patients with coronary artery disease. Attenuation artifacts, because of diaphragmatic attenuation, frequently affect the evaluation of the inferior wall, especially in male patients. The aim of this study was to evaluate the value of AC for the assessment of infarct size in coronary artery disease patients after inferior myocardial infarction. Gated-SPECT with Tc-labeled compounds with AC by hybrid SPECT/computed tomography (CT) was performed in 56 male patients with documented previous inferior myocardial infarction. Both corrected and uncorrected SPECT images were processed after motion and scatter correction by ordered-subset expectation maximization iterative reconstruction. When needed, a manual realignment between SPECT and computed tomography (CT) sections was performed. Uncorrected and corrected SPECT images were analyzed for perfusion using a 5-point segmental scoring scale from 0 (normal) to 4 (absent). Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) of the inferior left ventricle wall (inferoseptal, inferior, infero-apical and infero-lateral segments) were determined and compared with the regional wall motion score as determined by uncorrected gated-SPECT. The SSS, SRS, SDS for attenuation-uncorrected and attenuation-corrected studies were 14.02 ± 7.9, 9.51 ± 7, 4.5 ± 3.2 and 9.39 ± 7.1, 5.6 ± 6.1, 3.8 ± 2.8, respectively. Differences were statistically significant (P<0.0001) for SSS and SRS but not for SDS. The regional summed rest score of the inferior wall (SRS of inferior segments) showed a better correlation with the regional summed wall motion score of the same segments: R²=0.50 in comparison to uncorrected SRS, R²=0.46. The combination of diaphragmatic attenuation and inferior myocardial infarction determines an artifactual

  9. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

    This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma. PMID:25120392

  10. Left ventricular hypertrophy in athletes.

    Science.gov (United States)

    Douglas, P S; O'Toole, M L; Katz, S E; Ginsburg, G S; Hiller, W D; Laird, R H

    1997-11-15

    Left ventricular wall thickness >1.3 cm, septal-to-posterior wall ratios > 1.5, diastolic left ventricular size >6.0 cm, and eccentric or concentric remodeling are rare in athletes. Values outside of these cutoffs in an athlete of any age probably represent a pathologic state.

  11. The Left-Handed Writer.

    Science.gov (United States)

    Bloodsworth, James Gaston

    Contrary to the beliefs of many, right-handedness is not a single factor existing in almost all people, with a few exceptions termed left-handed: neither extreme exists independently of the other. During the first 4 years of life there is a period of fluctuation between right and left-handed dominance. Statistics and findings vary in determining…

  12. Two Lefts in Latin America?

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba

    In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given.......In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given....

  13. A Giant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Medhat F. Zaher

    2014-01-01

    Full Text Available Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma.

  14. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

    Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

  15. Left ventricular wall stress compendium.

    Science.gov (United States)

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  16. Open removal of a retained retrohepatic inferior vena cava filter with a residual primary neuroectodermal renal tumoral thrombus.

    Science.gov (United States)

    Hinojosa, Carlos A; Torres-Machorro, Adriana; Lizola, Rene; Anaya-Ayala, Javier E

    2015-10-29

    Primary neuroectodermal renal tumours (PNET) are rare and aggressive neoplasms; thrombosis of the inferior vena cava (IVC) is associated with this entity. We report here the case of a 19-year-old man who experienced a new onset of abdominal pain. A CT scan revealed a large left renal mass, perirenal haematoma and IVC thrombosis. Owing to an acute drop in haemoglobin and subsegmentary pulmonary embolism, he underwent emergency selective renal artery angiography and embolisation of bleeding vessels and IVC filter (IVCF) placement. Once stable, he underwent a left radical nephrectomy and IVC thrombectomy; the pathology report confirmed PNET. 6 months later, imaging revealed a residual tumoral thrombus in the IVCF located in the retrohepatic IVC. The patient underwent removal of this device and the thrombus via a right thoracoabdominal approach. He recovered well and at 4 months, he continues his chemotherapy cycles. 2015 BMJ Publishing Group Ltd.

  17. Case Report: Supernumerary right renal vein draining inferior to the ...

    African Journals Online (AJOL)

    With recent increase in renal transplantations, renovascular reconstructions and imaging advances, meticulous knowledge of the normal and variant anatomy of the renal vasculature is important to avoid potential pitfalls. We report a case of an accessory renal vein arising from the right kidney, and draining into the inferior ...

  18. Buccal Infiltration versus Inferior Alveolar Nerve Block in Mandibular ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... Purpose: The purpose of this study is to compare the success rates of inferior alveolar nerve block (IANB) and buccal infiltration anesthesia of mandibular second premolar with irreversible pulpitis and to evaluate the level of patient discomfort with these methods. Matherials and Methods: Forty patients, who.

  19. Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus

    Directory of Open Access Journals (Sweden)

    Xavier Durand

    2009-01-01

    Full Text Available A 57-year-old woman was found to have an inferior vena cava involvement of a known sinusal angiomyolipoma incompletely resected three years beforehand. Intravascular extension into the IVC of angiomyolipoma has rarely been reported. We present a new case and reconsider the literature about this uncommon complication of a benign renal tumor.

  20. Does the reduction of inferior turbinate affect lower airway functions?

    Science.gov (United States)

    Unsal, Ozlem; Ozkahraman, Mehtap; Ozkarafakili, Mufide Arzu; Akpinar, Meltem; Korkut, Arzu Yasemin; Kurt Dizdar, Senem; Uslu Coskun, Berna

    2017-11-06

    Although the nose and lungs are separate organs, numerous studies have reported that the entire respiratory system can be considered as a single anatomical and functional unit. The upper and lower airways affect each other either directly or through reflex mechanisms. In this study, we aimed to evaluate the effects of the radiofrequency ablation of persistent inferior turbinate hypertrophy on nasal and pulmonary function. Twenty-seven patients with bilateral persistent inferior turbinate hypertrophy without septal deviation were included in this study. All of the patients were evaluated using anterior rhinoscopy, nasal endoscopy, acoustic rhinometry, a visual analogue scale, and flow-sensitive spirometry on the day before and 4 months after the radiofrequency ablation procedure. The post-ablation measurements revealed that the inferior turbinate ablation caused an increase in the mean cross-sectional area and volume of the nose, as well as in the forced expiratory volume in 1s, forced vital capacity, and peak expiratory flow of the patients. These differences between the pre- and post-ablation results were statistically significant. The post-ablation visual analogue scale scores were lower when compared with the pre-ablation scores, and this difference was also statistically significant. This study demonstrated that the widening of the nasal passage after the reduction of the inferior turbinate size had a favorable effect on the pulmonary function tests. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  1. Pulmonary embolism presenting with ST segment elevation in inferior leads

    Directory of Open Access Journals (Sweden)

    Muzaffer Kahyaoğlu

    2017-03-01

    Full Text Available Acute pulmonary embolism is a form of venous thromboembolism that is widespread and sometimes mortal. The clinical presentation of pulmonary embolism is variable and often nonspecific making the diagnosis challenging. In this report, we present a case of pulmonary embolism characterized by ST segment elevation in inferior leads without reciprocal changes in the electrocardiogram.

  2. Incidental right Bochdalek hernia with interruption of the inferior ...

    African Journals Online (AJOL)

    2014-05-30

    May 30, 2014 ... Case Report doi:10.4102/sajr.v18i1.592 http://sajr.org.za. Incidental right Bochdalek hernia with interruption of the inferior vena cava and hepatic venous collateral continuation: A case report. Authors: Farzanah I. Ismail1. Rule Human2. Anith Chacko1. Parmanand Naran2. Samia Ahmad1. Siraj Ellemdin2.

  3. Brucellosis and thrombosis of the inferior vena cava.

    Science.gov (United States)

    Rüegger, Kristina; Tarr, Philip; Karatolios, Konstantinos; Humburg, Jörg; Hügli, Rolf; Jeanneret, Christina

    2017-01-01

    We describe the case of a 23-year old woman with a newly diagnosed thrombosis of the inferior vena cava associated with a Brucella melitensis infection. We suggest possible mechanisms leading to brucellosis-associated venous thrombosis and review 14 previously reported cases.
.

  4. reduction mammoplasty using inferior pedicle in heavy breasts

    African Journals Online (AJOL)

    2011-09-09

    Sep 9, 2011 ... reduction of the breast as well as enhancement of the aesthetic appearance of the breasts. In this study, the inferior ... of the procedure is reduction in weight, volume and improvement in aesthetic appearance ... resections are done in a beveling fashion leaving a carpet of breast tissue of the muscle fascia ...

  5. Buccal infiltration versus inferior alveolar nerve block in mandibular ...

    African Journals Online (AJOL)

    Purpose: The purpose of this study is to compare the success rates of inferior alveolar nerve block (IANB) and buccal infiltration anesthesia of mandibular second premolar with irreversible pulpitis and to evaluate the level of patient discomfort with these methods. Materials and Methods: Forty patients, who had irreversible ...

  6. Inferior vena cava leiomyosarcoma: vascular reconstruction is not ...

    African Journals Online (AJOL)

    Leiomyosarcoma (LMS) of inferior vena cava is a rare and aggressive tumor, arising from the smooth muscle cells in the vessel wall. A large complete surgical resection is the essential treatment. The need of vascular reconstruction is not always mandatory. It's above all to understand the place of the reconstruction with ...

  7. Suprarenal inferior vena cava filter placement prior to transcatheter arterial embolization (TAE) of a renal cell carcinoma with large renal vein tumor thrombus: Prevention of pulmonary tumor emboli after TAE

    International Nuclear Information System (INIS)

    Hirota, Shozo; Matsumoto, Shinnichi; Ichikawa, Satoshi; Tomita, Masaru; Koshino, Tukasa; Sako, Masao; Kono, Michio

    1997-01-01

    To prevent embolization of necrotic renal vein tumor after transcatheter embolization of a left renal cell carcinoma, we placed a suprarenal Bird's nest inferior vena cava filter. The patient tolerated the procedure well and had extensive tumor infarction including the tumor thrombus on 6-month follow-up computed tomography

  8. Injuries of the retrohepatic inferior vena cava and the liver

    Directory of Open Access Journals (Sweden)

    Koprivica Radenko

    2008-01-01

    Full Text Available Beckground. Injuries of the retrohepatic inferior vena cava, and the liver have mortality rate up to 71-78%. We presented a patient with combined injury of the retrohepatic inferior vena cava, liver, craniocerebral and thoracic traumas, inflicted in a traffic accident. Case report. Man, 20 years old has been injured in a traffic accident. At admission, 20 minutes after the injury, the patient was comatose and hypotensive. Bloody content was obtained by abdominal tracer. The patient underwent emergent laparotomy, utilizing trifurcated incision and cell saver device. Abdominal exploration revealed two liters of free blood and massive retroperitoneal hematoma. Manual compression of the liver was done, as well as perihepatic packing, complete hepatic vascular exclusion and mobilization of the right liver lobe. Due to impressive chemodynamic instability supraceliac aortic clamping was performed. Upon exposure of the retrohepatic inferior vena cava and right liver lobe, multiple lacerations of retrohepatic inferior vena cava and right hepatic vein, and right hepatic vein avulsion were found. We also identified an injury of VII and VIII segments of the liver (grade V according to the Moore's classification. Nonexpansive hepatoduodenal ligament hematoma and the injury of II and III segments of the liver group II/III according to Moore were found. Venorrhaphy of the inferior vena cava was done in the area of circumference of the right hepatic vein, a portion of which served as autologous vein patch. Continuous prolene 3/0 venorrhaphy of the distal caval laceration was done. Total caval and aorta clamping time of the inferior vena cava was 41 minutes. Atypical resection, debridment, of hepatic segments was done by using a harmonic scalpel. Hepatoduodenal ligament was declamped after 65 minutes. Fibrin glue was applied on the resectioned area of liver. The patient received 3.2 l of autologuos blood transfusion with 5 units of packed red blood cells, 6

  9. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus.

    Directory of Open Access Journals (Sweden)

    Takashi X Fujisawa

    Full Text Available Anorexia nervosa (AN is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05 of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01 and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset.

  10. Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery

    Directory of Open Access Journals (Sweden)

    Cristina G. Calogero

    2015-01-01

    Full Text Available Inferior thyroid artery (ITA rupture is rare and may progress to life-threatening conditions. We present a patient who visited the emergency department after an episode of syncope and dizziness in which he had a mechanical fall that resulted in abrasions and a hematoma to his left forehead. The patient presented with dysphagia and anterior neck swelling that progressed rapidly into airway compromise requiring endotracheal intubation. Emergent computed tomography revealed a large retropharyngeal hematoma, with active arterial extravasation that was thought to be arising from the thyrocervical trunk on the left. The hematoma measured approximately 6.7 cm transversely and 3.2 cm anteroposteriorly and extended from the level of the lower nasopharynx, down the neck into the retropharyngeal and danger space and into the mediastinum posterior to the esophagus, overall approximately 25 cm. The larynx was deviated anteriorly and there was esophageal compression. An emergent arteriogram and catheterization confirmed bleeding from branches of the ITA, and successful embolization was performed. It is important to recognize the ITA rupture as a potential etiology of an acute airway compromise. In emergent situations, while securing an airway is a priority, rapidly initiating diagnostic testing to confirm the diagnosis and arranging for arterial embolization can be life-saving.

  11. [Total dream loss secondary to left temporo-occipital brain injury].

    Science.gov (United States)

    Poza, J J; Martí Massó, J F

    2006-04-01

    Recently the case of a woman who reported cessation of dreaming after a bilateral PCA stroke but without REM sleep loss has been reported, suggesting that deep bilateral occipital lobe damage including the right inferior lingual gyrus may represent the "minimal lesion extension" necessary for dream loss. We report the case of a 24-year-old man who ceased dreaming after a unilateral left temporo- occipital hematoma. The polysomnographic characteristics in rapid eyes movements (REM) sleep were otherwise normal. Our patient demonstrates that a unilateral left temporo-occipital injury could be sufficient for losing dreams.

  12. Laparoscopic Technique for Serial Collection of Para-Colonic, Left Colic, and Inferior Mesenteric Lymph Nodes in Macaques.

    Directory of Open Access Journals (Sweden)

    Jeremy Smedley

    Full Text Available Unlike peripheral lymph nodes (PLN, the mesenteric lymph nodes (MLN draining the gastrointestinal (GI tract are exposed to microbes and microbial products from the intestines and as such, are immunologically distinct. GI draining (MLN have also been shown to be sites of early viral replication and likely impact early events that determine the course of HIV infection. They also are important reservoir sites that harbor latently-infected cells and from which the virus can emerge even after prolonged combination antiretroviral therapy (cART. Changes in the microbial flora and increased permeability of the GI epithelium associated with lentiviral infection can impact the gut associated lymphoid tissue (GALT and induce changes to secondary lymphoid organs limiting immune reconstitution with cART. Nonhuman primate models for AIDS closely model HIV infection in humans and serial sampling of the GALT and associated secondary lymphoid organs in this model is crucial to gain a better understanding of the critical early events in infection, pathogenesis, and the role of immune responses or drugs in controlling virus at these sites. However, current techniques to sample GI draining (MLN involve major surgery and/or necropsy, which have, to date, limited the ability to investigate mechanisms mediating the initiation, persistence and control of infection in this compartment. Here, we describe a minimally invasive laparoscopic technique for serial sampling of these sites that can be used with increased sampling frequency, yields greater cell numbers and immune cell subsets than current non-invasive techniques of the GALT and reduces the potential for surgical complications that could complicate interpretation of the results. This procedure has potential to facilitate studies of pathogenesis and evaluation of preventive and treatment interventions, reducing sampling variables that can influence experimental results, and improving animal welfare.

  13. Involvement of the Left Supramarginal Gyrus in Manipulation Judgment Tasks: Contributions to Theories of Tool Use.

    Science.gov (United States)

    Lesourd, Mathieu; Osiurak, François; Navarro, Jordan; Reynaud, Emanuelle

    2017-09-01

    Two theories of tool use, namely the gesture engram and the technical reasoning theories, make distinct predictions about the involvement of the left inferior parietal lobe (IPL) in manipulation judgement tasks. The objective here is to test these alternative predictions based on previous studies on manipulation judgment tasks using transcranial magnetic stimulations (TMS) targeting the left supramarginal gyrus (SMG). We review recent TMS studies on manipulation judgement tasks and confront these data with predictions made by both tool use theories. The left SMG is a highly intertwined region, organized following several functionally distinct areas and TMS may have disrupted a cortical network involved in the ability to use tools rather than only one functional area supporting manipulation knowledge. Moreover, manipulation judgement tasks may be impaired following virtual lesions outside the IPL. These data are more in line with the technical reasoning hypothesis, which assumes that the left IPL does not store manipulation knowledge per se. (JINS, 2017, 23, 685-691).

  14. Detection of active left ventricular thrombosis during acute myocardial infarction using indium-111 platelet scintigraphy

    International Nuclear Information System (INIS)

    Ezekowitz, M.D.; Kellerman, D.J.; Smith, E.O.; Streitz, T.M.

    1984-01-01

    Platelet scintigraphy with radioactive indium-111 may be used both to identify and to reflect the activity of thrombin in vivo in man. Forty-one patients with acute myocardial infarction were studied for active left ventricular thrombosis by platelet scintigraphy and followed until in-hospital death, discharge, or same-admission cardiac surgery for evidence of systemic embolization. Group 1 (n . 29) had transmural myocardial infarctions, of which 21 were anterior and eight were inferior. Group 2 (n . 12) had subendocardial myocardial infarctions. Those with subendocardial and transmural inferior myocardial infarctions had neither left ventricular thrombosis nor emboli. Ten (48 percent) of 21 with anterior transmural myocardial infarctions had left ventricular thrombosis by platelet scintigraphy. Three with and one without such thrombosis by scintigraphy had acute neurologic episodes. In the group with anterior myocardial infarctions, seven of ten patients with and four of 11 without left ventricular thrombosis received heparin subcutaneously. We conclude that platelet scintigraphy may be used to monitor antiplatelet and anticoagulant therapy in patients with anterior transmural myocardial infarctions who are at risk for left ventricular thrombosis and systemic embolization

  15. [Reversibility of cardiomyopathy after therapy of incessant left ventricular tachycardia with radiofrequency ablation in a newborn infant].

    Science.gov (United States)

    Benito Bartolomé F; Sánchez Fernández-Bernal C

    2000-08-01

    We present a 15-month-old infant with tachycardia-induced cardiomyopathy secondary to idiopathic left ventricular tachycardia, which was incessant despite medical treatment. In the electrocardiogram, the tachycardia showed right bundle branch morphology and left superior axis deviation and was successfully ablated with the application of radiofrequency in the inferior apical septal region of the left ventricle. One week after the procedure the shortening fraction increased from 12% to 30% and at 18 months of follow-up the patient is tachycardia-free.

  16. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Aslaner, Ramazan; Pekcevik, Yeliz; Sahin, Hilal [Dept. of Radiology, Tepecik Training and Research Hospital, Izmir (Turkmenistan); Toka, Onur [Dept. of Statistics, Hacettepe University, Ankara (Turkmenistan)

    2017-04-15

    Knowing the origin of the inferior phrenic artery (IPA) is important prior to surgical interventions and interventional radiological procedures related to IPA. We aimed to identify variations in the origin of IPA and to investigate the relationship between the origin of IPA and celiac axis variations using computed tomography angiography (CTA). The CTA images of 1000 patients (737 male and 263 female, the mean age 60, range 18–94 years) were reviewed in an analysis of IPA and celiac axis variations. The origin of IPA was divided into two groups, those originating as a common trunk and those originating independently without a truncus. The relationship between the origin of IPA and celiac axis variation was analyzed using Pearson's chi-square test. Both IPAs originated from a common trunk in 295 (29.5%) patients. From which the majority of the common trunk originated from the aorta. Contrastingly, the inferior phrenic arteries originated from different origins in 705 (70.5%) patients. The majority of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) originated independently from the celiac axis. Variation in the celiac axis were detected in 110 (11%) patients. The origin of IPA was found to be significantly different in the presence of celiac axis variation. The majority of IPA originated from the aorta in patients with a common IPA trunk, while the majority of RIPA and LIPA originating from the celiac axis in patients without a common IPA trunk. Thus, the origin of IPA may widely differ in the presence of celiac axis variation.

  17. Anterior cingulate volume predicts response to psychotherapy and functional connectivity with the inferior parietal cortex in major depressive disorder.

    Science.gov (United States)

    Sambataro, Fabio; Doerig, Nadja; Hänggi, Jürgen; Wolf, Robert Christian; Brakowski, Janis; Holtforth, Martin Grosse; Seifritz, Erich; Spinelli, Simona

    2018-01-01

    In major depressive disorder (MDD), the anterior cingulate cortex (ACC) has been associated with clinical outcome as well as with antidepressant treatment response. Nonetheless, the association between individual differences in ACC structure and function and the response to cognitive behavioral therapy (CBT) is still unexplored. For this aim, twenty-five unmedicated patients with MDD were scanned with structural and resting state functional magnetic resonance imaging before the beginning of CBT treatment. ACC morphometry was correlated with clinical changes following psychotherapy. Furthermore, whole-brain resting state functional connectivity with the ACC was correlated with clinical measures. Greater volume in the left subgenual (subACC), the right pregenual (preACC), and the bilateral supragenual (supACC) predicted depressive symptoms improvement after CBT. Greater subACC volume was related to stronger functional connectivity with the inferior parietal cortex and dorsolateral prefrontal cortex. Stronger subACC-inferior parietal cortex connectivity correlated with greater adaptive rumination. Greater preACC volume was associated with stronger functional connectivity with the inferior parietal cortex and ventrolateral prefrontal cortex. In contrast, greater right supACC volume was related to lower functional connectivity with the inferior parietal cortex. These results suggest that ACC volume and its functional connectivity with the fronto-parietal cortex are associated with CBT response in MDD, and this may be mediated by adaptive forms of rumination. Our findings support the role of the subACC as a potential predictor for CBT response. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  18. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography

    International Nuclear Information System (INIS)

    Aslaner, Ramazan; Pekcevik, Yeliz; Sahin, Hilal; Toka, Onur

    2017-01-01

    Knowing the origin of the inferior phrenic artery (IPA) is important prior to surgical interventions and interventional radiological procedures related to IPA. We aimed to identify variations in the origin of IPA and to investigate the relationship between the origin of IPA and celiac axis variations using computed tomography angiography (CTA). The CTA images of 1000 patients (737 male and 263 female, the mean age 60, range 18–94 years) were reviewed in an analysis of IPA and celiac axis variations. The origin of IPA was divided into two groups, those originating as a common trunk and those originating independently without a truncus. The relationship between the origin of IPA and celiac axis variation was analyzed using Pearson's chi-square test. Both IPAs originated from a common trunk in 295 (29.5%) patients. From which the majority of the common trunk originated from the aorta. Contrastingly, the inferior phrenic arteries originated from different origins in 705 (70.5%) patients. The majority of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) originated independently from the celiac axis. Variation in the celiac axis were detected in 110 (11%) patients. The origin of IPA was found to be significantly different in the presence of celiac axis variation. The majority of IPA originated from the aorta in patients with a common IPA trunk, while the majority of RIPA and LIPA originating from the celiac axis in patients without a common IPA trunk. Thus, the origin of IPA may widely differ in the presence of celiac axis variation

  19. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  1. Dabigatran for left ventricular thrombus

    Directory of Open Access Journals (Sweden)

    Satishkumar Kolekar

    2015-09-01

    Dabigatran is a reversible direct thrombin inhibitor and currently approved for the prevention of thromboembolic episodes in non-valvar atrial fibrillation. This case demonstrates possible thrombolytic properties of dabigatran in resolution of left ventricular thrombus.

  2. Apraxia in left-handers.

    Science.gov (United States)

    Goldenberg, Georg

    2013-08-01

    In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness. Pantomime of tool use, actual tool use and imitation of meaningless hand and finger postures were examined in 50 consecutive left-handed subjects with unilateral hemisphere lesions. There were three aphasic patients with pervasive apraxia caused by left-sided lesions. As the dominant hand is controlled by the right hemisphere, they constitute dissociations of apraxia from handedness. Conversely there were also three patients with pervasive apraxia caused by right brain lesions without aphasia. They constitute dissociations of apraxia from aphasia. Across the whole group of patients dissociations from handedness and from aphasia were observed for all manifestations of apraxia, but their frequency depended on the type of apraxia. Defective pantomime and defective tool use occurred rarely without aphasia, whereas defective imitation of hand, but not finger, postures was more frequent after right than left brain damage. The higher incidence of defective imitation of hand postures in right brain damage was mainly due to patients who had also hemi-neglect. This interaction alerts to the possibility that the association of right hemisphere damage with apraxia has to do with spatial aptitudes of the right hemisphere rather than with its control of the dominant left hand. Comparison with data from right-handed patients showed no differences between the severity of apraxia for imitation of hand or finger postures, but impairment on pantomime of tool use was milder in apraxic left-handers than in apraxic right-handers. This alleviation of the severity of apraxia corresponded with a similar alleviation of the severity of aphasia as

  3. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  4. Left Main Coronary Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Hossein Doustkami

    2016-07-01

    Full Text Available Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic.

  5. Right colon cancer: Left behind.

    Science.gov (United States)

    Gervaz, P; Usel, M; Rapiti, E; Chappuis, P; Neyroud-Kaspar, I; Bouchardy, C

    2016-09-01

    Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC. We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation. Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. [Surface ECG characteristics of right and left atrial flutter].

    Science.gov (United States)

    Rostock, Thomas; Konrad, Torsten; Sonnenschein, Sebastian; Mollnau, Hanke; Ocete, Blanca Quesada; Bock, Karsten; Spittler, Raphael; Huber, Carola; Theis, Cathrin

    2015-09-01

    Atrial tachycardia in virtually all areas of both atria has become more important in the clinical management of patients with previous complex atrial fibrillation ablation. Accurate interpretation of surface electrocardiogram (ECG) characteristics is of paramount importance to localize the origin of atrial tachycardia, particularly for planning interventional treatment. This article highlights the ECG features of different types of right and left atrial tachycardia. Typical right atrial flutter through the cavotricuspid isthmus conducts septally in a cranial direction and demonstrates sawtooth-like flutter waves which start negative in II, III and aVF and then show a steep slope upwards to the isoelectric line. The flutter rate typically ranges between 240-250 beats/min. In contrast, right atrial flutter in a clockwise rotation, flutter around the vena cava inferior or superior and around a scar (e.g. after cardiac surgery) show positive or biphasic flutter waves (lower or upper loop reentry). Left atrial flutter waves (e.g. around the mitral valve or around the pulmonary veins) are very heterogeneous and are typically positive in V1 as the left atrium is located in the posterior mediastinum. Specific knowledge of flutter wave morphology in surface ECG facilitates planning and performance of the ablation strategy.

  7. Some problems with non-inferiority tests in psychotherapy research: psychodynamic therapies as an example.

    Science.gov (United States)

    Rief, Winfried; Hofmann, Stefan G

    2018-02-14

    In virtually every field of medicine, non-inferiority trials and meta-analyses with non-inferiority conclusions are increasingly common. This non-inferiority approach has been frequently used by a group of authors favoring psychodynamic therapies (PDTs), concluding that PDTs are just as effective as cognitive-behavioral therapies (CBT). We focus on these examples to exemplify some problems associated with non-inferiority tests of psychological treatments, although the problems also apply to psychopharmacotherapy research, CBT research, and others. We conclude that non-inferiority trials have specific risks of different types of validity problems, usually favoring an (erroneous) non-inferiority conclusion. Non-inferiority trials require the definition of non-inferiority margins, and currently used thresholds have a tendency to be inflationary, not protecting sufficiently against degradation. The use of non-inferiority approaches can lead to the astonishing result that one single analysis can suggest both, superiority of the comparator (here: CBT) and non-inferiority of the other treatment (here PDT) at the same time. We provide recommendations how to improve the quality of non-inferiority trials, and we recommend to consider them among other criteria when evaluating manuscripts examining non-inferiority trials. If psychotherapeutic families (such as PDT and CBT) differ on the number of investigating trials, and in the fields of clinical applications, and in other validity aspects mentioned above, conclusions about their general non-inferiority are no more than a best guess, typically expressing the favored approach of the lead author.

  8. Microvascular Decompression of Facial Nerve and Pexy of the Left Vertebral Artery for Left Hemifacial Spasm: 3-Dimensional Operative Video.

    Science.gov (United States)

    Cheng, Chun-Yu; Shetty, Rakshith; Martinez, Vicente; Sekhar, Laligam N

    2018-03-29

    A 73-yr-old man presented with intractable left hemifacial spasm of 4 yr duration. Brain magnetic resonance imaging showed significant compression of left facial nerve by the left vertebral artery (VA) and anterior inferior cerebellar artery (AICA).The patient underwent a left retrosigmoid craniotomy and a microvascular decompression of the cranial nerve (CN) VII. Intraoperatively, we found that the distal AICA had a protracted subarcuate extradural course.1 This was relieved by intra/extradural dissection. The left VA and the AICA loop were compressing the root exit zone of CN VII. The VA was mobilized, and pexy into the petrosal dura was done with 8-0 nylon sutures (Ethilon Nylon Suture, Ethicon Inc, a subsidiary of Johnson & Johnson, Somerville, New Jersey). Once this was done, the lateral spread disappeared.2 The AICA loop was decompressed with 2 pieces of Teflon felt (Bard PTFE felt, Bard peripheral Vascular Inc, a subsidiary of CR Bard Inc, Temp, Arizona). After this, wave V of the brainstem auditory evoked potential (BAEP) disappeared completely, with no recovery despite the application of the nicardipine on the internal auditory artery (IAA). The IAA appeared to be stretched by the microvascular decompression. Arachnoidal dissection was done to release the CN VIII and an additional felt piece was placed to elevate the AICA loop; the BAEP recovered completely. The patient had a complete disappearance of the hemifacial spasm postoperatively, and hearing was unchanged.This 3-D video shows the technical nuances of performing a vertebropexy, release of the AICA from its extradural subarcuate course, and the surgical maneuvers in the event of an unexpected change in neuromonitoring response. The suture technique of vertebropexy is preferred to a loop technique, to avoid kinking of the VA.3Informed consent was obtained from the patient prior to the surgery that included videotaping of the procedure and its distribution for educational purposes. All relevant

  9. Treatment of an Anterior Inferior Cerebellar Artery Aneurysm With Microsurgical Trapping and In Situ Posterior Inferior Cerebellar Artery to Anterior Inferior Cerebellar Artery Bypass: Case Report.

    Science.gov (United States)

    Lee, Bryan S; Witek, Alex M; Moore, Nina Z; Bain, Mark D

    2017-12-30

    Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can involve microsurgical and/or endovascular techniques. Such treatment can be challenging and may carry a significant risk of neurological morbidity. To demonstrate a case involving a complex AICA aneurysm that was treated with a unique microsurgical approach involving trapping the aneurysm and performing in Situ bypass from the posterior inferior cerebellar artery (PICA) to the distal AICA. The nuances of AICA aneurysms and revascularization strategies are discussed. The aneurysm and the distal segments of AICA and PICA were exposed with a retrosigmoid and far lateral approach. A side-to-side anastomosis was performed between the adjacent caudal loops of PICA and AICA. The AICA aneurysm was then treated by trapping the aneurysm-bearing segment of the parent vessel between 2 clips. A postoperative angiogram demonstrated a patent PICA-AICA bypass and complete occlusion of the AICA aneurysm. There were no complications, and the patient made an excellent recovery. The combination of parent vessel sacrifice and bypass remains an excellent option for certain difficult-to-treat aneurysms. This case involving PICA-AICA bypass to treat an AICA aneurysm serves as an example of the neurosurgeon's ability to develop unique solutions that take advantage of individual anatomy. Copyright © 2017 by the Congress of Neurological Surgeons

  10. Anterior Inferior cerebellar artery infarction misdiagnosed as inner ear disease.

    Science.gov (United States)

    Yoshida, T; Ikemiyagi, Y; Ikemiyagi, F; Tamura, Y; Suzuki, M; Tsuyusaki, Y

    2016-08-01

    Anterior Inferior cerebellar artery infarction misdiagnosed as inner ear disease. The clinical >resentation of anterior inferior cerebellar artery (AICA) infarction may mimic that of inner ear disease. lethodology: This report presents two patients with cerebellar artery infarction initially misdiagnosed with inner ear lisease. ase Report: Both the patients presented with sudden hearing loss and vertigo. The patient in case 1 was initially liagnosed with idiopathic sudden sensorineural hearing loss. The patient in case 2 presented with 17 days of vertigo and iearing loss. Both were correctly diagnosed with AICA infarction after performing magnetic resonance imaging. esults and Conclusions: We differentiated AICA from inner ear disease based on the variability in degree and frequency ange of hearing loss, the duration of vertigo, and the manifestation of nystagmus. Because cases of AICA infarction and nner ear disease may present with si'milar symptoms, a detailed examination including clinical course assessments, aboratory findings, and neurological imaging is essential for appropriate diagnosis and treatment.

  11. Extraluminal leimyosarcoma of inferior vena cava. Report of a case

    International Nuclear Information System (INIS)

    Pedraza, S. de; Arenal, F.; Garcia, M.

    1997-01-01

    The leiomyosarcoma is the second most common primary retroperitoneal tumor in adults, after liposarcoma. Retroperitoneal leimyosarcoma (RLMS) and leiomyosarcoma of the inferior vena cava are presently considered to belong to the same group of tumors. RMLS presents three major growth patterns: a) totally extravascular (extraluminal); b) totally intravascular (intraluminal), and c) extra and intraluminal. In most cases, the growth of RLMS is extrinsic to the blood vessels. The most common clinical sign is a large abdominal mass. The variability in the findings and the potential intravascular extension results in differing radiological images. That most frequently observed is that of a large mass of soft tissue with partial necrosis, within the retroperitoneum, sometimes extending into vena cava. We present a typical case of RLMS with totally extravascular growth, which was discovered during surgery to be intimately joined to inferior vena cava. (Author) 13 refs

  12. Congenital absence of inferior vena cava and thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Iqbal Javaid

    2008-02-01

    Full Text Available Abstract Introduction A congenitally absent Inferior Vena Cava (IVC is a rare anomaly that is recognised to be associated with idiopathic Deep Venous Thrombosis (DVT, particularly in the young. It may not be apparent until later in life. Retrospectively, as discussed in this case, there can be clues indicating the presence of such an anomaly from a young age. However, it is not clear whether early recognition of this condition would affect the prognosis and treatment. Case presentation A 54 year old gentleman was admitted with 3 weeks of abdominal pain and localised swelling over the right flank. Examination revealed palpable 'snake-like' tortuous, tender lumps on the abdominal wall. Past history revealed chronic non-healing venous leg ulcers, and varicose veins necessitating varicose vein ligation at a very young age. The ulcers eventually needed skin grafting. During this, current admission he was investigated and diagnosed with Deep Vein Thrombosis (DVT. CT scan, performed to search for intra-abdominal cancer, revealed absence of the Inferior Vena Cava with extensive thrombosed collaterals of the superficial abdominal and azygous veins and a congenitally atrophic left kidney. Conclusion This is a case of one of the oldest patient described in the literature to be diagnosed with absence of the IVC. It is thought that IVC anomalies are under-diagnosed, and may be commoner than once believed. However there were vital clues in his previous medical history suspicious for an underlying venous anomaly. Idiopathic DVT in a relatively young person with a past history of chronic leg ulceration or varicose veins should be investigated for congenital anomalies of the IVC. This is best achieved by CT scan of the abdomen.

  13. Drive for thinness as a women's strategy to avoid inferiority

    OpenAIRE

    Ferreira, C.; Pinto-Gouveia, J.; Duarte, C.

    2013-01-01

    Ferreira, C., Pinto-Gouveia, J., & Duarte, C. (2013). Drive for thinness as a women's strategy to avoid inferiority. International Journal of Psychology and Psychological Therapy, 13(1), 15-29. http://www.ijpsy.com/volumen13/num1/344.html The emphasis on the need to achieve and be successful, and the contextual competitive dynamics in Western societies, may explain the increase of distinct forms of psychopathology. This study examined sex differences relative to the expression and conseque...

  14. Las alteraciones posturales en miembros inferiores en el surf

    OpenAIRE

    Gaspe, Guillermina

    2015-01-01

    Cuando el equilibrio neuromuscular no es óptimo durante la práctica de un deporte, es posible que, a largo plazo, aparezcan trastornos posturales que, dependiendo del tiempo de entrenamiento, pueden convertirse en un obstáculo para la salud. Es por esto, que mediante esta investigación he pretendido mostrar las alteraciones posturales que el surf puede llegar a provocar en quienes lo practican. Objetivo: Analizar las alteraciones posturales en los miembros inferiores de surfist...

  15. The Inferiority Complex of Homunculus in Hiromu Arakawa's Fullmetal Alchemist

    OpenAIRE

    Thenady, Tania P; Limanta, Liem Satya

    2013-01-01

    This article explores the causes and effects of inferiority complex in a character of a manga created by Hiromu Arakawa, Fullmetal Alchemist. Commonly seen as a child's play and underestimated by the society of literature, comic book or manga actually has the same quality as those considered as literary arts and stands equally with them. It embraces issues freely without the restriction of social rules and individual or group and uncontaminated by social, personal, or political influences. On...

  16. Nerve damage associated with inferior alveolar nerve blocks.

    Science.gov (United States)

    Pogrel, M A; Bryan, J; Regezi, J

    1995-08-01

    The authors reviewed 12 cases in which altered sensation occurred in the distribution of the inferior alveolar or lingual nerves following injection of a local anesthetic for restorative treatment only. Most patients suffered only partial damage, but recovery was poor. The exact mechanism of the nerve damage is unknown, but a number of theories are proposed. The extent of this problem is also unknown, but many more cases probably exist than have been reported to date.

  17. Optional inferior vena caval filters: where are we now?

    LENUS (Irish Health Repository)

    Keeling, A N

    2008-08-01

    With the advent of newer optional\\/retrievable inferior vena caval filters, there has been a rise in the number of filters inserted globally. This review article examines the currently available approved optional filter models, outlines the clinical indications for filter insertion and examines the expanding indications. Additionally, the available evidence behind the use of optional filters is reviewed, the issue of anticoagulation is discussed and possible future filter developments are considered.

  18. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  19. Inferior vestibular neuritis in a fighter pilot: a case report.

    Science.gov (United States)

    Xie, Su Jiang; Jia, Hong Bo; Xu, Po; Zheng, Ying Juan

    2013-06-01

    Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.

  20. Gaining surgical access for repositioning the inferior alveolar neurovascular bundle.

    Science.gov (United States)

    Al-Siweedi, Saif Yousif Abdullah; Nambiar, P; Shanmuhasuntharam, P; Ngeow, W C

    2014-01-01

    This study is aimed at determining anatomical landmarks that can be used to gain access to the inferior alveolar neurovascular (IAN) bundle. Scanned CBCT (i-CAT machine) data of sixty patients and reconstructions performed using the SimPlant dental implant software were reviewed. Outcome variables were the linear distances of the mandibular canal to the inferior border and the buccal cortex of the mandible, measured immediately at the mental foramen (D1) and at 10, 20, 30, and 40 mm (D2-D5) distal to it. Predictor variables were age, ethnicity, and gender of subjects. Apicobasal assessment of the canal reveals that it is curving downward towards the inferior mandibular border until 20 mm (D3) distal to the mental foramen where it then curves upwards, making an elliptic-arc curve. The mandibular canal also forms a buccolingually oriented elliptic arc in relation to the buccal cortex. Variations due to age, ethnicity, and gender were evident and this study provides an accurate anatomic zone for gaining surgical access to the IAN bundle. The findings indicate that the buccal cortex-IAN distance was greatest at D3. Therefore, sites between D2 and D5 can be used as favorable landmarks to access the IAN bundle with the least complications to the patient.

  1. Gaining Surgical Access for Repositioning the Inferior Alveolar Neurovascular Bundle

    Directory of Open Access Journals (Sweden)

    Saif Yousif Abdullah Al-Siweedi

    2014-01-01

    Full Text Available This study is aimed at determining anatomical landmarks that can be used to gain access to the inferior alveolar neurovascular (IAN bundle. Scanned CBCT (i-CAT machine data of sixty patients and reconstructions performed using the SimPlant dental implant software were reviewed. Outcome variables were the linear distances of the mandibular canal to the inferior border and the buccal cortex of the mandible, measured immediately at the mental foramen (D1 and at 10, 20, 30, and 40 mm (D2–D5 distal to it. Predictor variables were age, ethnicity, and gender of subjects. Apicobasal assessment of the canal reveals that it is curving downward towards the inferior mandibular border until 20 mm (D3 distal to the mental foramen where it then curves upwards, making an elliptic-arc curve. The mandibular canal also forms a buccolingually oriented elliptic arc in relation to the buccal cortex. Variations due to age, ethnicity, and gender were evident and this study provides an accurate anatomic zone for gaining surgical access to the IAN bundle. The findings indicate that the buccal cortex-IAN distance was greatest at D3. Therefore, sites between D2 and D5 can be used as favorable landmarks to access the IAN bundle with the least complications to the patient.

  2. Simulation of Left Atrial Function Using a Multi-Scale Model of the Cardiovascular System

    Science.gov (United States)

    Pironet, Antoine; Dauby, Pierre C.; Paeme, Sabine; Kosta, Sarah; Chase, J. Geoffrey; Desaive, Thomas

    2013-01-01

    During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors. PMID:23755183

  3. Simulation of left atrial function using a multi-scale model of the cardiovascular system.

    Directory of Open Access Journals (Sweden)

    Antoine Pironet

    Full Text Available During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors.

  4. The absent inferior epigastric artery: a unique anomaly and implications for deep inferior epigastric artery perforator flaps.

    Science.gov (United States)

    Rozen, Warren M; Houseman, Nicholas D; Ashton, Mark W

    2009-06-01

    The abdominal wall is particularly advantageous as a donor site due to the reliability of its vascular supply. Although the cutaneous perforators of the deep inferior epigastric artery (DIEA) and the superficial inferior epigastric artery (SIEA) may show significant individual variability, the DIEA itself has been shown to be ever-present as a vascular pedicle and to be highly dependable. The increasing use of preoperative computed tomographic angiography (CTA) has led to increasing reports of anatomic variability. With the use of preoperative CTA, we describe a unique case of a completely absent DIEA in patient who had not previously undergone any open abdominal surgery. The absence of the DIEA had led to vascular changes throughout the abdominal wall, including dilatation of both SIEAs and the ipsilateral deep superior epigastric artery. Preoperative CTA in this setting helped us identify this anomaly and aided surgical planning. The incidence of this anomaly was subsequently reviewed in 150 consecutive CTA scans performed at our institution.

  5. Association of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study.

    Science.gov (United States)

    Motomura, Kazuya; Fujii, Masazumi; Maesawa, Satoshi; Kuramitsu, Shunichiro; Natsume, Atsushi; Wakabayashi, Toshihiko

    2014-07-01

    Alexia and agraphia are disorders common to the left inferior parietal lobule, including the angular and supramarginal gyri. However, it is still unclear how these cortical regions interact with other cortical sites and what the most important white matter tracts are in relation to reading and writing processes. Here, the authors present the case of a patient who underwent an awake craniotomy for a left inferior parietal lobule glioma using direct cortical and subcortical electrostimulation. The use of subcortical stimulation allowed identification of the specific white matter tracts associated with reading and writing. These tracts were found as portions of the dorsal inferior frontooccipital fasciculus (IFOF) fibers in the deep parietal lobe that are responsible for connecting the frontal lobe to the superior parietal lobule. These findings are consistent with previous diffusion tensor imaging tractography and functional MRI studies, which suggest that the IFOF may play a role in the reading and writing processes. This is the first report of transient alexia and agraphia elicited through intraoperative direct subcortical electrostimulation, and the findings support the crucial role of the IFOF in reading and writing.

  6. Three dimensional endo-cardiovascular volume-rendered cine computed tomography of isolated left ventricular apical hypoplasia; A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sun Hwa; Kim, Yang Min; Lee, Hyun Jong [Sejong General Hospital, Bucheon (Korea, Republic of)

    2016-02-15

    We report multidetector computed tomography (MDCT) and cardiac magnetic resonance (CMR) findings of a 34-year-old female with isolated left ventricular apical hypoplasia. The MDCT and CMR scans displayed a spherical left ventricle (LV) with extensive fatty infiltration within the myocardium at the apex, interventricular septum and inferior wall, anteroapical origin of the papillary muscle, right ventricle wrapping around the deficient LV apex, and impaired systolic function. MDCT visualized morphologic and also functional findings of this unique cardiomyopathy.

  7. Left Activism, Succour and Selfhood

    DEFF Research Database (Denmark)

    Hughes, Celia Penelope

    2014-01-01

    an interchange of motherhood, domesticity, far-left politics, and close female friendship. The article will show how the women's epistolary friendship offers intimate insight into female self-fashioning at a breakthrough social and political moment in 1970s Britain. As they reflected on some of the key political...

  8. Preliminary experimental study of retrievable nitinol inferior vena cava filter

    International Nuclear Information System (INIS)

    Wei Baojie; Zhai Renyou; Ding Jingran; Dai Dingke

    2003-01-01

    Objective: To evaluate, in vitro and in an animal model together with the placement, stability, clot capturing efficacy, retrieval and safety of a new non-invasive retrievable nitinol inferior vena cava filter (RNIVCF) for temporary or permanent use. Methods: RNIVCF were made by wrapping nitinol monofilament wire on a steel mandrill to form a steric configuration. A 5-F Teflon sheath/dilator was taken for placement and retrieval. In vitro clots' trapping was assessed with size of 2.5/3/4-mm-diameter clots. Twenty adult mongrel dogs were used in this study. 2.5-mm-diameter homologous radiopaque clots (2.5-mm-HRC) were injected into IVC until the experimental animals die of acute pulmonary embolism (PE) and then to determine the minimum fatal quantity of clots in 8 dogs. RNIVCFs were introduced into the inferior vena cava in 12 dogs. For 10 animals, 10-ml 2.5-mm-HRC were injected below the filter to test its thrombus-trapping efficacy. The retrieval of filter was attempted on the 7th day after placement in two other dogs. Plain films of the abdomen and chest were made to document the effectiveness of the filter. Results: Initial experimental study showed that the RNIVCF functioned as intended. In vitro all 3 and 4-mm-diameter clots injected in the device simulating IVC flow was trapped by the filter. However, 95%-100% 2.5-mm-diameter clots were also captured by it. More than 10-ml 2.5-mm-HRC with once injection into IVC could cause the death of experimental animals due to acute PE in per-experiment. RNIVCF could be easily and successfully placed percutaneously in the inferior vena cava of the dogs through a 5-F sheath. The filter was accurately positioned in the inferior vena cava by moving the retrieval wire. All 13 RNIVCFs were placed in 12 dogs, one of those has double inferior vena cava and two filters were implanted. The filters trapped these 2.5-mm-diameter clots in the iliac veins of 8 dogs and none of them died of acute PE. But the initial two dogs with two

  9. Carcinoid tumor of the verumontanum (colliculus seminalis of the prostatic urethra with a coexisting prostatic adenocarcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Werahera Priya N

    2010-01-01

    Full Text Available Abstract Introduction Urethral carcinoid tumors are very rare tumors with only four cases described in the literature. Case presentation We present the case of a 61-year-old man with a primary carcinoid tumor of the verumontanum (colliculis seminalis portion of the prostatic urethra with a coexisting prostatic adenocarcinoma. In addition to whole mount hematoxylin and eosin staining, special immunoperoxidase staining specific for chromogranin A, neuron specific enolase, synaptophysin, pan-cytokeratin and PSA, and a special combined staining for racemase (α-methyl CoA antigen and p63 antigen were performed. A review of the literature is included. A single focus of invasive prostatic adenocarcinoma was identified in the periphery of the mid-left, posterior quadrant of the prostate. Approximately 17 mm from this adenocarcinoma, within the verumontanum of the prostatic urethra, there was a 3 mm maximal dimension carcinoid tumor. Conclusion Based on different histological features and antigenic profiles, we concluded that the two tumors were distinct.

  10. Healing of periodontal defects and calcitonin gene related peptide expression following inferior alveolar nerve transection in rats.

    Science.gov (United States)

    Lv, Linlin; Wang, Yanzhi; Zhang, Jing; Zhang, Ting; Li, Shu

    2014-06-01

    The roles of nerve and neuropeptides in the process of bone formation and remolding have been studied previously. However, the effects of nervous system and neuropeptide on periodontal alveolar bone formation remained unknown. The aim of this study was to assess the effect of innervation on regeneration of alveolar bone and expression levels of calcitonin gene related peptide (CGRP) in periodontal tissues of rats, so as to have a better understanding of the effect of nerve and its related neuropeptide on periodontal tissue regeneration. Rats received transection of the left inferior alveolar nerve and a surgery to produce bilateral periodontal defect, then the alveolar tissue was obtained from animals of each group at week 1, 2, 4, 6 and 8 weeks after operation, respectively. Hematoxylin and eosin staining, and Masson staining were performed to evaluate the ability to restore and repair periodontal tissues at 4, 6 and 8 after surgery. Then new bone formation area and mineralized area were quantified using imagepro-plus6.0 software after pictures were taken under the microscope and SPSS17.0 was used for statistical analysis. Immunohistochemical staining was applied to investigate the expression of CGRP at 1, 2, 4, 6 and 8 weeks. Rats received transection of the left inferior alveolar nerve surgery and were then sacrificed at day 1, 3, 7, 14, 21, 28 after the operation. The change of CGRP expression in periodontal tissue was detected using immunohistochemical methods. The results showed that the volume of new bone formation was not significantly difference between the experimental and control groups, but the mineralized new bone area between the two groups was statistically significant. The level of CGRP expression was lower than normal at week 1, and then it began to rise in the next stage. The plateau, at higher than normal level, was reached at 6 weeks post-surgery. Results of transection of the left inferior alveolar nerve demonstrated the expression of CGRP

  11. Vestibular neuritis affects both superior and inferior vestibular nerves.

    Science.gov (United States)

    Taylor, Rachael L; McGarvie, Leigh A; Reid, Nicole; Young, Allison S; Halmagyi, G Michael; Welgampola, Miriam S

    2016-10-18

    To characterize the profiles of afferent dysfunction in a cross section of patients with acute vestibular neuritis using tests of otolith and semicircular canal function sensitive to each of the 5 vestibular end organs. Forty-three patients fulfilling clinical criteria for acute vestibular neuritis were recruited between 2010 and 2016 and studied within 10 days of symptom onset. Otolith function was evaluated with air-conducted cervical and bone-conducted ocular/vestibular evoked myogenic potentials and the subjective visual horizontal test. Canal-plane video head impulse tests (vHITs) assessed the function of each semicircular canal. Patterns of recovery were investigated in 16 patients retested after a 6- to 12-month follow-up period. Rates of horizontal canal (97.7%), anterior canal (90.7%), and utricular (72.1%) dysfunction were significantly higher than rates of posterior canal (39.5%) and saccular (39.0%) dysfunction (p vestibular nerve divisions; 18 patients (41.9%) had superior neuritis; and 1 patient (2.3%) had inferior neuritis. A test battery that included horizontal and posterior canal vHIT and the cervical/vestibular evoked myogenic potentials identified superior or inferior neuritis in all patients tested acutely. Eight of 16 patients who were retested at follow-up had recovered a normal vestibular evoked myogenic potential and vHIT profile. Acute vestibular neuritis most often affects both vestibular nerve divisions. The horizontal vHIT alone identifies superior nerve dysfunction in all patients with vestibular neuritis tested acutely, whereas both cervical/vestibular evoked myogenic potentials and posterior vHIT are necessary for diagnosing inferior vestibular nerve involvement. © 2016 American Academy of Neurology.

  12. Impact of Middle vs. Inferior Total Turbinectomy on Nasal Aerodynamics

    Science.gov (United States)

    Dayal, Anupriya; Rhee, John S.; Garcia, Guilherme J. M.

    2016-01-01

    Objectives This computational study aims to: (1) Use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery; (2) Quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning; (3) Quantify to what extent total turbinectomy impairs the nasal air conditioning capacity. Study Design Virtual surgery and computational fluid dynamics (CFD). Setting Academic tertiary medical center. Subjects and Methods Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built based on pre-surgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a 15 L/min steady-state inhalation rate. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/cm2. Results In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/cm2 either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. Conclusion TIT yields greater increases in nasal airflow, but also impairs the nasal air conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. PMID:27165673

  13. Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics.

    Science.gov (United States)

    Dayal, Anupriya; Rhee, John S; Garcia, Guilherme J M

    2016-09-01

    This computational study aims to (1) use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery, (2) quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning, and (3) quantify to what extent total turbinectomy impairs the nasal air-conditioning capacity. Virtual surgery and computational fluid dynamics. Academic tertiary medical center. Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built according to presurgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a steady-state inhalation rate of 15 L/min. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/m(2). In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/m(2) either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. TIT yields greater increases in nasal airflow but also impairs the nasal air-conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. ST depression in lead aVL differentiates inferior ST-elevation myocardial infarction from pericarditis.

    Science.gov (United States)

    Bischof, Johanna E; Worrall, Christine; Thompson, Peter; Marti, David; Smith, Stephen W

    2016-02-01

    ST-segment elevation (STE) due to inferior STE myocardial infarction (STEMI) may be misdiagnosed as pericarditis. Conversely, this less life-threatening etiology of ST elevation may be confused for inferior STEMI. We sought to determine if the presence of any ST-segment depression in lead aVL would differentiate inferior STEMI from pericarditis. Retrospective study of 3 populations. Cohort 1 included patients coded as inferior STEMI, cohort 2 included patients with a discharge diagnosis of pericarditis who presented with chest pain and at least 0.5 mm of ST elevation in at least 1 inferior lead. We analyzed the presenting electrocardiogram in both populations, with careful assessment of leads II, III, aVF, and aVL. In addition, we retrospectively studied a third cohort of patients with subtle inferior STEMI (pericarditis group, all 49 had some inferior STE but none had any ST-segment depression in lead aVL (specificity, 100%; confidence interval, 91%-100%). In the third cohort, there were 272 inferior MIs with coronary occlusion, of which 54 were "subtle." Of these, 49 had some ST depression in lead aVL. When there is inferior ST-segment elevation, the presence of any ST depression in lead aVL is highly sensitive for coronary occlusion in inferior myocardial infarction and very specific for differentiating inferior myocardial infarction from pericarditis. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. NMDA receptor blockade alters the intracellular distribution of neuronal nitric oxide synthase in the superficial layers of the rat superior colliculus

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    R.E. de Bittencourt-Navarrete

    2009-02-01

    Full Text Available Nitric oxide (NO is a molecular messenger involved in several events of synaptic plasticity in the central nervous system. Ca2+ influx through the N-methyl-D-aspartate receptor (NMDAR triggers the synthesis of NO by activating the enzyme neuronal nitric oxide synthase (nNOS in postsynaptic densities. Therefore, NMDAR and nNOS are part of the intricate scenario of postsynaptic densities. In the present study, we hypothesized that the intracellular distribution of nNOS in the neurons of superior colliculus (SC superficial layers is an NMDAR activity-dependent process. We used osmotic minipumps to promote chronic blockade of the receptors with the pharmacological agent MK-801 in the SC of 7 adult rats. The effective blockade of NMDAR was assessed by changes in the protein level of the immediate early gene NGFI-A, which is a well-known NMDAR activity-dependent expressing transcription factor. Upon chronic infusion of MK-801, a decrease of 47% in the number of cells expressing NGFI-A was observed in the SC of treated animals. Additionally, the filled dendritic extent by the histochemical product of nicotinamide adenine di-nucleotide phosphate diaphorase was reduced by 45% when compared to the contralateral SC of the same animals and by 64% when compared to the SC of control animals. We conclude that the proper intracellular localization of nNOS in the retinorecipient layers of SC depends on NMDAR activation. These results are consistent with the view that the participation of NO in the physiological and plastic events of the central nervous system might be closely related to an NMDAR activity-dependent function.

  16. Visual Neurons in the Superior Colliculus Innervated by Islet2+ or Islet2− Retinal Ganglion Cells Display Distinct Tuning Properties

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    Rachel B. Kay

    2017-10-01

    Full Text Available Throughout the visual system, different subtypes of neurons are tuned to distinct aspects of the visual scene, establishing parallel circuits. Defining the mechanisms by which such tuning arises has been a long-standing challenge for neuroscience. To investigate this, we have focused on the retina’s projection to the superior colliculus (SC, where multiple visual neuron subtypes have been described. The SC receives inputs from a variety of retinal ganglion cell (RGC subtypes; however, which RGCs drive the tuning of different SC neurons remains unclear. Here, we pursued a genetic approach that allowed us to determine the tuning properties of neurons innervated by molecularly defined subpopulations of RGCs. In homozygous Islet2-EphA3 knock-in (Isl2EA3/EA3 mice, Isl2+ and Isl2− RGCs project to non-overlapping sub-regions of the SC. Based on molecular and anatomic data, we show that significantly more Isl2− RGCs are direction-selective (DS in comparison with Isl2+ RGCs. Targeted recordings of visual responses from each SC sub-region in Isl2EA3/EA3 mice revealed that Isl2− RGC-innervated neurons were significantly more DS than those innervated by Isl2+ RGCs. Axis-selective (AS neurons were found in both sub-regions, though AS neurons innervated by Isl2+ RGCs were more tightly tuned. Despite this segregation, DS and AS neurons innervated by Isl2+ or Isl2− RGCs did not differ in their spatial summation or spatial frequency (SF tuning. Further, we did not observe alterations in receptive field (RF size or structure of SC neurons innervated by Isl2+ or Isl2− RGCs. Together, these data show that innervation by Isl2+ and Isl2− RGCs results in distinct tuning in the SC and set the stage for future studies investigating the mechanisms by which these circuits are built.

  17. Functional changes in Tg P23H-1 rat retinal responses: differences between ON and OFF pathway transmission to the superior colliculus.

    Science.gov (United States)

    Fransen, James W; Pangeni, Gobinda; Pyle, Ian S; McCall, Maureen A

    2015-10-01

    The morphological consequences of retinal photoreceptor degeneration are well documented. Much less is known about changes in visual function during degeneration and whether central visual structures directly reflect changes in retinal ganglion cell (RGC) function. To address this, we compared changes in visual function of RGCs and cells in the superior colliculus (SC) in transgenic (Tg) P23H-1 rats, a model of retinitis pigmentosa (RP), and wild-type (WT) rats at postnatal days 35-50 (P35-50) and P300. RGCs were classified on the basis of their responses to light: onset (ON), offset (OFF), or both (ON-OFF). The distribution of ON, OFF, and ON-OFF RGCs is similar between WT and P35 Tg P23H-1 rats. By P300, many Tg P23H-1 RGCs are nonresponsive (NR). At this age, there is a sharp decline in ON and ON-OFF RGCs, and the majority that remain are OFF RGCs. Spontaneous rhythmic activity was observed in many RGCs at P300, but only in OFF or NR RGCs. In the SC, WT and P50 Tg P23H-1 responses are similar. At P300, Tg P23H-1 ON SC responses declined but OFF responses increased. We examined postsynaptic glutamate receptor expression located on the bipolar cells (BC), where the ON and OFF pathways arise. At P150, metabotropic glutamate receptor 6 (mGluR6) expression is lower than in WT, consistent with a decrease in ON RGC responses. GluR4 expression, an ionotropic glutamate receptor associated with OFF BCs, appears similar to that in WT. The loss of ON responses in Tg P23H-1 RGCs and in the SC is conserved and related to reduced mGluR6 signaling. Copyright © 2015 the American Physiological Society.

  18. Different Stimuli, Different Spatial Codes: A Visual Map and an Auditory Rate Code for Oculomotor Space in the Primate Superior Colliculus

    Science.gov (United States)

    Lee, Jungah; Groh, Jennifer M.

    2014-01-01

    Maps are a mainstay of visual, somatosensory, and motor coding in many species. However, auditory maps of space have not been reported in the primate brain. Instead, recent studies have suggested that sound location may be encoded via broadly responsive neurons whose firing rates vary roughly proportionately with sound azimuth. Within frontal space, maps and such rate codes involve different response patterns at the level of individual neurons. Maps consist of neurons exhibiting circumscribed receptive fields, whereas rate codes involve open-ended response patterns that peak in the periphery. This coding format discrepancy therefore poses a potential problem for brain regions responsible for representing both visual and auditory information. Here, we investigated the coding of auditory space in the primate superior colliculus(SC), a structure known to contain visual and oculomotor maps for guiding saccades. We report that, for visual stimuli, neurons showed circumscribed receptive fields consistent with a map, but for auditory stimuli, they had open-ended response patterns consistent with a rate or level-of-activity code for location. The discrepant response patterns were not segregated into different neural populations but occurred in the same neurons. We show that a read-out algorithm in which the site and level of SC activity both contribute to the computation of stimulus location is successful at evaluating the discrepant visual and auditory codes, and can account for subtle but systematic differences in the accuracy of auditory compared to visual saccades. This suggests that a given population of neurons can use different codes to support appropriate multimodal behavior. PMID:24454779

  19. Complete inferior rectus muscle transection secondary to orbital blowout fracture.

    Science.gov (United States)

    Carrere, Jonathan M; Lewis, Kyle T

    2018-01-05

    Complete extraocular muscle transection is uncommon in the setting of blunt trauma. We report a case of a 53-year-old male that developed diplopia after hitting his face directly on a concrete slab after a fall. On examination, he had a right hypertropia with a complete infraduction deficit. A CT scan of the face showed an orbital floor blowout fracture with complete inferior rectus transection. On surgical exploration, the distal and proximal ends of the muscle were identified and sutured together, and the floor fracture was repaired. At his post-operative visits, the patient had a persistent infraduction deficit, but subjectively had improved diplopia.

  20. A Novel Technique for Inferior Vena Cava Filter Extraction

    International Nuclear Information System (INIS)

    Johnston, Edward William; Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian

    2014-01-01

    Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed

  1. Evidence of mirror neurons in human inferior frontal gyrus.

    Science.gov (United States)

    Kilner, James M; Neal, Alice; Weiskopf, Nikolaus; Friston, Karl J; Frith, Chris D

    2009-08-12

    There is much current debate about the existence of mirror neurons in humans. To identify mirror neurons in the inferior frontal gyrus (IFG) of humans, we used a repetition suppression paradigm while measuring neural activity with functional magnetic resonance imaging. Subjects either executed or observed a series of actions. Here we show that in the IFG, responses were suppressed both when an executed action was followed by the same rather than a different observed action and when an observed action was followed by the same rather than a different executed action. This pattern of responses is consistent with that predicted by mirror neurons and is evidence of mirror neurons in the human IFG.

  2. Amiloidosis renal en paciente con osteomielitis de extremidad inferior

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    María Vicente Santos

    2012-09-01

    Full Text Available La amiloidosis secundaria (AA sistémica es una entidad frecuente, asociada con enfermedades inflamatorias e infecciones de larga evolución, así como con algunas neoplasias. Presentamos el caso de un varón de 58 años, con antecedente de úlcera en miembro inferior derecho de más de 30 años de evolución y con síndrome nefrótico secundario a amiloidosis AA.

  3. Hypertrophy of the inferior olivary nucleus impacts perception of gravity.

    Science.gov (United States)

    Tarnutzer, Alexander A; Palla, Antonella; Marti, Sarah; Schuknecht, Bernhard; Straumann, Dominik

    2012-01-01

    Interruption of the dentato-olivary projections, interconnecting the dentate nucleus (DN) and the contralateral inferior olivary nucleus (ION), is predicted to interfere with the DN' role in estimating direction of gravity. In a patient with pendular nystagmus due to hypertrophy of the ION secondary to predominantly right-sided ponto-mesencephalic hemorrhage, perceived vertical shifted from clockwise to counter-clockwise deviations within 4 months. We hypothesize that synchronized oscillations of ION neurons induce a loss of inhibitory control, leading to hyperactivity of the contralateral DN and, as a result, to perceived vertical roll-tilt to the side of the over-active DN.

  4. Omental flap transposition for inferior vena cava filter penetration

    Directory of Open Access Journals (Sweden)

    Junji Yamaguchi, MD

    2017-03-01

    Full Text Available A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava. Omental flap was used to cover the struts, and no associated complications occurred after operation.

  5. Left ventricular diastolic performance of left ventricular hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Ikezono, Tohru; Ozaki, Masaharu; Yamagishi, Takashi; Shimizu, Tatsuro; Furutani, Yuji; Kusukawa, Reizo

    1987-02-01

    To study left ventricular diastolic performance in different forms of left ventricular hypertrophy, ECG gated cardiac blood pool scan was performed in 11 patients with hypertrophic nonobstructive cardiomyopathy (HCM) and in 19 patients with hypertension (HT), and left ventricular volume curve (LVVC) was analyzed and compared with those of 13 normal subjects (N). Ejection fraction (EF) and early filling volume ratio (the ratio of volume increment of 100 msec later than the zero point in the first derivative of LVVC to the end diastolic volume) (%EFV) were computed from LVVC. Peak ejection rate (PER) and peak filling rate (PFR) were obtained from the first derivative of LVVC. Peak ejection acceleration (PEA) and peak filling acceleration (PFA) were calculated from the second derivative of LVVC. EF, PER and PEA did not show any difference between these 3 groups. PFR was lower in HT (2.6 +- 0.5) compared with those in HCM (3.0 +- 0.5) (p < 0.05) and in N (3.4 +- 0.5) (p < 0.001), but the %EFV in HCM (4.9 +- 1.8) was lower than those in HT (6.9 +- 1.9) (p < 0.01) and in N (11.4 +- 1.4) (p < 0.001). Moreover, PFA in HCM (27.9 +- 7.2) was increased than those in HT (20.2 +- 5.4) (p < 0.01) with no differences between HCM and N (29.4 +- 8.1). Significant correlation was observed between PFR and PFA (Y = 0.06X + 1.4. r = 0.856. p < 0.001). These result indicate that, in HCM, reduced increase in early left ventricular volume is compensated by a greater filling acceleration. In contrast, there is no compensation by filling acceleration in HT.

  6. Differential diagnosis of endodontic-related inferior alveolar nerve paraesthesia with cone beam computed tomography: a case report.

    Science.gov (United States)

    Gambarini, G; Plotino, G; Grande, N M; Testarelli, L; Prencipe, M; Messineo, D; Fratini, L; D'Ambrosio, F

    2011-02-01

    To discuss the use of cone-beam computed tomography (CBCT) in the differential diagnosis of a case of labiomandibular paraesthesia caused by extrusion of endodontic sealer into the mandibular canal. A 59-year-old woman suffering from a paraesthesia on the left posterior mandible and numbness on the left side of the lower lip was referred to an endodontic specialist 1 month after multiple root canal treatments. A panoramic radiograph revealed the presence of extruded root filling material beyond the apex of the mesial root of the mandibular left second molar and also beyond the apex of the first premolar. A cone beam computed tomography examination was undertaken, which confirmed the presence of radiopaque root canal filling material in the periapical area of the second molar, and revealed that the material was inside the mandibular canal. No extruded filling material was found inside the mental foramen beyond the apex of the first premolar tooth. Small field of view CBCT (where possible) can be considered an effective radiographic diagnostic device when endodontic-related inferior alveolar nerve or mental foramen paraesthesia are suspected. CBCT is able to provide detailed three-dimensional images of the tooth, the root canal system and the surrounding tissue. © 2010 International Endodontic Journal.

  7. Shifted inferior frontal laterality in women with major depressive disorder is related to emotion-processing deficits.

    Science.gov (United States)

    Briceño, E M; Weisenbach, S L; Rapport, L J; Hazlett, K E; Bieliauskas, L A; Haase, B D; Ransom, M T; Brinkman, M L; Peciña, M; Schteingart, D E; Starkman, M N; Giordani, B; Welsh, R C; Noll, D C; Zubieta, J-K; Langenecker, S A

    2013-07-01

    Facial emotion perception (FEP) is a critical human skill for successful social interaction, and a substantial body of literature suggests that explicit FEP is disrupted in major depressive disorder (MDD). Prior research suggests that weakness in FEP may be an important phenomenon underlying patterns of emotion-processing challenges in MDD and the disproportionate frequency of MDD in women. Method Women with (n = 24) and without (n = 22) MDD, equivalent in age and education, completed a FEP task during functional magnetic resonance imaging. The MDD group exhibited greater extents of frontal, parietal and subcortical activation compared with the control group during FEP. Activation in the inferior frontal gyrus (IFG) appeared shifted from a left >right pattern observed in healthy women to a bilateral pattern in MDD women. The ratio of left to right suprathreshold IFG voxels in healthy controls was nearly 3:1, whereas in the MDD group, there was a greater percentage of suprathreshold IFG voxels bilaterally, with no leftward bias. In MDD, relatively greater activation in right IFG compared with left IFG (ratio score) was present and predicted FEP accuracy (r = 0.56, p imaging-to-assessment translational applications in MDD.

  8. Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

    NARCIS (Netherlands)

    Dell'Omo, Roberto; Barca, Francesco; Tan, H. Stevie; Bijl, Heico M.; Oberstein, Sarit Y. Lesnik; Mura, Marco

    2013-01-01

    To compare anatomical, functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes. Eighty-five eyes from 85 patients with a minimum

  9. Sinus bradycardia as a predictor of right coronary artery occlusion in patients with inferior myocardial infarction.

    Science.gov (United States)

    Serrano, C V; Bortolotto, L A; César, L A; Solimene, M C; Mansur, A P; Nicolau, J C; Ramires, J A

    1999-01-01

    Differentiation of right coronary artery (RCA) from left circumflex artery (LCxA) occlusion may be difficult since both can present an electrocardiographic pattern of inferior myocardial infarction (IMI). We studied 133 patients with IMI, 92 patients with RCA occlusion and 41 patients with LCxA occlusion. Risk factors such as previous MI, arterial hypertension, diabetes, smoking, and dislipemia, were similar for RCA and LCxA occlusions. Patients with RCA occlusion had a higher incidence of isolated IMI than patients with LCxA occlusion, 50% vs. 17%, respectively (P<0.001). Arterial hypotension was more prevalent (P<0.05) among patients with RCA (18%) rather than those with LCxA occlusion (2%). RCA occlusion presented an association with sinus bradycardia, an association not observed with LCxA occlusion (15% vs. 0%, respectively; P<0.01). Total atrioventricular block was only present among patients with RCA (18%). Proximal occlusions of the RCA presented lower heart rates (sinus bradycardia) than medial and distal occlusions (13% vs. 1% and 1%, respectively; P<0.0001 and P<0.001). Therefore, regarding patients with IMI: (1) sinus bradycardia is more frequent when the infarct-related artery is the RCA; (2) proximal occlusions of the right coronary predispose low heart rates; and (3) occlusion of the LCxA rarely induces sinus bradycardia.

  10. Retrieval of TRAPEASE and OPTEASE Inferior Vena Cava Filters with Extended Dwell Times.

    Science.gov (United States)

    Scher, Daniel; Venbrux, Anthony; Okapal, Kevin; Gabriel, Gaby; Dufour, Robert; Chun, Albert; Sarin, Shawn; Akman, Andrew

    2015-10-01

    To demonstrate that OPTEASE and TRAPEASE filters can be removed after dwell times greater than 60 days. A retrospective review was performed of patients who underwent an attempted removal of a TRAPEASE or OPTEASE filter with a greater than 60-day dwell time between 2009 and 2015 at a single institution. Eleven patients within that time span were identified, and 10 were included in the review. One patient was excluded from the study because the date of filter placement was unknown. All filters were successfully retrieved. The average dwell time for removed TRAPEASE filters was 1,273 days (range, 129-3,582 d), with a median of 492 days (n = 5). The average dwell time for OPTEASE filters was 977 days (range, 123-2,584 d), with a median of 661 days (n = 5). The average dwell time of all filters was 1,125 days (range, 123-3,582 d), with a median of 577 days (n = 10). All patients exhibited inferior vena cava (IVC) stenosis after filter retrieval. An IVC pseudoaneurysm was present following retrieval in one case and resolved. In one case, a fractured filter strut was left completely embedded in the caval wall. Two patients reported unilateral leg swelling on clinical follow-up, and the remainder reported no leg swelling or tightness. Initial experience suggests that TRAPEASE and OPTEASE filters can be removed after extended dwell times. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  11. The right inferior frontal gyrus processes nested non-local dependencies in music.

    Science.gov (United States)

    Cheung, Vincent K M; Meyer, Lars; Friederici, Angela D; Koelsch, Stefan

    2018-02-28

    Complex auditory sequences known as music have often been described as hierarchically structured. This permits the existence of non-local dependencies, which relate elements of a sequence beyond their temporal sequential order. Previous studies in music have reported differential activity in the inferior frontal gyrus (IFG) when comparing regular and irregular chord-transitions based on theories in Western tonal harmony. However, it is unclear if the observed activity reflects the interpretation of hierarchical structure as the effects are confounded by local irregularity. Using functional magnetic resonance imaging (fMRI), we found that violations to non-local dependencies in nested sequences of three-tone musical motifs in musicians elicited increased activity in the right IFG. This is in contrast to similar studies in language which typically report the left IFG in processing grammatical syntax. Effects of increasing auditory working demands are moreover reflected by distributed activity in frontal and parietal regions. Our study therefore demonstrates the role of the right IFG in processing non-local dependencies in music, and suggests that hierarchical processing in different cognitive domains relies on similar mechanisms that are subserved by domain-selective neuronal subpopulations.

  12. Modulating Mimetic Preference with Theta Burst Stimulation of the Inferior Parietal Cortex

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    Luca F. Ticini

    2017-12-01

    Full Text Available We like an object more when we see someone else reaching for it. To what extent is action observation causally linked to object valuation? In this study, we set out to answer to this question by applying continuous theta burst stimulation (cTBS over the left inferior parietal lobule (IPL. Previous studies pointed to this region as critical in the representation of others' actions and in tool manipulation. However, it is unclear to what extent IPL's involvement simply reflects action observation, rather than a casual role in objects' valuation. To clarify this issue, we measured cTBS-dependent modulations of participants' “mimetic preference ratings”, i.e., the difference between the ratings of pairs of familiar objects that were (vs. were not reached out for by other individuals. Our result shows that cTBS increased mimetic preference ratings for tools, when compared to a control condition without stimulation. This effect was selective for items that were reached for or manipulated by another individual, whilst it was not detected in non-tool objects. Although preliminary, this finding suggests that the automatic and covert simulation of an observed action, even when there is no intention to act on an object, influences explicit affective judgments for objects. This work supports embodied cognition theories by substantiating that our subjective preference is grounded in action.

  13. Learning Morse Code Alters Microstructural Properties in the Inferior Longitudinal Fasciculus: A DTI Study.

    Science.gov (United States)

    Schlaffke, Lara; Leemans, Alexander; Schweizer, Lauren M; Ocklenburg, Sebastian; Schmidt-Wilcke, Tobias

    2017-01-01

    Learning relies on neuroplasticity, which has mainly been studied in gray matter (GM). However, there is mounting evidence indicating a critical role of white matter changes involved in learning processes. One of the most important learning processes in human development is language acquisition. However, due to the length of this learning process, it has been notoriously difficult to investigate the underlying neuroplastic changes. Here, we report a novel learning paradigm to assess the role of white matter plasticity for language acquisition. By acoustically presenting Morse Code (MC) using an in house developed audio book as a model for language-type learning, we generated a well-controlled learning environment that allows for the detection of subtle white matter changes related to language type learning in a much shorter time frame than usual language acquisition. In total 12 letters of the MC alphabet were learned within six learning session, which allowed study participants to perform a word recognition MC decoding task. In this study, we found that learning MC was associated with significant microstructural changes in the left inferior longitudinal fasciculus (ILF). The fractional anisotropy (FA) of this associative fiber bundle connecting the occipital and posterior temporal cortex with the temporal pole as well as the hippocampus and amygdala was increased. Furthermore, white matter plasticity was associated with task performance of MC decoding, indicating that the structural changes were related to learning efficiency. In conclusion, our findings demonstrate an important role of white matter neuroplasticity for acquiring a new language skill.

  14. Learning Morse Code Alters Microstructural Properties in the Inferior Longitudinal Fasciculus: A DTI Study

    Directory of Open Access Journals (Sweden)

    Lara Schlaffke

    2017-07-01

    Full Text Available Learning relies on neuroplasticity, which has mainly been studied in gray matter (GM. However, there is mounting evidence indicating a critical role of white matter changes involved in learning processes. One of the most important learning processes in human development is language acquisition. However, due to the length of this learning process, it has been notoriously difficult to investigate the underlying neuroplastic changes. Here, we report a novel learning paradigm to assess the role of white matter plasticity for language acquisition. By acoustically presenting Morse Code (MC using an in house developed audio book as a model for language-type learning, we generated a well-controlled learning environment that allows for the detection of subtle white matter changes related to language type learning in a much shorter time frame than usual language acquisition. In total 12 letters of the MC alphabet were learned within six learning session, which allowed study participants to perform a word recognition MC decoding task. In this study, we found that learning MC was associated with significant microstructural changes in the left inferior longitudinal fasciculus (ILF. The fractional anisotropy (FA of this associative fiber bundle connecting the occipital and posterior temporal cortex with the temporal pole as well as the hippocampus and amygdala was increased. Furthermore, white matter plasticity was associated with task performance of MC decoding, indicating that the structural changes were related to learning efficiency. In conclusion, our findings demonstrate an important role of white matter neuroplasticity for acquiring a new language skill.

  15. Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography.

    Science.gov (United States)

    Cina, A; Barone-Adesi, L; Rinaldi, P; Cipriani, A; Salgarello, M; Masetti, R; Bonomo, L

    2013-08-01

    Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning. Twenty-three women (mean age 48.0 years, range 26-72 years) underwent preoperative blinded evaluation using 64-slice CTA and 1.5-T MRA. Perforator identification, measurement of their calibre, intramuscular course (IMC), assessment of direct venous connections (DVC) with main superficial veins, superficial venous communications (SVC) between the right and left hemi-abdomen and deep inferior epigastric artery (DIEA) branching type were performed. Surgery was carried out by the same team. Intraoperative findings were the standard of reference. Accuracy in identifying dominant perforators was 91.3 % for both techniques and mean error in calibre measurement 1.18 ± 0.35 mm for CTA and 1.63 ± 0.39 mm for MRA. Accuracy in assessing perforator IMCs was 97.1 % for CTA and 88.4 % for MRA, DVC 94.4 % for both techniques, SVC 91.3 % as well, and DIEA branching type 100 % for CTA and 91.3 % for MRA. Image acquisition and interpretation time was 21 ± 3 min for CTA (35 ± 5 min for MRA). In a strategy to optimise DIEP flap planning avoiding radiation exposure, MRA can be proposed alternatively to CTA. • Identification of deep inferior epigastric perforators (DIEP) is important before breast reconstruction. • Both CT and MR angiography are accurate in identifying DIEA perforator branches. • CTA and MRA are equivalent in demonstrating perforator-venous connections. • MRA can be proposed as an alternative to CTA in DIEP planning.

  16. Inferior turbinate reduction: Diode laser or conventional partial turbinectomy?

    Science.gov (United States)

    Doreyawar, Venkatesh; Gadag, Raveendra P; Manjunath, Dandi Narasaiah; Javali, Shivalingappa B; Maradi, Nagaraj; Shetty, Deekshit

    2018-01-01

    Hypertrophy of the inferior nasal turbinate is one of the most common causes of nasal obstruction. The diode laser has proven to be as effective as other lasers for this indication. Our objective was to study various outcomes associated with the use of the diode laser, such as improvements in nasal obstruction and postoperative pain, reduction in intraoperative bleeding, and rapidity of healing. A nonrandomized, controlled trial was conducted in which outcomes were compared between diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT) in 60 patients, 30 who underwent LTR and 30 who underwent PIT. The improvement in nasal obstruction was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to the fifth postoperative day. Rapidity of healing was evaluated until 6 months postoperatively. Subjective relief of nasal obstruction occurred in 90.8% of the LTR group and 65% of the PIT group at 6 months (p diode laser were better and diode LTR caused less morbidity compared with the conventional technique.

  17. Concomitant pulmonary arteriovenous and inferior vena cava malformations

    International Nuclear Information System (INIS)

    Hawass, N.D.; Kolawole, T.M.; Badawi, M.G.

    1988-01-01

    A case of pulmonary arterio-venous malformation (AVM) presenting with dyspnoea diagnosed by computer tomography (CT) and pulmonary angiography is reported. Venous anomalies in the form of agenesis of the iliac veins and the inferior vena cava (IVC), were discovered through femoral venograms performed after technical difficulties were encountered at pulmonary angiography performed via the femoral route. These venous anomalies co-existed with normal but dilated azygos and hemiazygos systems, and with the azygos appearing as a right hilar mass lesion which showed the 'candy cane sign' on the lateral view on venography. A dilated varix at the confluence of the right renal vein and the IVC collaterals was also noted. This association of a pulmonary AVM and IVC agenesis has not been previously reported in the literature. The embryogenesis of the inferior vena cava and the azygos system is presented in an attempt to explain the rare association of these anomalies. The various techniques of diagnosing the disease entities, expecially by CT, are discussed. The rare co-existence of pulmonary AVM and the absence of the IVC is emphasized. (orig.)

  18. MICROCIRUGÍA RECONSTRUCTIVA EN TRAUMA DE EXTREMIDADES INFERIORES

    Directory of Open Access Journals (Sweden)

    Dr. Günther Mangelsdorff G.

    2016-01-01

    Full Text Available La complejidad y extensión de las lesiones traumáticas del miembro inferior son muy variables, incluyendo dehiscencias de abordajes quirúrgicos en lesiones cerradas, fracturas expuestas, avulsiones y amputaciones. El aporte de la cirugía plástica en estos pacientes radica especialmente en la reconstrucción mediante la movilización local o a distancia de tejidos vitales bien irrigados. La microcirugía es una herramienta fundamental para lograr reconstrucciones complejas con un diseño versátil, así los colgajos libres otorgan coberturas bien vascularizadas y se adaptan a requerimientos tan diversos. El éxito final de una reconstrucción debe ser evaluado en cuanto a la reinserción del paciente a sus actividades de vida diaria y a su calidad de vida. La coordinación y trabajo con los distintos profesionales necesarios en este proceso permite aproximarse a este objetivo. Revisaremos en este artículo las estrategias de reconstrucción en trauma de extremidad inferior y las técnicas de reconstrucción microquirúrgica más utilizadas.

  19. Ausência de veia cava inferior: relato de caso Absence of the inferior vena cava: case report

    Directory of Open Access Journals (Sweden)

    Elton Correia Alves

    2010-12-01

    Full Text Available A ausência congênita de veia cava inferior é achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razão de a maioria dos pacientes sem outras malformações serem assintomáticos, há dificuldade em estimar a prevalência dessas anomalias. O objetivo deste trabalho foi relatar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de tórax devido a quadro de febre alta (39ºC não-responsiva à medicação. Radiografia de tórax sugeriu dilatação de veia ázigos. Em inquérito dirigido para sintomas cardiovasculares, referiu dor torácica (durante atividade física e em repouso e dispneia ocasionais durante o sono associada ao período em que intensificou a prática de exercícios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas não esclareceram o caso, fazendo-se necessário angiotomografia, a qual evidenciou ausência de veia cava inferior torácica.The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-year-old patient, male, referred to thorax X-ray due to high fever state (39ºC, nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  20. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    This thesis is the first comprehensive research work conducted on the Beirut based TV station, an important representative of the post-2011 generation of Arab satellite news media. The launch of al-Mayadeen in June 2012 was closely linked to the political developments across the Arab world...... members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...

  1. Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Cina, A.; Rinaldi, P.; Cipriani, A.; Bonomo, L. [Agostino Gemelli Hospital, Catholic University of Sacred Heart, Department of Radiological Sciences, Rome (Italy); Barone-Adesi, L.; Salgarello, M. [Agostino Gemelli Hospital, Catholic University of Sacred Heart, Department of Surgery, Plastic and Reconstructive Surgery Unit, Rome (Italy); Masetti, R. [Agostino Gemelli Hospital, Catholic University of Sacred Heart, Department of Surgery, Breast Surgery Unit, Rome (Italy)

    2013-08-15

    Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning. Twenty-three women (mean age 48.0 years, range 26-72 years) underwent preoperative blinded evaluation using 64-slice CTA and 1.5-T MRA. Perforator identification, measurement of their calibre, intramuscular course (IMC), assessment of direct venous connections (DVC) with main superficial veins, superficial venous communications (SVC) between the right and left hemi-abdomen and deep inferior epigastric artery (DIEA) branching type were performed. Surgery was carried out by the same team. Intraoperative findings were the standard of reference. Accuracy in identifying dominant perforators was 91.3 % for both techniques and mean error in calibre measurement 1.18 {+-} 0.35 mm for CTA and 1.63 {+-} 0.39 mm for MRA. Accuracy in assessing perforator IMCs was 97.1 % for CTA and 88.4 % for MRA, DVC 94.4 % for both techniques, SVC 91.3 % as well, and DIEA branching type 100 % for CTA and 91.3 % for MRA. Image acquisition and interpretation time was 21 {+-} 3 min for CTA (35 {+-} 5 min for MRA). In a strategy to optimise DIEP flap planning avoiding radiation exposure, MRA can be proposed alternatively to CTA. (orig.)

  2. Comparison of superior vena caval and inferior vena caval access using a radioisotope technique during normal perfusion and cardiopulmonary resuscitation

    International Nuclear Information System (INIS)

    Dalsey, W.C.; Barsan, W.G.; Joyce, S.M.; Hedges, J.R.; Lukes, S.J.; Doan, L.A.

    1984-01-01

    Recent studies of thoracic pressure changes during external cardiopulmonary resuscitation (CPR) suggest that there may be a significant difference in the rate of delivery of intravenous drugs when they are administered through the extrathoracic inferior vena cava (IVC) rather than the intrathoracic superior vena cava (SVC). Comparison of delivery of a radionuclide given using superior and inferior vena caval access sites was made during normal blood flow and during CPR. Mean times from injection to peak emission count in each ventricle were determined. There were no significant differences between mean peak times for SVC or IVC routes during normal flow or CPR. When peak times were corrected for variations in cardiac output, there were no significant differences between IVC and SVC peak times during normal flow. During CPR, however, mean left ventricular peak time, when corrected for cardiac output, was significantly shorter (P less than .05) when the SVC route was used. The mean time for the counts to reach half the ventricular peak was statistically shorter (P less than .05) in both ventricles with the SVC route during the low flow of CPR. This suggests that during CPR, increased drug dispersion may occur when drugs are infused by the IVC route and thus may modify the anticipated effect of the drug bolus. These results suggest that during CPR, both the cardiac output and the choice of venous access are important variables for drug delivery

  3. Anatomy of the junction of the inferior petrosal sinus and the internal jugular vein. Evaluation with MR imaging

    International Nuclear Information System (INIS)

    Takahashi, Satoshi; Tomura, Noriaki; Kato, Koki; Hirano, Yosinori; Izumi, Jun-ichi; Watarai, Jiro

    2000-01-01

    To evaluate the anatomy of the junction of the inferior petrosal sinus (IPS) and the internal jugular vein (IJV), magnetic resonance (MR) images of the jugular bulbs in 50 patients (age range, 15 to 83 years; mean age, 59.6 years) were retrospectively reviewed. Both MR imaging and intra-arterial digital subtraction angiography (IADSA) were performed in the 50 patients, and IPS venography was performed in 7 patients. Multiplanar reconstruction of the MR images was obtained using three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) with gadopentate dimegulmin (Gd-DTPA). IPS and other venous structures were identified around the jugular bulbs both on the MR images and by IPS venography. The diameters of the junctions of the IPS and IJV were measured on the MR images. IN 97 side (97%) of the 50 patients, a petrosal confluence was found on the medial side of the jugular bulb, connecting with the anterior condylar vein, inferior petroclival vein, basilar plexus and the IPS. Extracranial extension of the IPS was seen on 3 sides of 3 patients (right: 1, left: 2) (3%). All 3 patients showed the IPS connecting with the internal jugular vein below the anterior condylar vein. The minimum diameter of IPS-IJV junction was 1 mm or greater in all cases. In conclusion, the junction of the IPS and the IJV is easily identified by contrast-enhanced 3-D fast SPGR sequences, which is helpful for IPS catheterization in endovascular treatment. (author)

  4. Inferior Turbinate Size and CPAP Titration Based Treatment Pressures: No Association Found among Patients Who Have Not Had Nasal Surgery.

    Science.gov (United States)

    Camacho, Macario; Zaghi, Soroush; Tran, Daniel; Song, Sungjin A; Chang, Edward T; Certal, Victor

    2016-01-01

    Objective. To evaluate the effect of turbinate sizes on the titrated continuous positive airway pressure (CPAP) therapeutic treatment pressures for patients with obstructive sleep apnea (OSA) who have not had nasal surgery. Study Design. Retrospective case series. Methods. A chart review was performed for 250 consecutive patients. Results. 45 patients met inclusion criteria. The mean ± standard deviation (M ± SD) for age was 54.6 ± 22.4 years and for body mass index was 28.5 ± 5.9 kg/m(2). The Spearman's rank correlation coefficient (r s ) between CPAP therapeutic treatment pressures and several variables were calculated and were weakly correlated (age r s = 0.29, nasal obstruction r s = -0.30), moderately correlated (body mass index r s = 0.42 and lowest oxygen saturation r s = -0.47), or strongly correlated (apnea-hypopnea index r s = 0.60 and oxygen desaturation index (r s = 0.62)). No statistical significance was found with one-way analysis of variance (ANOVA) between CPAP therapeutic treatment pressures and inferior turbinate size (right turbinates p value = 0.2012, left turbinate p value = 0.3064), nasal septal deviation (p value = 0.4979), or mask type (p value = 0.5136). Conclusion. In this study, CPAP titration based therapeutic treatment pressures were not found to be associated with inferior turbinate sizes; however, the CPAP therapeutic treatment pressures were strongly correlated with apnea-hypopnea index and oxygen desaturation index.

  5. Inferior Turbinate Size and CPAP Titration Based Treatment Pressures: No Association Found among Patients Who Have Not Had Nasal Surgery

    Directory of Open Access Journals (Sweden)

    Macario Camacho

    2016-01-01

    Full Text Available Objective. To evaluate the effect of turbinate sizes on the titrated continuous positive airway pressure (CPAP therapeutic treatment pressures for patients with obstructive sleep apnea (OSA who have not had nasal surgery. Study Design. Retrospective case series. Methods. A chart review was performed for 250 consecutive patients. Results. 45 patients met inclusion criteria. The mean ± standard deviation (M ± SD for age was 54.6±22.4 years and for body mass index was 28.5±5.9 kg/m2. The Spearman’s rank correlation coefficient (rs between CPAP therapeutic treatment pressures and several variables were calculated and were weakly correlated (age rs=0.29, nasal obstruction rs=-0.30, moderately correlated (body mass index rs=0.42 and lowest oxygen saturation rs=-0.47, or strongly correlated (apnea-hypopnea index rs=0.60 and oxygen desaturation index (rs=0.62. No statistical significance was found with one-way analysis of variance (ANOVA between CPAP therapeutic treatment pressures and inferior turbinate size (right turbinates p value = 0.2012, left turbinate p value = 0.3064, nasal septal deviation (p value = 0.4979, or mask type (p value = 0.5136. Conclusion. In this study, CPAP titration based therapeutic treatment pressures were not found to be associated with inferior turbinate sizes; however, the CPAP therapeutic treatment pressures were strongly correlated with apnea-hypopnea index and oxygen desaturation index.

  6. Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives

    Science.gov (United States)

    Kang, Chang Moo; Lee, Sung Hwan; Lee, Woo Jung

    2014-01-01

    Minimally invasive distal pancreatectomy with splenectomy has been regarded as a safe and effective treatment for benign and borderline malignant pancreatic lesions. However, its application for left-sided pancreatic cancer is still being debated. The clinical evidence for radical antegrade modular pancreatosplenectomy (RAMPS)-based minimally invasive approaches for left-sided pancreatic cancer was reviewed. Potential indications and surgical concepts for minimally invasive RAMPS were suggested. Despite the limited clinical evidence for minimally invasive distal pancreatectomy in left-sided pancreatic cancer, the currently available clinical evidence supports the use of laparoscopic distal pancreatectomy under oncologic principles in well-selected left sided pancreatic cancers. A pancreas-confined tumor with an intact fascia layer between the pancreas and left adrenal gland/kidney positioned more than 1 or 2 cm away from the celiac axis is thought to constitute a good condition for the use of margin-negative minimally invasive RAMPS. The use of minimally invasive (laparoscopic or robotic) anterior RAMPS is feasible and safe for margin-negative resection in well-selected left-sided pancreatic cancer. The oncologic feasibility of the procedure remains to be determined; however, the currently available interim results indicate that even oncologic outcomes will not be inferior to those of open radical distal pancreatosplenectomy. PMID:24605031

  7. Right Versus Left Colon Cancer Biology: Integrating the Consensus Molecular Subtypes.

    Science.gov (United States)

    Lee, Michael S; Menter, David G; Kopetz, Scott

    2017-03-01

    Although clinical management of colon cancer generally has not accounted for the primary tumor site, left-sided and right-sided colon cancers harbor different clinical and biologic characteristics. Right-sided colon cancers are more likely to have genome-wide hypermethylation via the CpG island methylator phenotype (CIMP), hypermutated state via microsatellite instability, and BRAF mutation. There are also differential exposures to potential carcinogenic toxins and microbiota in the right and left colon. Gene expression analyses further shed light on distinct biologic subtypes of colorectal cancers (CRCs), with 4 consensus molecular subtypes (CMSs) identified. Importantly, these subtypes are differentially distributed between right- and left-sided CRCs, with greater proportions of the "microsatellite unstable/immune" CMS1 and the "metabolic" CMS3 subtypes found in right-sided colon cancers. This review summarizes important biologic distinctions between right- and left-sided CRCs that likely impact prognosis and may predict for differential responses to biologic therapy. Given the inferior prognosis of stage III-IV right-sided CRCs and emerging data suggesting that anti-epidermal growth factor receptor antibody therapy is associated with worse survival in right-sided stage IV CRCs compared with left-sided cancers, these biologic differences between right- and left-sided CRCs provide critical context and may provide opportunities to personalize therapy. Copyright © 2017 by the National Comprehensive Cancer Network.

  8. Acute Hearing Loss Caused by Decreasing Anterior Inferior Cerebellar Arterial Perfusion in a Patient with Vertebral Artery Stenosis.

    Science.gov (United States)

    Fukuda, Rintaro; Miyamoto, Nobukazu; Hayashida, Arisa; Ueno, Yuji; Yamashiro, Kazuo; Tanaka, Ryota; Hattori, Nobutaka

    2017-06-01

    We report a case of bilateral hearing loss caused by decreased vascular flow in the anterior inferior cerebellar artery (AICA) territory. A 74-year-old man who experienced right hearing loss 5 months ago presented with bilateral deafness and right cerebellar ataxia; however, no ischemic lesion was detected in the bilateral AICA area. After stroke treatment, hearing loss was improved. One month later, we obtained blood flow improvement in the left AICA territory on single-photon-emission computed tomography and vertebral artery stenosis on magnetic resonance angiography. Therefore, clinicians should recognize that bilateral hearing loss may be related to stroke in the vertebrobasilar artery area. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report.

    Science.gov (United States)

    Lim, Joo Hee; Kim, Soo Jung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2016-03-01

    A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24-hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH) level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS) was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.

  10. A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report

    Directory of Open Access Journals (Sweden)

    Joo Hee Lim

    2016-03-01

    Full Text Available A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24-hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.

  11. Superior-inferior position of patellar component affects patellofemoral kinematics and contact forces in computer simulation.

    Science.gov (United States)

    Nakamura, Shinichiro; Tanaka, Yoshihisa; Kuriyama, Shinichi; Nishitani, Kohei; Ito, Hiromu; Furu, Moritoshi; Matsuda, Shuichi

    2017-06-01

    Anterior knee pain has been reported as a major postoperative complication after total knee arthroplasty, which may lead to patient dissatisfaction. Rotational alignment and the medial-lateral position correlate with patellar maltracking, which can cause knee pain postoperatively. However, the superior-inferior position of the patellar component has not been investigated. The purpose of the current study was to investigate the effects of the patellar superior-inferior position on patellofemoral kinematics and kinetics. Superior, central, and inferior models with a dome patellar component were constructed. In the superior and inferior models, the position of the patellar component translated superiorly and inferiorly, respectively, by 3mm, relative to the center model. Kinematics of the patellar component, quadriceps force, and patellofemoral contact force were calculated using a computer simulation during a squatting activity in a weight-bearing deep knee bend. In the inferior model, the flexion angle, relative to the tibial component, was the greatest among all models. The inferior model showed an 18.0%, 36.5%, and 22.7% increase in the maximum quadriceps force, the maximum medial patellofemoral force, and the maximum lateral patellofemoral force, respectively, compared with the superior model. Superior-inferior positions affected patellofemoral kinematic and kinetics. Surgeons should avoid the inferior position of the patellar component, because the inferior positioned model showed greater quadriceps and patellofemoral force, resulting in a potential risk for anterior knee pain and component loosening. Copyright © 2017. Published by Elsevier Ltd.

  12. Aneurysm in the anterior inferior cerebellar artery-posterior inferior cerebellar artery variant: Case report and review of literature.

    Science.gov (United States)

    Akhtar, Saad; Azeem, Abdul; Jiwani, Amyna; Javed, Gohar

    2016-01-01

    There are variations in the anatomy of the vertebrobasilar system amongst which the Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) variant is thought to have a prevalence of 20-24% (based on retrospective studies). Despite this, aneurysms of the AICA-PICA variant are rare. We present a case of an AICA-PICA aneurysm and discuss its presentation and management, along with a review of literature. We describe the case of a 35 year old female who presented with signs of meningismus. On the basis of radiological imaging it was initially misdiagnosed as a thrombosed arteriovenous malformation (AVM). The patient was eventually discharged with a plan of interval imaging and interventional radiology (if required). The patient presented again with similar signs and symptoms. Re-evaluation of imaging revealed an aneurysm of the AICA-PICA variant which was managed surgically. Aneurysms of the AICA-PICA variant are rare. The radiological features and surgical management represent a unique clinical entity and are discussed below. The prevalence of the AICA-PICA variant might be high but aneurysms in this vessel are rare. The scant knowledge available on this subject makes it a diagnostic difficulty. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...

  14. Abordagem fisioterapêutica do linfedema bilateral de membros inferiores

    Directory of Open Access Journals (Sweden)

    Pascale Mutti Tacani

    Full Text Available INTRODUÇÃO: O linfedema é um acúmulo de proteína no interstício em virtude de deficiência do sistema linfático, sendo recomendada a utilização da Terapia Física Complexa como forma de tratamento. OBJETIVO: Verificar os efeitos da Terapia Física Complexa no tratamento e na manutenção do linfedema bilateral de membros inferiores. MÉTODOS: Participaram deste estudo sete pacientes com linfedema bilateral nos membros inferiores, de faixa etária entre 59 e 85 anos, os quais foram submetidos a: 1ª avaliação fisioterapêutica, quando permaneceram sem tratamento (período controle; 2ª avaliação, quando receberam o tratamento fisioterapêutico (período tratamento - terapia física complexa - fase de redução; 3ª avaliação, quando receberam alta (período manutenção - terapia física complexa - fase de manutenção; e 4ª avaliação, para acompanhamento desse último período. O intervalo entre cada avaliação foi de 10 a 12 semanas. Os dados da perimetria foram transformados em volume do membro, por meio da fórmula do cone truncado, e a região do tornozelo foi avaliada pelo método da Figura Oito. RESULTADOS: A média da Figura Oito e do volume dos membros foi de 62,32 cm e 6233 ml, 62,57 cm e 6308 ml, 56,75 cm e 5505 ml, 57 cm e 5566 ml, respectivamente para 1ª, 2ª, 3ª e 4ª avaliações. Pelos testes de Friedman e Wilcoxon, observou-se diferença significativa entre a 3ª e a 4ª avaliações, quando comparadas à 1ª e à 2ª (p < 0,001, para ambas as variáveis, mostrando redução significante do linfedema e sua estabilização durante o período de manutenção. CONCLUSÃO: A terapia física complexa foi eficaz no tratamento e na manutenção do linfedema bilateral de membros inferiores.

  15. THE ANTONINE PLAGUE IN DACIA AND MOESIA INFERIOR

    Directory of Open Access Journals (Sweden)

    Dragoș Mitrofan

    2014-07-01

    Full Text Available  The study of epidemics, especially the ancient ones, has long eluded our scientists. And so, we have tried to use a different approach and different ways of studying the disastrous effects of such an epidemic, in the 2nd  century A.D. The goal of this paper is to analyze aspects such as chronology, expansion, and the effects of the disease, and especially, to raise a question about its presence in the roman provinces of Dacia and Moesia Inferior. Whether the presence of a full scale epidemic can be argued, evidence of disturbance can be found by numerous means .In the end, such scientific approach on epidemics can hold valuable clues regarding the rise and fall of civilizations and empires.      

  16. Auditory recognition memory is inferior to visual recognition memory.

    Science.gov (United States)

    Cohen, Michael A; Horowitz, Todd S; Wolfe, Jeremy M

    2009-04-07

    Visual memory for scenes is surprisingly robust. We wished to examine whether an analogous ability exists in the auditory domain. Participants listened to a variety of sound clips and were tested on their ability to distinguish old from new clips. Stimuli ranged from complex auditory scenes (e.g., talking in a pool hall) to isolated auditory objects (e.g., a dog barking) to music. In some conditions, additional information was provided to help participants with encoding. In every situation, however, auditory memory proved to be systematically inferior to visual memory. This suggests that there exists either a fundamental difference between auditory and visual stimuli, or, more plausibly, an asymmetry between auditory and visual processing.

  17. Evidence of Mirror Neurons in Human Inferior Frontal Gyrus

    Science.gov (United States)

    Kilner, James M.; Neal, Alice; Weiskopf, Nikolaus; Friston, Karl J.; Frith, Chris D.

    2009-01-01

    There is much current debate about the existence of mirror neurons in humans. To identify mirror neurons in the inferior frontal gyrus (IFG) of humans we employed a repetition suppression paradigm while measuring neural activity with functional magnetic resonance imaging. Subjects either executed or observed a series of actions. Here we show that in the IFG, responses were suppressed both when an executed action was followed by the same rather than a different observed action and when an observed action was followed by the same rather than a different executed action. This pattern of responses is consistent with that predicted by mirror neurons and is evidence of mirror neurons in the human IFG. PMID:19675249

  18. Efficiency of Intraligamentary Anesthesia of Inferior Molars for Endodontic Treatment

    Directory of Open Access Journals (Sweden)

    Peycheva K.

    2014-12-01

    Full Text Available The periodontal ligament injection appears to be the most consistently reliable in achieving clinically adequate pulpal anaesthesia. Materials and Methods: 130 inferior molar teeth; technique: The tooth was first cleaned with chlorhexidine 0.2% solution. The penetration of the ligament is performed with special intraligamentary needle (30 G - 9, 17,21 mm “sliding” along the side of the tooth, 300º angle between the needle and the tooth, having taken the care of determining support points which will prevent the needle from twisting. The penetration must be deep enough to obtain the seal required for the injection, injection for each root in particular points; volume of solution per root is 0.2-0.4 ml. Results: In 125 cases the technique was absolutely efficient. In only 5 cases with pulpitis chronica ulcerosa there was need for additional intrapulpal anesthesia. Conclusions: The method could be used as a primary anesthetic method for endodontic treatment.

  19. Recidiva en vena cava inferior de carcinoma suprarrenal

    Directory of Open Access Journals (Sweden)

    Javier Orrit

    2005-01-01

    Full Text Available Paciente de 15 meses sometido a resección de masa suprarrenal derecha. Estudio de extensión negativo e histología de tumor adrenocortical. Dos meses después presenta recidiva tumoral en vena cava inferior (VCI a nivel de venas suprahepáticas que se reseca bajo hipotermia profunda y parada circulatoria (19 min (Fig. 1. Se extrae una masa friable de 25 × 20 mm que ocluye la VCI, sin evidencia de resto tumoral, aunque se considera resección incompleta al estar infiltradas las paredes de VCI. La histología confirma carcinoma suprarrenal (Fig. 2. A los 5 meses sigue quimioterapia sin datos de nueva invasión de VCI.

  20. Modified technique for preservation of inferior alveolar nerve during mandibulectomy.

    Science.gov (United States)

    Chen, Min-Jie; Yang, Chi; Huang, Dong; He, Dong-Mei; Wang, Yi-Wen; Zhang, Wen-Hao

    2017-12-01

    The purpose of this article is to introduce the modified technique of preservation of the inferior alveolar nerve (IAN) during mandibulectomy for a benign lesion. Five cases of osteofibrous hyperplasia and 3 cases of centricity osteomyelitis were included. During surgery, the IAN was marked using a planned cutting guide. Using an oscillating saw, the depth of the osteotomy along the IAN was controlled until the bone cortex was cut through. After splitting, the bony section was removed, leaving the neurovascular bundle intact. The sensation of the lower lip was evaluated using current perceptive threshold testing during follow-up. After follow-up for 6-27 months, no recurrence or secondary deformity was found. One patient had severe sensory disturbance. With the use of a cutting guide and osteotomy tricks, mandibulectomy with preservation of the IAN can be accurately performed. © 2017 Wiley Periodicals, Inc.

  1. Anatomy and radiology of the anterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    Heimans, J.J.

    1983-01-01

    This study describes the variations of the Anterior Inferior Cerebellar Artery (AICA) and identifies its types of appearance in normal angiograms as well as in angiograms of patients suffering from posterior fossa tumours or from ischemic lesions in the vertebro-basilar territory. For this purpose a study of 20 normal specimens was undertaken. Four main types of the AICA are distinguished. One hundred normal vertebral angiograms, made between 1976 and 1982 in the Valeriuskliniek and the Academisch Ziekenhuis der Vrije Univesiteit are reviewed. The AICA's are classified in the same way as in the anatomical study. The same classification was used in the analysis of 41 vertebral angiograms of patients with posterior fossa tumours and nine angiograms of patients with ischemic disturbances in the posterior cranial fossa. (Auth.)

  2. Anterior inferior cerebellar artery aneurysms mimicking vestibular schwannomas.

    Science.gov (United States)

    Marchini, Aïda Kawkabani; Mosimann, Pascal J; Guichard, Jean-Pierre; Boukobza, Monique; Houdart, Emmanuel

    2014-01-01

    Unruptured anterior inferior cerebellar artery (AICA) aneurysms are rare but potentially lethal cerebellopontine angle (CPA) lesions that may be misdiagnosed as vestibular schwannomas when they present with vestibulo-cochlear symptoms. We report two cases of unruptured but symptomatic AICA aneurysms initially referred to us as atypical vestibular schwannomas requiring surgery. Two discriminant MR features are described. One patient refused treatment. The other was successfully treated by coil occlusion. Caution is advised before suspecting a CPA mass to be a purely extra-canalicular schwannoma, given its extreme rarity. Deafness and cerebellar ischemia may be prevented if AICA aneurysms are correctly identified preoperatively. In the absence of specific arterial imaging, two MR features may distinguish them from vestibular schwannomas: (1) the absence of internal auditory canal enlargement and (2) the "blurry dot sign," representing blood flow artefacts on pre- and postcontrast studies. Copyright © 2013 by the American Society of Neuroimaging.

  3. Indications, management, and complications of temporary inferior vena cava filters

    International Nuclear Information System (INIS)

    Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen

    1998-01-01

    Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters.Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis.Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis.Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

  4. Endovascular treatment of the posterior inferior cerebellar artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Bradac, G.B.; Bergui, M. [Neuroradiology, Univ. di Torino, Turin (Italy)

    2004-12-01

    Aneurysms may arise at various locations along the course of the posterior inferior cerebellar artery. Brainstem and cranial nerves manipulation make the surgical approach to proximal aneurysms difficult, while the occlusion of the parent vessel is sometimes unavoidable in peripheral aneurysms. Endovascular treatment can be a good alternative, but also with this approach the location of the aneurysm is critical. If occlusion of the parent vessel is planned, anatomical variations and vascular territories of the brainstem should be considered. We report our experience with 18 consecutive aneurysms (12 proximal, 6 peripheral) treated by coils. Complete occlusion was achieved in 14 patients and subtotal in 4. In three patients the parent vessel had to be sacrificed. During treatment two perforations occurred; aneurysms were completely occluded without clinical consequences. Two small asymptomatic cerebellar infarctions were seen on postoperative computed tomography. Clinical outcome was good in 16 patients. (orig.)

  5. Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis

    Directory of Open Access Journals (Sweden)

    S. Poudyal

    2017-01-01

    Full Text Available Pheochromocytoma associated with inferior vena cava (IVC thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal. Right adrenalectomy with IVC thrombectomy was done. Perioperative period was uneventful. Histopathology of the mass turned out to be pheochromocytoma with thrombus revealing fibroadipose tissue with fibrin. Pheochromocytoma may present with IVC thrombus as well as normal serum and urinary markers. Thus, clinical suspicion is imperative in perioperative management of adrenal mass.

  6. Arterial supply to the thyroid gland and the relationship between the recurrent laryngeal nerve and the inferior thyroid artery in human fetal cadavers.

    Science.gov (United States)

    Ozgüner, G; Sulak, O

    2014-11-01

    The aim of this study was to identify the arterial supply to the thyroid gland and the relationship between the inferior thyroid artery (ITA) and the recurrent laryngeal nerve (RLN) in fetal cadavers using anatomical dissection. The anterior necks of 200 fetuses were dissected. The origins of the superior thyroid artery (STA) and the ITA and location of the ITA in relation to the entrance of the thyroid lobe were examined. The relationship between the ITA and the RLN was determined. The origins of the STA were classified as: external carotid artery, common carotid artery (CCA), and the thyrolingual trunk. The origins of the ITA were the thyrocervical trunk and the CCA. The ITA was absent on the left side in two cases. The relationship of the RLN to the ITA fell into seven different types. Type 1: the RLN lay posterior to the artery; right (42.5%), left (65%). Type 2: the RLN lay anterior to the artery; right (40.5%), left (22.5%). Type 3: the RLN lay parallel to the artery; right (11.5%), left (7%). Type 4: the RLN lay between the two branches of the artery; right (1%), left (3.5%). Type 5: The extralaryngeal branch of the RLN was detected before it crossed the ITA; right (4.5%), left (0%). Type 6: the ITA lay between the two branches of the RLN; right (0%), left (0.5%). Type 7: the branches of the RLN lay among the branches of the ITA; right (0%), left (0.5%). The results from this study would be useful in future thyroid surgeries. © 2014 Wiley Periodicals, Inc.

  7. Rebuilding the US Health Left

    Directory of Open Access Journals (Sweden)

    Victor W. Sidel, MD

    2010-02-01

    Full Text Available With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series. We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance, provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health, traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA, fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics, were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health, supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights, played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay

  8. [A dissecting aneurysm of the posterior inferior cerebellar artery was reduced spontaneously during conservative therapy: case report].

    Science.gov (United States)

    Wakamoto, Hirooki; Orii, Maaya; Miyazaki, Hiromichi; Ishiyama, Naomi

    2002-04-01

    We report here a case of a patient with a dissecting aneurysm of the anterior medullary segment of the posterior inferior cerebellar artery (PICA) which presented with Wallenberg's syndrome. A 32-year-male presented with an unusual case of Wallenberg's syndrome due to a dissecting aneurysm of the PICA manifesting as a sensation of heaviness in the occipital region and vertigo. The occipital symptoms persisted and vertigo and vomiting developed after 6 days. Numbness developed on the left side of the patient's face, and hyperalgesia on the right side of the body. The diagnosis of Wallenberg's syndrome was based on the above findings. MRI revealed infarction of the lateral aspect of the medulla oblongata and MR angiography revealed dilatation in the proximal portion of the left PICA. Digital subtraction angiography revealed that the left vertebral artery was essentially normal, but there was a spindle-shaped dilatation in the proximal portion of the left PICA. We carried out conservative therapy at the patient's request and 3D-CTA revealed that the dissecting aneurysm was markedly reduced in size seven months after the onset. Dissecting aneurysms of the intracranial posterior circulation have been shown to be less uncommon than previously thought. However, those involving the PICA without involvement of the vertebral artery at all are extremely rare. The natural history of the dissecting PICA aneurysm was unknown, and the indication for surgical treatment of such aneurysms remains controversial. Management options are conservative treatment, open surgical treatment including wrapping, trapping, and resection with reconstruction, but almost all of the patients underwent radical treatment to prevent rupture of the aneurysm. However we had no knowledge of the risk of rupture of a PICA dissecting aneurysm presenting with ischemic symptoms. We have reviewed the well-documented 15 cases of dissecting aneurysms of the PICA reported in the literature and we discuss the

  9. RASGOS GEOGRÁFICOS DEL VALLE DEL RIO AGRIO INFERIOR.

    Directory of Open Access Journals (Sweden)

    Celia Torren

    1993-12-01

    Full Text Available El presente artículo es una síntesis del trabajo "Rasgos Geográficos del Valle del Río Agrio Inferior, el cual es un estudio de base para el conocimiento de la geografía de la región: - apoyando el esfuerzo que está realizando la población del área para lograr una identidad propia y una definitiva integración al contexto provincial; - aportando al proyecto "Rescate Arqueológico en Quili Malal, Neuquén" (subsidiado por CONICET y UNESCO, cuya dirección está a cargo de la profesora Susana Rodríguez de la U.N.C., a través de la confección del mapa geomorfológico del área; y - contribuyendo a los estudios que resultan necesarios ante la construcción de una obra hidroeléctrica de la magnitud de "El Chihuido I", emprendimiento que será llevado a cabo por Agua y Energía eléctrica de la Nación. Los límites del área estudiada fueron establecidos teniendo en cuenta el área del valle inferior del Río Agrio que será completamente inundada por el futuro embalse de la represa "El Chihuido I", a emplazarse 5,5 Km aguas abajo de la confluencia de los ríos Agrio y Neuquén. Además de esta área de afectación directa se tomó también una zona de perilago estrechamente vinculada a la anterior. De esta manera los límites este y oeste quedaron establecidos por la confluencia de los ríos antes mencionados y la localidad de Bajada del Agrio, respectivamente.

  10. Anterior and nasal transposition of the inferior oblique muscles.

    Science.gov (United States)

    Stager, David R; Beauchamp, George R; Wright, Weldon W; Felius, Joost; Stager, David

    2003-06-01

    When performing anterior transposition of the inferior oblique (IO) muscle, placement of the posterior suture close to the lateral border of insertion of the inferior rectus (IR) muscle decreases the incidence of antielevation syndrome (AES). We hypothesized that placement of the suture nasal to the IR muscle insertion will convert the IO muscle into an intorter and depressor. Here we present the first series of results obtained with a new procedure for the treatment of elevation in adduction with extorsion and abnormal head postures. Twenty patients with IO muscle overaction, superior oblique (SO) muscle palsy, absent SO muscles, AES, or Duane syndrome were studied. Before surgery, each patient showed at least one, but often more, of the following signs: elevation in adduction, exotropia (XT) in up gaze, abnormal head posture, and extorsion. Each underwent anterior and nasal transposition (ANT) of the IO muscle, with the new insertion typically 2 mm nasal and 2 mm posterior to the nasal border of the IR muscle insertion. Large improvements in ocular alignment, extorsion, and head posture were found in most patients. However, a poor result was noted in a patient with Y-pattern XT, who developed a mild amount of comitant XT after an extreme degree of ANT (4 mm nasal and 3 mm anterior to the nasal border of the IR muscle insertion). In Duane syndrome, ANT corrects upshoot, but downshoot may get worse. Mersilene permanent sutures, rather than dissolving suture materials, are recommended to avoid postoperative retraction of muscle fibers. ANT converts the IO muscle into an intorter and tonic depressor and can significantly improve elevation in adduction. This procedure seems particularly useful in patients with severe or recurrent congenital and acquired SO palsies, particularly as a secondary procedure. Extreme ANT may induce exotropia in the primary position.

  11. Thrombosis of the inferior vena cava related to Ormond's disease.

    Science.gov (United States)

    Paetzold, Sascha; Gary, Thomas; Hafner, Franz; Brodmann, Marianne

    2013-03-01

    A 46-year-old female patient presenting with unspecific lower back pain, diffuse abdominal pain, and slightly elevated body temperature was referred to the hospital. The X-ray of the spine detected an unspecific sclerotic lesion of the third lumbar vertebra; an abdominal computed tomography (CT) scan was performed. In this scan, a sheeting of the infrarenal abdominal aorta, a streaky densification of the periaortal fatty tissue, and a nearly complete thrombotic occlusion of the inferior vena cava and both iliac veins was detected. As these findings are typical for acute aortitis and this is a life-threatening disease, the patient was transferred to a university hospital. Imaging work-up including ultrasound, magnetic resonance imaging, and 18-flourodeoxyglucose positron emission tomography were performed after transfer. These examinations showed acute aortitis due to Ormond's disease. Furthermore, there was a thrombotic occlusion of the inferior vena cava due to a compression of the vein by inflamed connective tissue. This is a rare finding in Ormond's disease. We decided to treat our patient with a combined therapy including glucocorticoids and tamoxifen for 2 years. During these 2 years and the further follow-up period, the patient showed no relapse of the inflammatory disease. Retroperitoneal fibrosis is a rare but increasingly recognized disease characterized by the presence of fibro-inflammatory tissue, usually surrounding the abdominal aorta and the iliac arteries. This fibrotic tissue extends into the retroperitoneum and thus encases structures, for example, the ureters. Retroperitoneal fibrosis is generally idiopathic. It can also be secondary to certain drugs, malignant diseases, infections, surgery, and other triggering factors. Ormond's disease may lead to serious complications like renal failure. This can be avoided by successful treatment when diagnosed early.

  12. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2009-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta, respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional, de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación.

  13. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2011-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta; respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional: de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación. Palabras claves: Pseudoaneurisma, Infarto del Miocardio, Diabetes.

  14. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    OpenAIRE

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric re...

  15. Middle and Inferior Temporal Gyrus Gray Matter Volume Abnormalities in Chronic Schizophrenia: An MRI Study

    OpenAIRE

    Onitsuka, Toshiaki; Shenton, Martha E.; Salisbury, Dean F.; Dickey, Chandlee C.; Kasai, Kiyoto; Toner, Sarah K.; Frumin, Melissa; Kikinis, Ron; Jolesz, Ferenc A.; McCarley, Robert W.

    2004-01-01

    Objective: The middle temporal gyrus and inferior temporal gyrus subserve language and semantic memory processing, visual perception, and multimodal sensory integration. Functional deficits in these cognitive processes have been well documented in patients with schizophrenia. However, there have been few in vivo structural magnetic resonance imaging (MRI) studies of the middle temporal gyrus and inferior temporal gyrus in schizophrenia. Method: Middle temporal gyrus and inferior temporal gyru...

  16. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE)

    DEFF Research Database (Denmark)

    Makikallio, T.; Holm, Niels R.; Lindsay, Gail M.

    2016-01-01

    coronary artery disease. Methods In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1: 1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable...... angina pectoris, or non-ST-elevation myocardial infarction. Exclusion criteria were ST-elevation myocardial infarction within 24 h, being considered too high risk for CABG or PCI, or expected survival of less than 1 year. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE...

  17. Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.

    Science.gov (United States)

    Luciano, Debora; Laux, Daniela; Boudjemline, Younes; Hascoët, Sébastien; Lusson, Jean-René; Sorensen, Clio; Ovaert, Caroline; Kreitmann, Bernard; Van Praagh, Richard; Fraisse, Alain

    2013-12-10

    A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. We retrospectively studied such patients in 5 institutions. Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056). In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013.

  18. Strain Distribution in the Anterior Inferior Tibiofibular Ligament, Posterior Inferior Tibiofibular Ligament, and Interosseous Membrane Using Digital Image Correlation.

    Science.gov (United States)

    Xu, Daorong; Wang, Yibei; Jiang, Chunyu; Fu, Maoqing; Li, Shiqi; Qian, Lei; Sun, Peidong; Ouyang, Jun

    2018-05-01

    Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM. The foot underwent rotation from 0° to 25° internal and 35° external, with 3 ankle positions (neutral, 15° dorsiflexion, and 25° plantarflexion) and a vertical load of 430 N. Ligament strain was recorded using digital image correlation. The mean strain on the AITFL with 35° external rotation was greater in the proximal portion compared with distal portion in the neutral position ( P = .009) and dorsiflexion ( P = .003). The mean strain in the tibial insertion and midsubstance near tibial insertion were greater when compared with other regions ( P = .018 and P = .009). The subregions of mean strain in the PITFL and IOM groups were not significantly different. The strain trend of AITFL, PITFL, and IOM showed common transformation, just when the foot was externally rotated. The findings of this study show that a significantly high strain was observed on the proximal part and the midsubstance near the Chaput tubercle of the AITFL when the ankle was externally rotated. All 3 ligaments resisted the torque in the syndesmosis by external rotation of the foot. This study allows for better understanding of the mechanical behavior of the syndesmosis ligaments, which could influence the repair technique and AITFL augmentation techniques.

  19. Left-handed Children in Singapore.

    Science.gov (United States)

    Gan, Linda

    1998-01-01

    Used teacher questionnaires to examine incidence of left-handedness in nearly 2,800 Singaporean children, racial differences in this left-handed population, and educational provisions in preschool and primary school. Findings indicated that 7.5% of preschoolers and 6.3% of primary children were left-handed, with a higher proportion being Chinese…

  20. The Left-Handed: "Their Sinister" History.

    Science.gov (United States)

    Costas, Elaine Fowler

    The history of left-handedness can provide teachers and parents a better understanding of left-handed children and give those children more pride in their difference. No child should be made to feel that he or she is abnormal because of using the left hand, although some specific instruction for these students is necessary in handwriting. Many…

  1. Flavoured Dark Matter moving left

    Science.gov (United States)

    Blanke, Monika; Das, Satrajit; Kast, Simon

    2018-02-01

    We investigate the phenomenology of a simplified model of flavoured Dark Matter (DM), with a dark fermionic flavour triplet coupling to the left-handed SU(2) L quark doublets via a scalar mediator. The DM-quark coupling matrix is assumed to constitute the only new source of flavour and CP violation, following the hypothesis of Dark Minimal Flavour Violation. We analyse the constraints from LHC searches, from meson mixing data in the K, D, and B d,s meson systems, from thermal DM freeze-out, and from direct detection experiments. Our combined analysis shows that while the experimental constraints are similar to the DMFV models with DM coupling to right-handed quarks, the multitude of couplings between DM and the SM quark sector resulting from the SU(2) L structure implies a richer phenomenology and significantly alters the resulting impact on the viable parameter space.

  2. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: case report and review.

    Science.gov (United States)

    Villalon-Lopez, J S; Valle-Mejia, C A; Patino-Lara, A; Moreno-Perez, B A; Munoz-Lopez, J A; Alcantar-Andrade, A

    2006-01-01

    Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor for development of illness such as severe solar burns during childhood or adolescence. BCC is mainly located on sun-exposed sites, head and neck being the areas of more incidences; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options such as surgical and nonsurgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs' micrographic surgery is the standard treatment for all nonmelanoma skin cancers. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77-year-old patient is presented with BCC of inferior eyelid of 14 years' duration, formerly managed with radiotherapy; however, due to recurrent illness and invasion to the maxillary antrum, he needed supraestructure maxillectomy with left orbital exenteration.

  3. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review

    Directory of Open Access Journals (Sweden)

    Villalon-Lopez J

    2006-01-01

    Full Text Available Basal cell carcinoma (BCC is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor for development of illness such as severe solar burns during childhood or adolescence. BCC is mainly located on sun-exposed sites, head and neck being the areas of more incidences; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options such as surgical and nonsurgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs′ micrographic surgery is the standard treatment for all nonmelanoma skin cancers. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77-year-old patient is presented with BCC of inferior eyelid of 14 years′ duration, formerly managed with radiotherapy; however, due to recurrent illness and invasion to the maxillary antrum, he needed supraestructure maxillectomy with left orbital exenteration.

  4. Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review.

    Directory of Open Access Journals (Sweden)

    Sebastian Villalon-Lopez

    2005-01-01

    Full Text Available Basal cell carcinoma (BCC is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation (UVR as important risk factor for development of the illness as such as severe solar burns during childhood or adolescence. BCC is mainly located on sun exposed sites, being head and neck the areas of more incidence; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as: nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options as surgical and non-surgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs′ micrographic surgery is the standard treatment for all non-melanoma skin cancer. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77 year-old patient is presented with BCC of inferior eyelid of 14 years duration, formerly managed with radiotherapy and, due to recurrent illness and invasion to the maxillary antrum; he needed supraestructure maxillectomy with left orbital exenteration.

  5. Inferior vena cava dimensions in patients with acute kidney injury

    Directory of Open Access Journals (Sweden)

    Andres Yepes-Hurtado

    2016-07-01

    Full Text Available Background: Volume contraction frequently contributes to the development of acute kidney injury.  The rapid assessment of volume status in patients with acute kidney injury could improve decision making and outcomes. Methods: The maximum and minimum diameters and percent collapsibility of the inferior vena cava (IVC were measured in 30 patients admitted to the medical intensive care unit with laboratory evidence of acute kidney injury.  These measurements were made on the day of admission and 24 hours following admission.  Information about age, gender, body mass index, serum creatinine levels, and fluid balances was recorded. Results: This study included 30 patients with a mean age is 62.4 ±16.0 years.  The mean initial creatinine was 4.3 ± 4.2 mg/dL (range: 1.7 mg/dL to 22.1 mg/dL.  The mean fractional excretion of sodium was 2.06 ± 2.65%.  The mean maximum diameter of inferior vena cava was 1.8 ± 0.5 cm with the range is 0.4-2.65 cm.  The mean percent collapse was 32 ± 20%.  Five patients had evidence of hypovolemia using guidelines from the American Society of Echocardiology; 6 patients had evidence of hypervolemia.  Nineteen patients had measurements between these 2 categories.  There is no significant change in mean diameters following fluid administration for 24 hours.  An initial IVC diameter of 0.94 cm predicted ≥ 30% collapsibility with an area under the curve is 0.748. Discussion: Patients with acute kidney injury based on laboratory measurements had evidence for hypovolemia, euvolemia, and hypervolemia based on IVC measurements.  There was no consistent change in IVC dimensions following fluid administration, even though the creatinine fell in most patients.  Simple bedside measurements of IVC dimensions can facilitate fluid administration decisions but must be used with clinical assessment.

  6. Q-ball of inferior fronto-occipital fasciculus and beyond.

    Directory of Open Access Journals (Sweden)

    Eduardo Caverzasi

    Full Text Available The inferior fronto-occipital fasciculus (IFOF is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the "classical" fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a diffuse projections in the frontal lobe, b fronto-parietal lobes connections trough the external capsule in almost all the subjects and c widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function.

  7. Relationship of the Gonial Angle and Inferior Alveolar Canal Course Using Cone Beam Computed Tomography

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    Najmeh Anbiaee

    2016-03-01

    Full Text Available Objectives: Accurate localization of the inferior alveolar canal (IAC is extremely important in some dental treatments. Anatomical variation of the canal means that it can be difficult to locate. The purpose of this study was to assess the relationship of the gonial angle (GA size and IAC position using cone beam computed tomography (CBCT.Materials and Methods: In this in vitro study, 61 dry adult human hemi-mandibles were used. The CBCT scans were taken of all samples and GA was measured on all CBCT scans. The samples were divided into two groups of low angle (≤125° and high angle (>125°. The canal dimensions, length and course were evaluated. On the sagittal view, the IAC path was classified as type A, B or C. On the axial view, canal course was defined as A1 or A2 according to the mental foramen angle.Results: The average GA size was 121.8±7.05° at the right side and 123.8±6.32° at the left side. On the sagittal view, there was a significant correlation between the GA size and the canal course (P=0.04. In the high-angle group, type A was dominant; whereas in the low-angle group, type B was more common. On the axial view of IAC course, type A1 was more common (73.43%.Conclusion: The results showed that GA size was associated with IAC course. In cases with a larger GA, the canal runs in a more straightforward path, and at the same level as the mental foramen.Keywords: Cone Beam Computed Tomography; Mandibular Nerve; Mandible

  8. Inferior frontal gyrus preserves working memory and emotional learning under conditions of impaired noradrenergic signaling

    Directory of Open Access Journals (Sweden)

    Benjamin eBecker

    2013-12-01

    Full Text Available Compensation has been widely applied to explain neuroimaging findings in neuropsychiatric patients. Functional compensation is often invoked when patients display equal performance and increased neural activity in comparison to healthy controls. According to the compensatory hypothesis increased activity allows the brain to maintain cognitive performance despite underlying neuropathological changes. Due to methodological and pathology-related issues, however, the functional relevance of the increased activity and the specific brain regions involved in the compensatory response remain unclear. An experimental approach that allows a transient induction of compensatory responses in the healthy brain could help to overcome these issues. To this end we used the nonselective beta-blocker propranolol to pharmacologically induce sub-optimal noradrenergic signaling in healthy participants. In two independent fMRI experiments participants received either placebo or propranolol before they underwent a cognitive challenge (experiment 1: working memory; experiment 2: emotional learning: Pavlovian fear conditioning. In experiment 1 propranolol had no effects on working memory performance, but evoked stronger activity in the left inferior frontal gyrus (IFG. In experiment 2 propranolol produced no effects on emotional memory formation, but evoked stronger activity in the right IFG. The present finding that sub-optimal beta-adrenergic signaling did not disrupt performance and concomitantly increased IFG activity is consistent with, and extends, current perspectives on functional compensation. Together, our findings suggest that under conditions of impaired noradrenergic signaling, heightened activity in brain regions located within the cognitive control network, particularly the IFG, may reflect compensatory operations subserving the maintenance of behavioral performance.

  9. Is 2 mm a safe distance from the inferior alveolar canal to avoid ...

    African Journals Online (AJOL)

    2015-10-30

    Oct 30, 2015 ... related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 ... KEYWORDS: Dental implants, inferior alveolar nerve injury, neurosensory complication. Department of .... such injury occurs, a complete healing is difficult if the extent of the injury is not minor ...

  10. Enlargement of the vena azygos in case of agenesia of the vena cava inferior

    International Nuclear Information System (INIS)

    Stetter, G.; Pallapies, V.; Lange, S.

    1989-01-01

    The article discusses a case of complete agenesia of the vena cava inferior. In compensation of this malformation, the venae azygos and hemiazygos were found to be enlarged. The authors explain the embryogenesis of the vena cava inferior as far as relevant to the case reported. CT and intravenous DSA are the methods that allow an exact classification of the possible agenesias. (orig.) [de

  11. Generalizing Screen Inferiority--Does the Medium, Screen versus Paper, Affect Performance Even with Brief Tasks?

    Science.gov (United States)

    Sidi, Yael; Ophir, Yael; Ackerman, Rakefet

    2016-01-01

    Screen inferiority in performance and metacognitive processes has been repeatedly found with text learning. Common explanations for screen inferiority relate to technological and physiological disadvantages associated with extensive reading on screen. However, recent studies point to lesser recruitment of mental effort on screen than on paper.…

  12. Left ventricular microfistulization: A rare cause of ischemia in a patient with normal coronary arteries

    Directory of Open Access Journals (Sweden)

    İsmet Dindar

    2012-06-01

    Full Text Available A 71-year-old woman with chest pain occurring on physicalexercise was admitted to cardiology department.Myocardial perfusion scintigraphy revealed inferior andanteroapical segment hypoperfusion. Selective coronaryangiography revealed multiple coronary-cameral fistulasoriginating from the left anterior descending artery andthe right coronary artery and emptying into the left ventriclewithout any significant coronary artery stenosis. Coronaryartery fistulas are defined as abnormal communicationsbetween a coronary artery and a cardiac chamber ormajor vessel. Coronary-cameral fistulas terminating in theleft ventricle are uncommon. Small fistulas usually do notcause any hemodynamic compromise. However, the largerand multiple fistulas may cause myocardial ischemiaascribed to a coronary steal phenomenon. The best wayto manage cameral fistulae is uncertain largely due to therarity of the condition. In the present case, anti-ischemicmedications with metoprolol 50 mg/day provided an uneventfulfollow-up of six months without any intervention.

  13. Marginal artery stump pressure in left colic artery-preserving rectal cancer surgery: a clinical trial.

    Science.gov (United States)

    Guo, Yuchen; Wang, Daguang; He, Liang; Zhang, Yang; Zhao, Shishun; Zhang, Luyao; Sun, Xuan; Suo, Jian

    2017-07-01

    The aim of this clinical trial is to evaluate the influence of high and low ligation of the inferior mesenteric artery with apical lymph node dissection on the anastomotic blood supply, lymph node retrieval rate, operative time and anastomotic leakage rate in rectal cancer surgery. A total of 57 Chinese patients were randomly distributed into group A and group B and underwent radical resection of rectal cancer. Patients in group A underwent high ligation of the inferior mesenteric artery, and patients in group B underwent apical lymph node resection around the root of the inferior mesenteric artery with preservation of the left colic artery. The marginal artery stump pressure was measured after colon and artery reconstruction. Systemic pressure, distal colon length, operative time and lymph node retrieval rate were measured and recorded. The results were analysed and related to patient characteristics and post-operative complications. The anastomotic blood supply negatively and linearly correlated with age and distal colon length and showed a positive linear correlation with systemic pressure. Patients who received low ligation with apical lymph node dissection had a better anastomotic blood supply than those who received high ligation. No differences were found in lymph node retrieval rate, operative time and anastomotic leakage rate. Anastomotic leakage was associated with a worse anastomotic blood supply. Low ligation with apical lymph node dissection in rectal cancer treatment provides better anastomotic blood supply but is not associated with differences in node retrieval rate or operation time. © 2015 Royal Australasian College of Surgeons.

  14. Usefulness of pulse-wave doppler tissue sampling and dobutamine stress echocardiography for identification of false positive inferior wall defects in SPECT

    International Nuclear Information System (INIS)

    Altinmakas, S.; Dagdeviren, B.; Turkmen, M.; Gursurer, M.; Say, B.; Tezel, T.; Ersek, B.

    2000-01-01

    False positive inferior wall perfusion defects restrict the accuracy of SPECT in diagnosis of coronary artery disease (CAD). Pulse-Wave Tissue Doppler (PWTD) has been recently proposed to assess regional wall motion velocities. The objectives of this study were to evaluate the presence of CAD by using PWTD during dobutamine stress echocardiography (DSE) in patients with an inferior perfusion defect detected by SPECT and compare PWTD parameters of normal cases with patients who had inferior perfusion defect and CAD. Sixty-five patients (mean age 58±8 years, 30 men) with a normal LV systolic function at rest according to echocardiographic evaluation with an inferior ischemia determined by SPECT and a control group (CG) of 34 normal cases (mean age 56±7 years, 16 men) were included in this study. All patients underwent a standard DSE (up to 40 μg/kg/min with additional atropine during sub-maximum heart rate responses). Pulse-wave Doppler tissue sampling of inferior wall was performed in the apical 2-chamber view at rest and stress. The coronary angiography was performed within 24 hours. The results were evaluated for the prediction of significant right coronary artery (RCA) and/or left circumflex coronary artery (CX) with narrowing (≥50% diameter stenosis, assessed by quantitative coronary angiography). It was observed that the peak stress mean E/A ratio was lower in patients with CAD when compared to patients without CAD (0.78±0.2 versus 1.29±0.11 p<0.0001). Also the peak stress E/A ratio of normal cases was significantly higher than patients who had CAD (1.19±0.3 versus 0.78±0.2 p<0.0001). When the cut off point for the E/A ratio was determined as 1, the sensitivity and specificity of dobutamine stress PWTD E/A were 89% and 86%, respectively. The peak stress E/A ratio was higher than 1 in all patients with a false positive perfusion defect. Systolic S velocity increase during DSE was significantly lower in patients with CAD (54%±17 versus 99%±24 p=0

  15. Reverse Trendelenburg position is a safer technique for lowering central venous pressure without decreasing blood pressure than clamping of the inferior vena cava below the liver.

    Science.gov (United States)

    Yoneda, Godai; Katagiri, Satoshi; Yamamoto, Masakazu

    2015-06-01

    Bleeding remains an important intraoperative complication in patients who undergo hepatectomy. It is generally believed that a reduction in central venous pressure will decrease bleeding from the hepatic venous system. To our knowledge, however, no study has compared the effectiveness of these techniques for controlling bleeding. So we compared the effectiveness of central venous pressure control techniques, such as infrahepatic inferior vena cava clamping, changes in surgical position of the patient, and hypoventilation anesthesia, for lowering central venous pressure. The study group comprised 50 patients who underwent hepatectomy in our department from 2012 through 2013. A central venous catheter was inserted into the right internal jugular vein, and the tip was placed in the superior vena cava. A transducer was placed along the mid-axillary line of the left side of the chest. After opening the abdomen, changes in central venous pressure were measured during inferior vena cava clamping, the reverse Trendelenburg position, the Trendelenburg position, and hypoventilation anesthesia. The inclination relative to the transducer, as measured with an inclinometer, was -10 degrees for the Trendelenburg position and +10 degrees for the reverse Trendelenburg position. The tidal volume was set at 10 mL/kg during conventional anesthesia and 5 mL/kg during hypoventilation anesthesia. The mean central venous pressure was 8.0 cm H(2)O in the supine position during conventional anesthesia, 5.0 cm H(2)O during inferior vena cava clamping, 5.6 cm H(2)O during reverse Trendelenburg position, 10.6 cm H(2)O during Trendelenburg position, and 7.6 cm H(2)O during hypoventilation anesthesia. The mean central venous pressure during inferior vena cava clamping and reverse Trendelenburg position was significantly lower than that during supine position (P = 0.0017 and P = 0.0231, respectively). The mean central venous pressure during hypoventilation

  16. Inferior alveolar nerve cutting; legal liability versus desired patient outcomes.

    Science.gov (United States)

    Kim, Soung Min; Lee, Jong Ho

    2017-10-01

    Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

  17. An experimental study of inferior vena caval stent in canine.

    Science.gov (United States)

    Zhang, X; Wang, Z; Guo, J

    1999-09-01

    To investigate the feasibility of our self made inferior vena cave (IVC) stent. Self-expanding, stainless steel, Z-shaped stents were deployed in the IVC of 14 dogs. They were randomly divided into four groups, four dogs in the first three groups, and 2 in the fourth group. IVC specimens were taken at 2, 4, 8 and 16 weeks following stent deployment. No anticoagulant or antiplatelet therapy was given. All stents were widely stretched out and so was the vessel lumen. No thrombus was present and the patency was 100% in all groups. The stents were completely covered by neointima 2 weeks after stent deployment. The neointimal thickness varied significantly: the thinnest at 2 weeks, the thickest at 4 weeks and becoming thinner at 8 weeks and stable until 16 weeks. The inflammatory reaction was gradually reduced. Under scanning electronic microscopy, the neointima was covered by a layer of endothelial cells 2 weeks following stenting, which were irregularly shaped and aligned. The cells became slender, spindle-shaped and aligned parallel to the direction of bolld flow 4 weeks afterwards. Experimental study indicated that our self-expanding IVC stent was feasible for clinical application.

  18. The inferior cochlear vein: surgical aspects in cochlear implantation.

    Science.gov (United States)

    Guo, Rui; Zhang, HongLei; Chen, Wei; Zhu, XiaoQuan; Liu, Wei; Rask-Andersen, Helge

    2016-02-01

    The patency of the inferior cochlear vein (ICV) may be challenged in cochlear implantation (CI) due to its location near the round window (RW). This may be essential to consider during selection of different trajectories for electrode insertion aiming at preserving residual hearing. Venous blood from the human cochlea is drained through the ICV. The vein also drains blood from the modiolus containing the spiral ganglion neurons. Surgical interference with this vein could cause neural damage influencing CI outcome. We analyzed the topographical relationship between the RW and ICV bony channel and cochlear aqueduct (CA) from a surgical standpoint. Archival human temporal bones were further microdissected to visualize the CA and its accessory canals (AC1 and AC2). This was combined with examinations of plastic and silicone molds of the human labyrinth. Metric analyses were made using photo stereomicroscopy documenting the proximal portion of the AC1, the internal aperture of the CA and the RW. The mean distance between the AC1 and the anterior rim of the RW was 0.81 mm in bone specimens and 0.67 mm assessed in corrosion casts. The AC1 runs from the floor of the scala tympani through the otic capsule passing parallel to the CA to the posterior cranial fossa. The mean distance between the CA and AC1 canal was 0.31 and 0.25 mm, respectively.

  19. Compression of the inferior vena cava in bowel obstruction.

    Science.gov (United States)

    Cina, Alessandro; Zamparelli, Roberto; Venturino, Sara; Gargaruti, Riccardo; Semeraro, Vittorio; Cavaliere, Franco

    2013-01-01

    We investigated whether (a) the inferior vena cava (IVC) is compressed in bowel obstruction and (b) some tracts are more compressed than others. Two groups of abdominal computed tomography (CT) examinations were collected retrospectively. Group O (N = 69) scans were positive for bowel obstruction, group C (N = 50) scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD) were assessed at seven levels. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14), the area of which increased gradually from 1.9 (confluence of the iliac veins) to 3.1 cm²/m² of BSA (confluence of the hepatic veins) with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17). Along its course, IVC section area increased from 1.3 to 2.5 cm²/m². At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression.

  20. Compression of the Inferior Vena Cava in Bowel Obstruction

    Directory of Open Access Journals (Sweden)

    Alessandro Cina

    2013-01-01

    Full Text Available Introduction. We investigated whether (a the inferior vena cava (IVC is compressed in bowel obstruction and (b some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT examinations were collected retrospectively. Group O ( scans were positive for bowel obstruction, group C ( scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14, the area of which increased gradually from 1.9 (confluence of the iliac veins to 3.1 cm2/m2 of BSA (confluence of the hepatic veins with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17. Along its course, IVC section area increased from 1.3 to 2.5 cm2/m2. At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression.

  1. Effect of Preoperative Pain on Inferior Alveolar Nerve Block

    Science.gov (United States)

    Aggarwal, Vivek; Singla, Mamta; Subbiya, Arunajatesan; Vivekanandhan, Paramasivam; Sharma, Vikram; Sharma, Ritu; Prakash, Venkatachalam; Geethapriya, Nagarajan

    2015-01-01

    The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1–54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55–114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis. PMID:26650491

  2. Retrocaval ureter and anomalies of inferior vena cava

    International Nuclear Information System (INIS)

    Tsubogo, Yoshitaka; Hiraoka, Hisaki; Tonariya, Yoshito; Miyamae, Tatsuya; Fujioka, Mutsumi

    1980-01-01

    We report two cases of retrocaval ureter: one with the usual hook-shaped pattern of the course of ureter (Type 1 according to Kenawi and Williams) and the other with the ureter medially displaced in a large curving fashion without kinking or obstruction. (Type 2). The second case was diagnosed on CT without resorting to any invasive procedure. It can be classified as Type 2 of Kenawi and Williams because of the absence of obstruction and kinking of ureter. The first case is associated with a complicated anomaly of inferior vena cava previously not reported which shows the duplication of infrarenal segment of cava with azygos continuation via the right persistent supracardinal vein. This anomaly is also complicated by the persistent posterior cardinal vein which is continuous with the normal prerenal segment of cava after receiving the right renal vein. This persistent posterior cardinal vein is the cause of retrocaval ureter in this case. It is also stressed that the knowledge of various caval anomalies is important in the interpretation of CT. (author)

  3. Inferior cerebellar peduncular lesion causes a distinct vestibular syndrome.

    Science.gov (United States)

    Choi, J-H; Seo, J-D; Choi, Y R; Kim, M-J; Kim, H-J; Kim, J S; Choi, K-D

    2015-07-01

    The inferior cerebellar peduncle (ICP) contains various fibres to and from the cerebellum relating to the integration of the proprioceptive and vestibular functions. However, the full clinical features of isolated unilateral ICP lesions have not been defined in humans. Eight consecutive patients with isolated unilateral ICP lesions at the pontine level (six with stroke, one with multiple sclerosis and one with brainstem encephalitis) received bedside neurological and neuro-otological evaluations and underwent laboratory tests including measurements of the subjective visual vertical (SVV) and ocular torsion, bithermal caloric tests and pure tone audiometry. All patients developed isolated acute vestibular syndrome (AVS) with ipsilesional spontaneous nystagmus (n = 7) and contralesional ocular tilt reaction (OTR) and/or SVV tilt (n = 7). In view of the normal head impulse test in all patients and skew deviation in one, our patients met the criteria for AVS from central lesions. Five patients showed a directional dissociation between the OTR/SVV tilt and body lateropulsion that fell to the lesion side whilst the OTR/SVVtilt was contraversive. A unilateral ICP lesion at the pontine level leads to the development of isolated AVS. However, a negative head impulse test and directional dissociation between OTR/SVV tilt and body lateropulsion may distinguish lesions involving unilateral ICP at the pontine level from those affecting other vestibular structures. © 2015 EAN.

  4. Deep inferior epigastric artery perforator flap harvest after full abdominoplasty.

    Science.gov (United States)

    Zeltzer, Assaf A; De Baerdemaeker, Randy A; Hendrickx, Benoit; Seidenstücker, Katrin; Brussaard, Carola; Hamdi, Moustapha

    2018-03-01

    Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition. The patient was scheduled for a free lumbar artery perforator (LaP) flap. The preoperative computed tomography-angiography mapping showed nice lumbar perforators and to our surprise a good-sized DIEa perforator in the peri-umbilical region. The DIEa perforator on the right hemi-abdomen, consisting of two veins and one artery, was pulsatile and found suitable in size. A classical flap harvest and transfer was further performed. This case report is the first in which a dominant perforator is found in the area of undermining after a full abdominoplasty with umbilical repositioning. Further investigations regarding the nature and timing of re-permeation or regeneration of perforators after abdominoplasty are to be done. Nevertheless, we are convinced that with appropriate perforator mapping and a suitable plan B, previous abdominoplasty is no longer an absolute but a relative contra-indication for performing DIEaP-flap.

  5. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  6. Budd-Chiari syndrome: puncturing occlusion of inferior vena cava with blunt wire

    International Nuclear Information System (INIS)

    Han Xinwei; Wu Gang; Ding Pengxu; Gao Xuemei; Ma Nan; Wang Yanli; Guan Sheng

    2006-01-01

    Objective: To explore the safety of puncturing occlusion of inferior vena cava with blunt wire for Budd-Chiari syndrome. Methods: Under the fluoroscopic guidance, occlusions of inferior vena cava were punctured with blunt wire for 63 patients with membranous occlusion of inferior vena cava and 33 with segmental occlusion of the inferior vena cava; including 15 patients with hepatic vein stenosis or occlusion. Results: 96 patients with Budd-Chiari syndrome were operated successfully. All occlusions of inferior vena cava were punctured with patent rate of 100% and no serious complications occurred. Conclusion: Puncturing occlusion of IVC with blunt guide wire is safe, efficient, no serious complication and simple economic method, worthy to be recommended. (authors)

  7. Panmedullary edema with inferior olivary hypertrophy in bilateral medial medullary infarction.

    Science.gov (United States)

    Inoue, Yasuteru; Miyashita, Fumio; Koga, Masatoshi; Yamada, Naoaki; Toyoda, Kazunori; Minematsu, Kazuo

    2014-03-01

    Bilateral medial medullary infarction (MMI) is a rare type of stroke with poor outcomes. Inferior olivary nucleus hypertrophy results from a pathologic lesion in the Guillain-Mollaret triangle. The relationship between inferior olivary nucleus hypertrophy and the medullary lesion is obscure. To the best of our knowledge, only 1 autopsy case with unilateral medial medullary infarction that was associated with ipsilateral inferior olivary nucleus hypertrophy has been reported. We describe a rare case with acute infarction in the bilateral medial medulla oblongata accompanied by subacute bilateral inferior olivary nucleus hypertrophy and panmedullary edema. The hypertrophy appeared to have been caused by local ischemic damage to the termination of the central tegmental tract at the bilateral inferior olivary nucleus. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Influence of slice thickness on the determination of left ventricular wall thickness and dimension by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ohnishi, Shusaku; Fukui, Sugao; Atsumi, Chisato and others

    1989-02-01

    Wall thickness of the ventricular septum and left ventricle, and left ventricular cavity dimension were determined on magnetic resonance (MR) images with slices 5 mm and 10 mm in thickness. Subjects were 3 healthy volunteers and 7 patients with hypertension (4), hypertrophic cardiomyopathy (one) or valvular heart disease (2). In visualizing the cardiac structures such as left ventricular papillary muscle and right and left ventricles, 5 mm-thick images were better than 10 mm-thick images. Edges of ventricular septum and left ventricular wall were more clearly visualized on 5 mm-thick images than 10 mm-thick images. Two mm-thick MR images obtained from 2 patients yielded the most excellent visualization in end-systole, but failed to reveal cardiac structures in detail in end-diastole. Phantom studies revealed no significant differences in image quality of 10 mm and 5 mm in thickness in the axial view 80 degree to the long axis. In the axial view 45 degree to the long axis, 10 mm-thick images were inferior to 5 mm-thick images in detecting the edge of the septum and the left ventricular wall. These results indicate that the selection of slice thickness is one of the most important determinant factors in the measurement of left ventricular wall thickness and cavity dimension. (Namekawa, K).

  9. Assessment of left ventricular ejection fraction by gated blood pool scintigraphy on early and late phase from the onset of acute myocardial infarction

    International Nuclear Information System (INIS)

    Nakashima, Yoshiharu; Fukuzaki, Hisashi; Minamiji, Katsumi; Kida, Toru; Okada, Toshio; Yamada, Shigenobu; Goto, Takeshi; Maeda, Kazumi; Yoshida, Yutaka.

    1984-01-01

    To evaluate the change of left ventricular function after the onset of acute myocardial infarction, gated blood pool scintigraphy was performed in 19 patients on early and late phase (6 days and 1 month on the average). There was a difference in left ventricular ejection fraction (LVEF) between patients with anterior and inferior myocardial infarction. Patients with anterior infarction indicated low value of LVEF (31+-7%) on acute phase and its value was increased on chronic phase (37+-8%), whereas patients with inferior infarction had higher value of LVEF not only on acute phase but also on chronic phase (54+-9%→57+-10%), than those with anterior infarction. Left ventricular volume was larger in anterior group than in inferior group and tended to become smaller on chronic phase. In 4 of 10 cases with anterior infarction, a significant improvement of LVEF was found from 28+-6% to 43+-5%, but in 6 cases LVEF was unchanged during the same period. In 3 cases out of improved group, it was demonstrated angiographically that the collateral vessels were developed. It was, thus, suggested that collateral vessels may play an important role in the recovery of myocardial ischemia and wall motion abnormality in the marginal zone of infarcted area. From these results, we concluded that left ventricular function changed serially in most patients from the early phase to the late phase after the onset of acute myocardial infarction. (author)

  10. Resolution of an Anterior-Inferior Cerebellar Artery Feeding Aneurysm with the Treatment of a Transverse-Sigmoid Dural Arteriovenous Fistula

    Science.gov (United States)

    Kan, Peter; Stevens, Edwin A.; Warner, Judith; Couldwell, William T.

    2007-01-01

    A 27-year-old man developed an unruptured anterior-inferior cerebellar artery (AICA) feeding aneurysm from a transverse-sigmoid dural arteriovenous malformation. The patient, with a known history of left transverse and sigmoid sinus thrombosis, presented with pulse-synchronous tinnitus. Angiography revealed an extensive dural arteriovenous fistula (AVF), with feeders from both the extracranial and intracranial circulations, involving the right transverse sinus, the torcula, and the left transverse/sigmoid sinuses. Multimodal endovascular and open surgical therapy was used to manage the lesion. Before a planned second-stage treatment for the left sigmoid sinus component, the dural AVF improved significantly. During this interval, however, a small flow-related aneurysm developed on the left AICA feeding the petrous dural region. The aneurysm resolved after resection of the involved sigmoid sinus. This is the first reported case of an unruptured feeding-artery aneurysm in an intracranial dural AVF that resolved spontaneously with treatment of the dural AVF. Until more is known about the natural history, the decisions of when and whether to treat an unruptured dural AVF feeding-artery aneurysm must be made on an individual basis. PMID:17973034

  11. Subtotal laparoscopic splenectomy in rats with preservation of the inferior pole Esplenectomia subtotal laparoscópica com preservação do polo inferior em ratos

    Directory of Open Access Journals (Sweden)

    José Jorge da Silva

    2011-02-01

    Full Text Available Purpose: To evaluate the feasibility and safety of subtotal splenectomy by laparoscopy with inferior pole preservation and to determine the viability of the splenic remnant. Methods: Twenty male Wistar rats weighing between 365 g and 474 g (mean 417.92 ± 36.15g SD were operated and randomly assigned to two groups : Group 1 rats were killed on postoperative day 10 (n = 10, and Group 2 on the postoperative day 80 (n = 10. Both the inferior splenic pole and the superior part of the spleen, which was used as a control to measure inferior pole viability, were weighed and morphologically examined. Results: The technique was feasible in all cases. There were two postoperative deaths on immediate postoperative and one not well defined. The average weight percentage of the inferior pole, measured indirectly on the 10th day, was 53.67% ± 11.59% and on the 80th day was 62.69% ± 6.89%. The inferior pole was necrotic, with abscess formation in one case (5.9% and appeared normal in all other cases. Microscopy showed features that were compatible with normality. Conclusions: Subtotal splenectomy with preservation of the inferior pole by laparoscopy was feasible and safety. The lower splenic pole was viable in 94.1% of animals.Objetivo: Avaliar a exequibilidade e a segurança da esplenectomia subtotal com preservação do polo inferior do baço por videolaparoscopia, e a viabilidade do referido polo. Métodos: 20 ratos Wistar, machos, pesando entre 365g e 474g (MA 417,92 ± 36,15g foram operados e distribuídos em dois grupos de acordo com a época da retirada do polo inferior para estudo: grupo 1 do 10º dia, (n= 10, grupo 2, do 80º dia (n=10. A porção superior do baço que serviu de controle da viabilidade do pólo inferior e esse remanescente, retirados no término do experimento, foram medidos, pesados e enviados para exame morfológico. Resultados: A técnica foi exeqüível em todos os casos. O peso médio percentual do polo inferior avaliado de

  12. Inferior Glenohumeral Dislocation in a Division One Collegiate Wrestler

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    Alexander J. Gilmore

    2016-05-01

    Full Text Available Background: A twenty-two year old male collegiate wrestler with no previous history of any shoulder injuries experienced an inferior glenohumeral dislocation on his right arm during practice. The athlete was in in a front headlock by a teammate who attempted to roll him. The athlete was forced into hyperflexion and abduction. The athlete felt a pop and his arm was “stuck” in approximately ninety degrees of abduction. An obvious deformity was palpable in his armpit. The athlete then proceeded to make his way to the athletic training room where he was able to relax and the dislocation reduced itself. After relocation the athlete had no obvious deformity, immediate swelling, or ecchymosis. He was experiencing very generalized soreness and was tender to palpate. His range of motion was very limited due to pain and we were unable to get a good evaluation on him at the time of injury. The next day he was still pretty sore and experienced pain with internal and external rotation. He was experiencing weakness in his rotator cuff and had diffuse neuropraxia. Differential Diagnosis: Labral Tear, shoulder instability, fracture to the humeral head. Treatment: The athlete saw the team physician the day of injury, was placed in a sling, and followed up with x-rays and a visit with the team physician the next day. No bony abnormalities were shown on the x-rays. The team physician discussed options of surgery or waiting with the athlete, who was pretty set on surgery, which he ended up getting the next week. He saw the team physician one week post-operation where the surgery and pictures were reviewed and explained. Athlete was doing well with no complaints. He had good range of motion for one week post-op. At this point we had to explain to him that he needed to be patient in order to let himself heal. We were told to continue his rehabilitation program of active internal and external rotation, passive supination/pronation, and putty squeezes and that he

  13. Human left ventral premotor cortex mediates matching of hand posture to object use.

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    Guy Vingerhoets

    Full Text Available Visuomotor transformations for grasping have been associated with a fronto-parietal network in the monkey brain. The human homologue of the parietal monkey region (AIP has been identified as the anterior part of the intraparietal sulcus (aIPS, whereas the putative human equivalent of the monkey frontal region (F5 is located in the ventral part of the premotor cortex (vPMC. Results from animal studies suggest that monkey F5 is involved in the selection of appropriate hand postures relative to the constraints of the task. In humans, the functional roles of aIPS and vPMC appear to be more complex and the relative contribution of each region to grasp selection remains uncertain. The present study aimed to identify modulation in brain areas sensitive to the difficulty level of tool object - hand posture matching. Seventeen healthy right handed participants underwent fMRI while observing pictures of familiar tool objects followed by pictures of hand postures. The task was to decide whether the hand posture matched the functional use of the previously shown object. Conditions were manipulated for level of difficulty. Compared to a picture matching control task, the tool object - hand posture matching conditions conjointly showed increased modulation in several left hemispheric regions of the superior and inferior parietal lobules (including aIPS, the middle occipital gyrus, and the inferior temporal gyrus. Comparison of hard versus easy conditions selectively modulated the left inferior frontal gyrus with peak activity located in its opercular part (Brodmann area (BA 44. We suggest that in the human brain, vPMC/BA44 is involved in the matching of hand posture configurations in accordance with visual and functional demands.

  14. The inferior alveolar artery in the mandibular canal

    International Nuclear Information System (INIS)

    Kato, Hisanao

    1991-01-01

    The present study investigated the course of the inferior alveolar artery (IAA) of the mandibular canal (MC), as well as morphological structure of the vascular wall, and the effects of Co-60 gamma irradiation on it. Male Sprague-Dawley strain 7-week-old rats were used as experimental animals. Histopathological changes in the vascular wall were observed by both light and electron microscopy. A single gamma irradiation of 17.82 Gy (TDF 100), 27.97 Gy (TDF 200), or 36.41 Gy (TDF 300) was given to the mandibular area. The IAA/MC ratio on the cross section was 3.4% at the mandibular foramen, 0.1% at the area between the second and third molar teeth, and 0.1% at the mental foramen. The corresponding diameters for these sites were 100 μm, 30 μm, and 20 μm. Morphological examination revealed IAA to be the muscular type of artery. Trichrome staining revealed three layers, including the lamina intima (1.4 μm), lamina media (13.3 μm), and lamina adventitia (11.2 μm). Dilatation of IAA occurred immediately after irradiation, followed by marked contraction on Day 3 after irradiation in the 17.82 Gy group, on Day 5 in the 27.97 Gy group, and on Day 7 in the 36.41 Gy group. During the period between Weeks 2 and 7, however, the 17.82 Gy group showed IAA dilatation. None of radiation injuries, such as rupture, necrosis and stenosis, was seen, but both vacuolation of the lamina intima and media, and irregular arrangement of the fibrous layer were seen. The vasculonervous bundle in MC seemed to be supported with fibrous connective tissues, suggesting an effective buffer effect on the dilatation of the vascular wall and the resistance to traumatic injuries. (N.K.)

  15. Inferior vena cava filters in pulmonary embolism: A historic controversy.

    Science.gov (United States)

    Jerjes-Sanchez, Carlos; Rodriguez, David; Navarrete, Aline; Parra-Cantu, Carolina; Joya-Harrison, Jorge; Vazquez, Eduardo; Ramirez-Rivera, Alicia

    Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table. Finally, we analyzed the outcome of our PE patients that were submitted to thrombolysis with short and long term follow-up. IVCF induces thrombosis by several mechanisms including placement and removal, rapid protein adsorption, and simultaneous surface-induced activation via the contact activation pathway. Also, inorganic polyphosphate has an important role as a procoagulant, reversing the effect of anticoagulants. Randomized control trials included 904 cancer and non-cancer PE patients. In terms of ARR, RRR, and NNT, there is no evidence for routine use of IVCF. In 290 patients with proved PE, extensive thrombotic burden and right ventricular dysfunction under thrombolysis and oral anticoagulation, we observed a favorable outcome in a short- and long-term follow-up; additionally, IVCF was only used in 5% of these patients. Considering the complex mechanisms of thrombosis related with IVCF, the evidence from randomized control trials and ARR, RRR, and NNT obtained from venous thromboembolism patients with and without cancer, non-routine use of IVCF is recommended. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  16. A comparative CFD study of four inferior vena cava filters.

    Science.gov (United States)

    López, Josep M; Fortuny, Gerard; Puigjaner, Dolors; Herrero, Joan; Marimon, Francesc

    2018-03-30

    Computational fluid dynamics was used to simulate the flow of blood within an inferior vena cava (IVC) geometry model that was reconstructed from computed tomography images obtained from a real patient. The main novelty of the present work is that we simulated the implantation of four different filter models in this realistic IVC geometry. We considered different blood flow rates in the range between V in =20 and V in =80cm 3 /s and all simulations were performed with both the Newtonian and a non-Newtonian model for the blood viscosity. We compared the hemodynamics performance of the different filter models and we paid a special attention to the total drag force, F d , exerted by the blood flow on the filter surface. This force is the sum of two contributions: the viscous skin friction force, which was found to be roughly proportional to the filter surface area, and the pressure force, which depended on the particular filter geometry design. The F d force is relevant because it must be balanced by the total force exerted by the filter hooks/struts on the IVC wall at the attachment locations. For the highest V in value investigated, the variation in F d among filters was from 116 to 308 dyne. We also showed how the present results can be extrapolated to obtain good estimates of the drag forces if the blood viscosity levels change, i.e., if the patient with a filter implanted is treated with anticoagulant therapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Distal anterior inferior cerebellar artery syndrome after acoustic neuroma surgery.

    Science.gov (United States)

    Hegarty, Joseph L; Jackler, Robert K; Rigby, Peter L; Pitts, Lawrence H; Cheung, Steven W

    2002-07-01

    To define a clinicopathologic syndrome associated with persistent cerebellar dysfunction after acoustic neuroma (AN) excision. Case series derived from radiographic and clinical chart review. Tertiary referral center. In 12 patients with AN, persistent cerebellar dysfunction developed after AN removal. Each case demonstrated abnormality in the ipsilateral cerebellar peduncle on postoperative magnetic resonance imaging. Cerebellar function and ambulatory status over the first postoperative year. On magnetic resonance imaging scans, the extent of cerebellar peduncle infarcts was variable. It ranged from focal brain injury (2 cm) spanning the full thickness of the peduncle. Peduncular infarcts were associated with large tumor size (average 3.8 cm, range 2.0-5.5 cm diameter). The long-term functional outcomes (>1 yr) varied. Dysmetria was unchanged or improved in over half of the patients (6 of 11 patients). Gait recovered to normal or to preoperative levels in 5 patients. In the 6 patients with persistent impaired mobility, 2 had mild gait disturbance, 3 required regular use of a cane, and 1 has been dependent on a walker. One patient had sustained mild motor weakness. Three of 11 patients remained dependent on others for activities of daily living. Peduncle injury most likely stems from interruption of distal branches of the anterior inferior cerebellar artery (AICA). These small vessels are intimately related to the capsule of the tumor and may supply both the neoplasm and the brain parenchyma. It has long been recognized that interruption of the proximal segment of the AICA results in severe injury to the pons, with devastating neurologic sequelae. A limited AICA syndrome caused by loss of its distal ramifications seems a more plausible explanation for peduncular infarction than either venous insufficiency or direct surgical trauma.

  18. Clinico-anatomical correlations of left posterior cerebral artery occlusion. Alexia without agraphia, color anomia, and memory disturbance

    Energy Technology Data Exchange (ETDEWEB)

    Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

    1988-11-01

    The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.).

  19. "Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels

    Directory of Open Access Journals (Sweden)

    Toshihiko Satake

    2015-11-01

    Full Text Available This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.

  20. Multiplicativity of left centralizers forcing additivity

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    Mohammad Sayed Tammam El-Sayiad

    2014-01-01

    Full Text Available A multiplicative left centralizer for an associative ring R is a map satisfying T(xy = T\\(xy for all x,y in R. T is not assumed to be additive. In this paper we deal with the additivity of the multiplicative left centralizers in a ring which contains an idempotent element. Specially, we study additivity for multiplicative left centralizers in prime and semiprime rings which contain an idempotent element.

  1. Does a single session of theta-burst transcranial magnetic stimulation of inferior temporal cortex affect tinnitus perception?

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    Moser Tobias

    2009-05-01

    Full Text Available Abstract Background Cortical excitability changes as well as imbalances in excitatory and inhibitory circuits play a distinct pathophysiological role in chronic tinnitus. Repetitive transcranial magnetic stimulation (rTMS over the temporoparietal cortex was recently introduced to modulate tinnitus perception. In the current study, the effect of theta-burst stimulation (TBS, a novel rTMS paradigm was investigated in chronic tinnitus. Twenty patients with chronic tinnitus completed the study. Tinnitus severity and loudness were monitored using a tinnitus questionnaire (TQ and a visual analogue scale (VAS before each session. Patients received 600 pulses of continuous TBS (cTBS, intermittent TBS (iTBS and intermediate TBS (imTBS over left inferior temporal cortex with an intensity of 80% of the individual active or resting motor threshold. Changes in subjective tinnitus perception were measured with a numerical rating scale (NRS. Results TBS applied to inferior temporal cortex appeared to be safe. Although half of the patients reported a slight attenuation of tinnitus perception, group analysis resulted in no significant difference when comparing the three specific types of TBS. Converting the NRS into the VAS allowed us to compare the time-course of aftereffects. Only cTBS resulted in a significant short-lasting improvement of the symptoms. In addition there was no significant difference when comparing the responder and non-responder groups regarding their anamnestic and audiological data. The TQ score correlated significantly with the VAS, lower loudness indicating less tinnitus distress. Conclusion TBS does not offer a promising outcome for patients with tinnitus in the presented study.

  2. Subjective and objective parameters in the evaluation of radiofrequency ablation of the inferior turbinate do not correlate: A pilot study.

    Science.gov (United States)

    Tomazic, Peter Valentin; Gerstenberger, Claus; Rant, Bettina; Nemetz, Ulrike; Brezjak-Kahlert, Christiana; Wolf, Axel; Freudenschuss, Kurt; Wolf, Gerald

    2016-08-01

    Inferior turbinate hypertrophy is a common cause of nasal obstruction. We conducted a prospective study to correlate subjective and objective parameters in assessing the effectiveness of radiofrequency ablation (RFA). Our initial study population was made up of 10 patients who presented with nasal obstruction; 1 patient was lost to follow-up, leaving us with 7 women and 2 men, aged 26 to 65 years (mean: 37.9 ± 12.8), and 16 turbinates (7 bilateral, 1 right, and 1 left). Visual analogue scale (VAS) scores, Nasal Obstruction and Symptom Evaluation (NOSE) questionnaire scores, rhinomanometry results, and CT- and MRI-based volumetry were obtained before RFA and 6 months afterward. For the subjective parameters, the mean pre- and postoperative VAS scores for the 16 turbinates were 6.6 ± 1.6 and 2.8 ± 2.0 (p < 0.001), respectively, and the mean pre- and postoperative NOSE scores in the 9 patients were 15.3 ± 3.1 and 5.8 ± 5.4 (p = 0.003). For the objective parameters, the mean pre- and postoperative rhinomanometry values at 150 Pa were 241.0 ± 141.3 and 265.4 ± 157.3 ml/sec (p = 0.403), and the mean pre- and postoperative volumetry values were 5.3 ± 2.5 and 5.0 ± 2.1 cm(3) (p = 0.551). Note that only the differences in the subjective parameters reached statistical significance. RFA of the inferior turbinates as a treatment for nasal obstruction is safe and easy. However, our study found a discrepancy between the subjective and objective outcomes parameters, as the former showed highly significant improvement and the latter showed only a slight improvement that did not reach statistical significance.

  3. Anesthetic management for reentry sternotomy in a patient with a full stomach and pericardial tamponade from left ventricular rupture

    Directory of Open Access Journals (Sweden)

    Bryan G Maxwell

    2013-01-01

    Full Text Available A 57-year-old man presented with chest pain and shortness of breath 1 month after left ventricular aneurysmectomy and ventricular septal defect closure for post-infarct left ventricular aneurysm and ventricular septal defect. Echocardiography revealed a large recurrent ruptured inferior left ventricular aneurysm with high-velocity flow into a 5 cm posterolateral pericardial effusion. Thirty minutes earlier, the patient had eaten a full meal. Rapid sequence induction was performed with midazolam, ketamine, and succinylcholine. Moderate hypotension was treated effectively and the patient tolerated controlled transition to cardiopulmonary bypass. The ventricular defect was oversewn and reinforced with bovine pericardium. The patient had a difficult but ultimately successful recovery. Options for anesthetic management in the setting of tamponade and a full stomach are discussed, with a brief review of the evidence relating to this clinical problem.

  4. Anarchy, socialism and a Darwinian left.

    Science.gov (United States)

    Clarke, Ellen

    2006-03-01

    In A Darwinian left Peter Singer aims to reconcile Darwinian theory with left wing politics, using evolutionary game theory and in particular a model proposed by Robert Axelrod, which shows that cooperation can be an evolutionarily successful strategy. In this paper I will show that whilst Axelrod's model can give support to a kind of left wing politics, it is not the kind that Singer himself envisages. In fact, it is shown that there are insurmountable problems for the idea of increasing Axelrodian cooperation within a welfare state. My surprising conclusion will be that a Darwinian left worthy of the name would be anarchistic.

  5. What is Beyond Right/Left?

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    2009-01-01

    The article looks at New Labour's move beyond right/left in the mid/late 1990s, which is an occasion to spell out the nature of right/left and what it means for democracy. In contrast to both defenders and critics of this move I argue in the first part that right/left is not an empty label bound up...... right/left. I argue that the new hegemonic orientation is that of front/back, which designs political renewal as a response to the social changes cutting across the outdated lines of contestation of partisan politics. The democratic problem of this move lies in squeezing politics between technocratic...

  6. Primary research on direct multi-slice spiral CT venography in inferior vena cava

    International Nuclear Information System (INIS)

    Gong Peiyou; Liu Fengli; Ma Xianying; Zhao Li; Wang Liping; Li Xuehua; Li Jian

    2010-01-01

    Objective: To investigate the superiority of direct multi-slice spiral CT venography in inferior vena cava. Methods: Twenty-eight patients performed MSCT venography in inferior vena cava, including 2 cases with both indirect and direct venography, 10 cases with indirect venography, 20 cases with direct venography through unilateral or bilateral lower extremity venous injection. The image quality and enhancement degree of the inferior vena cava were compared in double-blind method. Results: Of 10 cases with indirect venography of inferior vena cava, 1 case was failed due to mild enhancement in inferior vena cava. Image quality was good in 2 cases, poor in 7 cases, no excellent case. Of 20 cases with direct venography of inferior vena cava, the enhancement degree was scored 1, 2 degree in 16, 4 cases respectively and no case was scored 3 degree, the image quality was excellent, good in 16, 4 cases and no case was bad. The success rate was 100%. Conclusion: The image quality of direct MSCT venography in inferior vena cava is better than that of indirect method. (authors)

  7. Assessment of inferior wall in 123I-metaiodobenzylguanidine myocardial SPECT in diabetic patients

    International Nuclear Information System (INIS)

    Fukumoto, Yoshihiro; Kuroda, Yasuhisa; Ohta, Jun; Osono, Ken; Saitou, Miyoko; Suzuki, Mituaki; Nakajima, Toshiki

    1994-01-01

    A phantom experiment and a clinical assessment have been made with the purpose of investigating the causes of low accumulation and deficiency of the inferior wall in 123 I-metaiodobenzylguanidine (MIBG) myocardial SPECT and the method for its evaluation. By the phantom experiment, assessments were made regarding (1) influence of the liver positioned adjacently; and (2) involvement of absorption and attenuation of the inferior wall. For the clinical assessment, 84 patients with diabetes in whom no abnormality was observed by exercise myocardial SPECT ( 201 TlCl) and 5 cases of inferior myocardial infarction (OMI group) were adopted as subjects. The inferior walls were evaluated as visually deficient because of the adjacently-positioned liver, but no low value was exhibited by quantitative evaluation. By pulmonary mediastinal phantom (-), improvement of the inferior wall was observed visually and quantitatively, compared with pulmonary mediastinal phantom (+). By quantitative evaluation, the patients were classified into normal MIBG group (N group); segmentally deficient group (S group); and non-accumulated group (DH group). In addition, S group was classified by severity score into those from S 1 to S 4 groups. No significant difference was observed in Relative Regional Uptake (RRU) in the inferior wall between S 4 group and OMI group. To sum up, we considered the causes for low accumulation and deficiency of the inferior wall, (1) adjacently-positioned liver; (2) absorption and attenuation; and (3) the lesion itself. Visual evaluation is not sufficient as the evaluating method. Quantitative evaluation becomes necessary. (author)

  8. Detecting and accounting for violations of the constancy assumption in non-inferiority clinical trials.

    Science.gov (United States)

    Koopmeiners, Joseph S; Hobbs, Brian P

    2018-05-01

    Randomized, placebo-controlled clinical trials are the gold standard for evaluating a novel therapeutic agent. In some instances, it may not be considered ethical or desirable to complete a placebo-controlled clinical trial and, instead, the placebo is replaced by an active comparator with the objective of showing either superiority or non-inferiority to the active comparator. In a non-inferiority trial, the experimental treatment is considered non-inferior if it retains a pre-specified proportion of the effect of the active comparator as represented by the non-inferiority margin. A key assumption required for valid inference in the non-inferiority setting is the constancy assumption, which requires that the effect of the active comparator in the non-inferiority trial is consistent with the effect that was observed in previous trials. It has been shown that violations of the constancy assumption can result in a dramatic increase in the rate of incorrectly concluding non-inferiority in the presence of ineffective or even harmful treatment. In this paper, we illustrate how Bayesian hierarchical modeling can be used to facilitate multi-source smoothing of the data from the current trial with the data from historical studies, enabling direct probabilistic evaluation of the constancy assumption. We then show how this result can be used to adapt the non-inferiority margin when the constancy assumption is violated and present simulation results illustrating that our method controls the type-I error rate when the constancy assumption is violated, while retaining the power of the standard approach when the constancy assumption holds. We illustrate our adaptive procedure using a non-inferiority trial of raltegravir, an antiretroviral drug for the treatment of HIV.

  9. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Chinali, M.; Simone, G. de; Wachtell, K.

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... with larger left ventricular diameter and higher left ventricular mass index (both P hypertrophy was greater (84 vs. 64%; P ..., transmitral peak E velocities and peak A velocities; and lower E/A ratio (all P hypertrophy, but normal left ventricular chamber systolic function with increased...

  10. Executive Semantic Processing Is Underpinned by a Large-scale Neural Network: Revealing the Contribution of Left Prefrontal, Posterior Temporal, and Parietal Cortex to Controlled Retrieval and Selection Using TMS

    Science.gov (United States)

    Whitney, Carin; Kirk, Marie; O'Sullivan, Jamie; Ralph, Matthew A. Lambon; Jefferies, Elizabeth

    2012-01-01

    To understand the meanings of words and objects, we need to have knowledge about these items themselves plus executive mechanisms that compute and manipulate semantic information in a task-appropriate way. The neural basis for semantic control remains controversial. Neuroimaging studies have focused on the role of the left inferior frontal gyrus…

  11. Bilateral, Mirror-imaged, Postero-inferior Cerebellar Artery Aneurysms: Report of a Rare Case

    Directory of Open Access Journals (Sweden)

    G R Sharma

    2011-06-01

    Full Text Available A 60-year-old right-handed lady presented with the features of subarachnoid haemorrhage. The CT angiogram showed a pair of very rare bilateral, mirror-imaged distal postero-inferior cerebellar artery aneurysms. Both aneurysms were clipped via the midline posterior fossa craniectomy under general anaesthesia. The literatures is reviewed on the incidence, presentation, management and outcome of bilateral distal posterior-inferior cerebellar artery aneurysms. Keywords: bilateral mirror image, distal postero-inferior cerebellar artery aneurysms, posterior fossa craniectomy, microsurgical clipping

  12. Isquemia aguda de miembros inferiores secundaria a ergortismo Acute ischemia of lower limbs secondary to ergotism

    OpenAIRE

    Franco J Vallejo; Juan F Gómez; Natalia Tamayo

    2011-01-01

    Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasod...

  13. Creation of the permanent inferior vena cava filter for prevention of pulmonary artery embolism

    Directory of Open Access Journals (Sweden)

    Yа.O. Povar

    2016-05-01

    Full Text Available The aim of the study was to create a new permanent cava filter to improve functional capacities of the construction and achieve high clinical parameters. A new geometry of the permanent inferior vena cava filter was presented which has high blood clot-capturing ability, does not cause thrombus fragmentation, makes migration impossible. The inferior vena cava filter does not injure the vessel wall and preserves integrity under long-term use. The inferior vena cava filter installation is safe and controllable, the filter self-positioning and reposition are possible, the delivery system size is 6F, the blood flow changing is minimal.

  14. Isolated congenital absence of inferior pubic rami ossification: a case report.

    Science.gov (United States)

    VandenBerg, Curtis; Novais, Eduardo

    2014-11-01

    Previously reported cases of congenital absence of the pubic rami have been associated with urogenital and musculoskeletal anomalies. Presented here is the case of an 11-year-old female who presented to the outpatient clinic and was incidentally found to have absence of inferior pubic rami ossification in the setting of otherwise normal pelvic, genitourinary, and musculoskeletal development. Radiographic, computed tomography, and MRI studies are shown and demonstrate normal musculoskeletal anatomy and a cartilaginous anlage in the location of the inferior pubic rami. Isolated absence of inferior pubic rami ossification can be present in an otherwise typically developing child with normal function.

  15. Left dorsal speech stream components and their contribution to phonological processing.

    Science.gov (United States)

    Murakami, Takenobu; Kell, Christian A; Restle, Julia; Ugawa, Yoshikazu; Ziemann, Ulf

    2015-01-28

    Models propose an auditory-motor mapping via a left-hemispheric dorsal speech-processing stream, yet its detailed contributions to speech perception and production are unclear. Using fMRI-navigated repetitive transcranial magnetic stimulation (rTMS), we virtually lesioned left dorsal stream components in healthy human subjects and probed the consequences on speech-related facilitation of articulatory motor cortex (M1) excitability, as indexed by increases in motor-evoked potential (MEP) amplitude of a lip muscle, and on speech processing performance in phonological tests. Speech-related MEP facilitation was disrupted by rTMS of the posterior superior temporal sulcus (pSTS), the sylvian parieto-temporal region (SPT), and by double-knock-out but not individual lesioning of pars opercularis of the inferior frontal gyrus (pIFG) and the dorsal premotor cortex (dPMC), and not by rTMS of the ventral speech-processing stream or an occipital control site. RTMS of the dorsal stream but not of the ventral stream or the occipital control site caused deficits specifically in the processing of fast transients of the acoustic speech signal. Performance of syllable and pseudoword repetition correlated with speech-related MEP facilitation, and this relation was abolished with rTMS of pSTS, SPT, and pIFG. Findings provide direct evidence that auditory-motor mapping in the left dorsal stream causes reliable and specific speech-related MEP facilitation in left articulatory M1. The left dorsal stream targets the articulatory M1 through pSTS and SPT constituting essential posterior input regions and parallel via frontal pathways through pIFG and dPMC. Finally, engagement of the left dorsal stream is necessary for processing of fast transients in the auditory signal. Copyright © 2015 the authors 0270-6474/15/351411-12$15.00/0.

  16. Left Paraduodenal Hernia: An Autopsy Case

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Hougen, Hans Petter

    2011-01-01

    We present a case of a left paraduodenal hernia diagnosed at autopsy. A left paraduodenal hernia is an internal hernia of congenital origin due to the abnormal rotation of the midgut during embryonic development. Internal hernias are a rare cause of intestinal obstruction, with the paraduodenal...

  17. Malignant phyllodes tumor of the left atrium

    Directory of Open Access Journals (Sweden)

    Anupam Bhambhani

    2014-03-01

    Full Text Available Metastatic tumors to the heart usually involve right sided chambers. We report a rare case of malignant phyllodes tumor of breast with metastatic involvement of left atrium occurring through direct invasion from mediastinal micro-metastasis and presenting as a left atrial mass causing arrhythmia.

  18. Left ventricular hypertrophy, geometric patterns and clinical ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy can be due to various reasons including hypertension. It constitutes an increased cardiovascular risk. Various left ventricular geometric patterns occur in hypertension and may affect the cardiovascular risk profile of hypertensive subjects. Methods: One hundred and eighty eight ...

  19. Leptogenesis with left-right domain walls

    Indian Academy of Sciences (India)

    the scale of left-right symmetry breaking. Keywords. Leptogenesis; baryogenesis; domain walls; left-right symmetry. PACS Nos 12.10.Dm; 98.80.Cq; 98.80.Ft. Explaining the observed baryon asymmetry of the Universe within the framework of gauge theories and the standard Big Bang cosmology remains an open problem.

  20. On establishing coreference in Left Dislocation constructions ...

    African Journals Online (AJOL)

    The phenomenon of left dislocation (LD) has received relatively little attention in the generative literature. In Government & Binding theory and early versions of Minimalist Syntax, the left-dislocated expression is conventionally taken to be base-generated in its sentence-initial surface position and the resumptive pronoun in ...

  1. Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion.

    Science.gov (United States)

    Wemmelund, Kristian Borup; Ringgård, Viktor Kromann; Vistisen, Simon Tilma; Hyldebrandt, Janus Adler; Sloth, Erik; Juhl-Olsen, Peter

    2017-09-11

    Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determine the impact of fluid loading and norepinephrine infusion on physiologic determinants of cardiac function obtained by ultrasonography during PLE. In this randomised, blinded, controlled laboratory study, 30 piglets (21.9 ± 1.3 kg) had bilateral PLE (75 mL/kg) induced. Subsequently, the piglets were randomised to intervention as follows: fluid loading (80 mL/kg/h for 1.5 h, n = 12), norepinephrine infusion (0.01, 0.03, 0.05, 0.1, 0.2 and 0.3 μg/kg/min (15 min each, n = 12)) or control (n = 6). Main outcome was left ventricular preload measured as left ventricular end-diastolic area. Secondary endpoints included contractility and afterload as well as global measures of circulation. All endpoints were assessed with echocardiography and invasive pressure-flow measurements. PLE decreased left ventricular end-diastolic area, mean arterial pressure and cardiac output (p values  0.05) to baseline. Left ventricular contractility increased with norepinephrine infusion (p = 0.002), but was not affected by fluid loading (p = 0.903). Afterload increased in both active groups (p values > 0.001). Overall, inferior vena cava distensibility remained unchanged during intervention (p values ≥ 0.085). Evacuation of PLE caused numerical increases in left ventricular end-diastolic area, but only significantly so in controls (p = 0.006). PLE significantly reduced left ventricular preload. Both fluid and norepinephrine treatment reverted this effect and normalised global haemodynamic parameters. Inferior vena cava distensibility remained unchanged. The haemodynamic significance of PLE may be underestimated during fluid or norepinephrine administration, potentially masking the presence of PLE.

  2. A new clinical sign probably associated to left hemiplegia with left hemineglect syndrome: the crossed legs.

    Science.gov (United States)

    Bazan, Rodrigo; Fernandes, Thiago; Braga, Gabriel; Luvizutto, Gustavo; Resende, Luiz

    2014-06-01

    To describe a new clinical sign associated with left unilateral neglect syndrome (UNS) in patients with ischemic stroke. Head computed tomography (CT) and National Institute of Health Stroke Scale were obtained in 150 patients with ischemic stroke. Those with right cerebral vascular lesions, left hemiplegia and right leg persistently crossed over the left were submitted to specific tests for UNS. The tests were also applied to 30 patients with right cerebral vascular lesions, left hemiplegia but without crossed legs. From 9 patients with persistent tendency to cross the right leg over the left, UNS was detected in 8. One patient died before the clinical tests were applied. Of the 30 patients without the crossed legs, 20 had normal clinical tests for UNS and 10 had minimal alterations, not sufficient for the diagnosis of UNS. The right leg crossed over the left may represent a new neurological semiotic sign associated with left hemiplegia and left UNS.

  3. Left ventricular thrombi detected by Ga-67-DFO-DAS-fibrinogen imaging and two-dimentional echocardiography

    International Nuclear Information System (INIS)

    Sakoda, Satoru; Kinoshita, Masahiko; Suzuki, Teruyasu

    1989-01-01

    The capability of diagnosing left ventricular thrombi was compared by scintigraphy using Ga-67-DFO-DAS- fibrinogen (Ga: gallium, DFO: deferoxamine, DAS: dialdehyde starch) and two-dimensional echocardiography. Ga-67-DFO-DAS-fibrinogen scintigraphy and two-dimensional echocardiography were performed in 17 consecutive patients following myocardial infarction. In 11 of the 17 patients, left ventricular thrombi were visualized by Ga-67-DFO-DAS-fibrinogen scintigraphy, but only five of the 11 patients were found to have thrombi by two-dimensional echocardiography. In eight patients with inferior or posterior myocardial infarction, no left ventricular thrombi were detected by two-dimensional echocardiography, while in six of the eight patients, ventricular thrombi were visualized by Ga-67-DFO-DAS-fibrinogen scintigraphy. Among the patients receiving adequate anticoagulants from the episode, only three patients had thrombi. In contrast, the remaining eight patients with thrombi were either receiving no anticoagulants, or were receiving inadequate anticoagulant therapy. Ga-67-DFO-DAS-fibrinogen scintigraphy is a very simple and useful method for detecting thrombi in the left ventricle after myocardial infarction. It is more sensitive for detecting thrombi in the left ventricle after myocardial infarction. It is more sensitive for detecting thrombi in the ventricle than was two-dimensional echocardiography. With this method, we can demonstrate the preventive effect of anticoagulants for left ventricular thrombus formation following myocardial infarction. (author)

  4. VARIATION IN THE OPENINGS (OSTIA OF LEFT PULMONARY VEINS INTO THE LEFT ATRIUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sesi

    2015-03-01

    Full Text Available During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmon ary veins which open into the left atrium, may vary. Here we report a variation in the opening of the Left upper (superior pulmonary vein into the Left atrium. A total of six openings observed

  5. Some essential considerations in the design and conduct of non-inferiority trials

    Science.gov (United States)

    Fleming, Thomas R; Odem-Davis, Katherine; Rothmann, Mark D; Shen, Yuan Li

    2012-01-01

    Background Suppose a standard therapy (Standard) has been established to provide a clinically important reduction in risk of irreversible morbidity or mortality. In that setting, the safety and efficacy of an experimental intervention likely would be assessed in a clinical trial providing a comparison with Standard rather than a placebo arm. Such a trial often is designed to assess whether the efficacy of the experimental intervention is not unacceptably worse than that of Standard, and is called a non-inferiority trial. Formally, the non-inferiority trial usually is designed to rule out a non-inferiority margin, defined as the minimum threshold for what would constitute an unacceptable loss of efficacy. Purpose Even though the literature has many important articles identifying various approaches to the design and conduct of non-inferiority trials, confusion remains especially regarding key considerations for selecting the non-inferiority margin. The purpose of this article is to provide improved clarity regarding these considerations. Methods We present scientific insights into many factors that should be addressed in the design and conduct of non-inferiority trials to enhance their integrity and reliability, and provide motivation for key considerations that guide the selection of non-inferiority margins. We also provide illustrations and insights from recent experiences. Results Two considerations are essential, and should be addressed in separate steps, in the formulation of the non-inferiority margin. First, the margin should be formulated using adjustments to account for bias or lack of reliability in the estimate of the effect of Standard in the non-inferiority trial setting. Second, the non-inferiority margin should be formulated to achieve preservation of an appropriate percentage of the effect of Standard. Limitations The considerations, in particular regarding the importance of preservation of effect, might not apply to settings where it would be ethical

  6. Is 2 mm a safe distance from the inferior alveolar canal to avoid ...

    African Journals Online (AJOL)

    . Conclusion: When 2 mm is considered as a safety distance, the distance of the implants to the IAC did not yield any statistical difference regarding postoperative neurosensory complications. Keywords: Dental implants, inferior alveolar nerve ...

  7. A Bayesian non-inferiority test for two independent binomial proportions.

    Science.gov (United States)

    Kawasaki, Yohei; Miyaoka, Etsuo

    2013-01-01

    In drug development, non-inferiority tests are often employed to determine the difference between two independent binomial proportions. Many test statistics for non-inferiority are based on the frequentist framework. However, research on non-inferiority in the Bayesian framework is limited. In this paper, we suggest a new Bayesian index τ = P(π₁  > π₂-Δ₀|X₁, X₂), where X₁ and X₂ denote binomial random variables for trials n1 and n₂, and parameters π₁ and π₂ , respectively, and the non-inferiority margin is Δ₀> 0. We show two calculation methods for τ, an approximate method that uses normal approximation and an exact method that uses an exact posterior PDF. We compare the approximate probability with the exact probability for τ. Finally, we present the results of actual clinical trials to show the utility of index τ. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    OpenAIRE

    Koppisetty, Shalini; Smith, Alton G.; Dhillon, Ravneet K.

    2015-01-01

    Inferior vena cava atresia (IVCA) is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT), found in approximately 5% of cases of unprovoked lower extremity (LE) DVT in patients

  9. Frequency of acute right ventricular myocardial infarction in patients with acute inferior myocardial infarction

    International Nuclear Information System (INIS)

    Iqbal, M.A.; Shah, I.; Rauf, M.A.; Khan, N.; Khan, S.B.; Hafizullah, M.

    2012-01-01

    Objective: To determine the frequency of acute right ventricular myocardial infarction (RVMI) in patients with acute inferior myocardial infarction. Methodology: This prospective case series study was conducted at Cardiology Department in a period from May to October 2009. A total of 174 patients with acute inferior myocardial infarction were evaluated for the presence of acute right ventricular myocardial infarction (RVMI). Results: Male patients were 135 (77.6%) and females 39 (24.4%). Patient's age ranged from 28 to 82 years with majority in the age group 40 to 60 years. Frequency of RVMI was 27% among patients presenting with acute inferior myocardial infarction. Among patients presenting with acute RVMI, 64 % patients received thrombolysis. Overall 65% patients of RVMI had hospital stay of more than 4 days. Conclusion: Frequency of RVMI among inferior MI patients was 27 % with longer hospital stay. (author)

  10. Outcomes following the Kawashima procedure for single-ventricle palliation in left atrial isomerism.

    Science.gov (United States)

    Vollebregt, Anne; Pushparajah, Kuberan; Rizvi, Maleeha; Hoschtitzky, Andreas; Anderson, David; Austin, Conal; Tibby, Shane M; Simpson, John

    2012-03-01

    Patients with left atrial isomerism and interrupted inferior vena cava palliated with a superior cavopulmonary connection or Kawashima procedure (KP) have a high incidence of developing pulmonary arteriovenous malformations. The necessity for hepatic vein redirection (HVR) and its timing remains a controversy. We aimed to assess the clinical outcome of patients with left atrial isomerism following a KP. The main end points were death, requirement for HVR and the impact of HVR on oxygen saturation. Retrospective review of 21 patients with a diagnosis of left atrial isomerism, interruption of the inferior vena cava and single-ventricle physiology managed with a KP at a single centre between January 1990 and March 2010. Twenty-one patients had a KP, with 12 subsequently undergoing HVR. There was relatively a constant monthly decrement in the proportion of patients who were free from death or HVR up until 60 months following the KP, with a dramatic increase in the hazard after this time. The Cox proportional hazards regression model demonstrated a reduced early risk for HVR or death in patients who underwent pulmonary artery banding versus arterial shunt as the primary procedure (hazard ratio: 0.10; P = 0.01), and an increased risk with bilateral superior vena cavas (SVCs) (hazard ratio: 3.4; P = 0.04) and age at KP (hazard ratio: 1.02 per month increase in age at KP; P = 0.02). HVR mortality was relatively high with 3 of 12 patients dying in the early postoperative period with profound cyanosis. The timing of HVR after the KP did not influence the postoperative rate of increase in oxygen saturation. These findings confirm that the majority of patients who undergo a KP will require HVR. Patients who are older at the time of the KP or having an initial arterial shunt or bilateral SVCs are at higher risk of HVR or death. The relatively high mortality at HVR was characterized by severe postoperative cyanosis.

  11. Statistical parametric mapping for analyzing interictal magnetoencephalography in patients with left frontal lobe epilepsy.

    Science.gov (United States)

    Zhu, Haitao; Zhu, Jinlong; Bao, Forrest Sheng; Liu, Hongyi; Zhu, Xuchuang; Wu, Ting; Yang, Lu; Zou, Yuanjie; Zhang, Rui; Zheng, Gang

    2016-01-01

    Frontal lobe epilepsy is a common epileptic disorder and is characterized by recurring seizures that arise in the frontal lobes. The purpose of this study is to identify the epileptogenic regions and other abnormal regions in patients with left frontal lobe epilepsy (LFLE) based on the magnetoencephalogram (MEG), and to understand the effects of clinical variables on brain activities in patients with LFLE. Fifteen patients with LFLE (23.20 ± 8.68 years, 6 female and 9 male) and 16 healthy controls (23.13 ± 7.66 years, 6 female and 10 male) were included in resting-stage MEG examinations. Epileptogenic regions of LFLE patients were confirmed by surgery. Regional brain activations were quantified using statistical parametric mapping (SPM). The correlation between the activations of the abnormal brain regions and the clinical seizure parameters were computed for LFLE patients. Brain activations of LFLE patients were significantly elevated in left superior/middle/inferior frontal gyri, postcentral gyrus, inferior temporal gyrus, insula, parahippocampal gyrus and amygdala, including the epileptogenic regions. Remarkable decreased activations were found mainly in the left parietal gyrus and precuneus. There is a positive correlation between the duration of the epilepsy (in month) and activations of the abnormal regions, while no relation was found between age of seizure onset (year), seizure frequency and the regions of the abnormal activity of the epileptic patients. Our findings suggest that the aberrant brain activities of LFLE patients were not restricted to the epileptogenic zones. Long duration of epilepsy might induce further functional damage in patients with LFLE. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Dissociations of action means and outcome processing in left-hemisphere stroke.

    Science.gov (United States)

    Kalénine, Solène; Shapiro, Allison D; Buxbaum, Laurel J

    2013-06-01

    Previous evidence suggests that distinct fronto-parietal regions may be involved in representing action kinematics (means) and action results (outcome) during action observation. However, the evidence is contradictory with respect to the precise regions that are critical for each type of representation. Additionally unknown is the degree to which ability to detect action means and outcome during observation is related to action production performance. We used a behavioral task to evaluate the ability of healthy and left-hemisphere stroke participants to detect differences between pairs of videos that dissociated object-related action means (e.g., wiping with circular or straight movement) and/or outcome (e.g., applying or removing detergent). We expected that deficits in detecting action means would be associated with spatiomotor gesture production deficits, whereas deficits in detecting action outcome would predict impairments in complex naturalistic action. We also hypothesized a posterior to anterior gradient in the regions critical for each type of representation, disproportionately affecting means and outcome encoding, respectively. Results indicated that outcome--but not means--detection predicted naturalistic action performance in stroke participants. Regression and voxel lesion-symptom mapping analyses of lesion data revealed that means--but not outcome--coding relies on the integrity of the left inferior parietal lobe, whereas no selective critical brain region could be identified for outcome detection. Thus, means and outcome representations are dissociable at both the behavioral and neuroanatomical levels. Furthermore, the data are consistent with a degree of parallelism between action perception and production tasks. Finally, they reinforce the evidence for a critical role of the left inferior parietal lobule in the representation of action means, whereas action outcome may rely on a more distributed neural circuit. Copyright © 2013 Elsevier Ltd. All

  13. Radiological evidence of double inferior vena cava in a young adult male

    International Nuclear Information System (INIS)

    Nevruz, O.; Ural, U.; Kirici, Y.; Kilic, C.; Bozlar, U.

    2007-01-01

    The development of the inferior vena cava IVC is a complex process comprising the formation and regression of some anastomoses, so various anomalies may occur during embryogenesis. These variations can increase the difficulty of aneurysm resection as well as the risk of venous injury and subsequent excessive bleeding during retroperitoneal and thoracic surgical interventions. Here, we report a patient with double inferior vena cava by radiographically during his investigation for the etiology of pancytopenia. (author)

  14. Spontaneous alignment of crowded inferior incisives after the extractionof temporary canines

    OpenAIRE

    Orellana Manrique, Tomás Oriel; Calderón Cortez, Iván; Orellana Manrique, Martín

    2014-01-01

    This investigation evaluated the behavior of permanent inferior incisives after the primary canine’s extractions. The study was carried out in the Pediatric Clinic of Dental Faculty of San Marcos University. The sample was conformed by 10 patients, male and female children, between 8 and 9 years of age, with good general health, having Class I malocclusion and severe crowding of the inferior incisives. It was taken Cephalometric and Panoramic radiographies, as well as models to make the ortho...

  15. Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach.

    Science.gov (United States)

    Bouman, A C; ten Cate-Hoek, A J; Ramaekers, B L T; Joore, M A

    2015-01-01

    Non-inferiority trials are performed when the main therapeutic effect of the new therapy is expected to be not unacceptably worse than that of the standard therapy, and the new therapy is expected to have advantages over the standard therapy in costs or other (health) consequences. These advantages however are not included in the classic frequentist approach of sample size calculation for non-inferiority trials. In contrast, the decision theory approach of sample size calculation does include these factors. The objective of this study is to compare the conceptual and practical aspects of the frequentist approach and decision theory approach of sample size calculation for non-inferiority trials, thereby demonstrating that the decision theory approach is more appropriate for sample size calculation of non-inferiority trials. The frequentist approach and decision theory approach of sample size calculation for non-inferiority trials are compared and applied to a case of a non-inferiority trial on individually tailored duration of elastic compression stocking therapy compared to two years elastic compression stocking therapy for the prevention of post thrombotic syndrome after deep vein thrombosis. The two approaches differ substantially in conceptual background, analytical approach, and input requirements. The sample size calculated according to the frequentist approach yielded 788 patients, using a power of 80% and a one-sided significance level of 5%. The decision theory approach indicated that the optimal sample size was 500 patients, with a net value of €92 million. This study demonstrates and explains the differences between the classic frequentist approach and the decision theory approach of sample size calculation for non-inferiority trials. We argue that the decision theory approach of sample size estimation is most suitable for sample size calculation of non-inferiority trials.

  16. Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2006-10-15

    Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting.

  17. Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

    International Nuclear Information System (INIS)

    Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min

    2006-01-01

    Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting

  18. Anterior and nasal transposition of inferior oblique muscle in cases of superior oblique palsy.

    Science.gov (United States)

    Saxena, Rohit; Sharma, Medha; Singh, Digvijay; Sharma, Pradeep

    2017-08-01

    To report long-term outcome of inferior oblique anterior and nasal transposition in superior oblique palsy. The medical records of patients with superior oblique palsy who underwent inferior oblique anterior nasal transposition were reviewed retrospectively. A comprehensive ophthalmic evaluation, including prism bar cover test and measurement of torsion, was performed for all cases. One-year postoperative results were evaluated for alignment in primary gaze, contralateral gaze, and upgaze; reduction in inferior oblique overaction and changes in fundus torsion to assess long-term outcome of the procedure. A total of 12 patients were included. Three cases also underwent horizontal muscle surgery. Mean age at the time of surgery was 20.6 years. The median preoperative hypertropia was 21.5 Δ (range, 12 Δ -36 Δ ), corrected to 4.5 Δ (range, 2 Δ -10 Δ ) at 12 months postoperatively (P = 0.002). Median inferior oblique overaction decreased from +3 (range, +1 to +4) to 0 (range, -1 to +1). Preoperative fundus extorsion was 19.2° ± 6.7°; postoperative, 0.58° ± 1.8° (P Extorsion was eliminated and head tilt improved in all patients. Inferior oblique anterior and nasal transposition resulted in good long-term outcomes in our patients with superior oblique palsy presenting with hypertropia, inferior oblique overaction, and extorsion in primary gaze. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  19. [Four cases of direct surgery for anterior inferior cerebellar artery aneurysms].

    Science.gov (United States)

    Gi, Hidefuku; Inoha, Satoshi; Uno, Jyunji; Ikai, Yoshiaki; Koga, Hiromichi; Yamaguchi, Shinya; Nagaoka, Shintaro

    2007-06-01

    Anterior inferior cerebellar artery (AICA) aneurysms are very rare. We carried out four direct operations for AICA aneurysms including two distal AICA aneurysms using lateral suboccipital retrosigmoid approaches (LSRA). We successfully performed the clipping by LSRA. but hearing loss occurred except in one of our cases which involved a chronic term operation in in our cases, In a 72 years old female with a ruptured dissecting aneurysm of the AICA anterior pontine segment, we performed the OA-PICA anastomosis first because of its being an AICA-PICA type, and then we continued to carry out the trapping operation of dissecting artery on day 0. She left our hospital cheerfully but hearing loss persisted on the operated side. Four examples of the dissecting aneurysm of AICA anterior pontine segment have been reported, but only our case involved the trapping with revascularization in acute stage. At the moment, there is no clinical or useful classification for distal AICA aneurysm because it is extremely rare. We will now propose a new classification. This classification is divided into two groups, (1) P (pons) -group and (2) C (cerebellum) -group. The P-group consists of pA (AICA anterior pontine segment). pL (lateral branch on the pons to the meatal loop) and pM (medial branch on the pons). C-group consists of m-loop (meatal loop), cL (lateral branch post meatal loop) and cM (medial branch on the cerebellum). From results of case reports (75 distal AICA aneurysms), we found that pA: 5 (6.7%), pL: 2 (2.8%), pM: 0, m-loop: 54 (72%), cL: 8 (11%), cM: 6 (8.3%). The followings factors were also found. (1) Occlusion of the parent artery of P-group without revascularization of peripheral circulation may entail the risk of death. (2) On the other hand, as for the C-group, the parent artery was able to be occluded without severe consequences, but hearing loss and/or cerebellar infarction occurred. We believe that this classification is simple and very useful for therapeutic

  20. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    Energy Technology Data Exchange (ETDEWEB)

    Uberoi, Raman, E-mail: raman.Uberoi@orh.nhs.uk; Tapping, Charles Ross [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom); Chalmers, Nicholas [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Allgar, Victoria [University of York, Hull and York Medical School (United Kingdom)

    2013-12-15

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter