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Sample records for left lobe hepatectomy

  1. Agenesis of the left hepatic lobe undergoing laparoscopic hepatectomy for hepatocellular carcinoma: a case report.

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    Matsushita, Katsunori; Gotoh, Kunihito; Eguchi, Hidetoshi; Iwagami, Yoshihumi; Yamada, Daisaku; Asaoka, Tadafumi; Noda, Takehiro; Wada, Hiroshi; Kawamoto, Koichi; Doki, Yuichiro; Mori, Masaki

    2017-12-01

    Agenesis of the left hepatic lobe is a rare anomaly. It is defined as the absence of liver tissue to the left of the gallbladder fossa. Additionally, agenesis of the left hepatic lobe accompanied by hepatocellular carcinoma is quite rare. We experienced the case of a patient with agenesis of the left hepatic lobe, undergoing laparoscopic hepatectomy for HCC. A 79-year-old man was referred to our department with epigastralgia. Abdominal computed tomography revealed agenesis of the left hepatic lobe, accompanied by hepatocellular carcinoma in segments 7 and 8. He underwent laparoscopic partial hepatectomy of segments 7 and 8. The operative findings revealed complete agenesis of the liver to the left of the falciform ligament. The patient had a favorable clinical course without liver dysfunction or any complications. We experienced a case with agenesis of the left hepatic lobe undergoing laparoscopic hepatectomy for HCC. Awareness of such anomaly is important for surgeons to avoid postoperative complications.

  2. Selective hypertrophy of the lobus caudatus as a novel approach enabling extended right hepatectomy in the presence of a non-perfused left lateral liver lobe.

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    Atanasov, Georgi; Schmelzle, Moritz; Thelen, Armin; Wiltberger, Georg; Hau, Hans-Michael; Krenzien, Felix; Petersen, Tim-Ole; Moche, Michael; Jonas, Sven

    2014-08-01

    Portal vein embolization (PVE) is a well-established technique to enhance functional hepatic reserves of segments II and III before curative extended right hepatectomy for tumors of the right liver lobe. However, an adequate hepatopetal flow of the left lateral portal vein branches is required for a sufficient PVE-associated hypertrophy. Here, we report a 65-year old patient suffering from a locally advanced intrahepatic cholangiocarcinoma in the right liver lobe and segment IV. A curative extended right hepatectomy after preoperative PVE of liver segments IV-VIII was initially impossible because of partial thrombosis of the left lateral portal vein branches resulting in an ischemic-type atrophy of segments II and III. However, due to a massive hypertrophy of the caudate lobe following PVE of liver segments IV-VIII, subsequent extended right hepatectomy with intraoperative thrombectomy of segments II and III was made possible. To our knowledge this is the first case in which an extended right hepatectomy for a liver malignancy, in the presence of atrophic left lateral section, was made possible by a massive PVE-associated hypertrophy of the caudate lobe.

  3. Left hepatectomy after right paramedian sectoriectomy.

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    Takamoto, Takeshi; Hashimoto, Takuya; Makuuchi, Masatoshi

    2017-12-01

    Repeat hepatectomy is beneficial for selected patients with recurrence of liver malignancies. However, the operative procedure becomes technically demanding when the previous hepatectomy was complex, with hepatic veins and stump of portal pedicles exposed on the liver transection surface. We performed left hepatectomy after right paramedian sectoriectomy (RPMS) for three patients. Here, we describe our surgical technique and the postoperative outcomes achieved. This procedure allowed for safe adhesiolysis between the middle and right hepatic veins by following a fibrous plane. The mean operative time was 8.7 h, including 4.9 h of adhesiolysis. The mean remnant liver volume (right lateral sector and the caudate lobe) was calculated as 704 ml, being 62% of total liver volume. There was no postoperative liver failure or mortality. In conclusion, left hepatectomy after RPMS is a feasible procedure for patients with sufficient remnant liver volume, even though the middle and right hepatic veins run side by side after liver regeneration.

  4. 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.

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    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.

  5. Resection of hilar cholangiocarcinoma with left hepatectomy after pre-operative embolization of the proper hepatic artery

    DEFF Research Database (Denmark)

    Yasuda, Yoshikazu; Larsen, Peter N; Ishibashi, Toshimitsu

    2010-01-01

    to obtain radical resection. The close relationship between the right hepatic artery and the HC in these patients frequently limits the ability to achieve a radial R0-resection without difficult vascular reconstruction. The aim of the present study was to describe the outcome of patients who underwent pre......Right or right-extended hepatectomy including the caudate lobe is the most common treatment for hilar cholangiocarcinoma (HC). A 5-year survival of up to 60% can be achieved using this procedure if R0-resection is obtained. However, for some patients a left-sided liver resection is necessary......-operative embolization of the proper hepatic artery in an effort to induce development of arterial collaterals thus allowing the resection of the proper and right hepatic artery without vascular reconstruction....

  6. MRI rare finding: Absence of the left liver lobe

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    Isabella Ceravolo

    Full Text Available We report a rare case of left liver lobe absence in an 80-year-old male patient discovered during an MRI scan. The main imaging features of this condition are briefly reviewed, together with its pathogenesis and the most common associations and differential diagnoses. Keywords: Left liver lobe, Liver abnormalities, Liver magnetic resonance imaging

  7. Accessory hepatic lobe simulating a left hemidiaphragmatic tumor

    International Nuclear Information System (INIS)

    Kuroiwa, Toshiro; Hirata, Hitoshi; Iwashita, Akinori; Yasumori, Kotaro; Mogami, Hiroshi; Teraoka, Hiroaki

    1984-01-01

    A 72-year-old woman with a 20-year history of neuralgia was confirmed at surgery to have a tumor in the left hemidiaphragmatic region which was connected with the left lobe of the liver. Reassessment of radiological diagnosis after surgery revealed that hepatobiliary scintigraphy and computed tomography using left anterior oblique scanning are useful in differentiating the accessory hepatic lobe of the liver from a tumor and in confirming the diagnosis, respectively. (Namekawa, K.)

  8. Famous People Knowledge and the Right and Left Temporal Lobes

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    Snowden, Julie S.; Thompson, Jennifer C.; Neary, David

    2012-01-01

    It is generally accepted that the anterior temporal lobes support knowledge of famous people. The specific roles of the right and left temporal lobe remain a subject of debate, with some studies suggesting differential roles based on modality (visual versus verbal information) and others category (person knowledge versus general semantics). The present study re-examined performance of semantic dementia patients with predominantly right and predominantly left temporal lobe atrophy on famous face, famous name and general semantic tasks, with the specific aim of testing the hypothesis that the right temporal lobe has a privileged role for person knowledge and the left temporal lobe for general semantic knowledge. Comparisons of performance rankings across tasks showed no evidence to support this hypothesis. By contrast, there was robust evidence from naming, identification and familiarity measures for modality effects: right-sided atrophy being associated with relatively greater impairment for faces and visual tasks and left-sided atrophy for names and verbal tasks. A double dissociation in test scores in two patients reinforced these findings. The data present a challenge for the influential ‘semantic hub’ model, which views the anterior temporal lobes as an area of convergence in which semantic information is represented in amodal form. PMID:22207421

  9. Semantic dementia and the left and right temporal lobes.

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    Snowden, Julie S; Harris, Jennifer M; Thompson, Jennifer C; Kobylecki, Christopher; Jones, Matthew; Richardson, Anna M; Neary, David

    2017-08-31

    Semantic dementia, a circumscribed disorder of semantic knowledge, provides a unique model for understanding the neural basis for semantic representation. The study addressed areas of contention: the relative roles of the left and right temporal lobe, the contribution of anterior versus posterior temporal cortex and the status of the anterior temporal lobes as amodal hub. Naming and word comprehension was examined in 41 semantic dementia patients, 31 with left-predominant and 10 right-predominant atrophy. In keeping with expectation, naming and comprehension were significantly poorer in left-predominant patients. Structural magnetic resonance image analysis, using a visual rating scale, showed strong inverse correlations between naming scores and severity of both left anterior and posterior temporal lobe atrophy. By contrast, comprehension performance was more strongly correlated with left posterior temporal atrophy. Analysis of naming errors revealed a correlation between anterior temporal atrophy and associative/functional descriptive responses, implying availability of semantic information. By contrast, 'don't know' responses, indicative of loss of semantic knowledge, were linked to left posterior temporal lobe atrophy. Semantic errors, the hallmark of semantic dementia, were linked to right hemisphere atrophy, especially the right posterior temporal lobe. Matched visual-verbal tasks (famous face and name identification, Pyramids and Palm trees pictures and words, animal knowledge from 3-D models and animal names) administered to nine patients elicited variable correspondence between performance on nonverbal and verbal versions of the task. Marked performance dissociations were demonstrated in some patients: poorer understanding of names/words in left-predominant patients and of faces/pictures/models in right-predominant cases. The findings are compatible with the notion of the anterior temporal lobes as areas of convergence, but are less easily accommodated

  10. Hepatocellular carcinoma developed in a living donor after left lobe donation: a case for caution.

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    Ikegami, Toru; Yoshizumi, Tomoharu; Kawasaki, Junji; Shimagaki, Tomonari; Uchiyama, Hideaki; Soejima, Yuji; Maehara, Yoshihiko

    2017-06-01

    Although it has been recognized that those who are positive for anti-hepatitis B core antibody (anti-HBcAb) and negative for hepatitis B surface antigen (HBsAg) with normal liver function could be donors for living donor liver transplantation under appropriate prophylaxis, the negative impact of positive HBcAb on such donors themselves has not been reported. We present a case of a living donor with positive HBcAb, who donated his left lobe for his sister with unresectable giant hepatic hemangioma, and the donor himself developed a de novo hepatocellular carcinoma (HCC) 10 years after donation. He had been lost from the follow-up program since 1 year after donation. Imaging studies showed a heterogeneously enhanced mass compatible with HCC, which was 9 cm in size with portal invasion into the anterior portal vein of the remnant liver. Re-laparotomy for hepatectomy with the removal of the tumor thrombus in the anterior portal vein of the remnant liver was carried out, and he is free from recurrence 6 months after surgery on prophylactic sorafenib. At our institute, 58 (9.6%) donors among the 603 living donors were anti-HBcAb positive and anti-HBsAg negative, and we started regular HCC surveillance using sonogram every 6 months for these patients. © 2016 The Japan Society of Hepatology.

  11. Initial experience with purely laparoscopic living-donor right hepatectomy.

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    Hong, S K; Lee, K W; Choi, Y; Kim, H S; Ahn, S W; Yoon, K C; Kim, H; Yi, N J; Suh, K S

    2018-03-26

    There may be concerns about purely laparoscopic donor right hepatectomy (PLDRH) compared with open donor right hepatectomy, especially when performed by surgeons accustomed to open surgery. This study aimed to describe technical tips and pitfalls in PLDRH. Data from donors who underwent PLDRH at Seoul National University Hospital between December 2015 and July 2017 were analysed retrospectively. Endpoints analysed included intraoperative events and postoperative complications. All operations were performed by a single surgeon with considerable experience in open living donor hepatectomy. A total of 26 donors underwent purely laparoscopic right hepatectomy in the study interval. No donor required transfusion during surgery, whereas two underwent reoperation. In two donors, the dissection plane at the right upper deep portion of the midplane was not correct. One donor experienced portal vein injury during caudate lobe transection, and one developed remnant left hepatic duct stenosis. One donor experienced remnant portal vein angulation owing to a different approach angle, and one experienced arterial damage associated with the use of a laparoscopic energy device. One donor had postoperative bleeding due to masking of potential bleeding foci owing to intra-abdominal pressure during laparoscopy. Two donors experienced right liver surface damage caused by a xiphoid trocar. Purely laparoscopic donor hepatectomy differs from open donor hepatectomy in terms of angle and caudal view. Therefore, surgeons experienced in open donor hepatectomy must gain adequate experience in laparoscopic liver surgery and make adjustments when performing PLDRH. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  12. Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

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    Apostolakis Efstratios

    2006-09-01

    Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

  13. First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

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    Chen, Louis C; Green, Jennifer B

    2011-06-01

    Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

  14. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

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    R.R. Uchida

    2003-07-01

    Full Text Available Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t21 = 2.37, P = 0.028. In addition, there was a trend (P values between 0.05 and 0.10 to smaller volumes of the right temporal lobe (7%, t21 = 1.99, P = 0.06, right amygdala (8%, t21 = 1.83, P = 0.08, left amygdala (5%, t21 = 1.78, P = 0.09 and left hippocampus (9%, t21 = 1.93, P = 0.07 in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025, with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures.

  15. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Neurologia e Psicologia Medica]. E-mail: fgraeff@keynet.com.br; Santos, A.C. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Clinica Medica; Guimaraes, F.S. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Farmacologia

    2003-07-01

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t{sub 21} = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t{sub 21} = 1.99, P = 0.06), right amygdala (8%, t{sub 21} = 1.83, P = 0.08), left amygdala (5%, t{sub 21} = 1.78, P 0.09) and left hippocampus (9%, t{sub 21} = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  16. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G.; Santos, A.C.; Guimaraes, F.S.

    2003-01-01

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t 21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t 21 = 1.99, P = 0.06), right amygdala (8%, t 21 = 1.83, P = 0.08), left amygdala (5%, t 21 = 1.78, P 0.09) and left hippocampus (9%, t 21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  17. Clinical experience in treatment of complex intrahepatic bile duct stones by regular hepatectomy

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    WU Xiao

    2016-09-01

    Full Text Available Objective To investigate the clinical effect of regular hepatectomy in patients with complex intrahepatic bile duct stones. Methods A retrospective analysis was performed for the clinical data of 98 patients with complex intrahepatic bile duct stones who were treated in our hospital from January to December, 2013. The distribution characteristics of intrahepatic bile duct stones, clinical manifestations, extent of operation, time of operation, complications, and surgical outcome were analyzed. Results All the 98 patients completed regular hepatectomy. Of all patients, 37 underwent choledocholithotomy with T-tube drainage and segmental hepatectomy, 6 underwent resection of the left lateral lobe of the liver, 1 underwent left hemihepatectomy, 7 underwent resection of a single hepatic segment in the right lobe of the liver combined with segmental hepatectomy, 45 underwent combined segmental hepatectomy of the left and right lobes of the liver, and 2 underwent biliary-enteric basin anastomosis after hilar bile duct reconstruction. No patients died during the perioperative period. The mean time of operation was 65.0±5.0 min, and the mean intraoperative blood loss was 83.0±6.2 ml. No patients experienced residual stones after surgery. Of all patients, 5 (5.1% experienced complications, among whom 3 experienced bile leakage and 2 experienced blood exudation on the surface of the wound in the liver; 3 patients were diagnosed with intrahepatic cholangiocarcinoma by postoperative pathological examination. All the patients for followed up for 5 years, and 11 (11.2% experienced recurrence of stones after surgery. Conclusion Regular hepatectomy is safe and effective in the treatment of complex intrahepatic bile duct stones, with few complications and a low recurrence rate of stones. Therefore, it holds promise for wide clinical application.

  18. Ictal spitting in left temporal lobe epilepsy: report of three cases.

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    Caboclo, Luís Otávio Sales Ferreira; Miyashira, Flavia Saori; Hamad, Ana Paula Andrade; Lin, Katia; Carrete, Henrique; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2006-09-01

    Ictal spitting is rarely reported in patients with epilepsy. More often it is observed in patients with temporal lobe epilepsy (TLE) and is presumed to be a lateralizing sign to language nondominant hemisphere. We report three patients with left TLE who had ictal spitting registered during prolonged video-EEG monitoring. Medical charts of all patients with medically refractory partial epilepsy submitted to prolonged video-EEG monitoring in the Epilepsy Unit at UNIFESP during a 3-year period were reviewed, in search of reports of ictal spitting. The clinical, neurophysiological and neuroimaging data of the identified patients were reviewed. Among 136 patients evaluated with prolonged video-EEG monitoring, three (2.2%) presented spitting automatisms during complex partial seizures. All of them were right-handed, and had clear signs of left hippocampal sclerosis on MRI. In two patients, in all seizures in which ictal spitting was observed, EEG seizure onset was seen in the left temporal lobe. In the third patient, ictal onset with scalp electrodes was observed in the right temporal lobe, but semi-invasive monitoring with foramen ovale electrodes revealed ictal onset in the left temporal lobe, confirming false lateralization in surface records. The three patients became seizure-free following left anterior temporal lobectomy. Ictal spitting is a rare finding in patients with epilepsy, and may be considered a localizing sign of seizure onset in the temporal lobe. It may be observed in seizures originating from the left temporal lobe, and thus should not be considered a lateralizing sign of nondominant TLE.

  19. Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

    International Nuclear Information System (INIS)

    Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

    1996-01-01

    To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

  20. 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.)

  1. 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.)

  2. Scannographic appearance of increased colloid uptake in the left liver lobe (Case presentation)

    International Nuclear Information System (INIS)

    Tadzher, Isak S.; Josifovska, Tatjana; Popgjorcheva, Daniela

    1996-01-01

    Incidentally increased uptake of Tc-99m sulfur colloid was found in scannographic images in the whole left liver lobe in all positions (PA, AP, DL, LL). The patient, a 60-year-old woman, was three years earlier cholocystecomized and had since occasional pain in the right upper abdominal quadrant due to biliary dyskinesia. Accessory spleen tissue was seen as well in the inferior lineal pole, probably presenting Shurer's phenomenon of 'lienis in liene' thus augmenting the serendipity of the scanographic findings. Imaging of the accessory spleen with heat denaturated spherocytes - Tc-99m confirmed the lienal structure of the tissue with preserved red pulp trabecular trapping mechanism in addition to phagocytic function of lineal Kupffer cells (in white pulp). Mebrofenin-Tc-99m (IDA-agent) showed in our patient normal distribution in both liver lobes contrary to focal nodular hyperplasia and adenoma of the liver where IDA-radio- pharmaceuticals have delayed clearance due to abnormal biliary canaliculi. In our patient uptake, distribution, excretion and liver washout of mebrofenin-Tc-99m was found to be normal. This is in favor of an exclusive, solitary increase of the number of Kupffer cells confined to the whole left lobe of the liver. Increased colloid uptake in the left liver lobe is dependent on a greater number of Kupffer cells pro volume than in the right lobe. (Author)

  3. BULLOUS DEGENERATION OF THE LEFT LOWER LOBE IN A HEROIN-ADDICT

    NARCIS (Netherlands)

    SMEENK, FWJM; SERLIE, J; VANDERJAGT, EJ; POSTMUS, PE

    1990-01-01

    A 34 yr old heroin addict was referred because of chest pain caused by air-trapping in a bulla in the left lower lobe. There was a marked difference between the functional residual capacity measured by body-plethysmography and helium dilution. A slow wash-in and wash-out were demonstrated by

  4. Verbal Memory Compensation: Application to Left and Right Temporal Lobe Epileptic Patients

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    Bresson, Christel; Lespinet-Najib, Veronique; Rougier, Alain; Claverie, Bernard; N'Kaoua, Bernard

    2007-01-01

    This study investigates the compensatory impact of cognitive aids on left and right temporal lobe epileptic patients suffering from verbal memory disorders, who were candidates for surgery. Cognitive aids are defined in the levels-of-processing framework and deal with the depth of encoding, the elaboration of information, and the use of retrieval…

  5. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    International Nuclear Information System (INIS)

    Oguz, Berna; Haliloglu, Mithat; Alan, Serdar; Ozcelik, Ugur

    2009-01-01

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  6. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Berna; Haliloglu, Mithat [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Alan, Serdar; Ozcelik, Ugur [Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara (Turkey)

    2009-09-15

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  7. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    International Nuclear Information System (INIS)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun

    2017-01-01

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location

  8. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2017-08-15

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location.

  9. A functional MRI study of language networks in left medial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Yu Aihong; Wang Xiaoyi; Xu Guoqing; Li Yongjie; Qin Wen; Li Kuncheng; Wang, Yuping

    2011-01-01

    Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

  10. An unusual case of left hepatectomy for Focal Nodular Hyperplasia (FNH) linked to the use of Anabolic Androgenic Steroids (AASs).

    Science.gov (United States)

    Romano, Angela; Grassia, Michele; Esposito, Giuseppe; Petrillo, Marianna; Pezzella, Modestino; Romano, Francesco Maria; Esposito, Francesco; Torelli, Francesco; Di Martino, Natale

    2017-01-01

    Focal Nodular Hyperplasia (FNH) is the second most common benign tumor of the liver. Clinically FNH is asymptomatic and discovered incidentally . The pathogenesis is unclear; FNH is usually asymptomatic. When the tumor is large, it may be painful. Surgery is recommended only in the case of complications such as compression of adjacent organs, lesion progression with tumor size >5cm and presence of symptoms. A 30 years old man, was evaluated during a routine visit, for diffuse abdominal pain and weight loss; Abdominal ultrasound showed no evidence of biliary obstruction but the US shows a hypoechoic, well defined focal lesion in the left liver. For a more accurate diagnosis a Magnetic Resonance detected a focal area about 14×9 cm in diameter, hypointense. Liver biopsy was not done.We could not diagnose it definitively as FNH from the results of imaging studies; so for the size of symptomatic lesion, the undefined diagnosis of FNH ,and due to the great increase in the size of the mass located in the left lobe, during such a short period , the surgery was been recommended. FNH is the second most common hepatic lesion, but clinically relevant cases of FNH are rare with a reported prevalence in US studies of 0,03%. In our case the young patient was taking dietary supplements including anabolic androgenic steroids (AASs), carnitine and l-arginine. The particularity of our case is the increasing of the lesion in two years in which the patient made use of anabolic steroids. under use of . This could be the explanation for increasing of nodule. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

    Directory of Open Access Journals (Sweden)

    Camila de Vasconcelos Geraldi

    Full Text Available ABSTRACT Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties. Objectives To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery. Methods Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures. Results Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term. Conclusion The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.

  12. LEFT LOBE LIVER TRANSPLANTATION FROM AB0-INCOMPATIBLE LIVING DONOR WITH SITUS INVERSUS

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2014-01-01

    Full Text Available Situs inversus is a rare congenital abnormality that affects approximately 0.005% of all live births. Traditionally, this condition is considered as a contraindication for liver donation, primarily due to the peculiarities of the vascular anatomy and the diffi culties in graft placement in the abdominal cavity. Review of the world literature testifi es to fi ve cases of use of the whole liver from deceased donor with situs inversus in adult recipients, and to just one case of inverted right lobe transplantation from living donor to 53-year-old man. Thus, transplantation of an inverted left liver lobe from a living related donor in pediatric patients was performed for the fi rst time. The article presents a successful experience of liver transplantation in child with tyrosinemia type 1 from AB0-incompatible living donor with situs inversus.

  13. 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.

  14. Gastric injury from {sup 90}Y to left hepatic lobe tumors adjacent to the stomach: fact or fiction?

    Energy Technology Data Exchange (ETDEWEB)

    Gates, Vanessa L.; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Lewandowski, Robert J. [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

    2015-12-15

    Radioembolization with {sup 90}Y microspheres is a locoregional radiation therapy for unresectable hepatic neoplasm. Non-target delivery of {sup 90}Y microspheres resulting in gastrointestinal (GI) symptoms is a recognized complication; there is minimal knowledge regarding the radiation effect to the gastric wall from left hepatic lobe {sup 90}Y treatments. Our aim was to study the incidence of GI complications when the target tissue (hepatic parenchyma ± tumor) is in close proximity to the gastric wall. We hypothesized that liver (tumor) to stomach proximity does not correlate with increased toxicity. Between November 2011 and September 2013, we studied all patients who underwent left lobe radioembolization with {sup 90}Y glass microspheres. With Institutional Review Board (IRB) approval, we retrospectively reviewed MRI/CT images of these patients, identifying a subset of patients with the left hepatic lobe <1 cm from the gastric wall. Patients were seen in clinic 1 month posttreatment and subsequently at 3-month intervals. Short- and long-term gastric adverse events were tabulated. Ninety-seven patients successfully underwent left hepatic lobe {sup 90}Y microsphere radioembolization in which the average distance from the liver to the stomach wall was 1.0 ± 2.8 mm. The average dose for patients who received radioembolization to the left hepatic lobe was 109 ± 57 Gy. Fifty patients had tumor within 1 cm of the gastric wall. The average dose for patients who received radioembolization to the left hepatic lobe with tumor within 1 cm of the gastric wall was 121 ± 41 Gy. There were no reportable or recordable medical events. Of the patients, 34 % reported abdominal pain that was grade 1-2; 65 % of the patients reported no abdominal pain. None of the 97 patients developed a clinically evident GI ulcer. Patients with left lobe tumors adjacent to or abutting the stomach do not exhibit acute or chronic radiation effects following radioembolization with glass

  15. Can FDG PET predict verbal specific memory decline after surgery for left temporal lobe epilepsy when MRI is normal?

    International Nuclear Information System (INIS)

    Sagona, J.A.; Rowe, C.C.; Thomas, D.; Dickinson-Rowe, K.L.

    2002-01-01

    Full text: Temporal lobectomy gives excellent control of seizures in over 80% of patients with temporal lobe epilepsy. The left temporal lobe, particularly the left hippocampus, is primarily responsible for verbal memory. In most patients, the hippocampus which lies in the medial temporal lobe is abnormal and can be removed without loss of memory function. However, removal of the left hippocampus when it appears normal on MRI, often causes a significant decline in verbal specific memory (VSM) function. This paper explores the significance of pre-operative FDG-PET asymmetry in temporal lobe metabolism in predicting the VSM outcome after left temporal lobectomy when MRI demonstrates a normal hippocampus. Fifteen patients between 1993 and 2000, underwent left temporal lobectomy including left hippocampal resection, Pre-operatively all patients underwent 1.5T MRI, FDG PET and neuropsychological assessment. Neuropsychological assessment was repeated post-operatively. The left hippocampus was normal on MRI in nine and demonstrated mild T2 signal change without atrophy in six. FDG PET demonstrated temporal lobe hypometabolism in 12 patients. Post-operatively, neuropsychological evaluation documented a decline in verbal specific memory function in six patients, three with normal MRI and three with mild T2 change. We found that all patients with normal FDG PET studies (n=3) demonstrated significant verbal memory deterioration post-operatively. Nine of twelve patients (75%) with left temporal lobe hypometabolism did not show new verbal memory deficits. FDG PET improves the risk stratification for verbal specific memory decline with left temporal lobectomy in patients with normal hippocampi on MRI. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Less cost by using hanging maneuver and Pringle maneuver in left lateral hepatectomy through small laparotomy wound--experience of Southern Taiwan.

    Science.gov (United States)

    Lin, Ting-Lung; Alikhanov, Ruslan; Kuo, Sheng-Chih; Li, Wei-Feng; Chen, Chao-Long; Wang, Shih-Ho; Lin, Chih-Che; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Wang, Chih-Chi

    2016-01-08

    Laparoscopic segmentectomy for liver tumor located in the left lateral segment (LLS) is thought to be a standard protocol nowadays with several advantages, such as small wound, few blood loss, and short hospital stay. However, there are still many disadvantages during executing laparoscopic LLS segmentectomy. This manuscript aims to present the technique to execute LLS segmentectomy with small incision, hanging maneuver without Pringle maneuver in patients with tumor at LLS of the liver. Between November 2010 and July 2011, hepatectomies through small incision for nine patients with benign and malignant tumors were performed at Kaohsiung Chang Gung Memorial Hospital, Taiwan. Perioperative and postoperative results, such as operation time, blood loss, incisional width, and postoperative stay were used to determine consequents for this technique. Results demonstrated that modified LLS segmentectomy by the author's team was performed successfully in patient with liver tumor with fewer blood loss, smaller incisional width, and lower hospital cost than traditional open surgery. In addition, the instrument cost and blood loss in our series were less than that in laparoscopic LLS segmentectomy in published literature. Authors concluded that minimally incisional segmentectomy, with less cost and technical demanding, could be an alternative choice in patient with liver tumor at LLS.

  17. Arteria praebronchialis found on MDCT: potentially dangerous aberrant artery supplying the left lower lobe.

    Science.gov (United States)

    Hong, Ji Hyun; Kim, Hyun Jung; Han, Dae Hee; Sung, Sook Hwan; Ahn, Myeong Im; Jung, Jung Im

    2015-11-01

    To describe the incidence and CT features of a rare branching pattern of the pulmonary artery, the Arteria praebronchialis (AP): According to the initial description, the AP originates as the first branch of the left pulmonary artery, crosses the front of the left mainstem bronchus and then runs along the mediastinal margin as it gives off branches to one or more of the basal segments. Since the incidental discovery of the first patient, contrast-enhanced CT was screened by one radiologist for the presence of AP, until three more cases were identified. In those four patients, segmental and lobar branching patterns of the AP were assessed. The estimated incidence of the AP was 0.03%. All four patients were men. Compared to the normal interlobar artery, the AP was smaller (n = 2), larger (n = 1), or of an equal size (n = 1). The segmental branches of the AP to the upper lobe (present in three patients) were A3 and A4 (n = 1), A3 and A5 (n = 1) and A4+5 (n = 1), respectively. Regarding the supply of the left lower lobe, AP gave off A7+8 and A9 (n = 2), A7+8 (n = 1), and A7 and A10 (n = 1), respectively. In two patients, a contralateral variant of pulmonary arterial branching was found, with (right) A7 arising as the first branch of right pulmonary artery. The AP is extremely rare, but has a strong male predilection and highly diverse branching patterns in both the current study and the literature. Radiologists should familiarize themselves with the CT features of this surgically important variation, and be able to describe its lobar and segmental blood supply.

  18. Correlation of neuropsychological and metabolic changes after epilepsy surgery in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Güvenç, Canan; Dupont, Patrick; Van den Stock, Jan; Seynaeve, Laura; Porke, Kathleen; Dries, Eva; Van Bouwel, Karen; van Loon, Johannes; Theys, Tom; Goffin, Karolien E; Van Paesschen, Wim

    2018-04-12

    Epilepsy surgery often causes changes in cognition and cerebral glucose metabolism. Our aim was to explore relationships between pre- and postoperative cerebral metabolism as measured with 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological test scores in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), who were rendered seizure-free after epilepsy surgery. Thirteen patients were included. All had neuropsychological testing and an interictal FDG-PET scan of the brain pre- and postoperative. Correlations between changes in neuropsychological test scores and metabolism were examined using statistical parametric mapping (SPM). There were no significant changes in the neuropsychological test scores pre- and postoperatively at the group level. Decreased metabolism was observed in the left mesial temporal regions and occipital lobe. Increased metabolism was observed in the bi-frontal and right parietal lobes, temporal lobes, occipital lobes, thalamus, cerebellum, and vermis. In these regions, we did not find a correlation between changes in metabolism and neuropsychological test scores. A significant negative correlation, however, was found between metabolic changes in the precuneus and Boston Naming Test (BNT) scores. There are significant metabolic decreases in the left mesial temporal regions and increases in the bi-frontal lobes; right parietal, temporal, and occipital lobes; right thalamus; cerebellum; and vermis in patients with left MTLE-HS who were rendered seizure-free after epilepsy surgery. We could not confirm that these changes translate into significant cognitive changes. A significant negative correlation was found between changes in confrontation naming and changes in metabolism in the precuneus. We speculate that the precuneus may play a compensatory role in patients with postoperative naming difficulties after left TLE surgery. Understanding of these neural mechanisms may aid in

  19. [Lesion of extrahippocampal cortices of left medial temporal lobe: a case report].

    Science.gov (United States)

    Spada, J A; Galíndez, C; Spada, A

    The cortex of medial temporal lobe is a group of different allocortical fields which included the hippocampal formation (dentate gyrus, hippocampus proper, and subicular complex) and extrahippocampal cortices (entorhinal, perirhinal, and parahippocampal). It is widely accepted that both of them play an important role in memory process. In humans, several reports indicates that damage to the hippocampus alone would lead to a clinically significant amnesia; when the injuries are more extensive others cognitive disorders, as those related to visual sphere, make worse the clinic picture, and some of these cases were reported as associative visual agnosias. Nevertheless, although evidence from animal studies points to the importance of the extrahippocampal medial temporal lobe cortices in order to recognise visual stimuli, such involvement has not been demonstrated in humans. A 44 year-old male who consulted us because they had lost about of '80% of his vision' after a stroke. Ophthalmological examination was entirely within normal limits, but neuropsychological test put in evidence difficulties in the visuo-verbal naming, discrimination of superposed images, recognition of faces and, mainly, in the test of immediate and deferred visual memory. Anterograde memory impairment was also revealed. Magnetic resonance imaging showed a lesion of left entorhinal, perirhinal and parahippocampal cortices. We suggest, in relation to anatomical evidences, that isolation of hippocampus is responsible for symptomatollogy of our patient.

  20. Dissociating the semantic function of two neighbouring subregions in the left lateral anterior temporal lobe.

    Science.gov (United States)

    Sanjuán, Ana; Hope, Thomas M H; Jones, 'Ōiwi Parker; Prejawa, Susan; Oberhuber, Marion; Guerin, Julie; Seghier, Mohamed L; Green, David W; Price, Cathy J

    2015-09-01

    We used fMRI in 35 healthy participants to investigate how two neighbouring subregions in the lateral anterior temporal lobe (LATL) contribute to semantic matching and object naming. Four different levels of processing were considered: (A) recognition of the object concepts; (B) search for semantic associations related to object stimuli; (C) retrieval of semantic concepts of interest; and (D) retrieval of stimulus specific concepts as required for naming. During semantic association matching on picture stimuli or heard object names, we found that activation in both subregions was higher when the objects were semantically related (mug-kettle) than unrelated (car-teapot). This is consistent with both LATL subregions playing a role in (C), the successful retrieval of amodal semantic concepts. In addition, one subregion was more activated for object naming than matching semantically related objects, consistent with (D), the retrieval of a specific concept for naming. We discuss the implications of these novel findings for cognitive models of semantic processing and left anterior temporal lobe function. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Paragonimus kellicotti Presenting With Hemoptysis and a Left Upper Lobe Mass.

    Science.gov (United States)

    Horn, Christopher B; Patel, Nikhil R; Hawasli, Jennifer A; Edwards, Melanie A

    2016-11-01

    A 46-year-old man presented to the thoracic surgery clinic with a 6-month history of cough and hemoptysis refractory to treatment. Examination of specimens from repeated biopsies was nondiagnostic, so the patient underwent video-assisted thoracoscopic left upper lobe wedge resection. Pathologic examination revealed Paragonimus organisms, and the patient was prescribed praziquantel, with resolution of his symptoms. Although Paragonimus infections are common in Asia, they are rare in the United States despite P kellicotti being endemic. Clinicians should have a high index of suspicion for patients presenting with unusual lung symptoms in endemic areas to avoid prolonged evaluations with potentially unnecessary diagnostic modalities. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Storage of Verbal Associations Is Sufficient to Activate the Left Medial Temporal Lobe

    Directory of Open Access Journals (Sweden)

    Andrew R. Mayes

    1999-01-01

    Full Text Available Neuroimaging studies have shown that memory encoding activates the medial temporal lobe (MTL. Many believe that these activations are related to novelty but it remains unproven which is critical - novelty detection or the rich associative encoding it triggers. We examined MTL activation during verbal associative encoding using functional magnetic resonance imaging. First, associative encoding activated left posterior MTL more than single word encoding even though novelty detection was matched, indicating not only that associative encoding activates the MTL particularly strongly, but also that activation does not require novelty detection. Moreover, it remains to be convincingly shown that novelty detection alone does produce such activation. Second, repetitive associative encoding produced less MTL activation than initial associative encoding, indicating that priming of associative information reduces MTL activation. Third, re-encoding familiar associations in a well-established way had a minimal effect on both memory and MTL activation, indicating that MTL activation reflects storage of associations, not merely their initial representation.

  3. Renoportal Anastomosis in Left Lateral Lobe Living Donor Liver Transplantation: A Pediatric Case

    Directory of Open Access Journals (Sweden)

    Hiroyuki Ogasawara

    2017-09-01

    Full Text Available In adult liver transplantation, renoportal anastomosis (RPA has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis. Simple end-to-end portal reconstruction and clamping of the collateral route after removing the thrombosis were unsuccessful. Thus, RPA was performed using a donor superficial femoral vein as an interpositional graft. The portal vein pressure was 20 mm Hg after arterial reperfusion. Ligation of the splenic artery reduced the portal vein pressure. Although she developed severe acute cellular rejection and chylous ascites, there were no signs of portal vein complications. She was discharged 73 days after transplantation without any signs of renal dysfunction. The patient’s condition was good at her last follow-up, 22 months after transplantation. To our knowledge, this is the youngest case of RPA in pediatric left lateral lobe LDLT. Additionally, this is the first case of RPA with splenic artery ligation and using the donor’s superficial femoral vein as the venous graft for RPA. Although long-term follow-up is necessary, RPA could be a salvage option in LDLT in infants if other methods are unsuccessful.

  4. Rudhe syndrome: reversible right middle lobe emphysema in infants with left-to-right shunts - an historical review

    International Nuclear Information System (INIS)

    Collins, Lee K.; Levin, Terry L.; Berdon, Walter E.; Cowles, Robert A.; Newman, Beverley

    2010-01-01

    In 1971, the Swedish radiologist Ulf Rudhe wrote a provocative paper on right middle lobe emphysema in infants with left-to-right shunts in which he suggested cardiac surgery rather than lung resection. At the time, this was counter to accepted medical practice. Earlier diagnosis and better medical management of ventricular septal defect in infants has proved Rudhe correct. However, two current cases of large left-to-right shunts in infants with emphysema of the right middle lobe prompt this historical review of what seemed a closed-episode in pediatric cardiac surgery. (orig.)

  5. Presurgical language fMRI activation correlates with postsurgical verbal memory decline in left-sided temporal lobe epilepsy.

    Science.gov (United States)

    Labudda, Kirsten; Mertens, Markus; Aengenendt, Joerg; Ebner, Alois; Woermann, Friedrich G

    2010-12-01

    We analysed the association of presurgical language fMRI activations and postsurgical verbal memory changes in 16 left-sided mesial temporal lobe epilepsy patients with initially intact memory. Patients with severe verbal memory decline after surgery (n = 9) had stronger presurgical fMRI activations within the left posterior temporal lobe, compared to those with no decline (n = 7). Language fMRI activation may predict verbal memory outcome, even in patients with a high risk of postsurgical memory deterioration. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Interstitial deletion of chromosome 4p associated with mild mental retardation, epilepsy and polymicrogyria of the left temporal lobe

    DEFF Research Database (Denmark)

    Møller, R S; Hansen, C P; Jackson, G D

    2007-01-01

    In this study, we present a 38-year-old woman with an interstitial deletion of 4p15.1-15.3, mild mental retardation, epilepsy and polymicrogyria adjacent to an arachnoid cyst of the left temporal lobe. The deletion was ascertained through array-comparative genome hybridization screening of patien...

  7. A comparison of portal vein embolization with poly(2-hydroxyethylmethacrylate) and a histoacryl/lipiodol mixture in patients scheduled for extended right hepatectomy

    Czech Academy of Sciences Publication Activity Database

    Peregrin, J. H.; Janoušek, R.; Kautznerová, D.; Oliverius, M.; Sticová, E.; Přádný, Martin; Michálek, Jiří

    2015-01-01

    Roč. 64, č. 6 (2015), s. 841-848 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA13-00939S Institutional support: RVO:61389013 Keywords : extended right hepatectomy * portal vein embolization * embolization-induced left liver lobe hypertrophy Subject RIV: FH - Neurology Impact factor: 1.643, year: 2015 http://www.biomed.cas.cz/physiolres/2015/6_15.htm

  8. Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8).

    Science.gov (United States)

    Galvez, Carlos; Lirio, Francisco; Sesma, Julio; Baschwitz, Benno; Bolufer, Sergio

    2017-01-01

    Unusual anatomical segmentectomies are technically demanding procedures that require a deep knowledge of intralobar anatomy and surgical skill. In the other hand, these procedures preserve more normal lung parenchyma for lesions located in specific anatomical segments, and are indicated for benign lesions, metastasis and also early stage adenocarcinomas without nodal involvement. A 32-year-old woman was diagnosed of a benign pneumocytoma in the anterior segment of the left-lower lobe (S8, LLL), so we performed a single-incision video-assisted thoracoscopic surgery (SI-VATS) anatomical S8 segmentectomy in 140 minutes under intercostal block. There were no intraoperative neither postoperative complications, the chest tube was removed at 24 hours and the patient discharged at 5 th postoperative day with low pain on the visual analogue scale (VAS). Final pathologic exam reported a benign sclerosant pneumocytoma with free margins. The patient has recovered her normal activities at 3 months completely with radiological normal controls at 1 and 3 months.

  9. Development Process and Technical Aspects of Laparoscopic Hepatectomy: Learning Curve Based on 15 Years of Experience.

    Science.gov (United States)

    Komatsu, Shohei; Scatton, Olivier; Goumard, Claire; Sepulveda, Ailton; Brustia, Raffaele; Perdigao, Fabiano; Soubrane, Olivier

    2017-05-01

    Laparoscopic hepatectomy continues to be a challenging operation associated with a steep learning curve. This study aimed to evaluate the learning process during 15 years of experience with laparoscopic hepatectomy and to identify approaches to standardization of this procedure. Prospectively collected data of 317 consecutive laparoscopic hepatectomies performed from January 2000 to December 2014 were reviewed retrospectively. The operative procedures were classified into 4 categories (minor hepatectomy, left lateral sectionectomy [LLS], left hepatectomy, and right hepatectomy), and indications were classified into 5 categories (benign-borderline tumor, living donor, metastatic liver tumor, biliary malignancy, and hepatocellular carcinoma). During the first 10 years, the procedures were limited mainly to minor hepatectomy and LLS, and the indications were limited to benign-borderline tumor and living donor. Implementation of major hepatectomy rapidly increased the proportion of malignant tumors, especially hepatocellular carcinoma, starting from 2011. Conversion rates decreased with experience for LLS (13.3% vs 3.4%; p = 0.054) and left hepatectomy (50.0% vs 15.0%; p = 0.012), but not for right hepatectomy (41.4% vs 35.7%; p = 0.661). Our 15-year experience clearly demonstrates the stepwise procedural evolution from LLS through left hepatectomy to right hepatectomy, as well as the trend in indications from benign-borderline tumor/living donor to malignant tumors. In contrast to LLS and left hepatectomy, a learning curve was not observed for right hepatectomy. The ongoing development process can contribute to faster standardization necessary for future advances in laparoscopic hepatectomy. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Composition of complex numbers: Delineating the computational role of the left anterior temporal lobe.

    Science.gov (United States)

    Blanco-Elorrieta, Esti; Pylkkänen, Liina

    2016-01-01

    What is the neurobiological basis of our ability to create complex messages with language? Results from multiple methodologies have converged on a set of brain regions as relevant for this general process, but the computational details of these areas remain to be characterized. The left anterior temporal lobe (LATL) has been a consistent node within this network, with results suggesting that although it rather systematically shows increased activation for semantically complex structured stimuli, this effect does not extend to number phrases such as 'three books.' In the present work we used magnetoencephalography to investigate whether numbers in general are an invalid input to the combinatory operations housed in the LATL or whether the lack of LATL engagement for stimuli such as 'three books' is due to the quantificational nature of such phrases. As a relevant test case, we employed complex number terms such as 'twenty-three', where one number term is not a quantifier of the other but rather, the two terms form a type of complex concept. In a number naming paradigm, participants viewed rows of numbers and depending on task instruction, named them as complex number terms ('twenty-three'), numerical quantifications ('two threes'), adjectival modifications ('blue threes') or non-combinatory lists (e.g., 'two, three'). While quantificational phrases failed to engage the LATL as compared to non-combinatory controls, both complex number terms and adjectival modifications elicited a reliable activity increase in the LATL. Our results show that while the LATL does not participate in the enumeration of tokens within a set, exemplified by the quantificational phrases, it does support conceptual combination, including the composition of complex number concepts. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Selective Familiarity Deficits after Left Anterior Temporal-Lobe Removal with Hippocampal Sparing Are Material Specific

    Science.gov (United States)

    Martin, Chris B.; Bowles, Ben; Mirsattari, Seyed M.; Kohler, Stefan

    2011-01-01

    Research has firmly established a link between recognition memory and the functional integrity of the medial temporal lobes (MTL). Dual-process models of MTL organization maintain that there is a division of labour within the MTL, with the hippocampus (HC) supporting recollective processes and perirhinal cortex (PRc) supporting familiarity…

  12. Laparoscopy-assisted hepatectomy versus conventional (open) hepatectomy for living donors: when you know better, you do better.

    Science.gov (United States)

    Makki, Kausar; Chorasiya, Vishal Kumar; Sood, Gaurav; Srivastava, Piyush Kumar; Dargan, Puneet; Vij, Vivek

    2014-10-01

    The conventional incision for donor hepatectomy is a right subcostal incision with a midline extension. With increased experience in both donor hepatectomy and laparoscopy, the conventional incision can be shortened to a significant extent. Laparoscopic mobilization of the liver coupled with a hand port allows the insertion of one hand inside the abdomen for control; this makes small-incision donor hepatectomy a technically feasible alternative. We compared 26 right lobe donor hepatectomies performed with a laparoscopy-assisted technique (the laparoscopy-assisted donor hepatectomy group) to 24 donor hepatectomies performed with the conventional open technique (the conventional donor hepatectomy group). The donors in both groups and their recipients were followed for 6 months. Pain, discomfort related to the scar [including abdominal wall sensorineural deficits (numbness and differences in tactile and temperature sensations) and tightness around the scar], and donor quality of life (assessed with the International Quality of Life Assessment Short Form 8 scoring system) were compared between the 2 groups. In conclusion, laparoscopy-assisted surgery can be a technically feasible alternative in experienced hands, and as with other minimally invasive surgeries, it has advantages such as significantly less pain, reduced incision-related complications, and better donor quality of life during the early postoperative period without compromising donor safety. © 2014 American Association for the Study of Liver Diseases.

  13. Left dorsolateral prefrontal cortex atrophy is associated with frontal lobe function in Alzheimer's disease and contributes to caregiver burden.

    Science.gov (United States)

    Matsuoka, Kiwamu; Yasuno, Fumihiko; Hashimoto, Akiko; Miyasaka, Toshiteru; Takahashi, Masato; Kiuchi, Kuniaki; Iida, Junzo; Kichikawa, Kimihiko; Kishimoto, Toshifumi

    2017-12-27

    Caregivers of patients with dementia experience physical and mental deterioration. We have previously reported a correlation between caregiver burden and the Frontal Assessment Battery (FAB) total scores of patients with Alzheimer's disease (AD), especially regarding the dependency factor from the Zarit Burden Interview. The present study aimed to identify an objective biomarker for predicting caregiver burden. The participants were 26 pairs of caregivers and patients with AD and mild-to-moderate dementia. Correlations between regional gray matter volumes in the patients with AD and the FAB total scores were explored by using whole-brain voxel-based morphometric analysis. Path analysis was used to estimate the relationships between regional gray matter volumes, FAB total scores, and caregiver burden based on the Zarit Burden Interview. The voxel-based morphometric revealed a significant positive correlation between the FAB total scores and the volume of the left dorsolateral prefrontal cortex. This positive correlation persisted after controlling for the effect of general cognitive dysfunction, which was assessed by using the Mini-Mental State Examination. Path analysis revealed that decreases in FAB scores, caused by reduced frontal lobe volumes, negatively affected caregiver burden. The present study revealed that frontal lobe function, based on FAB scores, was affected by the volume of the left dorsolateral prefrontal cortex. Decreased scores were associated with greater caregiver burden, especially for the dependency factor. These findings may facilitate the development of an objective biomarker for predicting caregiver burden. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Language localization in cases of left temporal lobe arachnoid cyst : Evidence against interhemispheric reorganization

    NARCIS (Netherlands)

    Stowe, LA; Go, KG; Pruim, J; den Dunnen, W; Meiners, LC; Paans, AMJ

    2000-01-01

    We investigated whether left-hemisphere arachnoid cysts lead to reorganization of the language function using PET. A group analysis demonstrated that patients showed no more right-hemisphere activation than a matched control group. Several patients had clear language localizations in the left

  15. Topiramate and its effect on fMRI of language in patients with right or left temporal lobe epilepsy

    Science.gov (United States)

    Szaflarski, Jerzy P.; Allendorfer, Jane B.

    2013-01-01

    Topiramate (TPM) is well recognized for its negative effects oncognition, language performance and lateralization results on the intracarotid amobarbital procedure (IAP). But, the effects of TPM on functional MRI (fMRI) of language and the fMRI signals are less clear. Functional MRI is increasingly used for presurgical evaluation of epilepsy patients in place of IAP for language lateralization. Thus, the goal of this study was to assess the effects of TPM on fMRI signals. In this study, we included 8 patients with right temporal lobe epilepsy (RTLE) and 8 with left temporal lobe epilepsy (LTLE) taking TPM (+TPM). Matched to them for age, handedness and side of seizure onset were 8 patients with RTLE and 8 with LTLE not taking TPM (−TPM). Matched for age and handedness to the patients with TLE were 32 healthy controls. The fMRI paradigm involved semantic decision/tone decision task (in-scanner behavioral data were collected). All epilepsy patients received a standard neuropsychological language battery. One sample t-tests were performed within each group to assess task-specific activations. Functional MRI data random-effects analysis was performed to determine significant group activation differences and to assess the effect of TPM dose on task activation. Direct group comparisons of fMRI, language and demographic data between patients with R/L TLE +TPM vs. −TPM and the analysis of the effects of TPM on blood oxygenation level-dependent (BOLD) signal were performed. Groups were matched for age, handedness and, within the R/L TLE groups, for the age of epilepsy onset/duration and the number of AEDs/TPM dose. The in-scanner language performance of patients was worse when compared to healthy controls — all pTPM vs. −TPM showed significant fMRI signal differences between groups (increases in left cingulate gyrus and decreases in left superior temporal gyrus in the patients with LTLE +TPM; increases in the right BA 10 and left visual cortex and decreases in the

  16. Increased emergence of alpha activity over the left but not the right temporal lobe within a dark acoustic chamber: differential response of the left but not the right hemisphere to transcerebral magnetic fields.

    Science.gov (United States)

    Persinger, M A

    1999-11-01

    The percentages of alpha activity per minute over the left and right temporal lobes were measured for the first and second successive 15-min intervals while subjects wore opaque goggles within an acoustic chamber. A weak (5 microT), burst-firing magnetic field was presented during this period for 1 s every 4 s primarily over the left or the right cerebral hemisphere. The results indicated that the left temporal lobe became less vigilant between the first and second 15 min while the right temporal lobe did not. When standardized scores for each subject's measures over time and across hemispheres were employed, increased alpha time over the left temporal lobe relative to the right temporal lobe was observed only when the transcerebral magnetic field was applied over the left hemisphere. Stimulation of the right hemisphere did not evoke this discrepancy. The detection of the effects of this specific complex magnetic field upon electroencephalographic activity may be more probable when the subjects are exposed to partial sensory deprivation.

  17. The role of the left anterior temporal lobe in exception word reading: reconciling patient and neuroimaging findings.

    Science.gov (United States)

    Wilson, Maximiliano A; Joubert, Sven; Ferré, Perrine; Belleville, Sylvie; Ansaldo, Ana Inés; Joanette, Yves; Rouleau, Isabelle; Brambati, Simona Maria

    2012-05-01

    Semantic dementia (SD) is a neurodegenerative disease that occurs following the atrophy of the anterior temporal lobes (ATLs). It is characterised by the degradation of semantic knowledge and difficulties in reading exception words (surface dyslexia). This disease has highlighted the role of the ATLs in the process of exception word reading. However, imaging studies in healthy subjects have failed to detect activation of the ATLs during exception word reading. The aim of the present study was to test whether the functional brain regions that mediate exception word reading in normal readers overlap those brain regions atrophied in SD. In Study One, we map the brain regions of grey matter atrophy in AF, a patient with mild SD and surface dyslexia profile. In Study Two, we map the activation pattern associated with exception word compared to pseudoword reading in young, healthy participants using fMRI. The results revealed areas of significant activation in healthy subjects engaged in the exception word reading task in the left anterior middle temporal gyrus, in a region observed to be atrophic in the patient AF. These results reconcile neuropsychological and functional imaging data, revealing the critical role of the left ATL in exception word reading. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Success of Anomia Treatment in Aphasia Is Associated With Preserved Architecture of Global and Left Temporal Lobe Structural Networks.

    Science.gov (United States)

    Bonilha, Leonardo; Gleichgerrcht, Ezequiel; Nesland, Travis; Rorden, Chris; Fridriksson, Julius

    2016-03-01

    Targeted speech therapy can lead to substantial naming improvement in some subjects with anomia following dominant-hemisphere stroke. We investigated whether treatment-induced improvement in naming is associated with poststroke preservation of structural neural network architecture. Twenty-four patients with poststroke chronic aphasia underwent 30 hours of speech therapy over a 2-week period and were assessed at baseline and after therapy. Whole brain maps of neural architecture were constructed from pretreatment diffusion tensor magnetic resonance imaging to derive measures of global brain network architecture (network small-worldness) and regional network influence (nodal betweenness centrality). Their relationship with naming recovery was evaluated with multiple linear regressions. Treatment-induced improvement in correct naming was associated with poststroke preservation of global network small worldness and of betweenness centrality in temporal lobe cortical regions. Together with baseline aphasia severity, these measures explained 78% of the variability in treatment response. Preservation of global and left temporal structural connectivity broadly explains the variability in treatment-related naming improvement in aphasia. These findings corroborate and expand on previous classical lesion-symptom mapping studies by elucidating some of the mechanisms by which brain damage may relate to treated aphasia recovery. Favorable naming outcomes may result from the intact connections between spared cortical areas that are functionally responsive to treatment. © The Author(s) 2015.

  19. Postoperative coagulopathy after live related donor hepatectomy: Incidence, predictors and implications for safety of thoracic epidural catheter

    Directory of Open Access Journals (Sweden)

    S T Karna

    2015-01-01

    Full Text Available Background: Coagulopathy after living donor hepatectomy (LDH may endanger donor safety during removal of thoracic epidural catheter (TEC. The present study was conducted to evaluate the extent and duration of immediate postoperative coagulopathy after LDH. Materials and Methods: A retrospective analysis of perioperative record of LDH over three years was conducted after IRB approval. Variables such as age, gender, BMI, ASA classification, liver volume on CT scan, preoperative and postoperative INR, platelet count (PC and ALT of each donor for five days was noted. In addition, duration of surgery, remnant as percentage total liver volume (Remnant%, blood loss, day of peak in PC and INR were also noted. Coagulopathy was defined as being present if INR exceeded 1.5 or platelet count fell below 1 × 10 5 /mm 3 on any day. Data was analyzed using SPSS 20 for Windows. Between group comparison was made using the Student ′t′ test for continuous variables and chi square test for categorical variables. Univariate analysis was done. Multiple logistic regression analysis was used to find independent factor associated with coagulopathy. Results: Eighty four (84 donors had coagulopathy on second day (mean INR 1.9 ± 0.42. Low BMI, % of remnant liver and duration of surgery were independent predictors of coagulopathy. Right lobe hepatectomy had more coagulopathy than left lobe and low BMI was the only independent predictor. There was no correlation of coagulopathy with age, gender, blood loss, presence of epidural catheter, postoperative ALT or duration of hospital stay. High INR was the main contributor for coagulopathy. Conclusions: Coagulopathy is seen after donor hepatectomy. We recommend removal of the epidural catheter after the fifth postoperative day when INR falls below 1.5.

  20. Left lobe of the prostate during clinical prostate cancer screening: the dark side of the gland for right-handed examiners.

    Science.gov (United States)

    Ploussard, G; Nicolaiew, N; Mongiat-Artus, P; Terry, S; Allory, Y; Vacherot, F; Abbou, C-C; Desgrandchamps, F; Salomon, L; de la Taille, A

    2014-06-01

    The predictive value of the abnormality side during digital rectal examination (DRE) has never been studied, suggesting that physicians examined the left lobe of the gland as well as the right lobe. We aimed to assess the predictive value of the side of DRE abnormality for prostate cancer (PCa) detection and aggressiveness in right-handed urologists. An analysis of a prospective database was carried out that included all consecutive men undergoing prostate biopsies between 2001 and 2012. The main end point was the predictive value of the abnormality side during DRE for cancer detection in clinically suspicious unilateral T2 disease. The diagnostic performance of left- versus right-sided abnormality was also assessed in terms of sensitivity, specificity and negative/positive predictive values. Overall, 308 patients had a suspicious unilateral clinical disease (detection rate 57.5%). The cancer detection rate was significantly higher in case of left-sided compared with right-sided clinical T2 stage (odds ratio 2.1). In case of left-sided disease, the number of positive cores, the rate of perineural invasion, the rate of primary grade 4 pattern and the percentage of cancer involvement per core were significantly higher compared with those reported for right-sided disease. The predictive value of abnormality laterality for cancer detection and aggressiveness remained statistically independent in multivariate models. The positive predictive value for cancer detection was 64.6 in case of suspicious left-sided disease versus 46.9 in case of right-sided disease. The risks of detecting PCa and aggressive disease on biopsy are significantly higher when DRE reveals a suspicious left-sided clinical disease as compared with right-sided disease. Right-handed physicians should be aware of this variance in diagnostic performance and potential underdetection of left-sided clinical disease, and should improve their examination of the left lobe of the gland by conducting longer exams

  1. Loss of resting-state posterior cingulate flexibility is associated with memory disturbance in left temporal lobe epilepsy.

    Science.gov (United States)

    Douw, Linda; Leveroni, Catherine L; Tanaka, Naoaki; Emerton, Britt C; Cole, Andrew J; Cole, Andrew C; Reinsberger, Claus; Stufflebeam, Steven M

    2015-01-01

    The association between cognition and resting-state fMRI (rs-fMRI) has been the focus of many recent studies, most of which use stationary connectivity. The dynamics or flexibility of connectivity, however, may be seminal for understanding cognitive functioning. In temporal lobe epilepsy (TLE), stationary connectomic correlates of impaired memory have been reported mainly for the hippocampus and posterior cingulate cortex (PCC). We therefore investigate resting-state and task-based hippocampal and PCC flexibility in addition to stationary connectivity in left TLE (LTLE) patients. Sixteen LTLE patients were analyzed with respect to rs-fMRI and task-based fMRI (t-fMRI), and underwent clinical neuropsychological testing. Flexibility of connectivity was calculated using a sliding-window approach by determining the standard deviation of Fisher-transformed Pearson correlation coefficients over all windows. Stationary connectivity was also calculated. Disturbed memory was operationalized as having at least one memory subtest score equal to or below the 5th percentile compared to normative data. Lower PCC flexibility, particularly in the contralateral (i.e. right) hemisphere, was found in memory-disturbed LTLE patients, who had up to 22% less flexible connectivity. No significant group differences were found with respect to hippocampal flexibility, stationary connectivity during both rs-fMRI and t-fMRI, or flexibility during t-fMRI. Contralateral resting-state PCC flexibility was able to classify all but one patient with respect to their memory status (94% accuracy). Flexibility of the PCC during rest relates to memory functioning in LTLE patients. Loss of flexible connectivity to the rest of the brain originating from the PCC, particularly contralateral to the seizure focus, is able to discern memory disturbed patients from their preserved counterparts. This study indicates that the dynamics of resting-state connectivity are associated with cognitive status of LTLE

  2. Loss of resting-state posterior cingulate flexibility is associated with memory disturbance in left temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Linda Douw

    Full Text Available The association between cognition and resting-state fMRI (rs-fMRI has been the focus of many recent studies, most of which use stationary connectivity. The dynamics or flexibility of connectivity, however, may be seminal for understanding cognitive functioning. In temporal lobe epilepsy (TLE, stationary connectomic correlates of impaired memory have been reported mainly for the hippocampus and posterior cingulate cortex (PCC. We therefore investigate resting-state and task-based hippocampal and PCC flexibility in addition to stationary connectivity in left TLE (LTLE patients. Sixteen LTLE patients were analyzed with respect to rs-fMRI and task-based fMRI (t-fMRI, and underwent clinical neuropsychological testing. Flexibility of connectivity was calculated using a sliding-window approach by determining the standard deviation of Fisher-transformed Pearson correlation coefficients over all windows. Stationary connectivity was also calculated. Disturbed memory was operationalized as having at least one memory subtest score equal to or below the 5th percentile compared to normative data. Lower PCC flexibility, particularly in the contralateral (i.e. right hemisphere, was found in memory-disturbed LTLE patients, who had up to 22% less flexible connectivity. No significant group differences were found with respect to hippocampal flexibility, stationary connectivity during both rs-fMRI and t-fMRI, or flexibility during t-fMRI. Contralateral resting-state PCC flexibility was able to classify all but one patient with respect to their memory status (94% accuracy. Flexibility of the PCC during rest relates to memory functioning in LTLE patients. Loss of flexible connectivity to the rest of the brain originating from the PCC, particularly contralateral to the seizure focus, is able to discern memory disturbed patients from their preserved counterparts. This study indicates that the dynamics of resting-state connectivity are associated with cognitive status

  3. A conceptual lemon: theta burst stimulation to the left anterior temporal lobe untangles object representation and its canonical color.

    Science.gov (United States)

    Chiou, Rocco; Sowman, Paul F; Etchell, Andrew C; Rich, Anina N

    2014-05-01

    Object recognition benefits greatly from our knowledge of typical color (e.g., a lemon is usually yellow). Most research on object color knowledge focuses on whether both knowledge and perception of object color recruit the well-established neural substrates of color vision (the V4 complex). Compared with the intensive investigation of the V4 complex, we know little about where and how neural mechanisms beyond V4 contribute to color knowledge. The anterior temporal lobe (ATL) is thought to act as a "hub" that supports semantic memory by integrating different modality-specific contents into a meaningful entity at a supramodal conceptual level, making it a good candidate zone for mediating the mappings between object attributes. Here, we explore whether the ATL is critical for integrating typical color with other object attributes (object shape and name), akin to its role in combining nonperceptual semantic representations. In separate experimental sessions, we applied TMS to disrupt neural processing in the left ATL and a control site (the occipital pole). Participants performed an object naming task that probes color knowledge and elicits a reliable color congruency effect as well as a control quantity naming task that also elicits a cognitive congruency effect but involves no conceptual integration. Critically, ATL stimulation eliminated the otherwise robust color congruency effect but had no impact on the numerical congruency effect, indicating a selective disruption of object color knowledge. Neither color nor numerical congruency effects were affected by stimulation at the control occipital site, ruling out nonspecific effects of cortical stimulation. Our findings suggest that the ATL is involved in the representation of object concepts that include their canonical colors.

  4. Laparoscopy-Specific Surgical Concepts for Hepatectomy Based on the Laparoscopic Caudal View: A Key to Reboot Surgeons' Minds.

    Science.gov (United States)

    Ogiso, Satoshi; Nomi, Takeo; Araki, Kenichiro; Conrad, Claudius; Hatano, Etsuro; Uemoto, Shinji; Fuks, David; Gayet, Brice

    2015-12-01

    Despite diffusion of laparoscopic hepatectomy, the acquisition of necessary skills is not easy for open liver surgeons. Concepts and techniques have totally changed in laparoscopic hepatectomy compared with open hepatectomy, which is an underlying cause of a technical hurdle in laparoscopic hepatectomy. This study aimed to illustrate laparoscopy-specific concepts and techniques for hepatectomy. Video footages of laparoscopic and open hepatectomies stored in the Institut Mutualiste Montsouris and Kyoto University were reviewed to define the differences in surgical view, surgical concept, and technical details, using left lateral sectionectomy (LLS) and right hepatectomy (RH) as representative examples. By comparison with open LLS and RH, laparoscopy-specific procedures were identified with regard to surgical view, parenchymal transection, available landmarks, and vascular dissection. By laparoscopy, the surgical field was constantly viewed and accessed from the caudal side to the cranial side. Similarly, the parenchyma was divided, and intrahepatic vessels were dissected in the same direction. Laparoscopy-specific landmarks were identified for both LLS and RH, behind the liver. The concepts and techniques in laparoscopic hepatectomy are totally different from those of open hepatectomy because of the different surgical views. Understanding the laparoscopy-specific concepts and techniques would facilitate safe and efficient execution of laparoscopic hepatectomy.

  5. 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.

  6. Hepatectomy After Yttrium-90 (Y90) Radioembolization-Induced Liver Fibrosis.

    Science.gov (United States)

    Maker, Ajay V; August, Carey; Maker, Vijay K; Weisenberg, Elliot

    2016-04-01

    An obese 55-year-old woman with nonalcoholic fatty liver disease presented 7 years after resection of a T3N1 ileal carcinoid tumor with an elevated chromogranin A, multifocal metastatic disease to the liver, and carcinoid syndrome. She underwent right hepatic artery yttrium-90 (Y90) radioembolization, followed a month later by selective Y90 treatment to segment IV. She then presented to our clinic 10 months later, remaining symptomatic with flushing, diarrhea, anxiety, myalgia, pain, and persistent night sweats despite Sandostatin administration. At least 11 tumors were identified in the right lobe of the liver and three in segment IV on liver-specific imaging. These lesions were stable over a year with no new lesions. At exploration, there was marked hypertrophy of the left lateral segment due to the yttrium-90 treatment of segments IV-VIII, corresponding with preoperative volumetrics predicting a functional liver remnant (FLR) of 40% after extended right hepatectomy. The right lobe and segment IV were fibrotic, hard, and visibly damaged. The gland had a thick, fibrotic capsule, and the parenchyma was dense, inflexible, and difficult to dissect, consistent with the previously reported morbidity of these operations. Extended right hepatectomy was performed. Final pathology demonstrated 15 foci of metastatic well-differentiated neuroendocrine carcinoma that were negative for necrosis, as was expected given her continued symptoms despite radioembolization. Numerous amorphous spheres, frequently in clusters, were present in segments IV-VIII in vessels and approximating tumors consistent with prior Y90 radioembolization. The patient had an uneventful post-operative recovery and remains symptom free on follow-up. Treatment options for metastatic tumors to the liver have increased in recent years and currently include radioembolization in selected patients. Surgical cytoreduction and complete metastasectomy continue to offer improvement in symptoms, quality of life, and

  7. Loss of Resting-State Posterior Cingulate Flexibility Is Associated with Memory Disturbance in Left Temporal Lobe Epilepsy

    NARCIS (Netherlands)

    Douw, L.; Leveroni, C.L.; Tanaka, N.; Emerton, B.C.; Cole, A.C.; Reinsberger, C.; Stufflebeam, S.M.

    2015-01-01

    The association between cognition and resting-state fMRI (rs-fMRI) has been the focus of many recent studies, most of which use stationary connectivity. The dynamics or flexibility of connectivity, however, may be seminal for understanding cognitive functioning. In temporal lobe epilepsy (TLE),

  8. Laparoscopic versus open major hepatectomy for hepatocellular carcinoma: a matched pair analysis.

    Science.gov (United States)

    Komatsu, Shohei; Brustia, Raffaele; Goumard, Claire; Perdigao, Fabiano; Soubrane, Olivier; Scatton, Olivier

    2016-05-01

    Laparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC) is currently perceived a complex and challenging laparoscopic procedure and is limited to a few expert teams. This study analyzed the short- and long-term outcomes of LMH for HCC compared with open hepatectomy. From January 2006 to May 2014, 38 patients underwent LMH for HCC (10 left and 28 right hepatectomy). They were matched and compared to 38 patients (10 left and 28 right hepatectomy) who underwent a conventional open approach. Short-term operative and postoperative outcomes as well as long-term outcomes, including disease-free survival and overall survival rates, were evaluated. Patients were well matched for several preoperative factors. Overall complication rates were significantly higher for the open group. No significant difference was seen in 3-year overall survival between the open and laparoscopic groups (69.2 vs. 73.4 %; p = 0.951). A trend toward better 3-year disease-free survival after laparoscopy was observed (29.7 vs. 50.3 %; p = 0.219), even though the difference did not reach statistical significance. The same trend was seen in subgroup analyses of right and left hepatectomy. This study shows the feasibility of LMH for HCC compared to open hepatectomy in regard to both short- and long-term outcomes. LMH offers many advantages commonly attributed to laparoscopy and is well suited for HCC with cirrhosis when performed by experienced surgeons.

  9. Laparoscopic Partial Hepatectomy: Animal Experiments

    Directory of Open Access Journals (Sweden)

    Haruhiro Inoue

    1995-01-01

    Full Text Available As a first step in firmly establishing laparoscopic hepatectomy, we introduce a porcine model of laparoscopic partial hepatectomy. This procedure has been successfully performed under the normal-pressure or low-pressure pneumoperitoneum condition supported by the full-thickness abdominal wall lifting technique. An ultrasonic dissector combined with electrocautery, newly developed by Olympus Optical Corporation (Japan was effectively utilized in facilitating safe and smooth incisions into the liver parenchyma. Although indications for this procedure seem to be limited only to peripheral lesions and not to central lesions, clinical application of this method may be useful for some patients in the near future.

  10. 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.

  11. 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.

  12. Progressive developmental restriction, acquisition of left-right identity and cell growth behavior during lobe formation in mouse liver development.

    Science.gov (United States)

    Weiss, Mary C; Le Garrec, Jean-Francois; Coqueran, Sabrina; Strick-Marchand, Helene; Buckingham, Margaret

    2016-04-01

    To identify cell-based decisions implicated in morphogenesis of the mammalian liver, we performed clonal analysis of hepatocytes/hepatoblasts in mouse liver development, using a knock-in allele of Hnf4a/laacZ This transgene randomly undergoes a low frequency of recombination that generates a functional lacZ gene that produces β-galactosidase in tissues in which Hnf4a is expressed. Two types of β-galactosidase-positive clones were found. Most have undergone three to eight cell divisions and result from independent events (Luria-Delbrück fluctuation test); we calculate that they arose between E8.5 and E13.5. A second class was mega-clones derived from early endoderm progenitors, generating many descendants. Some originated from multi-potential founder cells, with labeled cells in the liver, pancreas and/or intestine. A few mega-clones populate only one side of the liver, indicating hepatic cell chirality. The patterns of labeled cells indicate cohesive and often oriented growth, notably in broad radial stripes, potentially implicated in the formation of liver lobes. This retrospective clonal analysis gives novel insights into clonal origins, cell behavior of progenitors and distinct properties of endoderm cells that underlie the formation and morphogenesis of the liver. © 2016. Published by The Company of Biologists Ltd.

  13. Heterogeneity of the left temporal lobe in semantic representation and control: priming multiple versus single meanings of ambiguous words.

    Science.gov (United States)

    Whitney, Carin; Jefferies, Elizabeth; Kircher, Tilo

    2011-04-01

    Semantic judgments involve both representations of meaning plus executive mechanisms that guide knowledge retrieval in a task-appropriate way. These 2 components of semantic cognition-representation and control-are commonly linked to left temporal and prefrontal cortex, respectively. This simple proposal, however, remains contentious because in most functional neuroimaging studies to date, the number of concepts being activated and the involvement of executive processes during retrieval are confounded. Using functional magnetic resonance imaging, we examined a task in which semantic representation and control demands were dissociable. Words with multiple meanings like "bank" served as targets in a double-prime paradigm, in which multiple meaning activation and maximal executive demands loaded onto different priming conditions. Anterior inferior temporal gyrus (ITG) was sensitive to the number of meanings that were retrieved, suggesting a role for this region in semantic representation, while posterior middle temporal gyrus (pMTG) and inferior frontal cortex showed greater activation in conditions that maximized executive demands. These results support a functional dissociation between left ITG and pMTG, consistent with a revised neural organization in which left prefrontal and posterior temporal areas work together to underpin aspects of semantic control.

  14. Assessment of the financial implications for laparoscopic liver surgery: a single-centre UK cost analysis for minor and major hepatectomy.

    Science.gov (United States)

    Abu Hilal, Mohammed; Di Fabio, Francesco; Syed, Shareef; Wiltshire, Robert; Dimovska, Eleonora; Turner, David; Primrose, John N; Pearce, Neil W

    2013-07-01

    Laparoscopic hepatectomy is progressively gaining popularity. However, it is still unclear whether the laparoscopic approach offers cost advantages compared with the open approach, especially when major hepatectomies are required. Data providing useful insights into the costs of the laparoscopic approach for clinicians and hospitals are needed. The aim of this study is to assess the financial implications of the laparoscopic approach for two standardized minor and major hepatectomies: left lateral sectionectomy and right hepatectomy. A cost comparison analysis of patients undergoing laparoscopic right hepatectomy (LRH) and laparoscopic left lateral sectionectomy (LLLS) versus the open counterparts was performed. Data considered for the comparison analysis were operative costs (theatre cost, consumables and surgeon/anaesthetic labour cost), postoperative costs (hospital stay, complication management and readmissions) and overall costs. A total of 149 patients were included: 38 patients underwent LRH and 46 open right hepatectomy (ORH); 46 patients underwent LLLS and 19 open left lateral sectionectomy (OLLS). For LRH the mean operative, postoperative and overall costs were £10,181, £4,037 and £14,218; for ORH the mean operative, postoperative and overall costs were £6,483 (p costs were £5,460, £2,599 and £8,059; for OLLS the mean operative, postoperative and overall costs were £5,841 (p = 0.874), £5,796 (p cost advantage of the laparoscopic approach for left lateral sectionectomy and the cost neutrality for right hepatectomy.

  15. Robotic hepatectomies: advances and perspectives.

    Science.gov (United States)

    Dehlawi, Ammar; Memeo, Riccardo; DE Blasi, Vito; Mercoli, Henry A; Mutter, Didier; Marescaux, Jacques; Pessaux, Patrick

    2016-12-01

    Over recent years, minimally invasive hepatic resections have increasingly been reported in the literature. Even though hepatic surgery is still considered a challenge for surgeons due to its technical difficulties and high morbidity, the development and spread of robotic surgery has highlighted a new interest, which has induced a rapid dissemination of robotic approaches for hepatic pathologies. This article presents a systematic review of the literature regarding robotic hepatectomy in order to assess the safety and feasibility of robotic hepatic surgery. All eligible studies in robotic liver surgery which were published between January 2001 and January 2016 were reviewed systematically. Only series of ten patients and more were chosen in order to consider the experience of high-volume centers. In case of multiple articles on the same centers, the study including the largest number of patients was considered for the study. Overall, 18 studies, involving a total of 572 robotic liver resection (RLR) were finally analyzed. All articles in this review demonstrate that robotic liver surgery must be performed by surgeons trained in open liver surgery and skilled in minimally invasive techniques. RLR and laparoscopic liver resection (LLR) were comparable in terms of safety, feasibility, and outcome for hepatectomies. However, RLR is more expensive than LLR. Further studies are required before any final conclusion can be drawn.

  16. Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience.

    Science.gov (United States)

    Gorgen, Andre; Goldaracena, Nicolas; Zhang, Wei; Rosales, Roizar; Ghanekar, Anand; Lilly, Les; Cattral, Mark; Greig, Paul; McCluskey, Stuart; McGilvray, Ian; Selzner, Nazia; Bhat, Mamatha; Selzner, Markus; Levy, Gary; Grant, David; Sapisochin, Gonzalo

    2018-03-22

    The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy. Among those, 187 postoperative complications were diagnosed in 141 (24%) patients. One patient had >90-day morbidity, and there were no donor deaths. Overall complications were significantly higher in the first era, 2000 to 2008 (81 [57.4%]) versus the second era, 2009 to 2017 (60 [42.6%]) ( p  = 0.01). On multivariate analysis, the only predictor of postoperative complications was the center volume of RL live donor hepatectomy in the previous 12 months with an odds ratio of 0.97 (95% confidence interval: 0.95-0.99). In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. An unusual association of headache, epilepsy, and late-onset Kleist's pseudodepression syndrome in frontal lobe cavernoma of the cerebral left hemisphere.

    Science.gov (United States)

    Chirchiglia, Domenico; Della Torre, Attilio; Murrone, Domenico; Chirchiglia, Pasquale; Marotta, Rosa

    2017-01-01

    Cerebral cavernous angioma or cavernoma is a benign vascular malformation, usually asymptomatic. It is infrequent and often its discovery is incidental, a so-called incidentaloma. However, these lesions can be symptomatic, causing headaches, epilepsy, cerebral hemorrhage and other neurological signs depending on the brain area involved. Frontal localization is responsible for psychiatric disorders, particularly the prefrontal region, leading to prefrontal syndrome, a condition common in all frontal lobe tumors. Psychopathological syndrome can be depression-type, pseudodepression syndrome or maniac-type, pseudomaniac syndrome. Surgical treatment of lesions like this may not always be possible due to their location in eloquent areas. In this study, we describe an unusual association of migraine-like headache, epilepsy and frontal lobe pseudodepression late-onset syndrome in the same patient. We have considered this case interesting mainly for the rarity of both a headache with migraine features and for the late onset of pseudodepression syndrome. Pathophysiology underlying migraine-like headache and that concerning the late-onset pseudodepression frontal lobe syndrome seems to be unclear. This case leads to further hypotheses about the mechanisms responsible for headache syndromes and psychopathological disorders, in the specific case when caused by a cerebral frontal lobe lesion.

  18. Short-term outcomes of laparoscopy-assisted hybrid living donor hepatectomy: a comparison with the conventional open procedure.

    Science.gov (United States)

    Kitajima, Toshihiro; Kaido, Toshimi; Iida, Taku; Seo, Satoru; Taura, Kojiro; Fujimoto, Yasuhiro; Ogawa, Kohei; Hatano, Etsuro; Okajima, Hideaki; Uemoto, Shinji

    2017-12-01

    Although minimally invasive living donor surgery has been increasingly accepted, its safety remains to be fully clarified in a large-scale study. This study evaluated the safety and effectiveness of our laparoscopy-assisted hybrid living donor surgery (LAHDS) procedure with an upper median incision in comparison with conventional open donor hepatectomy (ODH). From 2011 to 2016, 153 adult living donors [right lobe (RL) graft: 80 donors; left lobe (LL) graft: 73 donors] were enrolled and divided into LAHDS (n = 76) and ODH (n = 77) groups. Donor characteristics, surgical outcomes, and postoperative complications were compared between the 2 groups in each graft subgroup. Postoperative liver function tests (LFTs), inflammatory markers, pain parameters, incision-related symptoms, and recipient outcomes were compared between the 2 groups in all donors. In RL donors, operative blood loss was significantly lower in the LAHDS group than in the ODH group (201 vs. 313 g; p = 0.034). In LL donors, duration of surgery was significantly longer in the LAHDS group than in the ODH group (459 vs. 403 min; p = 0.034). The incidence of complications, length of hospital stay, and postoperative changes in both LFTs and inflammatory markers were comparable. The incidence of postoperative scar discomfort or tightness was significantly lower in the LAHDS group than in the ODH group (2.6 vs. 31.2%; p < 0.001), whereas postoperative pain parameters were comparable. The incidence of wound problems and abdominal wall numbness tended to be lower, but not significantly so, in the LAHDS group. This large consecutive case series demonstrates that our LAHDS procedure can be performed as safely as ODH, and it can improve quality of life without impaired donor and recipient outcomes.

  19. An unusual association of headache, epilepsy, and late-onset Kleist’s pseudodepression syndrome in frontal lobe cavernoma of the cerebral left hemisphere

    Directory of Open Access Journals (Sweden)

    Chirchiglia D

    2017-05-01

    Full Text Available Domenico Chirchiglia,1 Attilio Della Torre,1 Domenico Murrone,2 Pasquale Chirchiglia,3 Rosa Marotta4 1Department of Neurosurgery, Neurophysiopathology Unit, University of Catanzaro “Magna Graecia”, Catanzaro, 2Neurosurgery Department, Di Venere Hospital, Bari, 3School of Medicine, University of Catanzaro, Catanzaro, 4Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy Abstract: Cerebral cavernous angioma or cavernoma is a benign vascular malformation, usually asymptomatic. It is infrequent and often its discovery is incidental, a so-called incidentaloma. However, these lesions can be symptomatic, causing headaches, epilepsy, cerebral hemorrhage and other neurological signs depending on the brain area involved. Frontal localization is responsible for psychiatric disorders, particularly the prefrontal region, leading to prefrontal syndrome, a condition common in all frontal lobe tumors. Psychopathological syndrome can be depression-type, pseudodepression syndrome or maniac-type, pseudomaniac syndrome. Surgical treatment of lesions like this may not always be possible due to their location in eloquent areas. In this study, we describe an unusual association of migraine-like headache, epilepsy and frontal lobe pseudodepression late-onset syndrome in the same patient. We have considered this case interesting mainly for the rarity of both a headache with migraine features and for the late onset of pseudodepression syndrome. Pathophysiology underlying migraine-like headache and that concerning the late-onset pseudodepression frontal lobe syndrome seems to be unclear. This case leads to further hypotheses about the mechanisms responsible for headache syndromes and psychopathological disorders, in the specific case when caused by a cerebral frontal lobe lesion. Keywords: cerebral cavernoma, cavernous angioma, headache, frontal syndrome, pseudodepression syndrome 

  20. Laparoscopy-assisted right hepatectomy in a case of Fasciola hepatica.

    Science.gov (United States)

    Kawashita, Yujo; Iwata, Toru; Kanetaka, Kengo; Ono, Shinichiro; Kawahara, Yasuhiro; Fujisawa, Hiroyuki; Yoshida, Toshiaki; Miyahara, Shinichi; Eto, Shozo; Kanematsu, Takashi

    2011-02-01

    Laparoscopic hepatectomy provides the usual advantages of a minimally invasive surgery. This study presents a case of Fasciola hepatica infection that was successfully treated with laparoscopic hepatectomy. The patient was referred because of persistent fever and right hypochondralgia with a huge mass occupying the right lobe of the liver, which was detected by imaging analysis. Serologic tests indicated an F. hepatica infection. The patient underwent a laparoscopic resection because the anthelmintic agent, triclabendazole was not effective. During the surgical technique, 5 trocars were inserted. After liver mobilization, the Glissonian pedicles and right hepatic veins were safely taped. A Penrose drain was placed behind the liver for a liver-hanging maneuver. A liver parenchymal transection was performed through an 8 cm handport site using a dissecting sealer (TissueLink Medical) after precoagulating its superficial layer by microtaze. Glissonian pedicles and the right hepatic vein were divided using an endolinear stapler (endcutter 45, Ethicon). Finally, the resected specimen was extracted from the handport. The surgical time was 450 minutes and the surgical blood loss was 370 mL. The patient was discharged 10 days after the surgery with an uneventful postoperative course. The laparoscopy-assisted hepatectomy in this case was beneficial for the patient's quality of life as a minimally invasive operation with a high degree of safety.

  1. Laparoscopic and Open Splenectomy and Hepatectomy.

    Science.gov (United States)

    Li, Jing-Feng; Bai, Dou-Sheng; Jiang, Guo-Qing; Chen, Ping; Jin, Sheng-Jie; Zhu, Zhi-Xian

    2017-01-01

    Patients undergoing synchronous open splenectomy and hepatectomy (OSH) for concurrent hepatocellular carcinoma (HCC) and hypersplenism usually have major surgical trauma caused by the long abdominal incision. Surgical procedures that contribute to rapid recovery with the least possible impairment are desired by both surgeons and patients. The objective of this study was to explore outcomes in patients treated with simultaneous laparoscopic or open splenectomy and hepatectomy for hepatocellular carcinoma (HCC) with hypersplenism. We retrospectively evaluated the treatment outcomes in 23 patients with cirrhosis, HCC, and hypersplenism, who underwent simultaneous laparoscopic splenectomy and hepatectomy (LSH; n = 12) or open splenectomy and hepatectomy (OSH; n = 11) from January 2012 through December 2015. Their perioperative variables were compared. LSH was successful in all patients. There were nonsignificant similarities between the 2 groups in duration of operation, estimated blood loss, and volume of blood transfused ( P > .05 each). Compared with OSH, LSH had a significantly shorter postoperative visual analog scale pain score ( P 38.0°C ( P < .01); fewer postoperative complications ( P < .05); and better liver and renal function on postoperative days 7 ( P < .05 each). Simultaneous LSH is safe for selected patients with HCC and hypersplenism associated with liver cirrhosis.

  2. Caudate lobe resections: a single-center experience and evaluation of factors predictive of outcomes

    OpenAIRE

    Philips, Prejesh; Farmer, Russell W; Scoggins, Charles R; McMasters, Kelly M; Martin, Robert CG

    2013-01-01

    Background Despite the increasing frequency of liver resection for multiple types of disease, caudate lobe resection remains a rare surgical event. The goal of this study is to review our experience and evaluate possible predictors of adverse outcomes in patients undergoing caudate lobectomy. Methods We reviewed a 1,900-patient prospective hepato-pancreatico-biliary database from January 2000 to December 2011, identifying 36 hepatectomy patients undergoing caudate lobe resection. Clinicopatho...

  3. Imaging memory in temporal lobe epilepsy: predicting the effects of temporal lobe resection.

    Science.gov (United States)

    Bonelli, Silvia B; Powell, Robert H W; Yogarajah, Mahinda; Samson, Rebecca S; Symms, Mark R; Thompson, Pamela J; Koepp, Matthias J; Duncan, John S

    2010-04-01

    Functional magnetic resonance imaging can demonstrate the functional anatomy of cognitive processes. In patients with refractory temporal lobe epilepsy, evaluation of preoperative verbal and visual memory function is important as anterior temporal lobe resections may result in material specific memory impairment, typically verbal memory decline following left and visual memory decline after right anterior temporal lobe resection. This study aimed to investigate reorganization of memory functions in temporal lobe epilepsy and to determine whether preoperative memory functional magnetic resonance imaging may predict memory changes following anterior temporal lobe resection. We studied 72 patients with unilateral medial temporal lobe epilepsy (41 left) and 20 healthy controls. A functional magnetic resonance imaging memory encoding paradigm for pictures, words and faces was used testing verbal and visual memory in a single scanning session on a 3T magnetic resonance imaging scanner. Fifty-four patients subsequently underwent left (29) or right (25) anterior temporal lobe resection. Verbal and design learning were assessed before and 4 months after surgery. Event-related functional magnetic resonance imaging analysis revealed that in left temporal lobe epilepsy, greater left hippocampal activation for word encoding correlated with better verbal memory. In right temporal lobe epilepsy, greater right hippocampal activation for face encoding correlated with better visual memory. In left temporal lobe epilepsy, greater left than right anterior hippocampal activation on word encoding correlated with greater verbal memory decline after left anterior temporal lobe resection, while greater left than right posterior hippocampal activation correlated with better postoperative verbal memory outcome. In right temporal lobe epilepsy, greater right than left anterior hippocampal functional magnetic resonance imaging activation on face encoding predicted greater visual memory decline

  4. Extended Hemi-Hepatectomy with Portal Vein Reconstruction in a Patient with Situs Ambiguous

    Directory of Open Access Journals (Sweden)

    Keishi Sugimachi

    2008-03-01

    Full Text Available We report a case of far-advanced hepatocellular carcinoma (HCC with situs ambiguous, complex visceral and vascular anomalies, who was successfully managed by extended hemi-hepatectomy. A 67-year-old man was referred to our hospital with a large liver mass. Abdominal ultrasonography, computed tomography and angiography revealed HCC with a diameter of 10 cm, with tumor thrombus in the main and first branch of the portal vein. Multiple complex anomalies in the abdomen were determined preoperatively. He had right-sided spleens-stomach-duodenum, liver at midline, inferior vena cava interruption with azygous continuation, and hepatic arterial anomaly. Extended left lobectomy of the liver with reconstruction of the portal vein was performed. Postoperatively, the patient recovered without major complications, and he was discharged on postoperative day 21. We report the first successful extended hepatectomy with portal vein reconstruction for HCC in a patient with rare situs anomalies.

  5. Laparoscopic hepatectomy is a safe procedure for cancer patients.

    Science.gov (United States)

    Pilgrim, Charles H C; To, Henry; Usatoff, Val; Evans, Peter M

    2009-05-01

    Utilizing laparoscopy for major surgeries such as hepatectomy is a relatively new concept. Initially, benign pathologies dominated indications for resection. Our experience in an Australian setting with primarily malignant diagnoses is described. A review of patients' profiles, pathology, surgery and outcome was performed on 35 patients between December 2005 and August 2008. Data were collected and analysed retrospectively from medical records on a pre-designed datasheet. Commonest indication for resection was colorectal metastasis (54%), 71% of all resections were for malignancy. Average operating time was 2 h 31 min (range 30 min-7 h, 15 min). Major morbidity consisted of one bile leak, two subphrenic abscesses and one pulmonary embolus. There were no deaths. Conversion to open was required in 20% and two patients required intra-operative blood transfusions. Average length of stay overall was 6.1 days (range 1-27), but as low as 2 days for some left lateral sectionectomies. Cessation of parenteral analgesia, return to normal diet and full mobility were achieved on average at 2.4, 2.3 and 2.8 days. Significant post-operative liver dysfunction was seen in two patients, which returned to normal by discharge. One patient died of disease progression 4 months after surgery. There were two involved margins in 35 patients (6%). Laparoscopic hepatectomy is a developing and safe technique in a select group of patients including those with malignancies, resulting in short hospital stays, rapid return to normal diet, full mobility and minimal morbidity with acceptable oncological parameters. This study is not comparative in nature, but provides evidence to support further investigation and establishment of this new technique for liver resection.

  6. Achado incidental de agenesia do lobo hepático esquerdo em paciente com colecistite aguda Incidental finding of agenesis of the left hepatic lobe in a patient with acute cholecystitis

    Directory of Open Access Journals (Sweden)

    Bruno da Costa Martins

    2008-12-01

    Full Text Available INTRODUÇÃO: Anomalias da morfologia hepática são entidades raras causadas por desenvolvimento embriológico anormal do fígado. Podem ser classificadas como anomalias devido a desenvolvimento defeituoso do fígado (agenesia, aplasia e hipoplasia ou devido ao desenvolvimento excessivo (lobos acessórios. RELATO DO CASO: Paciente de 48 anos, do sexo feminino, obesa (IMC=40, que procurou o serviço de emergência com quadro de colecistite aguda. A paciente foi submetida a colecistectomia videolaparoscópica e durante o procedimento cirúrgico foi verificada a agenesia do lobo hepático esquerdo. A vesícula biliar estava em sua topografia habitual e não havia parênquima hepático à esquerda do ligamento falciforme. A colecistectomia foi realizada sem intercorrências e uma banda gástrica foi colocada para o tratamento da obesidade mórbida. Ela recebeu alta após 60 horasINTRODUCTION: Anomalies of hepatic morphology are rare entities caused by abnormal embryological development of the liver. They can be classified as anomalies due to defective development (agenesis, aplasia or hypoplasia or anomalies due to excessive development of the liver (accessory lobes. CASE REPORT: A 48 years old obese female looked for emergency assistance with acute cholecystitis. An incidental finding of left hepatic lobe agenesis was observed when the patient was submitted to laparoscopic cholecystectomy. There was no hepatic parenchyma to the left of falciform ligament and gallbladder was settled on its normal position. Cholecystectomy was performed uneventfully and an adjustable gastric band was placed for the treatment of the morbid obesity. The patient was discharged after 60 hours.

  7. Morphology of the ligament of Treitz likely depends on its fetal topographical relationship with the left adrenal gland and liver caudate lobe as well as the developing lymphatic tissues: a histological study using human fetuses.

    Science.gov (United States)

    Yang, Jae Do; Ishikawa, Kazuo; Hwang, Hong Pil; Yu, Hee Chul; Rodríguez-Vázquez, Jose Francisco; Murakami, Gen; Cho, Baik Hwan

    2013-01-01

    To investigate the factors affecting the development of the ligament of Treitz, we examined sagittal and frontal histological sections of 35 human fetuses with a crown-rump length of 100-300 mm (approximately 16-38 weeks of gestation). The retropancreatic fascia consistently extended in a layer behind the pancreatic body and the splenic artery and vein, and also in front of the left renal vein and left adrenal. In 18 specimens, a connective tissue band was seen originating from the diaphragmatic crus around the esophageal opening and ending at the retropancreatic fascia to the left of the origin of the celiac artery. In 10 of these 18 specimens, these putative upper parts of the ligament contained striated muscles, or so-called Hilfsmuskel. Although most of other 17 specimens were larger fetuses, the left adrenal, the liver caudate lobe and the celiac ganglion made space for the ligament very limited. In 22 specimens including the above 18, the retropancreatic fascia extended inferiorly to approach the fourth portion of the duodenum (D4) or the duodenojejunal junction (DJJ). However, in 11 of the 22 examples of the putative lower part of the ligament, the connection between the duodenal muscle coat and the fascia was interrupted by developing lymphatic tissues. Consequently, the ligament of Treitz seemed to develop from both pleuroperitoneal membrane-derived cells and the retropancreatic fusion fascia, although the morphology was markedly modified by adjacent structures such as the adrenal gland. The ligament may "recover" after the adrenal becomes reduced in size after birth.

  8. Right azygos lobe occurring with fissural and lobation anomalies ...

    African Journals Online (AJOL)

    Background: The azygos lobe is a rare anomaly of the lung that is separated from the rest of the upper lobe by an azygos fissure. The lobe is encountered mostly in the right lung but a few cases have also been described in the left lung. It occurs at a frequency of 0.25-1% and has surgical and radiological importance.

  9. Liver regeneration is dependent on the extent of hepatectomy

    DEFF Research Database (Denmark)

    Meier, Michelle; Knudsen, Anders Riegels; Andersen, Kasper Jarlhelt

    of liver tissue and blood for liver specific serology. The change in liver weight after PH was evaluated as liver regeneration rate (RR). Histological analyses of liver cell proliferation and proteomic analyses are in progress. The gain in liver weight as well as RR increased significantly with the size......The upper limit for the size of hepatectomy is approximately 90% in rats. The present research project is designed to investigate the molecular pathways leading to either liver regeneration or liver failure after extended hepatectomy. In this first study we investigated the impact of different size...... of hepatectomy on liver regeneration in a rat model. Male Wistar rats were divided into four groups: 30% (n=24), 70% (n=24) and 90% (n=24) partial hepatectomy (PH) was performed together with a SHAM group (n=24). Euthanization took place at postoperative day (POD) 1 (n=8), 3 (n=8), and 5 (n=8) with harvesting...

  10. Silymarin Accelerates Liver Regeneration after Partial Hepatectomy

    Directory of Open Access Journals (Sweden)

    Jia-Ping Wu

    2015-01-01

    Full Text Available Partial hepatectomy (PHx is a liver regeneration physiological response induced to maintain homeostasis. Liver regeneration evolved presumably to protect wild animals from catastrophic liver loss caused by toxins or tissue injury. Silymarin (Sm ability to stimulate liver regeneration has been an object of curiosity for many years. Silymarin has been investigated for use as an antioxidant and anticarcinogen. However, its use as a supportive treatment for liver damage is elusive. In this study, we fed silymarin (Sm, 25 mg/kg to male Sprague-Dawley rats for 7 weeks. Surgical 2/3 PHx was then conducted on the rats at 6 hrs, 24 hrs, and 72 hrs. Western blot and RT-PCR were conducted to detect the cell cycle activities and silymarin effects on hepatic regeneration. The results showed that silymarin enhanced liver regeneration by accelerating the cell cycle in PHx liver. Silymarin led to increased G1 phase (cyclin D1/pRb, S phase (cyclin E/E2F, G2 phase (cyclin B, and M phase (cyclin A protein and mRNA at 6 hrs, 24 hrs, and 72 hrs PHx. HGF, TGFα, and TGFβ1 growth factor expressions were also enhanced. We suggest that silymarin plays a crucial role in accelerated liver regeneration after PHx.

  11. Unilateral spatial neglect due to right frontal lobe haematoma.

    OpenAIRE

    Maeshima, S; Funahashi, K; Ogura, M; Itakura, T; Komai, N

    1994-01-01

    Two patients with unilateral spatial neglect caused by right frontal lobe lesions underwent cerebral blood flow studies. A 54-year-old, right-handed woman developed left hemiplegia and frontal lobe neglect associated with cerebral haemorrhage after surgical excision of a frontal tumour. A 66-year-old, right-handed woman developed a haemorrhage in the right frontal lobe caused by rupture of an aneurysm. This was followed by left hemiplegia and frontal lobe neglect. In both cases, 123I-iodoamph...

  12. Effect of hepatectomy on the reticuloendothelial system of septic rats

    International Nuclear Information System (INIS)

    Vo, N.M.; Chi, D.S.

    1988-01-01

    The purpose of this study was to evaluate the function of the reticuloendothelial system (RES) of sham hepatectomy and 20% and 50% partial hepatectomy (PH 20%, PH 50%), with or without cecal ligation and puncture-induced sepsis. The animals were injected with 51-Chromium sheep red blood cells (SRBC) at 72 hours. SRBC half life (T1/2) was measured as an index of RES function and the percentage distribution of SRBC in liver, lung, and spleen was calculated. T1/2 was significantly prolonged in PH 50% rats and was associated with decreased radioactive uptake by the liver. Mortality was nil in the control groups and markedly increased in the presence of sepsis. The results suggest that decreased RES function following hepatectomy is dependent upon the proportion of liver removed and that sepsis further increased the mortality of hepatectomized animals

  13. Two-stage hepatectomy, a 10 years experience.

    Science.gov (United States)

    Levi Sandri, Giovanni Battista; Santoro, Roberto; Vennarecci, Giovanni; Lepiane, Pasquale; Colasanti, Marco; Ettorre, Giuseppe Maria

    2015-12-01

    Colorectal tumor represents in Europe the second most common cause of cancer death. Surgical resection in case of colorectal liver metastasis remain for patients the only cure. In 2003, Jaeck et al. described a one or two-stage hepatectomy combined with PVE for initially non-resectable colorectal liver metastases. The aim of our study was to retrospectively review all patients who underwent to a two-stage hepatectomy for CLM and evaluate the safety and feasibility of the procedure. We review all patient who underwent two-stage hepatectomy for CLM in our center. From 2004 to March 2014, 57 patients were candidate for a two-stage hepatectomy for CLM. Thirty-two patients (55.9 %) were men and twenty-five women (44.1 %). Median age was 60.9 years old. In forty-six cases, the two-stage hepatectomy was completed. Of these 46 patients, 38 patients completed the procedure with a PVL and 8 underwent a secondary PVE. Seven patients were planned but did not performed PVL after intraoperative evaluation and neither PVE after secondary evaluation due to disease progression. Five cases were treated with a laparoscopic approach for the first step procedure. We had no death in this series. Ten patients developed complications after the first-stage operation and 18 patients had complications after the second stage. The median interval between the two stages was 66 days. Long-term overall survival was 52 months from the first liver surgery. This study demonstrated the feasibility of two-stage hepatectomy without postoperative mortality. In our last experience in selected patient, a laparoscopic first step should be performed. Patients selection is extremely important to propose the best therapeutic option for each one.

  14. Liver failure after hepatectomy: A risk assessment using the pre-hepatectomy shear wave elastography technique

    Energy Technology Data Exchange (ETDEWEB)

    Han, Hong, E-mail: han.hong@zs-hospital.sh.cn [Department of Ultrasound, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032 (China); Hu, Hao; Xu, Ya Dan [Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai 200032 (China); Wang, Wen Ping, E-mail: puguang61@126.com [Department of Ultrasound, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032 (China); Ding, Hong; Lu, Qing [Department of Ultrasound, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032 (China)

    2017-01-15

    Objective: To determine the efficacy of liver stiffness (LS) measurements utilizing the Shear Wave Elastography (SWE) technique for predicting post-hepatectomy liver failure (PHLF) among patients with hepatocellular carcinoma (HCC). Methods: Data from eighty consecutive patients who were undergoing hepatectomy for HCC were prospectively identified and evaluated with preoperative SWE. The SWE was measured with advanced ultrasound equipment (Philips EPIQ7; Philips Healthcare, Seattle, WA, USA). PHLF classification was defined according to the International Study Group of Liver Surgery Recommendations (ISGLS). Results: SWE was successfully performed in 77 patients. According to the ISGLS criteria, PHLF occurred in 35.1% of patients (27 patients), including 2/25 patients with Grade A/B, respectively. Elevated SWE values (P = 0.002) and histological cirrhosis (P = 0.003) were independent predictors of PHLF according to the multivariate analysis. Patients with SWE values higher than or equal to 6.9 kPa were identified at higher risk of PHLF (area under the curve: 0.843, sensitivity: 77.8% and specificity: 78.0%). Postoperative dynamic course of the median the Model For End-stage Liver Disease (MELD) score showed irregular changes among patients with an SWE >6.9 kPa. Patients with an SWE <6.9 kPa, postoperative dynamic course of the median MELD score gradually decreased. Conclusion: LS measured with SWE is a valid and reliable method for the prediction of PHLF grade A/B among patients with HCC. SWE could become a routine examination for the preoperative evaluation of PHLF.

  15. Frontal lobe function in temporal lobe epilepsy

    Science.gov (United States)

    Stretton, J.; Thompson, P.J.

    2012-01-01

    Summary Temporal lobe epilepsy (TLE) is typically associated with long-term memory dysfunction. The frontal lobes support high-level cognition comprising executive skills and working memory that is vital for daily life functioning. Deficits in these functions have been increasingly reported in TLE. Evidence from both the neuropsychological and neuroimaging literature suggests both executive function and working memory are compromised in the presence of TLE. In relation to executive impairment, particular focus has been paid to set shifting as measured by the Wisconsin Card Sorting Task. Other discrete executive functions such as decision-making and theory of mind also appear vulnerable but have received little attention. With regard to working memory, the medial temporal lobe structures appear have a more critical role, but with emerging evidence of hippocampal dependent and independent processes. The relative role of underlying pathology and seizure spread is likely to have considerable bearing upon the cognitive phenotype and trajectory in TLE. The identification of the nature of frontal lobe dysfunction in TLE thus has important clinical implications for prognosis and surgical management. Longitudinal neuropsychological and neuroimaging studies assessing frontal lobe function in TLE patients pre- and postoperatively will improve our understanding further. PMID:22100147

  16. Use of robotics in liver donor right hepatectomy.

    Science.gov (United States)

    Chen, Po-Da; Wu, Chao-Yin; Wu, Yao-Ming

    2017-10-01

    Liver transplantation is the best solution for end stage liver disease, and has been widely accepted and rapidly developed in the past decades. Along with the improved outcomes of liver transplantation, living-related donor transplantation has been conducted to overcome the shortage of the deceased donor. The most important aspects of the living-related liver transplantation are donor safety and fast recovery after graft procurement. Meanwhile, the rapid progress of minimally invasive surgery (MIS) in general surgery has generated heated debate regarding the appropriateness of MIS in living-related donor graft hepatectomy. Technical innovations and instrument enhancements have been allowing recruitment of more potential candidates through smaller wounds and better surgical experience. Although MIS has been documented with safety and feasibility in complex liver surgery, the progress is slow in regard to the application of MIS in donor graft hepatectomy. Pioneer surgeons have devoted themselves to develop the pure MIS approach for the liver donor surgery, but the steep learning curve for pure MIS major hepatectomy remains a major barrier for wide adoption. The introduction of robotic system may lower the barrier for entry for practice into MIS donor hepatectomy.

  17. Cognitive impairments in patients with intractable temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Mahgol Tavakoli

    2011-01-01

    Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

  18. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    International Nuclear Information System (INIS)

    Rademacher, J.; Seitz, R.J.; Aulich, A.; Reifenberger, G.; Kiwit, J.C.W.; Langen, K.J.; Schmidt, D.

    2000-01-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[ 123 I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  19. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rademacher, J.; Seitz, R.J. [Department of Neurology, Heinrich-Heine University Duesseldorf (Germany); Aulich, A. [Department of Radiology, Heinrich-Heine University, Duesseldorf (Germany); Reifenberger, G. [Department of Neuropathology, Heinrich-Heine University, Duesseldorf (Germany); Kiwit, J.C.W. [Department of Neurosurgery, Heinrich-Heine University, Duesseldorf (Germany); Langen, K.J.; Schmidt, D. [Institute of Medicine, Research Center Juelich, Heinrich-Heine University, Duesseldorf (Germany)

    2000-06-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[{sup 123}I]iodo-{alpha}-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  20. Lung lobe torsion in seven juvenile dogs.

    Science.gov (United States)

    Latimer, Christian R; Lux, Cassie N; Sutton, Jessie S; Culp, William T N

    2017-12-15

    CASE DESCRIPTION 7 juvenile (< 12 months old) dogs with lung lobe torsion were evaluated. CLINICAL FINDINGS All patients were male; breeds included Pug (n = 5), Chinese Shar-Pei (1), and Bullmastiff (1). Dyspnea and lethargy were the most common initial complaints, with a duration of clinical signs ranging from 1 to 10 days. A CBC showed leukocytosis and neutrophilia in all dogs. Anemia was present in 6 dogs, 2 of which received packed RBC transfusions. The diagnosis was made on the basis of results of thoracic radiography, CT, ultrasonography, or a combination of modalities. The left cranial lung lobe was most commonly affected (n = 4), followed by the right middle lung lobe (2) and the right cranial lung lobe (1). TREATMENT AND OUTCOME A lateral intercostal thoracotomy with lobectomy of the affected lobe was performed in all patients. All dogs survived to be discharged between 1 and 2 days postoperatively. Six of 7 owners contacted for follow-up information 7 to 170 months after discharge reported satisfaction with the treatment and no apparent signs of recurrence of disease. CLINICAL RELEVANCE The juvenile patients of this report were successfully treated surgically with no apparent complications. Clinicians should be aware of the possibility of lung lobe torsion when evaluating young dogs with clinical signs related to the respiratory system, including those with vague signs, to avoid undue delays in treatment.

  1. Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Tae Kwan; Kim, Dong Wook; Park, Ha Kyoung; Jung, Soo Jin [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-12-15

    We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

  2. Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases.

    Science.gov (United States)

    Nagino, Masato; Nimura, Yuji; Nishio, Hideki; Ebata, Tomoki; Igami, Tsuyoshi; Matsushita, Masahiro; Nishikimi, Naomichi; Kamei, Yuzuru

    2010-07-01

    To outline our experience with hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma, and to discuss the clinical significance of this challenging hepatectomy. Only a few authors reported negative results for this surgery in a very limited number of patients. We retrospectively reviewed medical records of 50 patients with advanced cholangiocarcinoma who underwent hepatectomy (left trisectionectomy in 26, left hepatectomy in 23, and right hepatectomy in 1) with simultaneous resection and reconstruction of the portal vein and hepatic artery, focusing on surgical outcome and survival. The operative time was 776 +/- 191 minutes, and blood loss was 2593 +/- 1890 mL. Time of vessel resection and reconstruction was 25 +/- 19 minutes for the portal vein and 119 +/- 56 minutes for the hepatic artery. A total of 27 (54.0%) patients developed several kinds of complications, including intra-abdominal abscess (n = 13), wound infection (n = 9), bile leakage from liver stump (n = 9), and liver failure (n = 7). Relaparotomy was necessary in 5 (10.0%) patients. One (2.0%) patient died of a postoperative complication. Microscopic cancer invasion of the resected portal vein was found in 44 (88.0%) patients, while that of the resected hepatic artery was found in 27 (54.0%). The distal bile duct margin, proximal bile duct margin, and radial margin were positive for cancer in 2 (4.0%), 4 (8.0%), and 17 (34.0%) patients, respectively. Consequently, R0 resection was achieved in 33 (66.0%) patients. The 1-, 3-, and 5-year survival rates were 78.9%, 36.3%, and 30.3%, respectively. Survival for 30 patients with pM0 disease who underwent R0 resection was better, being 40.7% at the 3- and 5-year time points. Major hepatectomy with simultaneous resection and reconstruction of the portal vein and hepatic artery is technically demanding. However, this surgery can be performed with acceptable mortality by an experienced surgeon and

  3. The Structural Plasticity of White Matter Networks Following Anterior Temporal Lobe Resection

    Science.gov (United States)

    Yogarajah, Mahinda; Focke, Niels K.; Bonelli, Silvia B.; Thompson, Pamela; Vollmar, Christian; McEvoy, Andrew W.; Alexander, Daniel C.; Symms, Mark R.; Koepp, Matthias J.; Duncan, John S.

    2010-01-01

    Anterior temporal lobe resection is an effective treatment for refractory temporal lobe epilepsy. The structural consequences of such surgery in the white matter, and how these relate to language function after surgery remain unknown. We carried out a longitudinal study with diffusion tensor imaging in 26 left and 20 right temporal lobe epilepsy…

  4. Short Term Donor Outcomes After Hepatectomy in Living Donor Liver Transplantation

    International Nuclear Information System (INIS)

    Dar, F. S.; Zia, H.; Bhatti, A. B. H.; Kazmi, R.; Rana, A.; Nazer, R.; Khan, E. U. D.; Khan, N. A.; Salih, M.; Shah, N. H.

    2016-01-01

    Objective: To determine the outcome of living-donor liver transplant (LDLT) donors from the first liver transplant program in Pakistan. Study Design: Cohort study. Place and Duration of Study: Shifa International Hospital, Islamabad, from April 2012 to August 2014. Methodology: A total of 100 live donors who underwent hepatectomy were included. Demographics, etiologies, graft characteristics and operative variables were retrospectively assessed. Outcome was assessed based on morbidity and mortality. Results: Median donor age was 28 (17 - 45) years and median body mass index (BMI) was 24 kg/m2 (15 - 36). Male to female ratio was 1.5:1. Hepatitis B and C were the most common underlying etiologies and accounted for 79/100 (79%) of LDLT's. Overall, 93/100 (93%) donors donated a right lobe graft. Median estimated graft weight to recipient body weight (GW/BW) ratio was 1.03 (0.78 - 2). Standard arterial anatomy was present in 56% donors. The 90-day morbidity was 13/100 (13%) and overall morbidity was 17/100 (17%). Bile leak was encountered in 3 (3%) patients. There was no donor mortality. Conclusion: Acceptable short-term donor outcomes were achieved in an LDLT program in Pakistan with careful donor selection and planning. (author)

  5. Temporal Lobe Seizure

    Science.gov (United States)

    ... pregnancy Temporal lobe seizure Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  6. Pure laparoscopic right hepatectomy for giant hemangioma using anterior approach.

    Science.gov (United States)

    Kim, Seok-Hwan; Kim, Ki-Hun; Kirchner, Varvara A; Lee, Sang-Kyung

    2017-05-01

    Laparoscopic major hepatectomy remains a challenging procedure [1, 2]. In the case of giant tumors in the right liver, conventional approach (complete mobilization of the right liver before parenchymal transection) could be dangerous during mobilization because of large volume and weight [3, 4]. We present the case of a pure laparoscopic right hepatectomy for a giant hemangioma using an anterior approach. We achieved the informed consent with this patient and approved by the Ethics Committee of the Asan Medical Center. Giant hemangioma (13 × 11 × 14 cm) was located in right liver. After glissonean approach [5], Pringle maneuver was performed during the hepatic parenchymal transection. For the transection, the Cavitron Ultrasonic Surgical Aspirator was used. Small hepatic vein branches along the middle hepatic vein and small glissonean pedicles were sealed and divided with a THUNDERBEATTM (Olympus), which is the device with integration of both bipolar and ultrasonic energies delivered simultaneously. iDriveTM Ultra Powered Stapling device (Medtronic) was used for division of right glissonean pedicle and large hepatic veins. Hemangioma was removed through the lower abdominal transverse incision using the endo-bag. This technique has the advantage of avoiding excessive bleeding caused by avulsion of the hepatic vein and caval branches, iatrogenic tumor rupture [3]. By means of the anterior approach, pure laparoscopic right hepatectomy was performed successfully without intraoperative complications and transfusions. The operation time was 202 min, and the estimated blood loss was less than 150 ml. On postoperative day 3, computed tomographic scan showed no pathological findings. The patient was discharged on postoperative day 5 without complications. Laparoscopic approach has good results because of the view with magnification enabling meticulous hemostasis and the small wounds that give patients less pain [6, 7]. The authors recommend that the laparoscopic

  7. Hypophosphatemia after Right Hepatectomy for Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Kelly W Burak

    2004-01-01

    Full Text Available Hypophosphatemia has been described in patients undergoing right hepatectomy for liver cancer and in living donors for liver transplantation who also received total parenteral nutrition. At the study centre, significant hypophosphatemia (0.36 mmol/L or less requiring intravenous replacement was seen in two of the first nine living donors for adult-to-adult liver transplantation. To determine the frequency of hypophosphatemia in living donors, the authors obtained phosphate levels on stored serum samples from postoperative days 0, 1, 3 and 7 in all nine patients, none of whom were on total parenteral nutrition. Within the first week, hypophosphatemia developed in 55.6% of patients and phosphate levels returned to normal by day 7 in all nine patients. One patient had normal phosphate levels during the first week, but had profound hypophosphatemia (0.32 mmol/L on day 14 when he presented with a Staphylococcus aureus infection of a bile collection and significant hypoxemia. The extent of hepatectomy and the rate of liver regeneration, estimated by baseline and postoperative day 7 volumetric computed tomography scans, did not correlate with the development of hypophosphatemia. In conclusion, hypophosphatemia is common in living donors undergoing right hepatectomy and may be associated with complications. All living donors should be monitored for the development of hypophosphatemia during the first two postoperative weeks.

  8. Computed tomography in agenesis of the right lobe of the liver

    International Nuclear Information System (INIS)

    Demirci, A.; Diren, H.B.; Selcuk, M.B.

    1990-01-01

    Congenital agenesis of the right lobe of the liver is a rare anomaly. In a case report the diagnosis was made by computed tomography. A retro- or suprahepatic location of the gallbladder and compensatory hypertrophy of the left liver lobe and/or caudata lobe may give support to the diagnosis. Before diagnosing congenital agenesis of the lobe, lobar atrophy due to cirrhosis, cholangiocarcinoma or any other predisposing conditions should be eliminated. (orig.)

  9. Neocortical Temporal Lobe Epilepsy

    Science.gov (United States)

    Bercovici, Eduard; Kumar, Balagobal Santosh; Mirsattari, Seyed M.

    2012-01-01

    Complex partial seizures (CPSs) can present with various semiologies, while mesial temporal lobe epilepsy (mTLE) is a well-recognized cause of CPS, neocortical temporal lobe epilepsy (nTLE) albeit being less common is increasingly recognized as separate disease entity. Differentiating the two remains a challenge for epileptologists as many symptoms overlap due to reciprocal connections between the neocortical and the mesial temporal regions. Various studies have attempted to correctly localize the seizure focus in nTLE as patients with this disorder may benefit from surgery. While earlier work predicted poor outcomes in this population, recent work challenges those ideas yielding good outcomes in part due to better localization using improved anatomical and functional techniques. This paper provides a comprehensive review of the diagnostic workup, particularly the application of recent advances in electroencephalography and functional brain imaging, in neocortical temporal lobe epilepsy. PMID:22953057

  10. Changes in urinary taurine and hypotaurine excretion after two-thirds hepatectomy in the rat

    NARCIS (Netherlands)

    Brand, H. S.; Jörning, G. G.; Chamuleau, R. A.

    1998-01-01

    This study followed the time course of urinary taurine and hypotaurine excretion after two-thirds hepatectomy in rats. The excretion of both taurine and hypotaurine was elevated during 18 h following the hepatectomy, with maximal excretion during the first 6 h. Twelve and 24 h after partial

  11. Memory reorganization following anterior temporal lobe resection: a longitudinal functional MRI study.

    Science.gov (United States)

    Bonelli, Silvia B; Thompson, Pamela J; Yogarajah, Mahinda; Powell, Robert H W; Samson, Rebecca S; McEvoy, Andrew W; Symms, Mark R; Koepp, Matthias J; Duncan, John S

    2013-06-01

    Anterior temporal lobe resection controls seizures in 50-60% of patients with intractable temporal lobe epilepsy but may impair memory function, typically verbal memory following left, and visual memory following right anterior temporal lobe resection. Functional reorganization can occur within the ipsilateral and contralateral hemispheres. We investigated the reorganization of memory function in patients with temporal lobe epilepsy before and after left or right anterior temporal lobe resection and the efficiency of postoperative memory networks. We studied 46 patients with unilateral medial temporal lobe epilepsy (25/26 left hippocampal sclerosis, 16/20 right hippocampal sclerosis) before and after anterior temporal lobe resection on a 3 T General Electric magnetic resonance imaging scanner. All subjects had neuropsychological testing and performed a functional magnetic resonance imaging memory encoding paradigm for words, pictures and faces, testing verbal and visual memory in a single scanning session, preoperatively and again 4 months after surgery. Event-related analysis revealed that patients with left temporal lobe epilepsy had greater activation in the left posterior medial temporal lobe when successfully encoding words postoperatively than preoperatively. Greater pre- than postoperative activation in the ipsilateral posterior medial temporal lobe for encoding words correlated with better verbal memory outcome after left anterior temporal lobe resection. In contrast, greater postoperative than preoperative activation in the ipsilateral posterior medial temporal lobe correlated with worse postoperative verbal memory performance. These postoperative effects were not observed for visual memory function after right anterior temporal lobe resection. Our findings provide evidence for effective preoperative reorganization of verbal memory function to the ipsilateral posterior medial temporal lobe due to the underlying disease, suggesting that it is the capacity

  12. Enhanced Recovery via Peripheral Nerve Block for Open Hepatectomy.

    Science.gov (United States)

    Thornblade, Lucas W; Seo, Yongwoo D; Kwan, Tracy; Cardoso, Jane H; Pan, Eric; Dembo, Gregory; Yeung, Raymond S W; Park, James O

    2018-02-05

    Enhanced recovery after surgery (ERAS) protocols are now commonplace in many fields of surgery, but only limited data exists for their use in hepatobiliary surgery. We implemented standardized ERAS protocols for all open hepatectomies and replaced thoracic epidurals with a transversus abdominis plane (TAP) block. We performed a retrospective cohort study of all patients undergoing open hepatectomy during the 14 months before and 19 months after implementation of an ERAS protocol at our institution (January 2014-September 2016). Trained abstractors reviewed charts for patient demographics, perioperative details, and healthcare utilization. All nursing-reported visual analog scale pain scores were sampled to identify patients with uncontrolled pain (daily mean score > 5). Outcomes included length of stay (LOS), costs, and 30-day readmission. A total of 127 patients (mean age 54.6 ± 13.0 years, 44% female) underwent open liver resection (69 [54%] after ERAS implementation). ERAS protocols were associated with significantly lower rates of ICU admission (47 vs. 13%, p < 0.001), shorter LOS (median 5.3 vs. 4.3 days, p = 0.007), and lower median costs ($3566 less, p = 0.03). Readmission remained low throughout the study period (5% pre-ERAS, 4% during ERAS, p = 0.83). Rates of uncontrolled pain were either the same or better after ERAS implementation through post-operative day #3 (41% pre-ERAS, 23% during ERAS, p = 0.03). The use of TAP block for hepatectomy as part of an ERAS protocol is associated with improved quality and cost of care. Surgeons performing liver resections should consider standardization of evidence-based best practices in all patients.

  13. Sirolimus influence on hepatectomy-induced liver regeneration in rats

    Directory of Open Access Journals (Sweden)

    Edimar Leandro Toderke

    Full Text Available OBJECTIVE: To evaluate the influence of sirolimus on liver regeneration triggered by resection of 70% of the liver of adult rats. METHODS: we used 40 Wistar rats randomly divided into two groups (study and control, each group was divided into two equal subgroups according to the day of death (24 hours and seven days. Sirolimus was administered at a dose of 1mg/kg in the study group and the control group was given 1 ml of saline. The solutions were administered daily since three days before hepatectomy till the rats death to removal of the regenerated liver, conducted in 24 hours or 7 days after hepatectomy. Liver regeneration was measured by the KWON formula, by thenumber of mitotic figures (hematoxylin-eosin staining and by the immunohistochemical markers PCNA and Ki-67. RESULTS: there was a statistically significant difference between the 24h and the 7d groups. When comparing the study and control groups in the same period, there was a statistically significant variation only for Ki-67, in which there were increased numbers of hepatocytes in cell multiplication in the 7d study group compared with the 7d control group (p = 0.04. CONCLUSION: there was no negative influence of sirolimus in liver regeneration and there was a positive partial effect at immunohistochemistry with Ki-67.

  14. Mesial frontal lobe epilepsy.

    Science.gov (United States)

    Unnwongse, Kanjana; Wehner, Tim; Foldvary-Schaefer, Nancy

    2012-10-01

    Mesial frontal lobe epilepsies can be divided into epilepsies arising from the anterior cingulate gyrus and those of the supplementary sensorimotor area. They provide diagnostic challenges because they often lack lateralizing or localizing features on clinical semiology and interictal and ictal scalp electroencephalographic (EEG) recordings. A number of unique semiologic features have been described over the last decade in patients with mesial frontal lobe epilepsy (FLE). There are few reports of applying advanced neurophysiologic techniques such as electrical source imaging, magnetoencephalography, EEG/functional magnetic resonance imaging, or analysis of high-frequency oscillations in patients with mesial FLE. Despite these diagnostic challenges, it seems that patients with mesial FLE benefit from epilepsy surgery to the same extent or even better than patients with FLE do, as a whole.

  15. Nitrogen Metabolism During Hepatectomy and Hyperbaric Oxygenation: Experimental Study

    Directory of Open Access Journals (Sweden)

    P. N. Savilov

    2007-01-01

    Full Text Available Objective: to examine nitrogen metabolism in the organs of the portal system during liver resection (LR and hyperbaric oxygenation (HBO.Material and methods: Experiments were conducted on 65 female albino rats. LR was made under ether anesthesia, by removing a portion of the left hepatic lobe with an electric knife, which amounted to 15—20% of the organ’s mass. HBO was performed using medical oxygen at 3 ata for 50 min once daily within the first three days after LR. Lung tissue, gastrointestinal tract (GIT, spleen, and choledochal bile were the subject of the study. The tissue and blood levels of ammonia, glutamine, and urea were measured.Results: LR leads to pathological ammonia accumulation and decreases arterial glutamine consumption in GIT organs. Concurrently, the urea contained in the organs begins to come into portal blood flow, splenic glutamine deficiency develops, and hepatic ammonia-absorptive, glutamine- and urea-excretory functions diminish. Post-LR HBO prevents the accumulation of ammonia in the liver and GIT, restores the ammonia-absorptive, glutamine- and urea-excretory functions of the liver, and stimulates its glutamine and urea accumulation. Concomitantly, under HBO, there is an increase in glutamine entrance from the GIT into blood flow, but there is a decrease in GIT urea excretion and portal venous blood ammonia levels. HBO eliminates arterial hyperammonemia after LR and splenic glutamine deficiency.Conclusion: Hyperbaric oxygen eliminates nitrogen metabolic disturbances in the portal system, regulates compensatory-adaptive ammonia metabolic reactions triggered in the GIT and spleen during LR. 

  16. Dorsolateral frontal lobe epilepsy.

    Science.gov (United States)

    Lee, Ricky W; Worrell, Greg A

    2012-10-01

    Dorsolateral frontal lobe seizures often present as a diagnostic challenge. The diverse semiologies may not produce lateralizing or localizing signs and can appear bizarre and suggest psychogenic events. Unfortunately, scalp electroencephalographic (EEG) and magnetic resonance imaging (MRI) are often unsatisfactory. It is not uncommon that these traditional diagnostic studies are either unhelpful or even misleading. In some cases, SPECT and positron emission tomography imaging can be an effective tool to identify the origin of seizures. However, these techniques and other emerging techniques all have limitations, and new approaches are needed to improve source localization.

  17. Balance between von Willebrand factor and ADAMTS13 following major partial hepatectomy

    NARCIS (Netherlands)

    Groeneveld, D J; Alkozai, E M; Adelmeijer, J; Porte, R J; Lisman, T

    BACKGROUND: Conventional coagulation tests are frequently prolonged after liver surgery, suggesting a postoperative bleeding tendency. At the same time, thrombotic complications following partial hepatectomy (PH) are not uncommon. Little is known about changes in the platelet adhesive protein von

  18. Radiation therapy for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Otsuka, Masaaki; Ohara, Kiyosi; Takada, Yasutsugu; Ueda, Takanori; Murata, Souichirou; Ushijima, Ryou; Adachi, Shinya; Todoroki, Takesi

    2003-01-01

    The intrahepatic recurrence rate after curative hepatectomy for hepatocellular carcinoma (HCC) is high, and management of recurrence is thus important for long-term survival. The use of radiation therapy has been relatively uncommon in the treatment of recurrent HCC. Eight patients underwent radiation therapy for recurrent HCC 12-98 months after hepatectomy. Five of them were treated with protons (250 MeV; 68.8-84.5 Gy), and three were treated with X-rays (6 MV; 60 or 70 Gy). One patient received radiation therapy twice for another lesion with a 79-month interval. The target tumors were 1.2-4.5 cm. All patients also underwent transcatheter arterial embolization or other regional therapy. Although transient ascites was found in three patients after radiation therapy, no patient died as a result of the irradiation. Seven patients died 9 months to 4 years (median 1 year 6 months) after radiation therapy. Re-recurrence was observed in the irradiated liver in two patients (local control 78%). Four patients died of lung metastasis after radiation therapy. The median survival time was 3 years 3 months (range 1 year 1 month to 8 years 6 months) after recurrence. Multimodality therapy is necessary for the management of recurrence. Radiation therapy could be beneficial when other therapies present some difficulty regarding application or are performed incompletely. It must be emphasized that radiation therapy should be considered in addition to other regional therapies for the treatment of recurrent or re-recurrent HCC, and that radiation therapy can be repeated in selected patients. (author)

  19. [Evaluation of hepatic gluconeogenesis by intravenous L-alanine tolerance test after major hepatectomy].

    Science.gov (United States)

    Miyagi, N

    1989-11-01

    The response of glucose, insulin and glucagon to L-alanine tolerance test (0.5 g/kg, intravenously, A.T.T.) was examined in dogs following hepatectomy. Before A.T.T., dogs were starved for 24 hours after antecedent carbohydrate-free diets. Under this condition, hepatic glycogen and blood glucose were 0.5 +/- 0.2 mg/g liver and 85 +/- 11.9 mg/dl, respectively. The marked response of blood glucose to alanine tolerance test was observed and the maximal increment above the basal level was 47 +/- 5.2 mg/dl at 30 minutes after A.T.T. One week after 44% and 70% hepatectomy, the increments of glucose at 30 minutes after A.T.T. were 58% and 24% respectively, as compared with those before hepatectomy. These results suggest that the glucose response to alanine tolerance is useful for an index of functional reserve of glucose production in the remnant liver after hepatectomy. The increments of blood glucose at 30 minutes after A.T.T. 1, 2, 3 and 4 weeks after 70% hepatectomy were 24.0, 21.8, 52.7 and 80% of that before hepatectomy respectively. The insulin response to alanine tolerance gave two peaks at 2.5 min and 30 min and the latter peak was dependent on the blood glucose response before and after hepatectomy. One or two weeks after 70% hepatectomy, the exaggerated glucagon response to alanine tolerance was observed. These results suggest that A.T.T. is not only an excellent index of functional reserve of hepatic gluconeogenesis, but also is an appropriate method for investigation of the relation between endogenous glucose production and endocrine pancreas.

  20. Clinical effect of a positive surgical margin after hepatectomy on survival of patients with intrahepatic cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Yeh CN

    2014-12-01

    Full Text Available Chun-Nan Yeh,1 Feng-Jen Hsieh,1 Kun-Chun Chiang,1 Jen-Shi Chen,2 Ta-Sen Yeh,1 Yi-Yin Jan,1 Miin-Fu Chen1 1Department of General Surgery, 2Department of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan Background: Several unfavorable prognostic factors have been proposed for peripheral cholangiocarcinoma (PCC in patients undergoing hepatectomy, including gross type of tumor, vascular invasion, lymph node metastasis, a high carbohydrate antigen 19-9 level, and a positive resection margin. However, the clinical effect of a positive surgical margin on the survival of patients with PCC after hepatectomy still needs to be clarified due to conflicting results. Methods: A total of 224 PCC patients who underwent hepatic resection with curative intent between 1977 and 2007 were retrospectively reviewed. Eighty-nine patients had a positive resection margin, with 62 having a microscopically positive margin and 27 a grossly positive margin (R2. The clinicopathological features, outcomes, and recurrence pattern were compared with patients with curative hepatectomy. Results: PCC patients with hepatolithiasis, periductal infiltrative or periductal infiltrative mixed with mass-forming growth, higher T stage, and more advanced stage tended to have higher positive resection margin rates after hepatectomy. PCC patients who underwent curative hepatectomy had a significantly higher survival rate than did those with a positive surgical margin. When PCC patients underwent hepatectomy with a positive resection margin, the histological grade of the tumor, nodal positivity, and chemotherapy significantly affected overall survival. Locoregional recurrence was the most common pattern of recurrence. Conclusion: A positive resection margin had an unfavorable effect on overall survival in PCC patients undergoing hepatectomy. In these patients, the prognosis was determined by the biology of the tumor, including differentiation and nodal

  1. Portal Vein Embolization before Right Hepatectomy: Improved Results Using n-Butyl-Cyanoacrylate Compared to Microparticles Plus Coils

    Energy Technology Data Exchange (ETDEWEB)

    Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Bize, Pierre; Gunthern, Daniel [Centre Hospitalo-Univeristaire Vaudois, Digestive and Oncologic Imaging and Interventional Radiology Unit, Department of Radiology and Interventional Radiology (Switzerland); Demartines, Nicolas; Halkic, Nermin [Centre Hospitalo-Univeristaire Vaudois, Department of Visceral Surgery (Switzerland); Denys, Alban [Centre Hospitalo-Univeristaire Vaudois, Digestive and Oncologic Imaging and Interventional Radiology Unit, Department of Radiology and Interventional Radiology (Switzerland)

    2013-10-15

    Background: There is currently no consensus in the literature on which embolic agent induces the greatest degree of liver hypertrophy after portal vein embolization (PVE). Only experimental results in a pig model have demonstrated an advantage of n-butyl-cyanoacrylate (NBCA) over 3 other embolic materials (hydrophilic gel, small and large polyvinyl alcohol particles) for PVE. Therefore, the aim of this human study was to retrospectively compare the results of PVE using NBCA with those using spherical microparticles plus coils. Methods: A total of 34 patients underwent PVE using either NBCA (n = 20), or spherical microparticles plus coils (n = 14). PVE was decided according to preoperative volumetry on the basis of contrast-enhanced CT. Groups were compared for age, sex, volume of the left lobe before PVE and future remnant liver ratio (FRL) (volume of the left lobe/total liver volume - tumor volume). The primary end point was the increase in left lobe volume 1 month after PVE. Secondary end points were procedure complications and biological tolerance. Results: Both groups were similar in terms of age, sex ratio, left lobe volume, and FRL before PVE. NBCA induced a greater increase in volume after PVE than did microparticles plus coils (respectively, +74 {+-} 69 % and +23 {+-} 14 %, p < 0.05). The amount of contrast medium used for the procedure was significantly larger when microparticles and coils rather than NBCA were used (respectively, 264 {+-} 43 ml and 162 {+-} 34 ml, p < 0.01). The rate of PVE complications as well as the biological tolerance was similar in both groups. Conclusion: NBCA seems more effective than spherical microparticles plus coils to induce left-lobe hypertrophy.

  2. Bi‑lobed Perirectal Epidermoid Cyst: An Unusual Cause of ...

    African Journals Online (AJOL)

    tumor markers were unremarkable. Pelvic magnetic resonance imaging (MRI) showed a. 7.5 cm × 5 cm × 6 cm homogenous bi‑lobed cystic mass in the pelvis adherent to the left lateral wall of the rectum and posteriorly to the sacrum with a displacement of the rectum anteriorly and to the right. There was no pelvic sidewall ...

  3. Temporal lobe epilepsy semiology.

    Science.gov (United States)

    Blair, Robert D G

    2012-01-01

    Epilepsy represents a multifaceted group of disorders divided into two broad categories, partial and generalized, based on the seizure onset zone. The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies such as MRI, fMRI, FDG-PET, MEG, or invasive intracranial EEG recording. Temporal lobe epilepsy (TLE) is the commonest form of focal epilepsy and represents almost 2/3 of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone.

  4. Altered structural connectome in temporal lobe epilepsy.

    Science.gov (United States)

    DeSalvo, Matthew N; Douw, Linda; Tanaka, Naoaki; Reinsberger, Claus; Stufflebeam, Steven M

    2014-03-01

    To study differences in the whole-brain structural connectomes of patients with left temporal lobe epilepsy (TLE) and healthy control subjects. This study was approved by the institutional review board, and all individuals gave signed informed consent. Sixty-direction diffusion-tensor imaging and magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) magnetic resonance imaging volumes were analyzed in 24 patients with left TLE and in 24 healthy control subjects. MP-RAGE volumes were segmented into 1015 regions of interest (ROIs) spanning the entire brain. Deterministic white matter tractography was performed after voxelwise tensor calculation. Weighted structural connectivity matrices were generated by using the pairwise density of connecting fibers between ROIs. Graph theoretical measures of connectivity networks were compared between groups by using linear models with permutation testing. Patients with TLE had 22%-45% reduced (P < .01) distant connectivity in the medial orbitofrontal cortex, temporal cortex, posterior cingulate cortex, and precuneus, compared with that in healthy subjects. However, local connectivity, as measured by means of network efficiency, was increased by 85%-270% (P < .01) in the medial and lateral frontal cortices, insular cortex, posterior cingulate cortex, precuneus, and occipital cortex in patients with TLE as compared with healthy subjects. This study suggests that TLE involves altered structural connectivity in a network that reaches beyond the temporal lobe, especially in the default mode network.

  5. Giant lipoma arising from deep lobe of the parotid gland

    Directory of Open Access Journals (Sweden)

    Hsu Ying-Che

    2006-06-01

    Full Text Available Abstract Background Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. Case presentation A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 × 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. Conclusion Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result.

  6. Cognitive Functioning in Temporal Lobe Epilepsy: A BOLD-fMRI Study.

    Science.gov (United States)

    Guo, Lili; Bai, Genji; Zhang, Hui; Lu, Daoyan; Zheng, Jiyong; Xu, Gang

    2017-12-01

    We aimed to analyze the association between resting-state functional magnetic resonance imaging (re-fMRI) and cognitive function (including language, executive, and memory functions) in temporal lobe epilepsy (TLE) patients, which will help to explore the mechanism of brain function in patients. 15 TLE patients and 15 non-TLE patients were recruited. All subjects underwent neuropsychological testing and memory functional evaluation. Changes in verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), full intelligence quotient (FIQ), and memory quotient (MQ) were compared between two groups. Re-fMRI data were also collected from two groups to evaluate these changes. Each individual score of neuropsychological testing and memory functional evaluation were higher in control group, which was statistically different (all P temporal gyrus back, right superior temporal gyrus, left cerebellum, left angular gyrus, left wedge anterior lobe, and left central back; while the negatively activated brain regions were left prefrontal, right cerebellum, right corner back, and right anterior cingulate gyrus. During the language task, the activated brain regions of the TLE patients were right prefrontal lobe, the lateral temporal gyri, the left cerebellum, left cornu laterale gyrus, left precuneus, and the left postcentral gyrus, whereas the negatively activated brain areas were the left prefrontal cortex, the right cerebellum, right cornu laterale gyrus, and the right anterior cingulate gyrus. During the executive task, epilepsy patients showed activation difference in right prefrontal and right frontal lobe and right brain, left superior temporal gyrus, and right cerebellum anterior lobe compared with the control group; no negatively activated differences in brain areas. During the memory task, the difference lay in bilateral anterior cingulate gyrus and bilateral wedge anterior lobe while the negatively activated brain areas were the left inferior frontal

  7. Massive Temporal Lobe Cholesteatoma

    Directory of Open Access Journals (Sweden)

    Pasan Waidyasekara

    2015-01-01

    Full Text Available Introduction. Intracranial extension of cholesteatoma is rare. This may occur de novo or recur some time later either contiguous with or separate to the site of the original cholesteatoma. Presentation of Case. A 63-year-old female presented to a tertiary referral hospital with a fluctuating level of consciousness, fever, headache, and right-sided otorrhoea, progressing over several days. Her past medical history included surgery for right ear cholesteatoma and drainage of intracranial abscess 23 years priorly. There had been no relevant symptoms in the interim until 6 weeks prior to this presentation. Imaging demonstrated a large right temporal lobe mass contiguous with the middle ear and mastoid cavity with features consistent with cholesteatoma. The patient underwent a combined transmastoid/middle fossa approach for removal of the cholesteatoma and repair of the tegmen dehiscence. The patient made an uneventful recovery and remains well over 12 months later. Conclusion. This case presentation details a large intracranial cholesteatoma which had extended through a tegmen tympani dehiscence from recurrent right ear cholesteatoma treated by modified radical mastoidectomy over two decades priorly. There was a completely asymptomatic progression of disease until several weeks prior to this presentation.

  8. Usefulness of Pure Laparoscopic Hepatectomy for Hepatocellular Carcinoma in a Severely Cirrhotic Patient

    Directory of Open Access Journals (Sweden)

    Isamu Hosokawa

    2013-07-01

    Full Text Available The number of patients undergoing laparoscopic hepatectomy has rapidly increased in recent years, and indications for this procedure are gradually expanding. Pure laparoscopic hepatectomy is reportedly useful in cases with severe liver cirrhosis. A 55-year-old woman under observation for liver cirrhosis was found to have hepatocellular carcinoma in liver segment III and was referred to our hospital for surgery. The tumor was located in the edge of liver segment III, where percutaneous ablation therapy was unsuitable. Since her hepatic functional reserve was poor, pure laparoscopic partial hepatectomy was performed. The postoperative course was favorable, with no ascites retention, edema or weight gain. The greatest advantage of pure laparoscopic hepatectomy for hepatocellular carcinoma with concomitant liver cirrhosis is that postoperative ascites retention is minimal, meaning that there is little risk of water-electrolyte imbalance associated with ascites retention or hypoproteinemia. This is believed to be because the abdominal incision is small and mobilization of the liver is minimized, reducing the destruction of the routes of collateral lymph flow and blood flow generated in patients with liver cirrhosis. Pure laparoscopic hepatectomy may be a treatment choice for patients with hepatocellular carcinoma and concomitant severe liver cirrhosis.

  9. Single-port laparoscopic approach of the left liver: initial experience.

    Science.gov (United States)

    Camps Lasa, Judith; Cugat Andorrà, Esteban; Herrero Fonollosa, Eric; García Domingo, María Isabel; Sánchez Martínez, Raquel; Vargas Pierola, Harold; Rodríguez Campos, Aurora

    2014-11-01

    New technological advances have enabled the development of single-port laparoscopic surgery. This approach began with cholecystectomy and subsequently with other abdominal surgeries. However, few publications on laparoscopic liver surgery have described the use of complete single-port access. We present our initial experience of a single-port laparoscopic hepatectomy. Between May 2012 and December 2013, 5 single-port laparoscopic hepatectomies were performed: one for benign disease and four for colorectal liver metastases. The lesions were approached through a 3-5 cm right supraumbilical incision using a single-port access device. All the lesions were located in hepatic segments II or III. Four left lateral sectorectomies and one left hepatectomy were performed. Median operative time was 135 min. No cases were converted to conventional laparoscopic or open surgery. The oral intake began at 18 h. There were no postoperative complications and no patients required blood transfusion. The median hospital stay was 3 days. The degree of satisfaction was very good in 4 cases and good in one. Patients resumed their normal daily activities at 8 days. Single-port laparoscopic hepatectomy is safe and feasible in selected cases and may reduce surgical aggression and offer better cosmetic results. Comparative studies are needed to determine the real advantages of this approach. Copyright © 2014 AEC. Published by Elsevier Espana. All rights reserved.

  10. Tight Left Upper Lobe Collapse from Lung Cancer

    Science.gov (United States)

    2010-07-01

    tight pulmonary lobar collapse. Summary of Imaging Findings An 83-year-old male smoker with history of COPD on 2L home oxygen presented to...appendage.” Recent prior spirometry was noted to have “decreased FEV1 and FEV1/FVC ratio with hyperbolic expiratory limb of the flow-volume loop...when assessing lobar collapse in adults and smokers . 1 In young adults (less than age 40), endobronchial carcinoid tumor is common. In post

  11. Splenic simulation by left hepatic lobe following splenectomy

    International Nuclear Information System (INIS)

    Noel, A.; Harbert, J.C.

    1984-01-01

    Remodeling of the liver following splenectomy may simulate hypertrophy of an accessory spleen on sulfur colloid scans. Two patients are reported. In one case splenic simulation is attributed to unusual hepatic scarring confirmed at autopsy. In the second the unusual configuration appears to have been caused by molding of the liver. The clinician should be aware of possible splenic simulation in postsplenectomy patients suspected of hypersplenism

  12. Does mesenchymal stem cell improve the liver regeneration after the 70% hepatectomy?

    Science.gov (United States)

    Alves, Ana Karina Soares; Lanzoni, Valéria; Fuziy, Rogério Aoki; Franco, Rita Maria Aparecida Monteiro Moura; Maeda, Carlos Toshinori; Lopes, Gaspar de Jesus; Linhares, Marcelo Moura

    2017-07-01

    To evaluate the effects of mesenchymal stem cells on liver regeneration in rats following a 70% hepatectomy. Forty rats were subjected to 70% hepatectomy and then ~106 mesenchymal stem cells (test group), or saline solution (control group), were infused into their livers via the portal vein. Each treatment group was divided into early and late subgroups (euthanized 3 d and 5 d following the operation, respectively). Group comparisons of Albumin, aminotransaminases (AST, ALT), and Alcaline Phosphatase (AP) levels, proliferative index (ki-67+ straining), and mitotic cell counts were conducted. No significant differences in liver regeneration rate, number of mitoses, proliferative index, or serum levels of albumin, AST, or AP were observed. ALT levels were higher in the test group than in the control group (p<.05). Mesenchymal stem-cell therapy did not improve liver regeneration rate 3 d or 5 d after 70% hepatectomy in rats. Likewise, the therapy appeared not to affect liver function, proliferative index, or number of mitoses significantly.

  13. Arterial supply of the thoracic lobes of the thymus in dogs of the Great Dane race.

    Directory of Open Access Journals (Sweden)

    Rosana Marques Silva

    2007-09-01

    Full Text Available The origins, numbers and type of arterial branches responsible for the blood supply of thoracic lobes of the thymus were studied in 28 stillborn dogs of the Great Dane, of which 18 were males and 10 were females. The arterial systems of these animals were filled with aqueous solution of Neoprene Latex “450”, 50%. After, the specimens were fixed in 10% formaldehyde aqueous solution. The lobes of the thymus were supplied by direct or indirect arterial branches coming from the right and left internal thoracic arteries, pericardiacophrenicas arteries, right and left costocervicais trunks, and left subclavian artery. The left subclavian artery and brachiocephalic trunk emitted direct branches towards the left thoracic lobe of the thymus.

  14. The Safety and Feasibility of Three-Dimensional Visualization Technology Assisted Right Posterior Lobe Allied with Part of V and VIII Sectionectomy for Right Hepatic Malignancy Therapy.

    Science.gov (United States)

    Hu, Min; Hu, Haoyu; Cai, Wei; Mo, Zhikang; Xiang, Nan; Yang, Jian; Fang, Chihua

    2017-11-27

    Hepatectomy is the optimal method for liver cancer; the virtual liver resection based on three-dimensional visualization technology (3-DVT) could provide better preoperative strategy for surgeon. We aim to introduce right posterior lobe allied with part of V and VIII sectionectomy assisted by 3-DVT as a promising treatment for massive or multiple right hepatic malignancies to retain maximum residual liver volume on the basis of R0 resection. Among 126 consecutive patients who underwent hepatectomy, 9 (7%) underwent right posterior lobe allied with part of V and VIII sectionectomy. 21 (17%) underwent right hemihepatectomy (RH). The virtual RH was performed with 3-DVT, which provided better observation of spatial position relationship between tumor and vessels, and the more accurate estimation of the remnant liver volume. If remnant liver volume was transfusion, operation length, liver function, and postoperative complications, were similar between two groups before and after propensity matching. The postoperative first, third, fifth, and seventh days mean value of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), and total bilirubin had no significant difference compared with preoperative value. One patient in each group had recurrence six months after surgery. Right posterior lobe allied with part of V and VIII sectionectomy based on 3-DVT is safe and feasible surgery way, and can be a very promising method in massive or multiple right hepatic malignancy therapy.

  15. Outcome after hepatectomy-delirium as an independent predictor for mortality.

    Science.gov (United States)

    Veiga, Dalila; Luís, Clara; Parente, Daniela; Abelha, Fernando

    2013-02-02

    Most studies that follow up hepatectomy cases are limited in scope to an investigation of mortality and morbidity rates or the costs and length of hospital stay. In this study the authors aimed to characterize the quality of life and to evaluate mortality and its determinants after hepatectomy. This prospective study was carried in a Post-Anaesthesia Care Unit (PACU) over 15 months, and 70 patients submitted to hepatectomy were enrolled. Demographic and peri-operative characteristics were evaluated for associations with mortality. At admission and 6 months after discharge, patients completed a Short Form-36 questionnaire (SF-36) and have their independence in Activities of Daily Living (ADL) was evaluated. Binary and multiple logistic regression analyses were used to evaluate of associations with mortality, and the Wilcoxon signed rank test was used to compare SF-36 scores before and after 6 months after hepatectomy. The mortality rate was 19% at 6 months. Multivariate analysis identified postoperative delirium as an independent determinant for mortality. Six months after discharge, 46% patients stated that their health in general was better or much better than that 1 year previously. Six months after hepatectomy, patients had worse scores in the physical function domain of SF-36; however, scores for all the other domains did not differ. At this time point, patients were more dependent in instrumental ADL than before surgery (32% versus 7%, p = 0.027). This study identified postoperative delirium as an independent risk factor for mortality 6 months after hepatectomy. After 6 months, survivors were more dependent in instrumental ADL tasks and had worse scores in the physical function domain of SF-36.

  16. Predictors of Safety and Efficacy of 2-Stage Hepatectomy for Bilateral Colorectal Liver Metastases

    Science.gov (United States)

    Passot, Guillaume; Chun, Yun Shin; Kopetz, Scott E; Zorzi, Daria; Brudvik, Kristoffer Watten; Kim, Bradford J; Conrad, Claudius; Aloia, Thomas A; Vauthey, Jean-Nicolas

    2016-01-01

    Background In patients with bilateral colorectal liver metastases (CLM) not resectable in one operation, 2-stage hepatectomy is the standard surgical approach. The objective of this study was to determine factors associated with safety and efficacy of 2-stage hepatectomy. Study Design The study included all 109 patients for whom two-stage hepatectomy for CLM was planned during 2003-2014. RAS mutation status and other clinicopathologic factors were evaluated for association with major complications and survival using multivariate analysis. Results Two-stage hepatectomy was completed in 89 of 109 patients (82%). Reasons for dropout after first stage were disease progression (n=12), insufficient liver growth (n=5), and complications after first stage or portal vein embolization (n=3). More than six cycles of preoperative chemotherapy were associated with failure to proceed to second stage (p=0.009). Rates of major complications (26% vs. 6%; p<0.001) and 90-day mortality (7% vs. 0%; p=0.006) were higher after second stage. The cumulative rate of major complications was 15% (n=29). Factors independently associated with major complications were rectal primary tumor, metachronous CLM, and more than one lesion resected at first stage. At median follow-up of 29.5 months, 3-year (68% vs. 6%; p<0.001) and 5-year overall survival rates (49% vs. 0%; p<0.001) were better after two-stage hepatectomy completion than noncompletion. Factors independently associated with poor overall survival were rectal primary tumor (p=0.044), more than five CLM (p=0.043), need for chemotherapy after first stage (p=0.046), and RAS mutation (p<0.001). Conclusions RAS mutation independently predicts the oncologic efficacy of two-stage hepatectomy and may help guide patient selection for this aggressive surgical strategy. PMID:26968325

  17. Synchronous splenectomy and hepatectomy for patients with hepatocellular carcinoma and hypersplenism: A case-control study

    Science.gov (United States)

    Zhang, Xiao-Yun; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin; Wang, Wen-Tao; Jiang, Li

    2015-01-01

    AIM: To investigate whether the use of synchronous hepatectomy and splenectomy (HS) is more effective than hepatectomy alone (HA) for patients with hepatocellular carcinoma (HCC) and hypersplenism. METHODS: From January 2007 to March 2013, 84 consecutive patients with HCC and hypersplenism who underwent synchronous hepatectomy and splenectomy in our center were compared with 84 well-matched patients from a pool of 268 patients who underwent hepatectomy alone. The short-term and long-term outcomes of the two groups were analyzed and compared. RESULTS: The mean time to recurrence was 21.11 ± 12.04 mo in the HS group and 11.23 ± 8.73 mo in the HA group, and these values were significantly different (P = 0.001). The 1-, 3-, 5-, and 7-year disease-free survival rates for the patients in the HS group and the HA group were 86.7%, 70.9%, 52.7%, and 45.9% and 88.1%, 59.4%, 43.3%, and 39.5%, respectively (P = 0.008). Platelet and white blood cell counts in the HS group were significantly increased compared with the HA group one day, one week, one month and one year postoperatively (P Splenectomy and micro-vascular invasion were significant independent prognostic factors for disease-free survival. Gender, tumor number, and recurrence were independent prognostic factors for overall survival. CONCLUSION: Synchronous hepatectomy and hepatectomy potentially improves disease-free survival rates and alleviates hypersplenism without increasing the surgical risks for patients with HCC and hypersplenism. PMID:25741142

  18. Preoperative amygdala fMRI in temporal lobe epilepsy.

    Science.gov (United States)

    Bonelli, Silvia B; Powell, Robert; Yogarajah, Mahinda; Thompson, Pamela J; Symms, Mark R; Koepp, Matthias J; Duncan, John S

    2009-02-01

    Anterior temporal lobe resections (ATLR) benefit 70% of patients with refractory mesial temporal lobe epilepsy (TLE), but may be complicated by emotional disturbances. We used functional magnetic resonance imaging (fMRI) to investigate the role of the amygdala in processing emotions in TLE and whether this may be a potential preoperative predictive marker for emotional disturbances following surgery. We studied 54 patients with refractory mesial TLE due to hippocampal sclerosis (28 right, 26 left) and 21 healthy controls using a memory encoding fMRI paradigm, which included viewing fearful and neutral faces. Twenty-one TLE patients (10 left, 11 right) subsequently underwent ATLR. Anxiety and depression were assessed preoperatively and 4 months postoperatively using the Hospital Anxiety and Depression Scale. On viewing fearful faces, healthy controls demonstrated left lateralized, while right TLE patients showed bilateral amygdala activation. Left TLE patients had significantly reduced activation in left and right amygdalae compared to controls and right TLE patients. In right TLE patients, left and right amygdala activation was significantly related to preoperative anxiety and depression levels, and preoperative right amygdala activation correlated significantly with postoperative change of anxiety and depression scores, characterized by greater increases in anxiety and depression in patients with greater preoperative activation. No such correlations were seen for left TLE patients. The fearful face fMRI paradigm is a reliable method for visualizing amygdala activation in controls and patients with mesial TLE. Activation of the right amygdala preoperatively was predictive of emotional disturbances following right ATLR.

  19. Late bilateral temporal lobe necrosis after conventional radiotherapy. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, Michio; Hayashi, Toshiyuki; Kagami, Hiroshi; Murase, Ikurou; Nakatsukasa, Masashi [Saiseikai Utsunomiya Hospital (Japan)

    2003-04-01

    A 63-year-old woman presented with radionecrosis in the bilateral temporal lobes manifesting as dementia about 30 years after undergoing conventional radiotherapy for pituitary adenoma. Computed tomography and magnetic resonance (MR) imaging showed edema and cystic lesions in both temporal lobes. The mass in the left temporal lobe was excised. MR imaging 12 days after surgery showed reduced edema. Her dementia had improved. Radionecrosis usually occurs between several months and a few years after radiotherapy. The incidence of radionecrosis is estimated as 5%, but may be higher with longer follow-up periods. Clinical reports have suggested that larger total doses of radiation are associated with earlier onset of delayed necrosis and the fractional dose is the most significant factor causing cerebral radionecrosis. Radionecrosis can occur long after conventional radiotherapy or stereotactic radiosurgery using a linac-based system or a gamma knife unit. (author)

  20. Partial Hepatectomy for the Resistant Fasciola Hepatica Infection in a Child

    Science.gov (United States)

    S, Kanık Yüksek; H, Tezer; A, Özkaya Parlakay; B, Dalgıç; A, Dalgıç; G, Yilmaz

    2015-01-01

    Fascioliasis is an emerging and important chronic parasitic disease caused by two trematode liver fluke species: Fasciola hepatica (F. hepatica) and Fasciola gigantica (F. gigantica) infecting several herbivorous mammals including cattle, goats, sheep, and humans. We report a 9-year-old girl who suffered from F. hepatica infection and underwent right hepatectomy because of increasing abdominal pain resistant to anthelmintic chemotherapy. When anthelmintic drug treatment is not effective and abdominal pain persists, surgical resection including hepatectomy should be kept in mind for resistant F. hepatica infection. PMID:26623254

  1. Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery.

    Science.gov (United States)

    Tayar, Claude; Claude, Tayar; Subar, Daren; Daren, Subar; Salloum, Chady; Chady, Salloum; Malek, Alexandre; Alexandre, Malek; Laurent, Alexis; Alexis, Laurent; Azoulay, Daniel; Daniel, Azoulay

    2014-01-01

    Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS) has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH). From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure™ (Covidien-Valleylab. Boulder. USA), Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.). Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min) and the mean estimated blood loss was 57 ml (range: 25-150 ml). The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days). Pathology identified three benign and four malignant liver tumours with clear margins. SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.

  2. Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

    Directory of Open Access Journals (Sweden)

    Tayar Claude

    2014-01-01

    Full Text Available Background: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH. Patients and Methods: From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure TM (Covidien-Valleylab. Boulder. USA, Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.. Results: Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min and the mean estimated blood loss was 57 ml (range: 25-150 ml. The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days. Pathology identified three benign and four malignant liver tumours with clear margins. Conclusion: SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.

  3. Impairments in proverb interpretation following focal frontal lobe lesions☆

    Science.gov (United States)

    Murphy, Patrick; Shallice, Tim; Robinson, Gail; MacPherson, Sarah E.; Turner, Martha; Woollett, Katherine; Bozzali, Marco; Cipolotti, Lisa

    2013-01-01

    The proverb interpretation task (PIT) is often used in clinical settings to evaluate frontal “executive” dysfunction. However, only a relatively small number of studies have investigated the relationship between frontal lobe lesions and performance on the PIT. We compared 52 patients with unselected focal frontal lobe lesions with 52 closely matched healthy controls on a proverb interpretation task. Participants also completed a battery of neuropsychological tests, including a fluid intelligence task (Raven’s Advanced Progressive Matrices). Lesions were firstly analysed according to a standard left/right sub-division. Secondly, a finer-grained analysis compared the performance of patients with medial, left lateral and right lateral lesions with healthy controls. Thirdly, a contrast of specific frontal subgroups compared the performance of patients with medial lesions with patients with lateral frontal lesions. The results showed that patients with left frontal lesions were significantly impaired on the PIT, while in patients with right frontal lesions the impairments approached significance. Medial frontal patients were the only frontal subgroup impaired on the PIT, relative to healthy controls and lateral frontal patients. Interestingly, an error analysis indicated that a significantly higher number of concrete responses were found in the left lateral subgroup compared to healthy controls. We found no correlation between scores on the PIT and on the fluid intelligence task. Overall our results suggest that specific regions of the frontal lobes contribute to the performance on the PIT. PMID:23850600

  4. Seizure semiology identifies patients with bilateral temporal lobe epilepsy.

    Science.gov (United States)

    Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

    2015-01-01

    Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; psemiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Visuo-spatial construction in patients with frontal and parietal lobe lesions

    Directory of Open Access Journals (Sweden)

    Himani Kashyap

    2011-04-01

    Full Text Available Visuospatial construction, traditionally viewed as a putative parietal function, also requires sustained attention, planning, organization strategies and error correction, and hence frontal lobe mediation. The relative contributions of the frontal and parietal lobes are poorly understood. To examine the contributions of parietal, frontal lobes, as well as right and left cerebral hemispheres to visuospatial construction. The Stick Construction Test for two-dimensional construction and the Block Construction Test for three-dimensional construction were administered pre-surgically to patients with lesions in the parietal lobe (n =9 and the frontal lobe (n=11, along with normal control subjects (n =20 matched to the patients on age (+/- 3 years, gender, education (+/- 3 years and handedness. The patients were significantly slower than the controls on both two-dimensional and three-dimensional tests. Patients with parietal lesions were slower than those with frontal lesions on the test of three-dimensional construction. Within each lobe patients with right and left sided lesions did not differ significantly. It appears that tests of three-dimensional construction might be most sensitive to visuospatial construction deficits. Visuospatial construction involves the mediation of both frontal and parietal lobes. The function does not appear to be lateralized. The networks arising from the parieto-occipital areas and projecting to the frontal cortices (e.g., occipito-frontal fasciculus may be the basis of the mediation of both lobes in visuospatial construction. The present findings need replication from studies with larger sample sizes.

  6. Xenomelia: a new right parietal lobe syndrome.

    Science.gov (United States)

    McGeoch, Paul D; Brang, David; Song, Tao; Lee, Roland R; Huang, Mingxiong; Ramachandran, V S

    2011-12-01

    Damage to the right parietal lobe has long been associated with various disorders of body image. The authors have recently suggested that an unusual behavioural condition in which otherwise rational individuals desire the amputation of a healthy limb might also arise from right parietal dysfunction. Four subjects who desired the amputation of healthy legs (two right, one left and one, at first, bilateral and then left only) were recruited and underwent magnetoencephalography (MEG) scans during tactile stimulation of sites above and below the desired amputation line. Regions of interest (ROIs) in each hemisphere (superior parietal lobule (SPL), inferior parietal lobule, S1, M1, insula, premotor cortex and precuneus) were defined using FreeSurfer software. Analysis of average MEG activity across the 40-140 ms post-stimulation timeframe was carried out using an unpaired t test. This revealed significantly reduced activation only in the right SPL ROI for the subjects' affected legs when compared with both subjects' unaffected legs and that of controls. The right SPL is a cortical area that appears ideally placed to unify disparate sensory inputs to create a coherent sense of having a body. The authors propose that inadequate activation of the right SPL leads to the unnatural situation in which the sufferers can feel the limb in question being touched without it actually incorporating into their body image, with a resulting desire for amputation. The authors introduce the term 'xenomelia' as a more appropriate name than apotemnophilia or body integrity identity disorder, for what appears to be an unrecognised right parietal lobe syndrome.

  7. Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy.

    Science.gov (United States)

    Guldiken, Baburhan; Hartl, Elisabeth; Rémi, Jan; Noachtar, Soheyl

    2015-09-01

    We report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video-EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure-associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. [Published with video sequence].

  8. Effects of Urtica dioica on oxidative stress, proliferation and apoptosis after partial hepatectomy in rats.

    Science.gov (United States)

    Oguz, Serhat; Kanter, Mehmet; Erboga, Mustafa; Toydemir, Toygar; Sayhan, Mustafa Burak; Onur, Hatice

    2015-05-01

    The present study was performed to investigate the effect of Urtica dioica (UD) on liver regeneration after partial hepatectomy (PH) in rats. A total of 24 male Sprague Dawley rats were divided into three groups: sham-operated, PH and PH + UD; each group contains eight animals. The rats in UD-treated groups were given UD oils (2 ml/kg/day) once a day orally for 7 days starting 3 days prior to hepatectomy operation. At day 7 after resection, liver samples were collected. The levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were estimated in liver homogenates. Moreover, histopathological examination, mitotic index (MI), proliferating cell nuclear antigen labeling, proliferation index (PI), transferase-mediated deoxyuridine triphosphate nick end-labeling assay, apoptotic index (AI) were evaluated at day 7 after hepatectomy. As a result, UD significantly increased MI and PI, significantly decreased AI and also attenuated hepatic vacuolar degeneration and sinusoidal congestion in PH rats. UD treatment significantly decreased the elevated tissue MDA level and increased the reduced SOD activity and GSH level in the tissues. These results suggest that UD pretreatment was beneficial for rat liver regeneration after partial hepatectomy. © The Author(s) 2013.

  9. Early trends in serum phosphate and creatinine levels are associated with mortality following major hepatectomy.

    Science.gov (United States)

    Herbert, Garth S; Prussing, Kara B; Simpson, Amber L; D'Angelica, Michael I; Allen, Peter J; DeMatteo, Ronald P; Jarnagin, William R; Kingham, T Peter

    2015-12-01

    Mortality after major hepatectomy remains high and is frequently related to post-hepatectomy liver failure (PHLF). Other than pre-existing liver disease and a small future liver remnant, few patient factors or early postoperative indicators identify patients at elevated risk for PHLF and mortality. Data on demographics, comorbidities, operative procedures and postoperative laboratory trends were reviewed for patients submitted to major hepatectomy (at least three Couinaud segments) for malignancy during 1998-2013. These factors were compared among patients who died within 90 days, survivors who met the 50-50 criteria and all remaining survivors. A total of 1528 patients underwent major hepatectomy during the study period. Of these, 947 had metastatic colorectal cancer and underwent resection of a median of four segments. Overall, 49 patients (3.2%) died within 90 days of surgery and 48 patients (3.1%) met the 50-50 criteria for PHLF; 30 of these patients survived 90 days. Operative blood loss was higher in patients who died within 90 days compared with survivors (1.0 l versus 0.5 l; P trends in creatinine and phosphate (between the day of surgery and PoD 1) identify patients at risk for PHLF and mortality. © 2015 International Hepato-Pancreato-Biliary Association.

  10. Endotoxin and interleukin-1 related hepatic inflammatory response promotes liver failure after partial hepatectomy

    NARCIS (Netherlands)

    Boermeester, M. A.; Straatsburg, I. H.; Houdijk, A. P.; Meyer, C.; Frederiks, W. M.; Wesdorp, R. I.; van Noorden, C. J.; van Leeuwen, P. A.

    1995-01-01

    Impairment of various functions of the liver and concomitantly increased levels of parameters of liver damage, a clinical entity termed liver failure, is commonly seen after partial hepatectomy. We investigated in a rat model whether damage of the remnant liver was due to local inflammatory

  11. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors

    NARCIS (Netherlands)

    Jansen, P. L.; Chamuleau, R. A.; van Leeuwen, D. J.; Schipper, H. G.; Busemann-Sokole, E.; van der Heyde, M. N.

    1990-01-01

    Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single-photon computed tomography (SPECT), using 99mTc-colloid as tracer. The method was

  12. Hypertensive crisis caused by electrocauterization of the adrenal gland during hepatectomy.

    Science.gov (United States)

    Doo, A Ram; Son, Ji-Seon; Han, Young-Jin; Yu, Hee Chul; Ko, Seonghoon

    2015-02-14

    Hypertensive crisis (i.e., systolic blood pressure over 300 mmHg) is very rare during operation except pheochromocytoma, but it can be a fatal and embarrassing to surgeons and anesthesiologists. The right adrenal gland can be electrocauterized during a right hemi-hepatectomy. We report a case of hypertensive crisis during right hemi-hepatectomy in which the right adrenal gland was stimulated by monopolar electrocautery in a patient with normal neuroendocrine function. A 73-year-old man with hepatocellular carcinoma was scheduled to undergo right hemi-hepatectomy. Three hours into the surgery, the patient's blood pressure increased abruptly from 100/40 to over 350/130 mmHg (the maximum measurement pressure of the monitor; 350 mmHg). The surgeon had cauterized the right adrenal gland using monopolar electrocautery to separate the liver from the adrenal gland immediately prior to the event. Approximately 3 minutes after suspending the operation, blood pressure returned to baseline levels. After the event, the operation was successfully completed without any complication. Hormonal studies and iodine-123 meta-iodobenzylguanidine scintigraphy revealed no neuroendocrine tumor such as a pheochromocytoma. Operations such as hepatectomy that stimulate the adrenal gland may lead to an unexpected catecholamine surge and result in hypertensive crisis, even if neuroendocrine function of the adrenal gland is normal.

  13. Poor outcomes after hepatectomy in patients with ascites infected by methicillin-resistant staphylococci.

    Science.gov (United States)

    Nitta, Hidetoshi; Beppu, Toru; Itoyama, Akari; Higashi, Takaaki; Sakamoto, Keita; Nakagawa, Shigeki; Mima, Kosuke; Okabe, Hirohisa; Imai, Katsunori; Hayashi, Hiromitsu; Hashimoto, Daisuke; Chikamoto, Akira; Ishiko, Takatoshi; Baba, Hideo

    2015-02-01

    This study was designed to investigate the association between infectious ascites, clinical parameters and treatment outcomes after hepatectomy. Of 891 patients who underwent hepatectomy between 2006 and 2013, 74 who underwent paracentesis for bacterial cultivation of postoperative ascites after hepatectomy were analyzed. Of the 74 patients, 42 had positive bacterial cultures (positive group) and 32 patients had negative cultures (negative group). Hospital mortality was significantly higher in the positive group than in the negative group [9/42 (21.4%) vs. 2/32 (6.3%); P = 0.035]. Hospital mortality associated with each bacterial strain was as follows: methicillin-resistant staphylococci (MRS) (5/13, 38.5%), staphylococci (2/11, 18.2%), enterococci (2/12, 16.7%), Enterobacter (0/3, 0%), Klebsiella (0/2, 0%), and others (0/1, 0%). Cox proportional multivariate analysis revealed that MRS infection in ascites was the only risk factor of hospital death (HR = 5.08, P = 0.041) and MRS wound infection was the only risk factor to predict MRS infection in ascites (HR = 5.67, P = 0.015). Postoperative MRS infection in postoperative ascites after hepatectomy is a potentially fatal complication; therefore, the prevention of MRS wound infection is critical to decrease postoperative hospital mortality. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  14. Influence of anxiety on memory performance in temporal lobe epilepsy

    OpenAIRE

    Brown, Franklin C.; Westerveld, Michael; Langfitt, John T.; Hamberger, Marla; Hamid, Hamada; Shinnar, Shlomo; Sperling, Michael R.; Devinsky, Orrin; Barr, William; Tracy, Joseph; Masur, David; Bazil, Carl W.; Spencer, Susan S.

    2013-01-01

    This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 temporal lobe epilepsy patients from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was lower for those with high versus low level of anxiety, but was not found to be related to side of TLE. Verbal memory on the California Verbal Learning Test (CVLT) was significantly lower for left than right TLE patients with low anxiety, ...

  15. Predictors of Diarrhea after Hepatectomy and Its Impact on Gastrointestinal Quality of Life in Living Donors.

    Directory of Open Access Journals (Sweden)

    Szu-Han Wang

    Full Text Available Donor safety and preservation of donor health after living liver donation are of paramount importance. Diarrhea has a significant influence on gastrointestinal quality of life among donors who have undergone living donor hepatectomy. Thus, we aimed to investigate predictors of diarrhea after hepatectomy and its impact on gastrointestinal quality of life in living donors.We retrospectively examined the medical records of 204 living liver donors who underwent hepatectomy during the period January 2010 to June 2013 at a single medical center. Diarrhea was defined as the passing of three or more liquid stools per day. The Chinese version of the Gastrointestinal Quality of Life Index (GIQLI was used to assess the influence of diarrhea on quality of life in donors.During the study period, diarrhea was diagnosed in 62 (30.3% of the 204 donors and the duration of diarrhea in the majority of them (n = 46, 74% was <12 months. Risk factors associated with diarrhea included age [risk ratio (RR = 0.84, 95% confidence interval (CI: 0.79-0.89, risk difference = 16%], and chronic cholecystitis (RR = 0.48, 95% CI: 0.24-0.99, risk difference = 52%. Compared to donors without diarrhea, donors with diarrhea had lower GIQLI scores in the following GIQLI domains: GI symptoms (1.8 vs. 3.6, physical function (2.1 vs. 3.5, emotional function (3.0 vs. 3.6, social function (3.3 vs. 3.7, and treatment reaction (2.6 vs. 3.7.Our findings show that younger donors and those without chronic cholecystitis are at increased risk for diarrhea after living donor hepatectomy and that diarrhea is associated with lower GIQLI scores after hepatectomy.

  16. Effect of L-arginine supplement on liver regeneration after partial hepatectomy in rats

    Directory of Open Access Journals (Sweden)

    Kurokawa Tsuyoshi

    2012-05-01

    Full Text Available Abstract Background Nitric oxide (NO has been reported to be a key mediator in hepatocyte proliferation during liver regeneration. NO is the oxidative metabolite of L-arginine, and is produced by a family of enzymes, collective termed nitric oxide synthase (NOS. Thus, administration of L-arginine might enhance liver regeneration after a hepatectomy. Another amino acid, L-glutamine, which plays an important role in catabolic states and is a crucial factor in various cellular and organ functions, is widely known to enhance liver regeneration experimentally. Thus, the present study was undertaken to evaluate the effects of an L-arginine supplement on liver regeneration, and to compared this with supplementation with L-glutamine and L-alanine (the latter as a negative control, using a rat partial hepatectomy model. Methods Before and after a 70% hepatectomy, rats received one of three amino acid solutions (L-arginine, L-glutamine, or L-alanine. The effects on liver regeneration of the administered solutions were examined by assessment of restituted liver mass, staining for proliferating cell nuclear antigen (PCNA, and total RNA and DNA content 24 and 72 hours after the operation. Results At 72 hours after the hepatectomy, the restituted liver mass, the PCNA labeling index and the DNA quantity were all significantly higher in the L-arginine and L-glutamine groups than in the control. There were no significant differences in those parameters between the L-arginine and L-glutamine groups, nor were any significant differences found between the L-alanine group and the control. Conclusion Oral supplements of L-arginine and L-glutamine enhanced liver regeneration after hepatectomy in rats, suggesting that an oral arginine supplement can clinically improve recovery after a major liver resection.

  17. Creative innovation with temporal lobe epilepsy and lobectomy.

    Science.gov (United States)

    Ghacibeh, Georges A; Heilman, Kenneth M

    2013-01-15

    Some patients with left temporal degeneration develop visual artistic abilities. These new artistic abilities may be due to disinhibition of the visuo-spatially dominant right hemisphere. Many famous artists have had epilepsy and it is possible that some may have had left temporal seizures (LTS) and this left temporal dysfunction disinhibited their right hemisphere. Alternatively, unilateral epilepsy may alter intrahemispheric connectivity and right anterior temporal lobe seizures (RTS) may have increased these artists' right hemisphere mediated visual artistic creativity. To test the disinhibition versus enhanced connectivity hypotheses we studied 9 participants with RTS and 9 with left anterior temporal seizures (LTS) who underwent unilateral lobectomy for the treatment of medically refractory epilepsy. Creativity was tested using the Torrance Test of Creative Thinking (TTCT). There were no between group differences in either the verbal or figural scores of the TTCT, suggesting that unilateral anterior temporal ablation did not enhance visual artistic ability; however, for the RTS participants' figural creativity scores were significantly higher than verbal scores. Whereas these results fail to support the left temporal lobe disinhibition postulate of enhanced figural creativity, the finding that the patients with RTS had better figural than verbal creativity suggests that their recurrent right hemispheric seizures lead to changes in their right hemispheric networks that facilitated visual creativity. To obtain converging evidence, studies on RTS participants who have not undergone lobectomy will need to be performed. Published by Elsevier B.V.

  18. Late-presenting right congenital diaphragmatic hernia with severe hypotrophy of the right lobe of the liver

    Directory of Open Access Journals (Sweden)

    E.A. De Marco

    2015-01-01

    Conclusions: Evidence of this phenomenon represents an absolute novelty in the extant scientific literature. Even if rare, we suggest to suspect the presence of CDH in fetus with disparity in right and left liver lobe at prenatal ultrasound.

  19. Exercise-induced seizures and lateral asymmetry in patients with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Jordan T. Kamel

    2014-01-01

    Conclusions: Exercise may be an underrecognized form of reflex epilepsy, which tended to be refractory to both medical and surgical interventions in our patients. Almost all patients in our cohort had seizures localizing to the left temporal lobe. We discuss potential mechanisms by which exercise may precipitate seizures, and its relevance regarding our understanding of temporal lobe epilepsy and lateralization of seizures. Recognition of, as well as advice regarding avoidance of, known triggers forms an important part of management of these patients.

  20. The parietal lobe and the vestibular system.

    Science.gov (United States)

    Dieterich, Marianne; Brandt, Thomas

    2018-01-01

    The vestibular cortex differs in various ways from other sensory cortices. It consists of a network of several distinct and separate temporoparietal areas. Its core region, the parietoinsular vestibular cortex (PIVC), is located in the posterior insula and retroinsular region and includes the parietal operculum. The entire network is multisensory (in particular, vestibular, visual, and somatosensory). The peripheral and central vestibular systems are bilaterally organized; there are various pontomesencephalic brainstem crossings and at least two transcallosal connections of both hemispheres, between the PIVC and the motion-sensitive visual cortex areas, which also mediate vestibular input. Structural and functional vestibular dominance characterizes the right hemisphere in right-handers and the left hemisphere in left-handers. This explains why right-hemispheric lesions in right-handers more often generally cause hemispatial neglect and the pusher syndrome, both of which involve vestibular function. Vestibular input also contributes to cognition and may determine individual lateralization of brain functions such as handedness. Bilateral organization is a major key to understanding cortical functions and disorders, for example, the visual-vestibular interaction that occurs in spatial orientation. Although the vestibular cortex is represented in both hemispheres, there is only one global percept of body position and motion. The chiefly vestibular aspects of the multiple functions and disorders of the parietal lobe dealt with in this chapter cannot be strictly separated from various multisensory vestibular functions within the entire brain. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Persistent impairment of liver function caused by a pendulated accessory liver lobe

    International Nuclear Information System (INIS)

    Fogh, J.; Tromholt, N.; Joergensen, F.

    1989-01-01

    A large pendulated accessory liver lobe and complete absence of the left lobe were discovered by liver scintigraphy and ultrasound scanning in a patient suspected of having an ovarian tumor. The patient had a history of fluctuating impaired liver function tests for many years, probably caused by intermittent torsion of the peduncle. Pedunculated accessory liver lobes are extremely rare and seldom diagnosed in vivo. Our patient seems to be the 11th published case, and the only one in which longstanding fluctuating impaired liver function tests have been observed. (orig.)

  2. Brain SPECT imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Krausz, Y.; Yaffe, S.; Atlan, H.; Cohen, D.; Konstantini, S.; Meiner, Z.

    1991-01-01

    Temporal lobe epilepsy is diagnosed by clinical symptoms and signs and by localization of an epileptogenic focus. A brain SPECT study of two patients with temporal lobe epilepsy, using 99m Tc-HMPAO, was used to demonstrate a perfusion abnormality in the temporal lobe, while brain CT and MRI were non-contributory. The electroencephalogram, though abnormal, did not localize the diseased area. The potential role of the SPECT study in diagnosis and localization of temporal lobe epilepsy is discussed. (orig.)

  3. Hepatectomy with primary closure of common bile duct for hepatolithiasis combined with choledocholithiasis.

    Science.gov (United States)

    Jia, Chang-Ku; Weng, Jie; Chen, You-Ke; Yang, Qing-Zhuang; Fu, Yu; Qin, Qi-Fan; Yu, Wei-Ming

    2015-03-28

    To evaluate the feasibility of hepatectomy and primary closure of common bile duct for intrahepatic and extrahepatic calculi. From January 2008 to May 2013, anatomic hepatectomy followed by biliary tract exploration without biliary drainage (non-drainage group) was performed in 43 patients with intrahepatic and extrahepatic calculi. After hepatectomy, flexible choledochoscopy was used to extract residual stones and observe the intrahepatic bile duct and common bile duct (CBD) for determination of biliary stricture and dilatation. Function of the sphincter of Oddi was determined by manometry of the CBD. Primary closure of the CBD without T-tube drainage or bilioenteric anastomosis was performed when there was no biliary stricture or sphincter of Oddi dysfunction. Dexamethasone and anisodamine were intravenously injected 2-3 d after surgery to prevent postoperative retrograde infection due to intraoperative bile duct irrigation, and to maintain relaxation of the sphincter of Oddi, respectively. During the same period, anatomic hepatectomy followed by biliary tract exploration with biliary drainage (drainage group) was performed in 48 patients as the control group. Postoperative complications and hospital stay were compared between the two groups. There was no operative mortality in either group of patients. Compared to intrahepatic and extrabiliary drainage, hepatectomy with primary closure of the CBD (non-drainage) did not increase the incidence of complications, including residual stones, bile leakage, pancreatitis and cholangitis (P > 0.05). Postoperative hospital stay and costs were nevertheless significantly less in the non-drainage group than in the drainage group. The median postoperative hospital stay was shorter in the non-drainage group than in the drainage group (11.2 ± 2.8 d vs 15.4 ± 2.1 d, P = 0.000). The average postoperative cost of treatment was lower in the non-drainage group than in the drainage group (29325.6 ± 5668.2 yuan vs 32933.3 ± 6235

  4. Distally lobed integuments in some Angiosperm ovules

    NARCIS (Netherlands)

    Heel, van W.A.

    1970-01-01

    In this treatise ‘De l’Ovule’ Warming (1878) remarked that although the borders of the integuments grow uniformly, very rarely a division into lobes can be observed. He mentioned Symplocarpus foetida (inner integument four-lobed), Lagarosiphon schweinfurthii (outer integument four- or five-lobed)

  5. Historical Evolution of the Frontal Lobe Syndrome

    NARCIS (Netherlands)

    Krudop, W.A.; Pijnenburg, Y.A.L.

    2015-01-01

    The function of the frontal lobes and the related frontal lobe syndrome have not been described in detail until relatively late in history. Slowly, the combination of knowledge from animal models, the detailed examination of symptoms after traumatic frontal lobe injuries, and the rise and fall of

  6. Temporal Lobe Epilepsy in Children

    Science.gov (United States)

    Nickels, Katherine C.; Wong-Kisiel, Lily C.; Moseley, Brian D.; Wirrell, Elaine C.

    2012-01-01

    The temporal lobe is a common focus for epilepsy. Temporal lobe epilepsy in infants and children differs from the relatively homogeneous syndrome seen in adults in several important clinical and pathological ways. Seizure semiology varies by age, and the ictal EEG pattern may be less clear cut than what is seen in adults. Additionally, the occurrence of intractable seizures in the developing brain may impact neurocognitive function remote from the temporal area. While many children will respond favorably to medical therapy, those with focal imaging abnormalities including cortical dysplasia, hippocampal sclerosis, or low-grade tumors are likely to be intractable. Expedient workup and surgical intervention in these medically intractable cases are needed to maximize long-term developmental outcome. PMID:22957247

  7. Laparoscopy-assisted and open living donor right hepatectomy: a comparative study of outcomes.

    Science.gov (United States)

    Baker, Talia B; Jay, Colleen L; Ladner, Daniela P; Preczewski, Luke B; Clark, Lori; Holl, Jane; Abecassis, Michael M

    2009-10-01

    Minimally invasive liver surgery is a rapidly advancing field with demonstrated applicability to living donation. In this paper, we compare the safety and efficacy of laparoscopy-assisted donor right hepatectomy (LADRH) to open donor right hepatectomy (ODRH). We performed a retrospective, comparative analysis of 33 LADRH to the most recent 33 ODRH performed at our institution, evaluating donor complications, costs, and recipient outcomes. Donor demographics including age, gender, body mass index (BMI), and vascular and biliary anomalies were comparable. Donor complication rates were equivalent for LADRH and ODRH. Donor operative times were shorter for LADRH (LADRH 265 minutes, ODRH 316; P size, recipient patient or graft survival, or recipient vascular or biliary complications. Our experience suggests that LADRH compares favorably with ODRH with equivalent safety, resource utilization, and effectiveness. We believe that LADRH provides potential physical and psychological benefits without an adverse effect on outcomes.

  8. A novel three-dimensional print of liver vessels and tumors in hepatectomy.

    Science.gov (United States)

    Oshiro, Yukio; Mitani, Jun; Okada, Toshiyuki; Ohkohchi, Nobuhiro

    2017-04-01

    Creating a three-dimensional (3D)-printed liver model is costly, and the visibility of the inner structures is slightly hindered. We developed a novel structure that simultaneously solves both of these problems. The outer frames were set up along the liver surface. Our structure did not use the transparent loading material because this material increases the printing cost. Therefore, we were able to directly observe the inside of the structure. We performed hepatectomy using this novel 3D-printed liver model. Using this model, we were able to clearly simulate the resection line and safely perform the surgery. Our process was more cost effective, had a shorter production time, and improved the visibility than other processes. We developed a novel 3D-printed liver for hepatectomy, which made the procedure easier, reduced the production cost, and improved the visibility; this approach may be useful for future surgeries.

  9. Effect of cadmium pretreatment on liver regeneration after partial hepatectomy in rats

    International Nuclear Information System (INIS)

    Margeli, A.; Theocharis, S.; Skaltsas, S.; Skopelitou, A.; Kittas, C.; Mykoniatis, M.; Varonos, D.

    1994-01-01

    In this study we examined the effect of cadmium pretreatment, administered 24 h before partial hepatectomy, on the liver regenerative process in rats, at different time intervals. The rate of 3 H thymidine incorporation into hepatic DNA and the activity of the enzyme thymidine kinase were used as indices of liver proliferative capacity. Thymidine kinase, the rate-determining enzyme of DNA biosynthesis, was suppressed during the first hours following partial hepatectomy in the liver of cadmium pretreated animals. DNA biosynthesis was also strongly decreased in cadmium pretreated animals, by delaying the first peak of liver regeneration, compared with the partially hepatectomized ones. Biochemical parameters, mitotic index and proliferating cell nuclear antigen staining were also coestimated. The above data suggest that cadmium pretreatment suppressed the hepatic regenerative process, probably due to the inhibition of thymidine kinase. (orig./MG)

  10. Effect of cadmium pretreatment on liver regeneration after partial hepatectomy in rats

    Energy Technology Data Exchange (ETDEWEB)

    Margeli, A. (Dept. of Experimental Pharmacology, Medical School, Univ. Athens (Greece)); Theocharis, S. (Dept. of Experimental Pharmacology, Medical School, Univ. Athens (Greece)); Skaltsas, S. (Dept. of Experimental Pharmacology, Medical School, Univ. Athens (Greece)); Skopelitou, A. (Dept. of Pathology, Medical School, Univ. Athens (Greece)); Kittas, C. (Dept. of Pathology, Medical School, Univ. Athens (Greece)); Mykoniatis, M. (Dept. of Experimental Pharmacology, Medical School, Univ. Athens (Greece)); Varonos, D. (Dept. of Experimental Pharmacology, Medical School, Univ. Athens (Greece))

    1994-02-01

    In this study we examined the effect of cadmium pretreatment, administered 24 h before partial hepatectomy, on the liver regenerative process in rats, at different time intervals. The rate of [sup 3]H thymidine incorporation into hepatic DNA and the activity of the enzyme thymidine kinase were used as indices of liver proliferative capacity. Thymidine kinase, the rate-determining enzyme of DNA biosynthesis, was suppressed during the first hours following partial hepatectomy in the liver of cadmium pretreated animals. DNA biosynthesis was also strongly decreased in cadmium pretreated animals, by delaying the first peak of liver regeneration, compared with the partially hepatectomized ones. Biochemical parameters, mitotic index and proliferating cell nuclear antigen staining were also coestimated. The above data suggest that cadmium pretreatment suppressed the hepatic regenerative process, probably due to the inhibition of thymidine kinase. (orig./MG)

  11. Imaging language networks before and after anterior temporal lobe resection: results of a longitudinal fMRI study.

    Science.gov (United States)

    Bonelli, Silvia B; Thompson, Pamela J; Yogarajah, Mahinda; Vollmar, Christian; Powell, Robert H W; Symms, Mark R; McEvoy, Andrew W; Micallef, Caroline; Koepp, Matthias J; Duncan, John S

    2012-04-01

    Anterior temporal lobe resection (ATLR) controls seizures in up to 70% of patients with intractable temporal lobe epilepsy (TLE) but, in the language dominant hemisphere, may impair language function, particularly naming. Functional reorganization can occur within the ipsilateral and contralateral hemispheres. We investigated reorganization of language in left-hemisphere-dominant patients before and after ATLR; whether preoperative functional magnetic resonance imaging (fMRI) predicts postoperative naming decline; and efficiency of postoperative language networks. We studied 44 patients with TLE due to unilateral hippocampal sclerosis (24 left) on a 3T GE-MRI scanner. All subjects performed language fMRI and neuropsychological testing preoperatively and again 4 months after left or right ATLR. Postoperatively, individuals with left TLE had greater bilateral middle/inferior frontal fMRI activation and stronger functional connectivity from the left inferior/middle frontal gyri to the contralateral frontal lobe than preoperatively, and this was not observed in individuals with right TLE. Preoperatively, in left and right TLE, better naming correlated with greater preoperative left hippocampal and left frontal activation for verbal fluency (VF). In left TLE, stronger preoperative left middle frontal activation for VF was predictive of greater decline in naming after ATLR. Postoperatively, in left TLE with clinically significant naming decline, greater right middle frontal VF activation correlated with better postoperative naming. In patients without postoperative naming decline, better naming correlated with greater activation in the remaining left posterior hippocampus. In right TLE, naming ability correlated with left hippocampal and left and right frontal VF activation postoperatively. In left TLE, early postoperative reorganization to the contralateral frontal lobe suggests multiple systems support language function. Postoperatively, ipsilateral recruitment

  12. Predicting post-hepatectomy liver failure by combined volumetric, functional MR image and laboratory analysis.

    Science.gov (United States)

    Chuang, Yi-Hsuan; Ou, Hsin-You; Lazo, Marirose Z; Chen, Chao-Long; Chen, Meng-Hsiang; Weng, Ching-Chun; Cheng, Yu-Fan

    2017-10-07

    To assess the efficacy of functional MR image with volumetric, liver function test and indocyanine green clearance (ICG) in identifying the patients who are at risk of post-hepatectomy liver failure (PHLF). We retrospectively included 115 patients undergoing gadoxetic acid-enhanced MR imaging before hepatectomy at one medical centre from January 2013 to December 2015. Contrast enhancement ratio (CER) between transitional and hepatobiliary phases (3 and 30 minutes post-contrast) was calculated. Total liver volume (TLV) and spleen volume (Sp) were measured. Post-operatively, the histological Ishak fibrosis score was collected. Potential risk factors for liver failure were analysed, and the performance was examined by receiver operating characteristic curve. Post-hepatectomy liver failure (PHLF) occurred in 16 patients (13.9%). TLV/SLV, ADC value, CER HBP/TP and total liver contrast enhancement ratio (tCER) were associated with PHLF (P imaging with volumetric is a reliable method for evaluating functional liver volume and determining the risk of PHLF. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Obesity Does Not Influence Outcomes in Hepatocellular Carcinoma Patients following Curative Hepatectomy.

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    Zhe Guo

    Full Text Available Whether obesity affects surgical outcomes in patients with hepatocellular carcinoma (HCC is controversial. Here we retrospectively evaluated the impact of obesity on outcomes in HCC patients after curative hepatectomy.Patients with Child-Pugh A liver function who underwent curative hepatectomy between 2006 and 2010 were categorized as obese (BMI ≥25 kg/m2, n = 68 and non-obese (0.05. Obese and non-obese patients had comparable 30-day mortality (1.6% vs. 2.6%, P = 1.000, 90-day mortality (3.3% vs. 4.3%, P = 1.000, and incidence of postoperative complications (19.7% vs. 18.3%, P = 0.819. Overall survival at 1, 3, and 5 years was similar for obese patients (83.6%, 63.6%, 41.6% as for non-obese patients (80.9%, 65.9%, 49.1%; P = 0.358. Disease-free survival at 1, 3, and 5 years was also similar for obese patients (71.5%, 36.3%, 24.3% as for non-obese ones (60.2%, 43.7%, 27.7%; P = 0.969.Our propensity score-matched analysis strengthens the case that obesity does not adversely affect surgical outcomes of HCC patients undergoing curative hepatectomy.

  14. Evolution of laparoscopic surgery in a high volume hepatobiliary unit: 150 consecutive pure laparoscopic hepatectomies.

    Science.gov (United States)

    López-Ben, Santiago; Ranea, Alejandro; Albiol, M Teresa; Falgueras, Laia; Castro, Ernesto; Casellas, Margarida; Codina-Barreras, Antoni; Figueras, Joan

    2017-05-01

    Compared to other surgical areas, laparoscopic liver resection (LLR) has not been widely implemented and currently less than 20% of hepatectomies are performed laparoscopically worldwide. The aim of our study was to evaluate the feasibility, and the ratio of implementation of LLR in our department. We analyzed a prospectively maintained database of 749 liver resections performed during the last 10-year period in a single centre. A total of 150 (20%) consecutive pure LLR were performed between 2005 and 2015. In 87% of patients the indication was the presence ofprimary or metastatic liver malignancy. We performed 30 major hepatectomies (20%) and (80%) were minor resections, performed in all liver segments. Twelve patients were operated twice and 2 patients underwent a third LLR. The proportion of LLR increased from 12% in 2011 to 62% in the last year. Conversion rate was 9%. Overall morbidity rate was 36% but only one third were classified as severe. The 90-day mortality rate was 1%. Median hospital stay was 4 days and the rate of readmissions was 6%. The implementation of LLR has been fast with morbidity and mortality comparable to other published series. In the last 2 years more than half of the hepatectomies are performed laparoscopically in our centre. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Factors influencing liver and spleen volume changes after donor hepatectomy for living donor liver transplantation

    International Nuclear Information System (INIS)

    Bae, Ji Hee; Ryeom, Hunku; Song, Jung Hup

    2013-01-01

    To define the changes in liver and spleen volumes in the early postoperative period after partial liver donation for living-donor liver transplantation (LDLT) and to determine factors that influence liver and spleen volume changes. 27 donors who underwent partial hepatectomy for LDLT were included in this study. The rates of liver and spleen volume change, measured with CT volumetry, were correlated with several factors. The analyzed factors included the indocyanine green (ICG) retention rate at 15 minutes after ICG administration, preoperative platelet count, preoperative liver and splenic volumes, resected liver volume, resected-to-whole liver volume ratio (LV R /LV W ), resected liver volume to the sum of whole liver and spleen volume ratio [LV R /(LV W + SV 0 )], and pre and post hepatectomy portal venous pressures. In all hepatectomy donors, the volumes of the remnant liver and spleen were increased (increased rates, 59.5 ± 50.5%, 47.9 ± 22.6%). The increment rate of the remnant liver volume revealed a positive correlation with LV R /LV W (r = 0.759, p R /LV W influences the increment rate of the remnant liver volume.

  16. Partial hepatectomy in a Plains garter snake (Thamnophis sirtalis radix with biliary cystadenoma: case report

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    Zdeněk Knotek

    2012-01-01

    Full Text Available A four-year-old, captive-bred, female Plains garter snake (Thamnophis sirtalis radix was presented with a large midbody distension (5 cm × 3 cm × 3 cm in the second third of the body length (total body length 123 cm. Contrast radiography technique excluded an envolvement of the oesophagus or stomach. Aspiration of 8 ml of acellular straw coloured fluid negative for presence of bacteria, fungi or parasites, reduced the swelling to a third of its original size. Surgical exploration revealed a pathologically changed central part of the liver with multiple different sized cysts. Histopathologically the diagnosis was defined as biliary cystadenoma. As the liver had a physiological appearance cranial and caudal to the central area, a partial hepatectomy was performed. The snake recovered well and started to feed spontaneously two days after surgery. During the check up two, four and seven months after hepatectomy, the snake was active and in a good condition. Hypoproteinaemia and altered activity of lactate dehydrogenase were present two months after surgery, azurophilia and hyperuricaemia were present in the blood sampled four months after hepatectomy. Except for azurophilia, the other values of the blood profile were within the expected range for a healthy snake seven months after surgery, indicating full recovery. This is the first detailed report of a successful central resection of a large pathologically changed part of the liver in snakes which was diagnosed as biliary cystadenoma.

  17. Encapsulated Whole Bone Marrow Cells Improve Survival in Wistar Rats after 90% Partial Hepatectomy

    Directory of Open Access Journals (Sweden)

    Carolina Uribe-Cruz

    2016-01-01

    Full Text Available Background and Aims. The use of bone marrow cells has been suggested as an alternative treatment for acute liver failure. In this study, we investigate the effect of encapsulated whole bone marrow cells in a liver failure model. Methods. Encapsulated cells or empty capsules were implanted in rats submitted to 90% partial hepatectomy. The survival rate was assessed. Another group was euthanized at 6, 12, 24, 48, and 72 hours after hepatectomy to study expression of cytokines and growth factors. Results. Whole bone marrow group showed a higher than 10 days survival rate compared to empty capsules group. Gene expression related to early phase of liver regeneration at 6 hours after hepatectomy was decreased in encapsulated cells group, whereas genes related to regeneration were increased at 12, 24, and 48 hours. Whole bone marrow group showed lower regeneration rate at 72 hours and higher expression and activity of caspase 3. In contrast, lysosomal-β-glucuronidase activity was elevated in empty capsules group. Conclusions. The results show that encapsulated whole bone marrow cells reduce the expression of genes involved in liver regeneration and increase those responsible for ending hepatocyte division. In addition, these cells favor apoptotic cell death and decrease necrosis, thus increasing survival.

  18. Pulmonary sequestrations of the upper lobe in children: Three presentations

    International Nuclear Information System (INIS)

    Hoeffel, J.C.; Bernard, C.; Didier, F.; Bretagne, M.C.; Gautry, P.; Olive, D.; Prevot, J.; Pernot, C.; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy

    1986-01-01

    Pulmonary sequestrations are congenital abnormalities where nonfunctioning lung tissue receives its vascular supply from the systemic circulation (thoracic or abdominal aorta). It is necessary to establish the diagnosis in childhood when the lesions are uncomplicated. The authors present three cases of sequestration of the apex (2 extralobar and 1 atypical) with the main clinical and radiological features. Sequestrations in the upper lobe are rare, and the usual site is the left lower lobe. Plain X-rays show a dense opacity, sometimes with an air-fluid level: angiography is currently the best mean for definitive diagnosis; however, computed tomography will probably be very useful in the future. Differential diagnosis includes tumours of the superior mediastinum (neurogenic tumours, digestive duplication, bronchogenic cysts, pheochromocytoma and hydatid cysts). (orig.) [de

  19. Laparoscopic hepatectomy for liver metastases from colorectal cancer: a meta-analysis.

    Science.gov (United States)

    Luo, Li-Xi; Yu, Zhao-Yan; Bai, Yan-Nan

    2014-04-01

    Liver resection can improve long-term survival for liver metastases from colorectal cancer. Laparoscopic hepatectomy is gaining increasing applications in colorectal liver metastases. We conducted a meta-analysis to investigate the safety, feasibility, and efficacy of laparoscopic liver resection compared with open hepatectomy for patients with colorectal liver metastases. We performed both database and manual searching for comparative studies published before June 2013 without language or region restriction. Outcomes of interest consisted of perioperative outcomes and oncologic outcomes. Seven observational studies including 624 patients (241 in the laparoscopic group, 383 in the open group) were included. No randomized controlled trials were available. Pooled long-term oncologic outcomes of overall survival (hazard ratio=0.844; 95% confidence interval [CI] 0.412, 1.730; P=.644; I(2)=80.6%) and disease-free survival (hazard ratio=1.234; 95% CI 0.652, 2.333; P=.518; I(2)=79.6%) were similar in both groups. Subgroup analyses of studies with high quality and homogeneity confirmed the above outcomes. However, a lower incidence of R1 resection was observed in the laparoscopic group (relative risk [RR]=0.357; 95% CI 0.180, 0.708; P=.003; I(2)=0.0%) than in the open group. As for perioperative outcomes, laparoscopic hepatectomy presented a lower occurrence of postoperative complications (RR=0.647; 95% CI 0.477, 0.877; P=.005; I(2)=0.0%) and similar mortality (RR=0.625; 95% CI 0.12, 3.25; P=.576; I(2)=0.0%); less blood loss and less need for transfusion were also found in laparoscopic patients, whereas comparable operative time and length of hospital stay were required in the two groups. Laparoscopic hepatectomy is a safe procedure for colorectal liver metastases with long-term survival comparable to that of open hepatectomy. More prospective studies with adequate subgroup analyses are awaited to construct defined criteria for patient selection. Future randomized

  20. Histopathologic variation between liver lobes in dogs.

    Science.gov (United States)

    Kemp, S D; Zimmerman, K L; Panciera, D L; Monroe, W E; Leib, M S

    2015-01-01

    Biopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown. To describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes. Seventy dogs undergoing necropsy. Prospective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality. In this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten (14%) of the dogs had ≤ 3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/6 lobes in 39 (56.5%) dogs, 5/6 lobes in 10 (14.5%) dogs, 4/6 lobes in 10 (14.5%) dogs, 3/6 lobes in 7 (10.1%) dogs, and 2/6 in 3 (4.3%) dogs. The number of discordant results did not differ between the liver lobes. The likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

  1. A functional magnetic resonance imaging study mapping the episodic memory encoding network in temporal lobe epilepsy

    Science.gov (United States)

    Sidhu, Meneka K.; Stretton, Jason; Winston, Gavin P.; Bonelli, Silvia; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J.; Koepp, Matthias J.

    2013-01-01

    Functional magnetic resonance imaging has demonstrated reorganization of memory encoding networks within the temporal lobe in temporal lobe epilepsy, but little is known of the extra-temporal networks in these patients. We investigated the temporal and extra-temporal reorganization of memory encoding networks in refractory temporal lobe epilepsy and the neural correlates of successful subsequent memory formation. We studied 44 patients with unilateral temporal lobe epilepsy and hippocampal sclerosis (24 left) and 26 healthy control subjects. All participants performed a functional magnetic resonance imaging memory encoding paradigm of faces and words with subsequent out-of-scanner recognition assessments. A blocked analysis was used to investigate activations during encoding and neural correlates of subsequent memory were investigated using an event-related analysis. Event-related activations were then correlated with out-of-scanner verbal and visual memory scores. During word encoding, control subjects activated the left prefrontal cortex and left hippocampus whereas patients with left hippocampal sclerosis showed significant additional right temporal and extra-temporal activations. Control subjects displayed subsequent verbal memory effects within left parahippocampal gyrus, left orbitofrontal cortex and fusiform gyrus whereas patients with left hippocampal sclerosis activated only right posterior hippocampus, parahippocampus and fusiform gyrus. Correlational analysis showed that patients with left hippocampal sclerosis with better verbal memory additionally activated left orbitofrontal cortex, anterior cingulate cortex and left posterior hippocampus. During face encoding, control subjects showed right lateralized prefrontal cortex and bilateral hippocampal activations. Patients with right hippocampal sclerosis showed increased temporal activations within the superior temporal gyri bilaterally and no increased extra-temporal areas of activation compared with

  2. Gray, White Matter Concentration Changes and Their Correlation with Heterotopic Neurons in Temporal Lobe Epilepsy

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    Tae, Woo Suk; Joo, Eun Yun; Kim, Sung Tae; Hong, Seung Bong [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    To identify changes in gray and white matter concentrations (GMC, WMC), and their relation to heterotopic neuron numbers in mesial temporal lobe epilepsy (mTLE). The gray matter or white matter concentrations of 16 left and 15 right mTLE patients who achieved an excellent surgical outcome were compared with those of 24 healthy volunteers for the left group and with 23 healthy volunteers for the right group, by optimized voxel-based morphometry using unmodulated and modulated images. A histologic count of heterotopic neurons was obtained in the white matter of the anterior temporal lobe originating from the patients' surgical specimens. In addition, the number of heterotopic neurons were tested to determine if there was a correlation with the GMC or WMC. The GMCs of the left and right mTLE groups were reduced in the ipsilateral hippocampi, bilateral thalami, precentral gyri, and in the cerebellum. The WMCs were reduced in the ipsilateral white matter of the anterior temporal lobe, bilateral parahippocampal gyri, and internal capsules, but increased in the pons and bilateral precentral gyri. The heterotopic neuron counts in the left mTLE group showed a positive correlation (r = 0.819, p < 0.0001) with GMCs and a negative correlation (r = - 0.839, p < 0.0001) with WMCs in the white matter of the anterior temporal lobe. The present study shows the abnormalities of the cortico-thalamo- hippocampal network including a gray matter volume reduction in the anterior frontal lobes and an abnormality of brain tissue concentration in the pontine area. Furthermore, heterotopic neuron numbers were significantly correlated with GMC or WMC in the left white matter of anterior temporal lobe.

  3. Middle lobe syndrome: a review of clinicopathological features, diagnosis and treatment.

    Science.gov (United States)

    Gudbjartsson, Tomas; Gudmundsson, Gunnar

    2012-01-01

    Middle lobe syndrome (MLS) is a rare but important clinical entity that has been poorly defined in the literature. It is characterized by recurrent or chronic collapse of the middle lobe of the right lung but can also involve the lingula of the left lung. Pathophysiologically, there are two forms of MLS, namely obstructive and nonobstructive. Obstructive MLS is usually caused by endobronchial lesions or extrinsic compression of the middle lobe bronchus such as from hilar lymphadenopathy or tumors of neoplastic origin, resulting in postobstructive atelectasis and pneumonitis. In the nonobstructive type, no obstruction of the middle lobe bronchus is evident during bronchoscopy or with computerized tomography of the chest. The etiology of the nonobstructive form is not completely understood. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role, and bronchiectasis is the most common histological finding. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection directly. This contrasts with nonobstructive MLS, where most patients respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. However, some patients do not respond to conservative treatment and may suffer irreversible damage of the middle lobe or lingula, in addition to having recurrent symptoms of infection or inflammation. These selected patients can be offered surgical resection of the middle lobe or lingula, which is associated with a low mortality rate and favorable outcome. Copyright © 2012 S. Karger AG, Basel.

  4. The contribution of the parietal lobes to speaking and writing.

    Science.gov (United States)

    Brownsett, Sonia L E; Wise, Richard J S

    2010-03-01

    The left parietal lobe has been proposed as a major language area. However, parietal cortical function is more usually considered in terms of the control of actions, contributing both to attention and cross-modal integration of external and reafferent sensory cues. We used positron emission tomography to study normal subjects while they overtly generated narratives, both spoken and written. The purpose was to identify the parietal contribution to the modality-specific sensorimotor control of communication, separate from amodal linguistic and memory processes involved in generating a narrative. The majority of left and right parietal activity was associated with the execution of writing under visual and somatosensory control irrespective of whether the output was a narrative or repetitive reproduction of a single grapheme. In contrast, action-related parietal activity during speech production was confined to primary somatosensory cortex. The only parietal area with a pattern of activity compatible with an amodal central role in communication was the ventral part of the left angular gyrus (AG). The results of this study indicate that the cognitive processing of language within the parietal lobe is confined to the AG and that the major contribution of parietal cortex to communication is in the sensorimotor control of writing.

  5. Distinct frontal lobe morphology in girls and boys with ADHD.

    Science.gov (United States)

    Dirlikov, Benjamin; Shiels Rosch, Keri; Crocetti, Deana; Denckla, Martha B; Mahone, E Mark; Mostofsky, Stewart H

    2015-01-01

    This study investigated whether frontal lobe cortical morphology differs for boys and girls with ADHD (ages 8-12 years) in comparison to typically developing (TD) peers. Participants included 226 children between the ages of 8-12 including 93 children with ADHD (29 girls) and 133 TD children (42 girls) for which 3T MPRAGE MRI scans were obtained. A fully automated frontal lobe atlas was used to generate functionally distinct frontal subdivisions, with surface area (SA) and cortical thickness (CT) assessed in each region. Analyses focused on overall diagnostic differences as well as examinations of the effect of diagnosis within boys and girls. Girls, but not boys, with ADHD showed overall reductions in total prefrontal cortex (PFC) SA. Localization revealed that girls showed widely distributed reductions in the bilateral dorsolateral PFC, left inferior lateral PFC, right medial PFC, right orbitofrontal cortex, and left anterior cingulate; and boys showed reduced SA only in the right anterior cingulate and left medial PFC. In contrast, boys, but not girls, with ADHD showed overall reductions in total premotor cortex (PMC) SA. Further localization revealed that in boys, premotor reductions were observed in bilateral lateral PMC regions; and in girls reductions were observed in bilateral supplementary motor complex. In line with diagnostic group differences, PMC and PFC SAs were inversely correlated with symptom severity in both girls and boys with ADHD. These results elucidate sex-based differences in cortical morphology of functional subdivisions of the frontal lobe and provide additional evidence of associations among SA and symptom severity in children with ADHD.

  6. Differences in the neural correlates of frontal lobe tests.

    Science.gov (United States)

    Matsuoka, Teruyuki; Kato, Yuka; Imai, Ayu; Fujimoto, Hiroshi; Shibata, Keisuke; Nakamura, Kaeko; Yamada, Kei; Narumoto, Jin

    2018-01-01

    The Executive Interview (EXIT25), the executive clock-drawing task (CLOX1), and the Frontal Assessment Battery (FAB) are used to assess executive function at the bedside. These tests assess distinct psychometric properties. The aim of this study was to examine differences in the neural correlates of the EXIT25, CLOX1, and FAB based on magnetic resonance imaging. Fifty-eight subjects (30 with Alzheimer's disease, 10 with mild cognitive impairment, and 18 healthy controls) participated in this study. Multiple regression analyses were performed to examine the brain regions correlated with the EXIT25, CLOX1, and FAB scores. Age, gender, and years of education were included as covariates. Statistical thresholds were set to uncorrected P-values of 0.001 at the voxel level and 0.05 at the cluster level. The EXIT25 score correlated inversely with the regional grey matter volume in the left lateral frontal lobe (Brodmann areas 6, 9, 44, and 45). The CLOX1 score correlated positively with the regional grey matter volume in the right orbitofrontal cortex (Brodmann area 11) and the left supramarginal gyrus (Brodmann area 40). The FAB score correlated positively with the regional grey matter volume in the right precentral gyrus (Brodmann area 6). The left lateral frontal lobe (Brodmann area 9) and the right lateral frontal lobe (Brodmann area 46) were identified as common brain regions that showed association with EXIT25, CLOX1, and FAB based only a voxel-level threshold. The results of this study suggest that the EXIT25, CLOX1, and FAB may be associated with the distinct neural correlates of the frontal cortex. © 2018 Japanese Psychogeriatric Society.

  7. Upper lobe pulmonary edema and dry gangrene in scorpion sting

    Directory of Open Access Journals (Sweden)

    Stalin Viswanathan

    2011-06-01

    Full Text Available A 17 year old student admitted to our hospital following a red scorpion sting had pulmonary edema and hypotension. Chest radiography revealed asymmetrical upper lobe pulmonary edema with air bronchogram. Due to high counts, antibiotics were initiated. Chest radiograph indicated that the chest radiography abnormalities were improved within 36 hours. Thirty hours after admission he developed discoloration of left foot which was managed conservatively with heparin and warfarin. His inotropes were gradually tapered and stopped 78 hours after admission. Echocardiography repeated on the sixth day of his admission was normal. He was discharged on pentoxyphylline, warfarin and tramadol since there was no surgical intervention possible due to poor demarcation.

  8. Particle doses in the pulmonary lobes of electronic and conventional cigarette users

    International Nuclear Information System (INIS)

    Manigrasso, Maurizio; Buonanno, Giorgio; Stabile, Luca; Morawska, Lidia; Avino, Pasquale

    2015-01-01

    The main aim of the present study was to estimate size segregated doses from e-cigarette aerosols as a function of the airway generation number in lung lobes. After a 2-second puff, 7.7 × 10 10 particles (D Tot ) with a surface area of 3.6 × 10 3  mm 2 (S Tot ), and 3.3 × 10 10 particles with a surface area of 4.2 × 10 3  mm 2 were deposited in the respiratory system for the electronic and conventional cigarettes, respectively. Alveolar and tracheobronchial deposited doses were compared to the ones received by non-smoking individuals in Western countries, showing a similar order of magnitude. Total regional doses (D R ), in head and lobar tracheobronchial and alveolar regions, ranged from 2.7 × 10 9 to 1.3 × 10 10 particles and 1.1 × 10 9 to 5.3 × 10 10 particles, for the electronic and conventional cigarettes, respectively. D R in the right-upper lung lobe was about twice that found in left-upper lobe and 20% greater in right-lower lobe than the left-lower lobe. - Highlights: • Lobar doses were compared for mainstreams of electronic and conventional cigarettes. • Aerosol doses from e-cigarettes were more than double that from conventional ones. • Doses from a 2-s puff exceed the daily doses of a no smoking Australian subject. • Highest deposition densities occurred at the lobar bronchi. • Aerosol deposition was greater in the right than in the left lung lobes. - Lobar bronchi and right lung lobes represent sites where effects of the aerosol from e-cigarette smoke may be more likely to occur

  9. Levels of Processing with Free and Cued Recall and Unilateral Temporal Lobe Epilepsy

    Science.gov (United States)

    Lespinet-Najib, Veronique; N'Kaoua, Bernard; Sauzeon, Helene; Bresson, Christel; Rougier, Alain; Claverie, Bernard

    2004-01-01

    This study investigates the role of the temporal lobes in levels-of-processing tasks (phonetic and semantic encoding) according to the nature of recall tasks (free and cued recall). These tasks were administered to 48 patients with unilateral temporal epilepsy (right ''RTLE''=24; left ''LTLE''=24) and a normal group (n=24). The results indicated…

  10. Treatment of Proper Name Retrieval Deficits in an Individual with Temporal Lobe Epilepsy

    Science.gov (United States)

    Minkina, Irene; Ojemann, Jeffrey G.; Grabowski, Thomas J.; Silkes, JoAnn P.; Phatak, Vaishali; Kendall, Diane L.

    2013-01-01

    Purpose: Studies investigating language deficits in individuals with left temporal-lobe epilepsy have consistently demonstrated impairments in proper name retrieval. The aim of this Phase I rehabilitation study was to investigate the effects of a linguistically distributed word retrieval treatment on proper name retrieval in an individual with…

  11. The combined effect of erythropoietin and granulocyte macrophage colony stimulating factor on liver regeneration after major hepatectomy in rats

    Directory of Open Access Journals (Sweden)

    Frangou Matrona

    2010-07-01

    Full Text Available Abstract Background The liver presents a remarkable capacity for regeneration after hepatectomy but the exact mechanisms and mediators involved are not yet fully clarified. Erythropoietin (EPO and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF have been shown to promote liver regeneration after major hepatectomy. Aim of this experimental study is to compare the impact of exogenous administration of EPO, GM-CSF, as well as their combination on the promotion of liver regeneration after major hepatectomy. Methods Wistar rats were submitted to 70% major hepatectomy. The animals were assigned to 4 experimental groups: a control group (n = 21 that received normal saline, an EPO group (n = 21, that received EPO 500 IU/kg, a GM-CSF group (n = 21 that received 20 mcg/kg of GM-CSF and a EPO+GMCSF group (n = 21 which received a combination of the above. Seven animals of each group were killed on the 1st, 3rd and 7th postoperative day and their remnant liver was removed to evaluate liver regeneration by immunochemistry for PCNA and Ki 67. Results Our data suggest that EPO and GM-CSF increases liver regeneration following major hepatectomy when administered perioperatively. EPO has a more significant effect than GM-CSF (p Conclusion EPO, GM-CSF and their combination enhance liver regeneration after hepatectomy in rats when administered perioperatively. However their combination has a weaker effect on liver regeneration compared to EPO alone. Further investigation is needed to assess the exact mechanisms that mediate this finding.

  12. Hepatectomy for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus, Including Cases with Obstructive Jaundice.

    Science.gov (United States)

    Orimo, Tatsuya; Kamiyama, Toshiya; Yokoo, Hideki; Wakayama, Kenji; Shimada, Shingo; Tsuruga, Yosuke; Kamachi, Hirofumi; Taketomi, Akinobu

    2016-08-01

    This study aimed to evaluate the short- and long-term outcomes of hepatectomy for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT), including cases with obstructive jaundice. The study reviewed 42 HCC patients with BDTT, including six patients who needed preoperative biliary drainage due to obstructive jaundice, and 732 HCC patients without BDTT. The authors analyzed the impact of BDTT on the surgical outcomes and assessed the outcomes of hepatectomy for patients presenting with obstructive jaundice. The HCC patients with BDTT, almost all with stage 3 or 4 disease, had increased alpha-fetoprotein expression, larger tumors, and more portal vein invasion status. The survival of the HCC patients with BDTT was significantly inferior to that of the patients without BDTT (p = 0.0003). Survival did not differ significantly between the HCC patients with BDTT and those without BDTT when the two groups were matched by stage (p = 0.3366). The HCC patients with BDTT who presented with obstructive jaundice demonstrated outcomes similar to those for the HCC patients with BDTT who did not present with obstructive jaundice in terms of the overall survival rate (p = 0.5469). The perioperative outcomes for the HCC patients with BDTT did not depend on the presence or absence of preoperative jaundice. No patients in either BDTT group demonstrated 90-day mortality in this study. Hepatectomy should be considered for HCC patients with BDTT, even for patients with obstructive jaundice, because the surgical outcomes equivalent to those for HCC without BDTT can be achieved.

  13. Preoperative Controlling Nutritional Status (CONUT) Score for Assessment of Prognosis Following Hepatectomy for Hepatocellular Carcinoma.

    Science.gov (United States)

    Takagi, Kosei; Yagi, Takahito; Umeda, Yuzo; Shinoura, Susumu; Yoshida, Ryuichi; Nobuoka, Daisuke; Kuise, Takashi; Araki, Hiroyuki; Fujiwara, Toshiyoshi

    2017-09-01

    Immune-nutritional status has been recently reported as a prognostic factor in hepatocellular carcinoma (HCC). The controlling nutritional status (CONUT) score has been established as a useful tool to evaluate immune-nutritional status. This study aimed to investigate the efficacy of the CONUT score as a prognostic factor in patients undergoing hepatectomy for HCC. A total of 295 patients who underwent curative hepatectomy for HCC between January 2007 and December 2014 were retrospectively analyzed. Patients were divided into two groups according to the CONUT score. The impact of the CONUT score on clinicopathological, surgical, and long-term outcomes was evaluated. Subsequently, the impact of prognostic factors, including the CONUT score, associated with outcomes was assessed using multivariate analyses. Of 295 patients, 118 (40%) belonged to the high CONUT group (CONUT score ≥ 3). The high CONUT group had a significantly lower 5-year recurrence-free survival rate than the low CONUT group (27.9 vs. 41.4%, p = 0.011) and a significantly lower 5-year overall survival rate (61.9 vs. 74.9%, p = 0.006). In multivariate analyses of prognostic factors, the CONUT score was an independent predictor of recurrence-free survival (hazard ratio = 1.64, p = 0.006) and overall survival (hazard ratio = 2.50, p = 0.001). The CONUT score is a valuable preoperative predictor of survival in patients undergoing hepatectomy for HCC.

  14. Quantitative electroencephalographic and neuropsychological investigation of an alternative measure of frontal lobe executive functions: the Figure Trail Making Test.

    Science.gov (United States)

    Foster, Paul S; Drago, Valeria; Ferguson, Brad J; Harrison, Patti Kelly; Harrison, David W

    2015-12-01

    The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. Relatively little is known about right frontal lobe contributions to executive functioning given the paucity of measures sensitive to right frontal functioning. The present investigation reports the development and initial validation of a new measure designed to be sensitive to right frontal lobe functioning, the Figure Trail Making Test (FTMT). The FTMT, the classic Trial Making Test, and the Ruff Figural Fluency Test (RFFT) were administered to 42 right-handed men. The results indicated a significant relationship between the FTMT and both the TMT and the RFFT. Performance on the FTMT was also related to high beta EEG over the right frontal lobe. Thus, the FTMT appears to be an equivalent measure of executive functioning that may be sensitive to right frontal lobe functioning. Applications for use in frontotemporal dementia, Alzheimer's disease, and other patient populations are discussed.

  15. Agenesis of the right lobe of liver

    International Nuclear Information System (INIS)

    Lee, Jeung Min; Kim, Chong Soo; Chung, Soo Hyun; Sohn, Myung Hee; Chung, Gyung Ho; Han, Young Min; Choi, Ki Chul; Cho, Baik Hwan

    1993-01-01

    Agenesis of the right lobe of the liver is a rear anomaly which may be associated with biliary stone disease, portal hypertension, and other congenital anomalies. The radiological differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. We present a case of agenesis of the right lobe the liver with characteristic clinical and radiological findings

  16. Accessory Lobes, Accessory Fissures and Prominent Papillary ...

    African Journals Online (AJOL)

    Often unreported hepatic variations include accessory fissures, lobes and processes. Variant hepatic fissures further show variations in location and depth. Accessory lobes of the liver have different size, shape, situation, connection with maternal organ. These abnormalities in the anatomy of human liver have the ...

  17. Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy: A meta-analysis.

    Science.gov (United States)

    Yang, Rui; Tao, Wan; Chen, Yang-Yang; Zhang, Bing-Hong; Tang, Jun-Ming; Zhong, Sen; Chen, Xian-Xiang

    2016-12-01

    Enhanced recovery after surgery (ERAS) programs are a series of measures being taken during the perioperation to alleviate surgical stress and accelerate the recovery rate of patients. Although several studies reported the efficacy of ERAS in liver surgery, the role of ERAS in laparoscopic hepatectomy is still unclear. This meta-analysis is aimed to evaluate the efficacy and safety of ERAS programs versus traditional care in laparoscopic hepatectomy. We searched PubMed, EMBASE, the Cochrane Library, CNKI, Wang Fang Database and VIP Database for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) concerning using ERAS in laparoscopic hepatectomy. Data collection ended in June 1st, 2016. The main end points were intraoperative blood loss, intraoperative blood transfusion, operative time, the cost of hospitalization, time to first flatus, the time to first diet after surgery, duration of postoperative hospital stay, total postoperative complication rate, gradeⅠcomplication rate, grade Ⅱ-Ⅴcomplication rate. 8 studies with 580 patients were eligible for analysis. There were 292 cases in ERAS group and 288 cases in traditional perioperative care (CTL) group. Compared with CTL group, ERAS group was associated with significantly accelerated of time to first diet after surgery (SMD = -1.79, 95%CI: -3.19 ∼ -0.38, P = 0.01), time to first flatus (MD = -0.51, 95%CI: -0.91 ∼ -0.12, P = 0.01). Meanwhile, it was associated with significantly decreased of duration of the postoperative hospital stay (MD = -3.31, 95%CI: -3.95 ∼ -2.67, P  0.05), intraoperative blood transfusion (P > 0.05), operative time (P > 0.05) between ERAS group and CTL group. Application of ERAS in laparoscopic hepatectomy is safe and effective, and it could accelerate the postoperative recovery and lighten the financial burden of patients. Copyright © 2016 IJS Publishing Group Ltd. All rights reserved.

  18. [Effects of berberine on the recovery of rat liver xenobiotic-metabolizing enzymes after partial hepatectomy].

    Science.gov (United States)

    Zverinsky, I V; Zverinskaya, H G; Sutsko, I P; Telegin, P G; Shlyahtun, A G

    2015-01-01

    We have studied the effect of berberine on the recovery processes of liver xenobiotic-metabolizing function during its compensatory growth after 70% partial hepatectomy. It was found the hepatic ability to metabolize foreign substances are not restored up to day 8. Administration of berberine (10 mg/kg intraperitoneally) for 6 days led to normalization of both cytochrome P450-dependent and flavin-containing monooxygenases. It is suggested that in the biotransformation of berberine involved not only cytochrome P450, but also flavin-containing monooxygenases.

  19. Anesthetic implications of extended right hepatectomy in a patient with fontan physiology.

    Science.gov (United States)

    Weyker, Paul David; Allen-John Webb, Christopher; Emond, Jean C; Brentjens, Tricia E; Johnston, Taylor A

    2014-04-15

    Patients who have undergone complete cavopulmonary anastomosis, the Fontan procedure, have passive venous blood flow from the superior and inferior vena cava into the pulmonary circulation without passing through the right ventricle. Although this procedure is an effective means of palliation, the resultant chronically increased central venous pressure, leads to several types of hepatic dysfunction including chronic congestion, cardiac cirrhosis, and even hepatocellular carcinoma. In this case report, we describe a patient with Fontan-associated hepatocellular carcinoma who successfully underwent a right hepatectomy.

  20. Complex Partial Epilepsy Associated with Temporal Lobe Developmental Venous Anomaly.

    Science.gov (United States)

    Sohail, Amna; Xiong, Zhengming; Qureshi, Mushtaq H; Qureshi, Adnan I

    2015-05-01

    Developmental venous anomalies (DVA) are found incidentally but sometimes patients with these anomalies present with varying degrees of neurologic manifestations. We report a patient with early onset complex partial epilepsy and associated DVA and discuss the natural history, neuroimaging and clinical characteristics, and management. A 21-year-old man presented with a history of complex partial epilepsy with secondary generalization which started at the age of 4 years. An electroencephalogram (EEG) was performed which demonstrated spike and wave discharges predominantly in the left frontotemporal region. A magnetic resonance imaging (MRI) was performed which demonstrated a linear flow void suggestive of a DVA. The angiogram demonstrated DVA that connected with the left transverse venous sinus and an anastomotic vein between the straight sinus and the transverse venous sinus traversing the brain parenchyma. He was started on carbamezipine for the treatment of complex partial seizures. Temporal lobe DVA may be associated with complex partial seizures and can be diagnosed by MRI and angiographic findings.

  1. Frontal lobe alterations in schizophrenia: a review.

    Science.gov (United States)

    Mubarik, Ateeq; Tohid, Hassaan

    2016-01-01

    To highlight the changes in the frontal lobe of the human brain in people with schizophrenia. This was a qualitative review of the literature. Many schizophrenic patients exhibit functional, structural, and metabolic abnormalities in the frontal lobe. Some patients have few or no alterations, while some have more functional and structural changes than others. Magnetic resonance imaging (MRI) shows structural and functional changes in volume, gray matter, white matter, and functional activity in the frontal lobe, but the mechanisms underlying these changes are not yet fully understood. When schizophrenia is studied as an essential topic in the field of neuropsychiatry, neuroscientists find that the frontal lobe is the most commonly involved area of the human brain. A clear picture of how this lobe is affected in schizophrenia is still lacking. We therefore recommend that further research be conducted to improve understanding of the pathophysiology of this psychiatric dilemma.

  2. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    Full Text Available A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG, but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale—III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures

  3. Apraxia and the Parietal Lobes

    Science.gov (United States)

    Goldenberg, Georg

    2009-01-01

    The widely held belief in a central role of left parietal lesions for apraxia can be traced back to Liepmann's model of a posterior to anterior stream converting mental images of intended action into motor execution. Although this model has undergone significant changes, its modern descendants still attribute the parietal contribution to the…

  4. Episodic and Semantic Autobiographical Memory in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Claudia P. Múnera

    2014-01-01

    Full Text Available Autobiographical memory (AM is understood as the retrieval of personal experiences that occurred in specific time and space. To date, there is no consensus on the role of medial temporal lobe structures in AM. Therefore, we investigated AM in medial temporal lobe epilepsy (TLE patients. Twenty TLE patients candidates for surgical treatment, 10 right (RTLE and 10 left (LTLE, and 20 healthy controls were examined with a version of the Autobiographical Interview adapted to Spanish language. Episodic and semantic AM were analyzed during five life periods through two conditions: recall and specific probe. AM scores were compared with clinical and cognitive data. TLE patients showed lower performance in episodic AM than healthy controls, being significantly worst in RTLE group and after specific probe. In relation to semantic AM, LTLE retrieved higher amount of total semantic details compared to controls during recall, but not after specific probe. No significant differences were found between RTLE and LTLE, but a trend towards poorer performance in RTLE group was found. TLE patients obtained lower scores for adolescence period memories after specific probe. Our findings support the idea that the right hippocampus would play a more important role in episodic retrieval than the left, regardless of a temporal gradient.

  5. Preoperative neuropsychological presentation of patients with refractory frontal lobe epilepsy.

    Science.gov (United States)

    Patrikelis, Panayiotis; Gatzonis, Stylianos; Siatouni, Anna; Angelopoulos, Elias; Konstantakopoulos, George; Takousi, Maria; Sakas, Damianos E; Zalonis, Ioannis

    2016-06-01

    This study investigated whether certain cognitive deficits are associated with frontal lobe epilepsy (FLE) aiming to contribute with localization data to the preoperative assessment of epilepsy surgery candidates. We evaluated 34 patients with refractory FLE, 37 patients with refractory medial temporal lobe epilepsy (MTLE), and 22 healthy individuals in attention, psychomotor speed, motor function, verbal memory span, verbal fluency, response inhibition/interference, concept formation and set shifting, anticipation and planning, global memory. Neuropsychological performances of FLE and MTLE were similar, with the only exception the WCST-number of categories index, measuring mental flexibility, in which MTLE patients performed significantly worse than FLE patients. Left-FLE patients presented more perseverative responding compared to both other patient groups and healthy controls (HCs), while left-MTLE patients showed worse sorting abilities than the other epilepsy groups. Our findings suggest a weak cognitive differentiation between FLE and MTLE, probably attributed to the intricate nature of fronto-temporal connectivity frequently resulting in overlapping deficits as well as the confounding effects of seizure-related variables. In clinical practice, a highly individualized (idiographic) neuropsychological approach along with the inclusion of concurrent EEG recordings (e.g., interictal coupling) may be of help for neuropsychologists in identifying FLE patients from those with medial temporal pathology presenting frontal dysfunction as a secondary cognitive symptom.

  6. Particle doses in the pulmonary lobes of electronic and conventional cigarette users.

    Science.gov (United States)

    Manigrasso, Maurizio; Buonanno, Giorgio; Stabile, Luca; Morawska, Lidia; Avino, Pasquale

    2015-07-01

    The main aim of the present study was to estimate size segregated doses from e-cigarette aerosols as a function of the airway generation number in lung lobes. After a 2-second puff, 7.7 × 10(10) particles (DTot) with a surface area of 3.6 × 10(3) mm(2) (STot), and 3.3 × 10(10) particles with a surface area of 4.2 × 10(3) mm(2) were deposited in the respiratory system for the electronic and conventional cigarettes, respectively. Alveolar and tracheobronchial deposited doses were compared to the ones received by non-smoking individuals in Western countries, showing a similar order of magnitude. Total regional doses (D(R)), in head and lobar tracheobronchial and alveolar regions, ranged from 2.7 × 10(9) to 1.3 × 10(10) particles and 1.1 × 10(9) to 5.3 × 10(10) particles, for the electronic and conventional cigarettes, respectively. D(R) in the right-upper lung lobe was about twice that found in left-upper lobe and 20% greater in right-lower lobe than the left-lower lobe. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. An unusual case of left hepatectomy for Focal Nodular Hyperplasia (FNH linked to the use of Anabolic Androgenic Steroids (AASs

    Directory of Open Access Journals (Sweden)

    Angela Romano

    2017-01-01

    Conclusion: The particularity of our case is the increasing of the lesion in two years in which the patient made use of anabolic steroids. under use of . This could be the explanation for increasing of nodule.

  8. The timing of associative memory formation: frontal lobe and anterior medial temporal lobe activity at associative binding predicts memory

    Science.gov (United States)

    Hales, J. B.

    2011-01-01

    The process of associating items encountered over time and across variable time delays is fundamental for creating memories in daily life, such as for stories and episodes. Forming associative memory for temporally discontiguous items involves medial temporal lobe structures and additional neocortical processing regions, including prefrontal cortex, parietal lobe, and lateral occipital regions. However, most prior memory studies, using concurrently presented stimuli, have failed to examine the temporal aspect of successful associative memory formation to identify when activity in these brain regions is predictive of associative memory formation. In the current study, functional MRI data were acquired while subjects were shown pairs of sequentially presented visual images with a fixed interitem delay within pairs. This design allowed the entire time course of the trial to be analyzed, starting from onset of the first item, across the 5.5-s delay period, and through offset of the second item. Subjects then completed a postscan recognition test for the items and associations they encoded during the scan and their confidence for each. After controlling for item-memory strength, we isolated brain regions selectively involved in associative encoding. Consistent with prior findings, increased regional activity predicting subsequent associative memory success was found in anterior medial temporal lobe regions of left perirhinal and entorhinal cortices and in left prefrontal cortex and lateral occipital regions. The temporal separation within each pair, however, allowed extension of these findings by isolating the timing of regional involvement, showing that increased response in these regions occurs during binding but not during maintenance. PMID:21248058

  9. Effects of Hydrogen-Rich Saline on Hepatectomy-Induced Postoperative Cognitive Dysfunction in Old Mice.

    Science.gov (United States)

    Tian, Yue; Guo, Shanbin; Zhang, Yan; Xu, Ying; Zhao, Ping; Zhao, Xiaochun

    2017-05-01

    This study aims to investigate the protective effects and underlying mechanisms of hydrogen-rich saline on the cognitive functions of elder mice with partial hepatectomy-induced postoperative cognitive dysfunction (POCD). Ninety-six old male Kunming mice were randomly divided into 4 groups (n = 24 each): control group (group C), hydrogen-rich saline group (group H), POCD group (group P), and POCD + hydrogen-rich saline group (group PH). Cognitive function was subsequently assessed using Morris water-maze (MWM) test. TNF-α and IL-1β levels were measured by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry, along with NF-κB activity determined by ELISA. The morphology of hippocampal tissues were further observed by HE staining. Learning and memory abilities of mice were significantly impaired at day 10 and day 14 post-surgery, as partial hepatectomy significantly prolonged the escape latency, decreased time at the original platform quadrant and frequency of crossing in group P when compared to group C (p hydrogen-rich saline (group PH) partially rescued spatial memory and learning as it shortened escape latency and increased time and crossing frequency of original platform compared to group P (p hydrogen-rich saline. Hydrogen-rich saline can alleviate POCD via inhibiting NF-κB activity in the hippocampus and reducing inflammatory response.

  10. Rapid Liver Hypertrophy After Portal Vein Occlusion Correlates with the Degree of Collateralization Between Lobes-a Study in Pigs.

    Science.gov (United States)

    Deal, Rebecca; Frederiks, Charles; Williams, Lauren; Olthof, Pim B; Dirscherl, Konstantin; Keutgen, Xavier; Chan, Edie; Deziel, Daniel; Hertl, Martin; Schadde, Erik

    2018-02-01

    Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) induces more rapid liver growth than portal vein ligation (PVL). Transection of parenchyma in ALPPS may prevent the formation of collaterals between lobes. The aim of this study was to determine if abrogating the formation of collaterals through parenchymal transection impacted growth rate. Twelve Yorkshire Landrace pigs were randomized to undergo ALPPS, PVL, or "partial ALPPS" by varying degrees of parenchymal transection. Hepatic volume was measured after 7 days. Portal blood flow and pressure were measured. Portal vein collaterals were examined from epoxy casts. PVL, ALPPS, and partial ALPPS led to volume increases of the RLL by 15.5% (range 3-22), 64% (range 45-76), and 32% (range 18-77), respectively, with significant differences between PVL and ALPPS/partial ALPPS (p new portal vein collaterals were found. The number of collaterals correlated inversely with the growth rate (p = 0.039). Portal vein pressure was elevated in all models after ligation suggesting hyperflow to the portal vein-supplied lobe (p < 0.05). These data suggest that liver hypertrophy following PVL is inversely proportional to the development of collaterals. Hypertrophy after ALPPS is likely more rapid due to reduction of collaterals through transection.

  11. Connectivity pattern differences bilaterally in the cerebellum posterior lobe in healthy subjects after normal sleep and sleep deprivation: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Liu XM

    2015-05-01

    Full Text Available Xuming Liu,1 Zhihan Yan,2 Tingyu Wang,1 Xiaokai Yang,1 Feng Feng,3 Luping Fan,1 Jian Jiang4 1Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 2Department of Radiology, The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, 3Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 4Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China Objective: The aim of this study was to use functional magnetic resonance imaging (fMRI technique to explore the resting-state functional connectivity (rsFC differences of the bilaterial cerebellum posterior lobe (CPL after normal sleep (NS and after sleep deprivation (SD. Methods: A total of 16 healthy subjects (eight males, eight females underwent an fMRI scan twice at random: once following NS and the other following 24 hours’ SD, with an interval of 1 month between the two scans. The fMRI scanning included resting state and acupuncture stimulation. The special activated regions located during the acupuncture stimulation were selected as regions of interest for rsFC analysis. Results: Bilateral CPLs were positively activated by acupuncture stimulation. In the NS group, the left CPL showed rsFC with the bilateral CPL, bilateral frontal lobe (BFL, left precuneus and right inferior parietal lobule, while the right CPL showed rsFC with the bilateral temporal lobe, right cerebellum anterior lobe, right CPL, left frontal lobe, left anterior cingulate, right posterior cingulate, and bilateral inferior parietal lobule. In the SD group, the left CPL showed rsFC with the left posterior cingulate gyrus bilateral CPL, left precuneus, left precentral gyrus, BFL, and the left parietal lobe, while the right CPL showed rsFC with bilateral cerebellum anterior lobe, bilateral CPL, left frontal lobe and left temporal lobe. Compared with the NS group, the

  12. Hippocampal activation correlates with visual confrontation naming: fMRI findings in controls and patients with temporal lobe epilepsy.

    Science.gov (United States)

    Bonelli, Silvia B; Powell, Rob; Thompson, Pamela J; Yogarajah, Mahinda; Focke, Niels K; Stretton, Jason; Vollmar, Christian; Symms, Mark R; Price, Cathy J; Duncan, John S; Koepp, Matthias J

    2011-08-01

    In patients with left temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) decreased naming ability is common, suggesting a critical role for the medial left temporal lobe in this task. We investigated the integrity of language networks with functional MRI (fMRI) in controls and TLE patients. We performed an fMRI verbal fluency paradigm in 22 controls and 66 patients with unilateral mesial TLE (37 left HS, 29 right HS). Verbal fluency and naming ability were investigated as part of the standard presurgical neuropsychological assessment. Naming ability was assessed using a visual confrontation naming test. Left TLE patients had significantly lower naming scores than controls and those with right TLE. Right TLE patients performed less well than controls, but better than those with left TLE. Left TLE had significantly lower scores for verbal fluency than controls. In controls and right TLE, left hippocampal activation during the verbal fluency task was significantly correlated with naming, characterised by higher scores in subjects with greater hippocampal fMRI activation. In left TLE no correlation with naming scores was seen in the left hippocampus, but there was a significant correlation in the left middle and inferior frontal gyri, not observed in controls and right TLE. In left and right TLE, out of scanner verbal fluency scores significantly correlated with fMRI activation for verbal fluency in the left middle and inferior frontal gyri. Good confrontation naming ability depends on the integrity of the hippocampus and the connecting fronto-temporal networks. Functional MRI activation in the left hippocampus during verbal fluency is associated with naming function in healthy controls and patients with right TLE. In left TLE, there was evidence of involvement of the left frontal lobe when naming was more proficient, most likely reflecting a compensatory response due to the ongoing epileptic activity and/or underlying pathology. Copyright © 2011 Elsevier

  13. Necessary Contributions of Human Frontal Lobe Subregions to Reward Learning in a Dynamic, Multidimensional Environment.

    Science.gov (United States)

    Vaidya, Avinash R; Fellows, Lesley K

    2016-09-21

    Real-world decisions are typically made between options that vary along multiple dimensions, requiring prioritization of the important dimensions to support optimal choice. Learning in this setting depends on attributing decision outcomes to the dimensions with predictive relevance rather than to dimensions that are irrelevant and nonpredictive. This attribution problem is computationally challenging, and likely requires an interplay between selective attention and reward learning. Both these processes have been separately linked to the prefrontal cortex, but little is known about how they combine to support learning the reward value of multidimensional stimuli. Here, we examined the necessary contributions of frontal lobe subregions in attributing feedback to relevant and irrelevant dimensions on a trial-by-trial basis in humans. Patients with focal frontal lobe damage completed a demanding reward learning task where options varied on three dimensions, only one of which predicted reward. Participants with left lateral frontal lobe damage attributed rewards to irrelevant dimensions, rather than the relevant dimension. Damage to the ventromedial frontal lobe also impaired learning about the relevant dimension, but did not increase reward attribution to irrelevant dimensions. The results argue for distinct roles for these two regions in learning the value of multidimensional decision options under dynamic conditions, with the lateral frontal lobe required for selecting the relevant dimension to associate with reward, and the ventromedial frontal lobe required to learn the reward association itself. The real world is complex and multidimensional; how do we attribute rewards to predictive features when surrounded by competing cues? Here, we tested the critical involvement of human frontal lobe subregions in a probabilistic, multidimensional learning environment, asking whether focal lesions affected trial-by-trial attribution of feedback to relevant and irrelevant

  14. Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy.

    Science.gov (United States)

    Holtkamp, Martin; Sharan, Ashwini; Sperling, Michael R

    2012-10-01

    Surgery in frontal lobe epilepsy (FLE) has a worse prognosis regarding seizure freedom than anterior lobectomy in temporal lobe epilepsy. The current study aimed to assess whether intracranial interictal and ictal EEG findings in addition to clinical and scalp EEG data help to predict outcome in a series of patients who needed invasive recording for FLE surgery. Patients with FLE who had resective surgery after chronic intracranial EEG recording were included. Outcome predictors were compared in patients with seizure freedom (group 1) and those with recurrent seizures (group 2) at 19-24 months after surgery. Twenty-five patients (16 female) were included in this study. Mean age of patients at epilepsy surgery was 32.3 ± 15.6 years (range 12-70); mean duration of epilepsy was 16.9 ± 13.4 years (range 1-48). In each outcome group, magnetic resonance imaging revealed frontal lobe lesions in three patients. Fifteen patients (60%) were seizure-free (Engel class 1), 10 patients (40%) continued to have seizures (two were class II, three were class III, and five were class IV). Lack of seizure freedom was seen more often in patients with epilepsy surgery on the left frontal lobe (group 1, 13%; group 2, 70%; p = 0.009) and on the dominant (27%; 70%; p = 0.049) hemisphere as well as in patients without aura (29%; 80%; p = 0.036), whereas sex, age at surgery, duration of epilepsy, and presence of an MRI lesion in the frontal lobe or extrafrontal structures were not different between groups. Electroencephalographic characteristics associated with lack of seizure freedom included presence of interictal epileptiform discharges in scalp recordings (31%; 90%; p = 0.01). Detailed analysis of intracranial EEG revealed widespread (>2 cm) (13%; 70%; p = 0.01) in contrast to focal seizure onset as well as shorter latency to onset of seizure spread (5.8 ± 6.1 s; 1.5 ± 2.3 s; p = 0.016) and to ictal involvement of brain structures beyond the frontal lobe (23.5 ± 22.4 s; 5.8 ± 5.4 s

  15. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G. [David Geffen School of Medicine at UCLA, Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, Los Angeles, CA (United States); Strange, Charlie [Medical University of South Carolina, Department of Pulmonary and Critical Care Medicine, Columbia, SC (United States); Tashkin, Donald P. [David Geffen School of Medicine at UCLA, Division of Pulmonary and Critical Care Medicine, Los Angeles, CA (United States)

    2012-07-15

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  16. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    International Nuclear Information System (INIS)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G.; Strange, Charlie; Tashkin, Donald P.

    2012-01-01

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  17. Ictal asystole: A rare cardiac manifestation of temporal lobe epilepsy, treated with epilepsy surgery.

    Science.gov (United States)

    Ravat, Shreyas Hasmukh; Bhatti, Amit Ashok; Shah, Mansi Viraj; Muzumdar, Dattatraya P; Ravat, Sangeeta Hasmukh

    2017-01-01

    Seizures are associated with fascinatingly varied cardiac and autonomic manifestations, of which ictal tachycardia is common, and asystole and bradycardia are rare. Ictal asystole (IA), an often unsought autonomic phenomenon, occurs most commonly with temporal followed by frontal lobe seizures. Prolonged IA may lead to cerebral anoxic ischemia. As the mysteries of sudden unexplained death in epilepsy are unraveled, it is quite possible that the key to it lays within these seizure-induced cardiac rhythm abnormalities. We present a case of a young male with temporal lobe epilepsy due to left mesial temporal sclerosis with prolonged IA, which was successfully managed with epilepsy surgery.

  18. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95......HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...

  19. Immunocytochemical determination of ploidy class-dependent bromodeoxyuridine incorporation in rat liver parenchymal cells after partial hepatectomy

    NARCIS (Netherlands)

    Frederiks, W. M.; Marx, F.; Chamuleau, R. A.; van Noorden, C. J.; James, J.

    1990-01-01

    Immunocytochemistry of bromodeoxyuridine (BrdU) incorporated in DNA was performed on cryostat sections of rat liver and on isolated hepatocytes after partial hepatectomy using a two-step labeling technique. The method enabled the detection of S-phase nuclei in both tissue preparations.

  20. Pulsed cold plasma-induced blood coagulation and its pilot application in stanching bleeding during rat hepatectomy

    Science.gov (United States)

    Keping, YAN; Qikang, JIN; Chao, ZHENG; Guanlei, DENG; Shengyong, YIN; Zhen, LIU

    2018-04-01

    This paper presents plasma-induced blood coagulation and its pilot application in rat hepatectomy by using a home-made pulsed cold plasma jet. Experiments were conducted on blood coagulation in vitro, the influence of plasma on tissue in vivo, and the pilot application of rat hepatectomy. Experimental results show that the cold plasma can lead to rapid blood coagulation. Compared with the control sample, the plasma-induced agglomerated layer of blood is thicker and denser, and is mostly composed of broken platelets. When the surface of the liver was treated by plasma, the influence of the plasma can penetrate into the liver to a depth of about 500 μm. During the rat hepatectomy, cold plasma was proved to be effective for stanching bleeding on incision. No obvious bleeding was found in the abdominal cavities of all six rats 48 h after the hepatectomy. This implies that cold plasma can be an effective modality to control bleeding during surgical operation.

  1. 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.)

  2. Clinical outcomes of patients with and without diabetes mellitus after hepatectomy: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Qingshan Li

    Full Text Available Clinical data regarding the influence of diabetes mellitus (DM on the outcomes of patients undergoing hepatectomy are conflicting. To determine the impact of DM on the clinical outcomes of patients undergoing hepatectomy, we systematically reviewed published studies and carried out a meta-analysis.A systematic literature search of Pubmed, Sciencedirect, Web of Science, and Chinese Biomedical Database was conducted from their inception through February 2, 2016. The combined relative risk (RR or hazard ratio (HR with 95% confidence intervals (95% CI was calculated.A total of 16 observational studies with 15710 subjects were eligible for meta-analysis. The pooled results showed that DM significantly increased the risk of overall postoperative complications (RR 1.34; 95% CI 1.19-1.51; P<0.001, DM-associated complications (RR 1.8; 95% CI 1.29-2.53; P<0.001, liver failure (RR 2.21; 95% CI 1.3-3.76; P = 0.028 and post-operative infections (RR 1.59; 95% CI 1.01-2.5; P = 0.045. In addition, DM was also found to be significantly associated with unfavorable overall survival and disease free survival after liver resection. The pooled HR was 1.63 (95% CI 1.33-1.99; P<0.001 for overall survival and 1.55 (95% CI 1.07-2.25; P = 0.019 for disease free survival.DM is associated with poor outcomes in patients undergoing hepatectomy. DM should be taken into account cautiously in the management of patients undergoing hepatectomy. Further prospective studies are warranted to explore effective interventions to improve the poor outcomes of diabetic patients undergoing hepatectomy.

  3. Early enteral and parenteral nutritional support after hepatectomy in patients with hepatic carcinoma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Gao LB

    2015-03-01

    Full Text Available Lin-Ben Gao,1* He Tian,2* Xing-Guang Wang,3 Xiao-Fei Yu,4 Yan Guan,2 Ming-Lu Chen,5 Jian Zhang6 1Department of Respiratory Medicine, Haiyang People’s Hospital, Haiyang, 2Department of Oncology, Shandong Province Tumor Hospital, Jinnan, 3Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinnan, 4Department of Emergency, Haiyang People’s Hospital, Haiyang, 5Department of Nuclear Radiology, Shandong Province Tumor Hospital, Jinnan, 6Department of Gastroenterology, Haiyang People’s Hospital, Haiyang, People’s Republic of China *These two authors contributed equally to this work Background: This study sought to conduct a systematic review providing a comparative analysis of enteral nutrition (EN and parenteral nutrition (PN after hepatectomy. Methods: PubMed, Embase, and the China National Knowledge Infrastructure databases were searched for publications describing randomized controlled trials that compared early EN and PN after hepatectomy. The time period for this search was from January 1990 to December 2013. In accordance with the inclusion criteria of this study, two researchers independently screened the retrieved literature, extracted data, and assessed methodological quality. A meta-analysis of the included publications was then performed using RevMan 5.2 software. Results: The meta-analysis results indicated statistically significant differences between the group that received EN and the group that received PN during the early stages after hepatectomy with respect to average total bilirubin and alanine aminotransferase levels after nutrition, prealbumin levels, incidence of diarrhea and abdominal bloating, time to flatus, and average cost of nutrition. To varying degrees, better results were observed in the EN group than in the PN group for these metrics. Conclusion: During the early stages after hepatectomy, EN has obvious advantages relative to PN; thus, EN merits more widespread promotion

  4. Human Frontal Lobes and AI Planning Systems

    Science.gov (United States)

    Levinson, Richard; Lum, Henry Jr. (Technical Monitor)

    1994-01-01

    Human frontal lobes are essential for maintaining a self-regulating balance between predictive and reactive behavior. This paper describes a system that integrates prediction and reaction based on neuropsychological theories of frontal lobe function. In addition to enhancing our understanding of deliberate action in humans' the model is being used to develop and evaluate the same properties in machines. First, the paper presents some background neuropsychology in order to set a general context. The role of frontal lobes is then presented by summarizing three theories which formed the basis for this work. The components of an artificial frontal lobe are then discussed from both neuropsychological and AI perspectives. The paper concludes by discussing issues and methods for evaluating systems that integrate planning and reaction.

  5. Deployment Instabilities of Lobed-Pumpkin Balloon

    Science.gov (United States)

    Nakashino, Kyoichi

    A lobed-pumpkin balloon, currently being developed in ISAS/JAXA as well as in NASA, is a promising vehicle for long duration scientific observations in the stratosphere. Recent ground and flight experiments, however, have revealed that the balloon has deployment instabilities under certain conditions. In order to overcome the instability problems, a next generation SPB called 'tawara' type balloon has been proposed, in which an additional cylindrical part is appended to the standard lobed-pumpkin balloon. The present study investigates the deployment stability of tawara type SPB in comparison to that of standard lobed-pumpkin SPB through eigenvalue analysis on the basis of finite element methods. Our numerical results show that tawara type SPB enjoys excellent deployment performance over the standard lobed-pumpkin SPBs.

  6. Mesial temporal lobe epilepsy diminishes functional connectivity during emotion perception.

    Science.gov (United States)

    Steiger, Bettina K; Muller, Angela M; Spirig, Esther; Toller, Gianina; Jokeit, Hennric

    2017-08-01

    Unilateral mesial temporal lobe epilepsy (MTLE) has been associated with impaired recognition of emotional facial expressions. Correspondingly, imaging studies showed decreased activity of the amygdala and cortical face processing regions in response to emotional faces. However, functional connectivity among regions involved in emotion perception has not been studied so far. To address this, we examined intrinsic functional connectivity (FC) modulated by the perception of dynamic fearful faces among the amygdala and limbic, frontal, temporal and brainstem regions. Regions of interest were identified in an activation analysis by presenting a block-design with dynamic fearful faces and dynamic landscapes to 15 healthy individuals. This led to 10 predominately right-hemispheric regions. Functional connectivity between these regions during the perception of fearful faces was examined in drug-refractory patients with left- (n=16) or right-sided (n=17) MTLE, epilepsy patients with extratemporal seizure onset (n=15) and a second group of 15 healthy controls. Healthy controls showed a widespread functional network modulated by the perception of fearful faces that encompassed bilateral amygdalae, limbic, cortical, subcortical and brainstem regions. In patients with left MTLE, a downsized network of frontal and temporal regions centered on the right amygdala was present. Patients with right MTLE showed almost no significant functional connectivity. A maintained network in the epilepsy control group indicates that findings in mesial temporal lobe epilepsy could not be explained by clinical factors such as seizures and antiepileptic medication. Functional networks underlying facial emotion perception are considerably changed in left and right MTLE. Alterations are present for both hemispheres in either MTLE group, but are more pronounced in right MTLE. Disruption of the functional network architecture possibly contributes to deficits in facial emotion recognition frequently

  7. Frontal lobe connectivity and cognitive impairment in pediatric frontal lobe epilepsy.

    Science.gov (United States)

    Braakman, Hilde M H; Vaessen, Maarten J; Jansen, Jacobus F A; Debeij-van Hall, Mariette H J A; de Louw, Anton; Hofman, Paul A M; Vles, Johan S H; Aldenkamp, Albert P; Backes, Walter H

    2013-03-01

    Cognitive impairment is frequent in children with frontal lobe epilepsy (FLE), but its etiology is unknown. With functional magnetic resonance imaging (fMRI), we have explored the relationship between brain activation, functional connectivity, and cognitive functioning in a cohort of pediatric patients with FLE and healthy controls. Thirty-two children aged 8-13 years with FLE of unknown cause and 41 healthy age-matched controls underwent neuropsychological assessment and structural and functional brain MRI. We investigated to which extent brain regions activated in response to a working memory task and assessed functional connectivity between distant brain regions. Data of patients were compared to controls, and patients were grouped as cognitively impaired or unimpaired. Children with FLE showed a global decrease in functional brain connectivity compared to healthy controls, whereas brain activation patterns in children with FLE remained relatively intact. Children with FLE complicated by cognitive impairment typically showed a decrease in frontal lobe connectivity. This decreased frontal lobe connectivity comprised both connections within the frontal lobe as well as connections from the frontal lobe to the parietal lobe, temporal lobe, cerebellum, and basal ganglia. Decreased functional frontal lobe connectivity is associated with cognitive impairment in pediatric FLE. The importance of impairment of functional integrity within the frontal lobe network, as well as its connections to distant areas, provides new insights in the etiology of the broad-range cognitive impairments in children with FLE. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  8. Topographical anatomy of Spiegel's lobe and its adjacent organs in mid-term fetuses: Its implication on the development of the lesser sac and adult morphology of the upper abdomen.

    Science.gov (United States)

    Hwang, Si Eun; Cho, Baik Hwan; Hirai, Ichiro; Kim, Hyoung Tae; Kim, Ji-Hyun; Fujimiya, Mineko; Murakami, Gen; Kimura, Wataru

    2010-09-01

    At 8-16 weeks of gestation, Spiegel's lobe of the caudate lobe appears as a sac-like herniation of the liver parenchyma between the inferior vena cava and ductus venosus or Arantius' duct. In 5 of 11 fetuses at 20-30 weeks of gestation, we found that an external notch was formed into the posterior aspect of the caudate lobe by a peritoneal fold containing the left gastric artery. This notch appeared to correspond to that observed in adults, which is usually seen at the antero-inferior margin of the lobe after rotation of the lobe along the horizontal or transverse axis. However, the notch did not accompany two of the three fetuses in which the left hepatic artery originated from the left gastric artery. Notably, until 9-10 weeks of gestation, the inferior and left part of Spiegel's lobe rode over the hepatoduodenal ligament and protruded medially into the lesser sac (bursa omentalis) behind the stomach. Thus, the fetal Winslow's foramen was located at the "superior" side of the ligament. However, as seen in adults, the protruding Spiegel's lobe was located at the posterior side of the lesser omentum. Therefore, a hypothetical rotation along the transverse axis in the later stages of development seems necessary to explain this repositioning. Considering that Spiegel's lobe develops faster than surrounding structures, it is likely that the lesser sac resulting from the rotation of the gastrointestinal tract, which actively contributes to facilitate the growth of the Spiegel lobe.

  9. The Lobe Fissure Tracking by the Modified Ant Colony Optimization Framework in CT Images

    Directory of Open Access Journals (Sweden)

    Chii-Jen Chen

    2014-11-01

    Full Text Available Chest computed tomography (CT is the most commonly used technique for the inspection of lung lesions. However, the lobe fissures in lung CT is still difficult to observe owing to its imaging structure. Therefore, in this paper, we aimed to develop an efficient tracking framework to extract the lobe fissures by the proposed modified ant colony optimization (ACO algorithm. We used the method of increasing the consistency of pheromone on lobe fissure to improve the accuracy of path tracking. In order to validate the proposed system, we had tested our method in a database from 15 lung patients. In the experiment, the quantitative assessment shows that the proposed ACO method achieved the average F-measures of 80.9% and 82.84% in left and right lungs, respectively. The experiments indicate our method results more satisfied performance, and can help investigators detect lung lesion for further examination.

  10. Variability of the Left Atrial Appendage in Human Hearts.

    Directory of Open Access Journals (Sweden)

    Rafał Kamiński

    Full Text Available Atrial fibrillation increases the risk of thrombus formation. It is commonly responsible for cerebral stroke whereas less frequently for pulmonary embolism. The aim of the study was to describe the morphology of the left atrial appendage in the human heart with respect to sex, age and weight. Macroscopic examination was carried out on 100 left appendages taken from the hearts of the patients aged 18-77, both sexes. All hearts preserved in 4% water solution of formaldehyde carried neither marks of coronary artery disease nor congenital abnormalities. Three axes of appendage orientation were performed. After the appendage had been cut off, morphological examination was performed in long and perpendicular axes. Measurements of the appendages were taken from anatomical specimens and their silicone casts. We classified the left atrial appendage into 4 morphological groups according to the number of lobes. Most left atrial appendages in female population were composed of 2 lobes. In the male group typically 2 or 3-lobed appendages were observed. The mean left atrial appendage orifice ranged from 12.0 to 16.0 mm and the most significant difference in the orifices between males and females was observed in LAA type 2 (about 3.3 mm. A smaller orifice and narrower, tubular shape of the LAA lobes could explain a higher risk of thrombus formation during nonvalvular atrial fibrillation in women. Knowledge of anatomical variability of the LAA helps diagnose some undefined echoes in the appendage during transesophageal echocardiographic examination.

  11. Living donor hepatectomy in female donors with ongoing menstruation: Safety and ethical issues

    Directory of Open Access Journals (Sweden)

    Horng-Ren Yang

    2017-01-01

    Conclusions: Our study shows safety of right lobe living donation in female donors with ongoing menstruation with no increased risk of intraoperative excessive bleeding and postoperative physiological impact on their general health.

  12. Auditory aura in nocturnal frontal lobe epilepsy: a red flag to suspect an extra-frontal epileptogenic zone.

    Science.gov (United States)

    Ferri, Lorenzo; Bisulli, Francesca; Nobili, Lino; Tassi, Laura; Licchetta, Laura; Mostacci, Barbara; Stipa, Carlotta; Mainieri, Greta; Bernabè, Giorgia; Provini, Federica; Tinuper, Paolo

    2014-11-01

    To describe the anatomo-electro-clinical findings of patients with nocturnal hypermotor seizures (NHS) preceded by auditory symptoms, to evaluate the localizing value of auditory aura. Our database of 165 patients with nocturnal frontal lobe epilepsy (NFLE) diagnosis confirmed by videopolysomnography (VPSG) was reviewed, selecting those who reported an auditory aura as the initial ictal symptom in at least two NHS during their lifetime. Eleven patients were selected (seven males, four females). According to the anatomo-electro-clinical data, three groups were identified. Group 1 [defined epileptogenic zone (EZ)]: three subjects were studied with stereo-EEG. The EZ lay in the left superior temporal gyrus in two cases, whereas in the third case seizures arose from a dysplastic lesion located in the left temporal lobe. One of these three patients underwent left Heschl's gyrus resection, and is currently seizure-free. Group 2 (presumed EZ): three cases in which a presumed EZ was identified; in the left temporal lobe in two cases and in the left temporal lobe extending to the insula in one subject. Group 3 (uncertain EZ): five cases had anatomo-electro-clinical correlations discordant. This work suggests that auditory aura may be a helpful anamnestic feature suggesting an extra-frontal seizure origin. This finding could guide secondary investigations to improve diagnostic definition and selection of candidates for surgical treatment. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Metallothionein expression during liver regeneration after partial hepatectomy in cadmium-pretreated rats

    Energy Technology Data Exchange (ETDEWEB)

    Margeli, A.P. (Dept. of Forensic Medicine and Toxicology, School of Medicine, Univ. of Athens (Greece)); Theocharis, S.E. (Dept. of Forensic Medicine and Toxicology, School of Medicine, Univ. of Athens (Greece)); Yannacou, N.N. (Dept. of Forensic Medicine and Toxicology, School of Medicine, Univ. of Athens (Greece)); Spiliopoulou, C. (Dept. of Forensic Medicine and Toxicology, School of Medicine, Univ. of Athens (Greece)); Koutselinis, A. (Dept. of Forensic Medicine and Toxicology, School of Medicine, Univ. of Athens (Greece))

    1994-10-01

    Metallothionein is a low molecular mass protein inducible mainly by heavy metals, having high affinity for binding cadmium, zinc and copper. In the present study we investigated the expression of metallothionein in regenerating liver, at different time intervals, in cadmium pretreated partially hepatectomized rats. Liver metallothionein is highly expressed during regeneration induced by partial hepatectomy in rats, providing zinc within the rapidly growing tissue. Cadmium pretreatment caused inhibition of the first peak of liver regeneration, while metallothionein expression was markedly more prominent in the liver residues of cadmium-pretreated rats. These results demonstrate that although metallothionein able to bind temporarily metal ions as zinc and cadmium has been highly expressed, the liver regenerative process was inhibited possibly due to the effects of cadmium on other pivotal events necessary to the DNA replication. (orig.)

  14. Microsurgical anatomy of the central lobe.

    Science.gov (United States)

    Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

    2015-03-01

    The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

  15. [Impact of microwave dealing with the cutting surface on the hepatocellular carcinoma recurrence after hepatectomy].

    Science.gov (United States)

    Wu, Zhengshan; Wang, Xing; Wang, Dong; Fan, Ye; Li, Donghua; Kong, Lianbao; Wang, Xuehao; Wang, Ke

    2015-12-01

    To explore the impact of microwave dealing with cutting surface on perioperative liver function recovery and recurrence and metastasis after hepatectomy for HCC. Clinical data of 133 patients with HCC from March 2009 to November 2010 were retrospectively analyzed. They were divided into the conventional surgery group (66 cases) and microwave treatment group (67 cases). A domestic ECO-100 microwave knife was inserted into the liver cutting surface 0.5 cm from the cutting edge, and repeated multi-point burning with an average time of 25 minutes in the microwave treatment group. Then the perioperative liver function recovery and recurrence and metastasis in the two groups were compared. The operation time of conventional surgery group was (158.0 ± 31.0) minutes, and that of microwave treatment group was significantly longer (181.0 ± 28.0) minutes (P=0.027). There were no significant differences in the liver function recovery between the two groups (P>0.05). There were 6 cases of recurrence and metastasis after 6 months and 9 cases after 12 months in the microwave treatment group, while there were 15 cases of recurrence and metastasis after 6 months and 20 cases after 12 months in the conventional surgery group, showing a significant difference (P=0.034 and 0.022, respectively). Microwave dealing with the cutting surface has no significant effect on perioperative liver function recovery in hepatectomy. However, microwave treatment can reduce the in situ recurrence in HCC patients within the first year after surgery, indicating a good clinical application value.

  16. Interleukin-1 receptor antagonist modulates the early phase of liver regeneration after partial hepatectomy in mice.

    Directory of Open Access Journals (Sweden)

    Antonino Sgroi

    Full Text Available BACKGROUND: Cytokine administration is a potential therapy for acute liver failure by reducing inflammatory responses and favour hepatocyte regeneration. The aim of this study was to evaluate the role of interleukin-1 receptor antagonist (IL-1ra during liver regeneration and to study the effect of a recombinant human IL-1ra on liver regeneration. METHODS: We performed 70%-hepatectomy in wild type (WT mice, IL-1ra knock-out (KO mice and in WT mice treated by anakinra. We analyzed liver regeneration at regular intervals by measuring the blood levels of cytokines, the hepatocyte proliferation by bromodeoxyuridin (BrdU incorporation, proliferating cell nuclear antigen (PCNA and Cyclin D1 expression. The effect of anakinra on hepatocyte proliferation was also tested in vitro using human hepatocytes. RESULTS: At 24h and at 48 h after hepatectomy, IL-1ra KO mice had significantly higher levels of pro-inflammatory cytokines (IL-6, IL-1β and MCP-1 and a reduced and delayed hepatocyte proliferation measured by BrdU incorporation, PCNA and Cyclin D1 protein levels, when compared to WT mice. IGFBP-1 and C/EBPβ expression was significantly decreased in IL-1ra KO compared to WT mice. WT mice treated with anakinra showed significantly decreased levels of IL-6 and significantly higher hepatocyte proliferation at 24h compared to untreated WT mice. In vitro, primary human hepatocytes treated with anakinra showed significantly higher proliferation at 24h compared to hepatocytes without treatment. CONCLUSION: IL1ra modulates the early phase of liver regeneration by decreasing the inflammatory stress and accelerating the entry of hepatocytes in proliferation. IL1ra might be a therapeutic target to improve hepatocyte proliferation.

  17. Do children with aggressive behavior have temporal lobe changes?

    International Nuclear Information System (INIS)

    Thomas, C.T.; Mishkin, F.; Goldberg, M.

    2002-01-01

    Aggressive behavior and mood disorders may afflict children. One problem is the lack of objective data to arrive at a specific clinical diagnosis. Abnormalities in neurotransmitters such as serotonin, dopamine, acetylcholine and gamma-aminobutyric acid have been reported to play an important role in the onset of these disorders. We studied 8 patients, 3 girls and 5 boys, ages ranging from 6 to 12, referred to us with the diagnosis of ADHD or autism and reported as having temper problems by their families. These patients were injected with a dose of Tc-99m HMPAO calculated according to patient age and weight and were imaged 1 hour later using a Picker camera with Fan Beam collimators. We analyzed the brain SPECT using 3D as well as the traditional transverse, coronal and sagittal images. With the help of surface rendered 3D images with a cut off of 88% (high) and 60-65% (lower value depending on the patient RCBF value), we observed increased perfusion or activation of either or both right and left temporal lobes in all 8 of the patients. This pattern was not seen in children whose parents did not report temper problems. Increase in perfusion to the temporal lobes may indicate an association with oppositional or aggressive behavior that may be amenable to treatment. Brain SPECT may be useful not only in early diagnosis, but also in guiding appropriate therapy

  18. The right hemisphere's contribution to discourse processing: A study in temporal lobe epilepsy.

    Science.gov (United States)

    Lomlomdjian, Carolina; Múnera, Claudia P; Low, Daniel M; Terpiluk, Verónica; Solís, Patricia; Abusamra, Valeria; Kochen, Silvia

    2017-08-01

    Discourse skills - in which the right hemisphere has an important role - enables verbal communication by selecting contextually relevant information and integrating it coherently to infer the correct meaning. However, language research in epilepsy has focused on single word analysis related mainly to left hemisphere processing. The purpose of this study was to investigate discourse abilities in patients with right lateralized medial temporal lobe epilepsy (RTLE) by comparing their performance to that of patients with left temporal lobe epilepsy (LTLE). 74 pharmacoresistant temporal lobe epilepsy (TLE) patients were evaluated: 34 with RTLE and 40 with LTLE. Subjects underwent a battery of tests that measure comprehension and production of conversational and narrative discourse. Disease related variables and general neuropsychological data were evaluated. The RTLE group presented deficits in interictal conversational and narrative discourse, with a disintegrated speech, lack of categorization and misinterpretation of social meaning. LTLE group, on the other hand, showed a tendency to lower performance in logical-temporal sequencing. RTLE patients showed discourse deficits which have been described in right hemisphere damaged patients due to other etiologies. Medial and anterior temporal lobe structures appear to link semantic, world knowledge, and social cognition associated areas to construct a contextually related coherent meaning. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Reduced frontal and occipital lobe asymmetry on the CT-scans of schizophrenic patients. Its specificity and clinical significance

    International Nuclear Information System (INIS)

    Falkai, P.; Schneider, T.; Greve, B.; Klieser, E.; Bogerts, B.

    1995-01-01

    Frontal and occipital lobe widths were determined in the computed tomographic (CT) scans of 135 schizophrenic patients, 158 neuro psychiatrically healthy and 102 psychiatric control subjects, including patients with affective psychosis, neurosis and schizoaffective psychosis. Most healthy right-handed subjects demonstrate a relative enlargement of the right frontal as well as left occipital lobe compared to the opposite hemisphere. These normal frontal and occipital lobe asymmetries were selectively reduced in schizophrenics (f.: 5%, p < .0005; o.: 3%, p < .05), irrespective of the pathophysiological subgroup. Schizophrenic neuroleptic non-responders revealed a significant reduction of frontal lobe asymmetry (3%, p < .05), while no correlation between BPRS-sub scores and disturbed cerebral laterality could be detected. In sum the present study demonstrates the disturbed cerebral lateralisation in schizophrenic patients supporting the hypothesis of interrupted early brain development in schizophrenia. (author)

  20. The medial temporal lobe: memory and beyond.

    Science.gov (United States)

    Lech, Robert K; Suchan, Boris

    2013-10-01

    The structures of the medial temporal lobe, e.g., the hippocampus, entorhinal cortex, perirhinal cortex, and parahippocampal cortex, are known to be essential for long-term memory processing and hence are labeled the medial temporal lobe memory system. Nevertheless, the exact contributions of each structure and the involvement in different cognitive processes remain controversial. This article discusses recent findings dealing with recognition memory and a long lasting involvement of the hippocampus and perirhinal cortex in episodic memory, based on functional imaging and lesion studies. Furthermore, a new paradigm employing objective manipulations of recollection and familiarity is presented, showing no anatomical distinction for these two processes, as opposed to studies using subjective ratings. Additionally, results regarding an involvement of the medial temporal lobe in visual processing are presented, in general supporting the visual-mnemonic theory. The discussed findings show that many questions regarding the functional organization remain unsolved, and that we are in need of further research to create a comprehensive model of the medial temporal lobe. For this, we might need to give up the distinctions into different cognitive processes and start to investigate the different types of representations that are processed by the medial temporal lobe. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. 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.

  2. Infectious Causes of Right Middle Lobe Syndrome.

    Science.gov (United States)

    Rashid, Aatif; Nanjappa, Sowmya; Greene, John N

    2017-01-01

    Right middle lobe (RML) syndrome is defined as recurrent or chronic obstruction or infection of the middle lobe of the right lung. Nonobstructive causes of middle lobe syndrome include inflammatory processes and defects in the bronchial anatomy and collateral ventilation. We report on 2 case patients with RML syndrome, one due to infection with Mycobacterium avium complex followed by M asiaticum infection and the other due to allergic bronchopulmonary aspergillosis. A history of atopy, asthma, or chronic obstructive pulmonary disease has been reported in up to one-half of those with RML. The diagnosis can be made by plain radiography, computed tomography, and bronchoscopy. Medical treatment consists of bronchodilators, mucolytics, and antimicrobials. Patients whose disease is unresponsive to treatment and those with obstructive RML syndrome can be offered surgical treatment.

  3. Automated MRI parcellation of the frontal lobe.

    Science.gov (United States)

    Ranta, Marin E; Chen, Min; Crocetti, Deana; Prince, Jerry L; Subramaniam, Krish; Fischl, Bruce; Kaufmann, Walter E; Mostofsky, Stewart H

    2014-05-01

    Examination of associations between specific disorders and physical properties of functionally relevant frontal lobe sub-regions is a fundamental goal in neuropsychiatry. Here, we present and evaluate automated methods of frontal lobe parcellation with the programs FreeSurfer(FS) and TOADS-CRUISE(T-C), based on the manual method described in Ranta et al. [2009]: Psychiatry Res 172:147-154 in which sulcal-gyral landmarks were used to manually delimit functionally relevant regions within the frontal lobe: i.e., primary motor cortex, anterior cingulate, deep white matter, premotor cortex regions (supplementary motor complex, frontal eye field, and lateral premotor cortex) and prefrontal cortex (PFC) regions (medial PFC, dorsolateral PFC, inferior PFC, lateral orbitofrontal cortex [OFC] and medial OFC). Dice's coefficient, a measure of overlap, and percent volume difference were used to measure the reliability between manual and automated delineations for each frontal lobe region. For FS, mean Dice's coefficient for all regions was 0.75 and percent volume difference was 21.2%. For T-C the mean Dice's coefficient was 0.77 and the mean percent volume difference for all regions was 20.2%. These results, along with a high degree of agreement between the two automated methods (mean Dice's coefficient = 0.81, percent volume difference = 12.4%) and a proof-of-principle group difference analysis that highlights the consistency and sensitivity of the automated methods, indicate that the automated methods are valid techniques for parcellation of the frontal lobe into functionally relevant sub-regions. Thus, the methodology has the potential to increase efficiency, statistical power and reproducibility for population analyses of neuropsychiatric disorders with hypothesized frontal lobe contributions. Copyright © 2013 Wiley Periodicals, Inc.

  4. Migration of Sparganum of the Frontal Lobe to the Ipsilateral Cerebellar Hemisphere: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Eun A; Choi, See Sung; Jeon, Se Jeong; Kim, Hey Won; Lee, Young Hwan [Wonkwang University Hopital, Iksan (Korea, Republic of)

    2009-05-15

    Most cerebral sparganosis lesions are located in the white matter of the cerebral hemisphere. A few cases of cerebral sparganosis where the sparganum have migrated into the contralateral cerebral hemisphere have been reported. We report a case of cerebral sparganosis where the sparganum migrated from the white matter of the left frontal lobe to the ipsilateral cerebellar hemisphere after failure of surgical removal of the worm

  5. Sustained methylene blue staining to guide anatomic hepatectomy for hepatocellular carcinoma: Initial experience and technical details.

    Science.gov (United States)

    Shou-wang, Cai; Shi-zhong, Yang; Wen-ping, Lv; Geng, Chen; Wan-qing, Gu; Wei-dong, Duan; Wei-yi, Wang; Zhi-qiang, Huang; Jia-hong, Dong

    2015-07-01

    The boundary of the target hepatic segment within the liver parenchyma cannot be marked by the use of a conventional anatomic hepatectomy approach. This study describes a novel methylene blue staining technique for guiding the anatomic resection of hepatocellular carcinoma (HCC). Between February 2009 and February 2012, anatomic hepatectomy was performed in 106 patients with HCC via a novel, sustained methylene blue staining technique. Sustained staining was achieved by injecting methylene blue into the distal aspect of the portal vein after exposing Glisson's sheath. The hepatic pedicle was immediately ligated, and the hepatic parenchymal transection was performed along the interface between methylene blue stained tissue and unstained tissue. Anatomic hepatectomies included subsegmentectomy (n = 16), monosegmentectomy (n = 57), multisegmentectomy (n = 27), and hemihepatectomy (n = 6). The portal vein was injected successfully with methylene blue in 100% of cases, and complete staining of the target hepatic segment was achieved in 98 of 106 (92.5%) cases. Mean intraoperative bleeding was 360 ± 90 mL, and the postoperative complication rate was 24.5% (26/106). No perioperative mortality occurred. Operative margins were all negative on pathologic examination. Mean duration of postoperative follow-up was 40 months (range, 24-60). No local recurrence (around the operative margin) occurred. This novel technique of achieving sustained staining by injecting methylene blue then immediately ligating the hepatic pedicle is simple and feasible. It can guide the selection of the operative margin during hepatic parenchyma transection to improve the accuracy of anatomic hepatectomy for the treatment of HCC. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Temporal lobe sclerosis associated with hippocampal sclerosis in temporal lobe epilepsy: neuropathological features.

    Science.gov (United States)

    Thom, Maria; Eriksson, Sofia; Martinian, Lillian; Caboclo, Luis O; McEvoy, Andrew W; Duncan, John S; Sisodiya, Sanjay M

    2009-08-01

    Widespread changes involving neocortical and mesial temporal lobe structures can be present in patients with temporal lobe epilepsy and hippocampal sclerosis. The incidence, pathology, and clinical significance of neocortical temporal lobe sclerosis (TLS) are not well characterized. We identified TLS in 30 of 272 surgically treated cases of hippocampal sclerosis. Temporal lobe sclerosis was defined by variable reduction of neurons from cortical layers II/III and laminar gliosis; it was typically accompanied by additional architectural abnormalities of layer II, that is, abnormal neuronal orientation and aggregation. Quantitative analysis including tessellation methods for the distribution of layer II neurons supported these observations. In 40% of cases, there was a gradient of TLS with more severe involvement toward the temporal pole, possibly signifying involvement of hippocampal projection pathways. There was a history of a febrile seizure as an initial precipitating injury in 73% of patients with TLS compared with 36% without TLS; no other clinical differences between TLS and non-TLS cases were identified. Temporal lobe sclerosis was not evident preoperatively by neuroimaging. No obvious effect of TLS on seizure outcome was noted after temporal lobe resection; 73% became seizure-free at 2-year follow-up. In conclusion, approximately 11% of surgically treated hippocampal sclerosis is accompanied by TLS. Temporal lobe sclerosis is likely an acquired process with accompanying reorganizational dysplasia and an extension of mesial temporal sclerosis rather than a separate pathological entity.

  7. Improvements in memory function following anterior temporal lobe resection for epilepsy.

    Science.gov (United States)

    Baxendale, Sallie; Thompson, Pamela J; Duncan, John S

    2008-10-21

    While up to a third of patients may experience a decline in memory following an anterior temporal lobe resection (ATL) for epilepsy, between 10 and 20% may experience a postoperative improvement in function. The aim of this study was to examine the preoperative characteristics of these patients. Logistic regression analyses were used to determine which variables influenced postoperative memory improvement following ATL on standardized memory tests in 237 patients with unilateral hippocampal sclerosis (105 right; 132 left). A total of 22% of the right ATL and 9% of the left ATL group demonstrated a significant postoperative improvement in verbal learning. A total of 9% of the right ATL and 16% of the left ATL group demonstrated a significant postoperative improvement in visual learning. In the R ATL group, postoperative improvements in verbal learning were associated with poor preoperative verbal learning, a shorter duration of epilepsy, higher scores on the visual learning task, and an older age at the time of surgery. In the L ATL group, postoperative improvements in visual learning were associated with poor preoperative visual learning, a shorter duration of epilepsy, and a higher IQ. Postoperative improvements in memory functions associated with the ipsilateral temporal lobe were not associated with demographic or epilepsy-related variables. Memory deficits normally associated with the function of the contralateral temporal lobe in patients with unilateral hippocampal sclerosis may improve postoperatively in patients with a shorter duration of epilepsy and the cognitive capacity to develop compensatory strategies.

  8. Temporal lobe cortical electrical stimulation during the encoding and retrieval phase reduces false memories.

    Directory of Open Access Journals (Sweden)

    Paulo S Boggio

    Full Text Available A recent study found that false memories were reduced by 36% when low frequency repetitive transcranial magnetic stimulation (rTMS was applied to the left anterior temporal lobe after the encoding (study phase. Here we were interested in the consequences on a false memory task of brain stimulation throughout the encoding and retrieval task phases. We used transcranial direct current stimulation (tDCS because it has been shown to be a useful tool to enhance cognition. Specifically, we examined whether tDCS can induce changes in a task assessing false memories. Based on our preliminary results, three conditions of stimulation were chosen: anodal left/cathodal right anterior temporal lobe (ATL stimulation ("bilateral stimulation"; anodal left ATL stimulation (with a large contralateral cathodal electrode--referred as "unilateral stimulation" and sham stimulation. Our results showed that false memories were reduced significantly after the two active conditions (unilateral and bilateral stimulation as compared with sham stimulation. There were no significant changes in veridical memories. Our findings show that false memories are reduced by 73% when anodal tDCS is applied to the anterior temporal lobes throughout the encoding and retrieval stages, suggesting a possible strategy for improving certain aspects of learning.

  9. Diagnosis of abscesses at the resection margin after hepatectomy. Evaluation of computed tomography appearance of perihepatic fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Shojiro; Takasaki, Ken; Ueno, Keiko [Tokyo Women`s Medical Coll. (Japan)] [and others

    1995-11-01

    Postoperative diagnosis based on computed tomography (CT) was investigated for the early recognition of intra-abdominal infectious disease following hepatectomy. This study included 159 patients in whom CT was undertaken during postoperative hospitalization, among 637 patients who had undergone hepatectomy during the 7-year period from 1987 to 1994. The CT findings of 75 patients with infection and 84 patients without infection were compared. Fluid collection at the resection margin was observed in 66 and 63 of the patients with and without infection, respectively. The significant CT findings observed in the patients with infection were uneven fluid collection indicated by a high attenuation value, gas in fluid collection, irregularity of the fluid collection margin, marginal enhancement, and complications of pleural effusion. These findings were more significant in patients with hyperthermic symptoms than in those without such symptoms. The investigation of postoperative CT findings in post-hepatectomy patients makes the diagnosis of intra-abdominal infection more certain, and appears to be useful for applying treatment with drainage. (author).

  10. Functional discrepancy between two liver lobes after hemilobe biliary drainage in patients with jaundice and bile duct cancer: an appraisal using (99m)Tc-GSA SPECT/CT fusion imaging.

    Science.gov (United States)

    Sumiyoshi, Tatsuaki; Shima, Yasuo; Okabayashi, Takehiro; Noda, Yoshihiro; Hata, Yasuhiro; Murata, Yoriko; Kozuki, Akihito; Tokumaru, Teppei; Nakamura, Toshio; Uka, Kiminori

    2014-11-01

    To determine the functional discrepancy between the two liver lobes using technetium 99m ((99m)Tc) diethylenetriamine-pentaacetic acid-galactosyl human serum albumin ( GSA diethylenetriamine-pentaacetic acid-galactosyl human serum albumin ) single photon emission computed tomography (SPECT)/computed tomography (CT) fusion imaging following preoperative biliary drainage and portal vein embolization ( PVE portal vein embolization ) in patients with jaundice who have bile duct cancer ( BDC bile duct cancer ). This retrospective study was approved by the institutional review board, with waiver of informed consent. Preoperative (99m)Tc- GSA diethylenetriamine-pentaacetic acid-galactosyl human serum albumin SPECT/CT fusion images from 32 patients with extrahepatic BDC bile duct cancer were retrospectively reviewed. Patients were classified into four groups according to the extent of biliary drainage and presence of a preoperative right PVE portal vein embolization : right lobe drainage group (right drainage), bilateral lobe drainage group (bilateral drainage), left lobe drainage group (left drainage), and left lobe drainage with right PVE portal vein embolization group (left drainage with right PVE portal vein embolization ). Percentage volume and percentage function were measured in each lobe using fusion imaging. The ratio between percentage function and percentage volume (the function-to-volume ratio) was calculated for each lobe, and the results were compared among the four groups. Statistical analysis was performed with Wilcoxon signed-rank tests and Mann-Whitney U tests. The median values for the function-to-volume ratio in the right drainage, bilateral drainage, left drainage, and left drainage with right PVE portal vein embolization group were 1.12, 1.05, 1.02, and 0.81 in the right lobe; and 0.51, 0.88, 0.96, and 1.17 in the left lobe. Significant differences in the function-to-volume ratio were observed among the four groups (right drainage vs bilateral

  11. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Calley, Cynthia S.J. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States)

    2015-02-01

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

  12. Age-Dependent Mesial Temporal Lobe Lateralization in Language FMRI

    Science.gov (United States)

    Sepeta, Leigh N.; Berl, Madison M.; Wilke, Marko; You, Xiaozhen; Mehta, Meera; Xu, Benjamin; Inati, Sara; Dustin, Irene; Khan, Omar; Austermuehle, Alison; Theodore, William H.; Gaillard, William D.

    2015-01-01

    Objective FMRI activation of the mesial temporal lobe (MTL) may be important for epilepsy surgical planning. We examined MTL activation and lateralization during language fMRI in children and adults with focal epilepsy. Methods 142 controls and patients with left hemisphere focal epilepsy (Pediatric: epilepsy, n = 17, mean age = 9.9 ± 2.0; controls, n = 48; mean age = 9.1 ± 2.6; Adult: epilepsy, n = 20, mean age = 26.7 ± 5.8; controls, n = 57, mean age = 26.2 ± 7.5) underwent 3T fMRI using a language task (auditory description decision task). Image processing and analyses were conducted in SPM8; ROIs included MTL, Broca’s area, and Wernicke’s area. We assessed group and individual MTL activation, and examined degree of lateralization. Results Patients and controls (pediatric and adult) demonstrated group and individual MTL activation during language fMRI. MTL activation was left lateralized for adults but less so in children (p’s < 0.005). Patients did not differ from controls in either age group. Stronger left-lateralized MTL activation was related to older age (p = 0.02). Language lateralization (Broca’s and Wernicke’s) predicted 19% of the variance in MTL lateralization for adults (p = 0.001), but not children. Significance Language fMRI may be used to elicit group and individual MTL activation. The developmental difference in MTL lateralization and its association with language lateralization suggests a developmental shift in lateralization of MTL function, with increased left lateralization across the age span. This shift may help explain why children have better memory outcomes following resection compared to adults. PMID:26696589

  13. Formation of Bipolar Lobes by Jets

    Science.gov (United States)

    Soker, Noam

    2002-04-01

    I conduct an analytical study of the interaction of jets, or a collimated fast wind (CFW), with a previously blown asymptotic giant branch (AGB) slow wind. Such jets (or CFWs) are supposedly formed when a compact companion, a main-sequence star, or a white dwarf accretes mass from the AGB star, forms an accretion disk, and blows two jets. This type of flow, which I think shapes bipolar planetary nebulae (PNs), requires three-dimensional gasdynamical simulations, which are limited in the parameter space they can cover. By imposing several simplifying assumptions, I derive simple expressions which reproduce some basic properties of lobes in bipolar PNs and which can be used to guide future numerical simulations. I quantitatively apply the results to two proto-PNs. I show that the jet interaction with the slow wind can form lobes which are narrow close to, and far away from, the central binary system, and which are wider somewhere in between. Jets that are recollimated and have constant cross section can form cylindrical lobes with constant diameter, as observed in several bipolar PNs. Close to their source, jets blown by main-sequence companions are radiative; only further out they become adiabatic, i.e., they form high-temperature, low-density bubbles that inflate the lobes.

  14. Centrifugal acceleration in the magnetotail lobes

    Directory of Open Access Journals (Sweden)

    H. Nilsson

    2010-02-01

    Full Text Available Combined Cluster EFW and EDI measurements have shown that cold ion outflow in the magnetospheric lobes dominates the hydrogen ion outflow from the Earth's atmosphere. The ions have too low kinetic energy to be measurable with particle instruments, at least for the typical spacecraft potential of a sunlit spacecraft in the tenuous lobe plasmas outside a few RE. The measurement technique yields both density and bulk velocity, which can be combined with magnetic field measurements to estimate the centrifugal acceleration experienced by these particles. We present a quantitative estimate of the centrifugal acceleration, and the velocity change with distance which we would expect due to centrifugal acceleration. It is found that the centrifugal acceleration is on average outward with an average value of about of 5 m s−2. This is small, but acting during long transport times and over long distances the cumulative effect is significant, while still consistent with the relatively low velocities estimated using the combination of EFW and EDI data. The centrifugal acceleration should accelerate any oxygen ions in the lobes to energies observable by particle spectrometers. The data set also put constraints on the effectiveness of any other acceleration mechanisms acting in the lobes, where the total velocity increase between 5 and 19 RE geocentric distance is less than 5 km s−1.

  15. Radiologic evaluation of right middle lobe collapse

    International Nuclear Information System (INIS)

    Kwun, Dae Young; Kim, Jong Deok; Kim, Jong Chul

    1989-01-01

    There are many pathogenetic factors for collapse of right middle lobe; profuse peribronchial clustering of lymph nodes about the right middle lobe bronchus, poor drainage of the bronchus because of its acute angle of take-off from the intermediate bronchus, and the isolation of this small lobe from the right upper and lower lobes, and thus from the aerating effects of collateral ventilation. Retrospectively we reviewed 36 cases of right of right middle lobe collapse of which causes were confirmed by histopathologic or bronchographic findings during the recent 6 years from March 1983 to February 1988 at Inje College Pusan Paik Hospital, and obtained the following results: 1. Male to female ratio was 1:1:4,and peak incidence (64%) was in the fifth and sixth decades with the mean age of 51.1 years. 2. Bronchiectasis was the most common cause (30.6%), and the others were chronic bronchitis (25.0%), pulmonary tuberculosis (19.4%), lung cancer (16.7%), and non-specific inflammatory disease (8.3%). This suggests benign disease is 5 times more common cause of right middle lobe collapse than lung cancer. 3. Among the plain chest radiolograph findings, obliteration of right cardiac border and triangular radiopaque density were the most frequent findings(77.8% in each) and the next was downward and anterior displacement of minor and major fissures (55.6%) 4. Bronchography was done in 11 cases; bronchiectasis was found in 8 cases and chronic bronchitis in 3 cases. Right middle lobe bronchus was obstructed in 2 cases of chronic bronchitis. 5. Chest CT scan was performed in 4 cases of lung cancer, 2 of non-specific inflammatory disease, and 1 of pulmonary tuberculosis: all of lung cancer revealed hilar mass, budged or lobulated fissures, in homogenous density, and mediastinal lymph node enlargement, and all benign disease showed homogenous density and flat to concave fissures. Right middle lobar bronchus narrowing was seen in 5 cases and its obstruction in 2 cases

  16. 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.

  17. 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.

  18. Hemichorea and dystonia due to frontal lobe meningioma

    Directory of Open Access Journals (Sweden)

    Abdul Qayyum Rana

    2014-01-01

    Full Text Available Tumors originating from the meninges, also known as meningiomas, have rarely been known to cause parkinsonian symptoms and other movement disorders. Although some cases of AV malformations causing movement disorders have been described in the literature, not much has been reported about meningiomas in this regard. The aim of this case report is to further highlight the importance of brain imaging in patients with movement disorders for even a benign tumor; and also emphasize the need for a careful movement disorder examination because more than one phenomenology of movement disorders may result from the mechanical pressure caused by a tumor. We present a case report of a patient with a heavily calcified right frontal lobe meningioma. Our patient had irregular, involuntary, brief, fleeting and unpredictable movements of her left upper and lower extremities, consistent with chorea. The patient also had abnormal dystonic posturing of her left arm while walking. This case report highlights the importance of brain imaging as well as careful neurological examinations of patients with benign meningiomas. Moreover, it illustrates the remarkable specificity yet clinical diversity of meningiomas in presentation through movement disorders.

  19. Influence of anxiety on memory performance in temporal lobe epilepsy.

    Science.gov (United States)

    Brown, Franklin C; Westerveld, Michael; Langfitt, John T; Hamberger, Marla; Hamid, Hamada; Shinnar, Shlomo; Sperling, Michael R; Devinsky, Orrin; Barr, William; Tracy, Joseph; Masur, David; Bazil, Carl W; Spencer, Susan S

    2014-02-01

    This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 patients with temporal lobe epilepsy from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was poorer for those with high versus low levels of anxiety but was not found to be related to the TLE side. The verbal memory score on the California Verbal Learning Test (CVLT) was significantly lower for patients with left-sided TLE than for patients with right-sided TLE with low anxiety levels but equally impaired for those with high anxiety levels. These results suggest that we can place more confidence in the ability of verbal memory tests like the CVLT to lateralize to left-sided TLE for those with low anxiety levels, but that verbal memory will be less likely to produce lateralizing information for those with high anxiety levels. This suggests that more caution is needed when interpreting verbal memory tests for those with high anxiety levels. These results indicated that RCFT performance was significantly affected by anxiety and did not lateralize to either side, regardless of anxiety levels. This study adds to the existing literature which suggests that drawing-based visual memory tests do not lateralize among patients with TLE, regardless of anxiety levels. © 2013.

  20. Genetics Home Reference: autosomal dominant nocturnal frontal lobe epilepsy

    Science.gov (United States)

    ... Health Conditions ADNFLE Autosomal dominant nocturnal frontal lobe epilepsy Printable PDF Open All Close All Enable Javascript ... collapse boxes. Description Autosomal dominant nocturnal frontal lobe epilepsy ( ADNFLE ) is an uncommon form of epilepsy that ...

  1. Repair of pectus excavatum in a toddler with Prune Belly syndrome and left bronchus compression

    Directory of Open Access Journals (Sweden)

    Shawn T. Liechty

    2017-01-01

    Full Text Available A 2-year-old boy with prune-belly syndrome and severe pectus excavatum experienced recurrent pulmonary infections. A CT scan of the chest demonstrated compression of the left mainstem bronchus and leftward shift of the heart. The bronchial compression resulted in left upper lobe collapse and left lower lobe air-trapping requiring two hospitalizations for respiratory distress and pneumonia. The child underwent minimally invasive repair of his pectus excavatum and has not experienced any further pulmonary events. The pectus bar was removed 3 years post-operatively and at seven years following surgery he has a sustained repair.

  2. Unusual congenital pulmonary anomaly with presumed left lung hypoplasia in a young dog.

    Science.gov (United States)

    Lee, C M; Kim, J H; Kang, M H; Eom, K D; Park, H M

    2014-05-01

    A seven-month-old, entire, male miniature schnauzer dog was referred with acute vomiting, inappetence and depression primarily as a result of a gastric foreign body (pine cones). During investigations, thoracic radiographs revealed increased volume of the right lung lobes, deviated cardiomediastinal structures and elevation of the heart from the sternum. Thoracic computed tomography revealed left cranial lung lobe hypoplasia and extension of the right cranial lung parenchyma across the midline to the left hemithorax. Branches of the right pulmonary vessels and bronchi also crossed the midline and extended to the left caudal lung lobe. These findings suggested that the right and left lungs were fused. In humans this finding is consistent with horseshoe lung, which is an uncommon congenital malformation. To the authors' knowledge, this case represents the first report of such a pulmonary anomaly in a dog. © 2014 British Small Animal Veterinary Association.

  3. The circadian optimal time for hepatectomy in the study of liver regeneration.

    Science.gov (United States)

    Souto, M; Llanos, J M

    1985-01-01

    Standardized (light from 0600 to 1800) C3HS mice, hepatectomized at different circadian stages, were killed at 1400 (the peak time of mitotic activity in intact mice). The higher values of mitotic index were those of mice operated at 1400, 48 hr before. The curve of mitotic activity of the regenerating liver of mice operated at 1400 and that of mice operated at 0200 (an opposite time in the circadian stage) are, both, grossly in phase with the curves of mitotic index in young and adult mice liver. The amplitude of the first peak of mitotic activity in mice operated at 0200 was dramatically lower than that of animals operated at 1400. The same applies to hepatocytes as well as to the sinusoid litoral population of cells. It is concluded that 1400 hr, as contrast to 0200 hr, is an optimal time for hepatectomy if one wants to obtain the highest mitotic index first peak during regeneration in a normal phase position (the position of the mitotic index peak in the liver of normal young and adult mice).

  4. Perioperative antiviral therapy improves safety in patients with hepatitis B related HCC following hepatectomy.

    Science.gov (United States)

    Zhang, Binhao; Xu, Dafeng; Wang, Rui; Zhu, Peng; Mei, Bin; Wei, Gang; Xiao, Hua; Zhang, Bixiang; Chen, Xiaoping

    2015-03-01

    Hepatectomies may exacerbate chronic hepatitis B in patients with high hepatitis B viral (HBV) DNA levels, and could result in hepatic insufficiency. Antiviral treatment is effective for suppressing HBV virus loads. This study investigated whether perioperative antiviral therapy is warranted for resection of hepatocellular carcinoma (HCC) with concurrent HBV infections. Patients with HBV-related HCC (n = 112) who underwent major liver resection were retrospectively divided into two groups based on treatment with perioperative antiviral therapy (antiviral group) (n = 72) or absence of antiviral treatment (control group) (n = 40). Exacerbation of chronic hepatitis B occurred in 6 patients of the control group (15.0%). The prevalence of hepatic insufficiency in the antiviral group and control group were 1.4% (1/72) and 12.5% (5/40), respectively (p antiviral group. The control group had significantly higher levels of postoperative alanine aminotransferase (ALT) and serum bilirubin than the antiviral group. Perioperative antiviral treatment improves patient safety by decreasing morbidity and speeding recovery of postoperative liver function for HBV-related major HCC resection. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Paracrine Effects of Bone Marrow Mononuclear Cells in Survival and Cytokine Expression after 90% Partial Hepatectomy

    Directory of Open Access Journals (Sweden)

    Carlos Oscar Kieling

    2017-01-01

    Full Text Available Acute liver failure is a complex and fatal disease. Cell-based therapies are a promising alternative therapeutic approach for liver failure due to relatively simple technique and lower cost. The use of semipermeable microcapsules has become an interesting tool for evaluating paracrine effects in vivo. In this study, we aimed to assess the paracrine effects of bone marrow mononuclear cells (BMMC encapsulated in sodium alginate to treat acute liver failure in an animal model of 90% partial hepatectomy (90% PH. Encapsulated BMMC were able to increase 10-day survival without enhancing liver regeneration markers. Gene expression of Il-6 and Il-10 in the remnant liver was markedly reduced at 6 h after 90% PH in animals receiving encapsulated BMMC compared to controls. This difference, however, was neither reflected by changes in the number of CD68+ cells nor by serum levels of IL6. On the other hand, treated animals presented increased caspase activity and gene expression in the liver. Taken together, these results suggest that BMMC regulate immune response and promote apoptosis in the liver after 90% PH by paracrine factors. These changes ultimately may be related to the higher survival observed in treated animals, suggesting that BMMC may be a promising alternative to treat acute liver failure.

  6. Comparison of Hepatectomy for Patients with Metabolic Syndrome-Related HCC and HBV-Related HCC.

    Science.gov (United States)

    Tian, Yunhong; Lyu, Huan; He, Yunhong; Xia, Yong; Li, Jun; Shen, Feng

    2018-04-01

    Metabolic syndrome (MetS) is a group of clinicopathological manifestations. The outcome of liver surgery in metabolic syndrome-related hepatocellular carcinoma (MetS-HCC) still needs to be evaluated. We aim to clarify the outcomes following liver resection in patients with MetS-HCC compared those with hepatitis B virus-related HCC (HBV-HCC). All the consecutive patients undergoing hepatectomy for HCC between January 2009 and December 2012 were retrospectively considered. Patients were divided into three groups: MetS-HCC, MetS-HBV-HCC, and HBV-HCC. Data on clinical characteristics, postoperative complications, and long-term outcome were collected and analyzed. A total of 1352 patients were included in this study. In MetS-HCC group, the severe morbidity rate was 33.33%, which was higher than that of HBV-HCC group (15.68%). In subgroup analysis, patients with MetS-HCC in American Joint Committee on Cancer (AJCC) stage I had superior DFS and OS when compared with those of the other two groups. We should pay more attention to patients with MetS-HCC perioperatively due to the high rate of surgical complications. Nevertheless, curative treatment should be provided to patients with MetS.

  7. The beneficial role of simultaneous splenectomy after extended hepatectomy: experimental study in pigs.

    Science.gov (United States)

    Athanasiou, Antonios; Papalois, Apostolos; Kontos, Michael; Griniatsos, John; Liakopoulos, Dimitrios; Spartalis, Eleftherios; Agrogiannis, George; Liakakos, Theodoros; Pikoulis, Emmanouil

    2017-02-01

    The role of hepatic hemodynamic modulation in the development of "small-for-size" syndrome (SFSS) after extended hepatectomy (EH) or living-donor liver transplantation is still controversial. We have designed an experimental study to investigate the effect of hemodynamic parameters of the liver circulation on the development of SFSS after EH in a porcine model. Eighteen pigs were randomly divided into two groups: group A has received EH (75%-80%) without splenectomy, and group B with EH and simultaneous splenectomy was carried out. Portal hemodynamics, liver function tests, histologic findings, injury and survival rates were compared between groups A and B. The 7-d survival rate in the splenectomy group was significantly improved compared with group A (88.9% versus 44.4%, P splenectomy group were significantly lower than in group A immediately after splenectomy and postoperatively until the day of sacrifice. Histologic findings in group A clearly illustrate severe inflammation, bridging necrosis, ischemic cholangitis, and severe congestion, while in group B there were less serious histologic changes. Our experimental study indicates that perioperative portal modulation can successfully prevent the manifestation of SFSS after EH. Therefore, by focusing on "flow" rather than on "size," researchers may understand better the pathophysiology of this syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Leukocyte nucleus segmentation and nucleus lobe counting.

    Science.gov (United States)

    Chan, Yung-Kuan; Tsai, Meng-Hsiun; Huang, Der-Chen; Zheng, Zong-Han; Hung, Kun-Ding

    2010-11-12

    Leukocytes play an important role in the human immune system. The family of leukocytes is comprised of lymphocytes, monocytes, eosinophils, basophils, and neutrophils. Any infection or acute stress may increase or decrease the number of leukocytes. An increased percentage of neutrophils may be caused by an acute infection, while an increased percentage of lymphocytes can be caused by a chronic bacterial infection. It is important to realize an abnormal variation in the leukocytes. The five types of leukocytes can be distinguished by their cytoplasmic granules, staining properties of the granules, size of cell, the proportion of the nuclear to the cytoplasmic material, and the type of nucleolar lobes. The number of lobes increased when leukemia, chronic nephritis, liver disease, cancer, sepsis, and vitamin B12 or folate deficiency occurred. Clinical neutrophil hypersegmentation has been widely used as an indicator of B12 or folate deficiency.Biomedical technologists can currently recognize abnormal leukocytes using human eyes. However, the quality and efficiency of diagnosis may be compromised due to the limitations of the biomedical technologists' eyesight, strength, and medical knowledge. Therefore, the development of an automatic leukocyte recognition system is feasible and necessary. It is essential to extract the leukocyte region from a blood smear image in order to develop an automatic leukocyte recognition system. The number of lobes increased when leukemia, chronic nephritis, liver disease, cancer, sepsis, and vitamin B12 or folate deficiency occurred. Clinical neutrophil hypersegmentation has been widely used as an indicator of B12 or folate deficiency. The purpose of this paper is to contribute an automatic leukocyte nuclei image segmentation method for such recognition technology. The other goal of this paper is to develop the method of counting the number of lobes in a cell nucleus. The experimental results demonstrated impressive segmentation accuracy

  9. Agenesis of the right lobe of liver: a case report

    International Nuclear Information System (INIS)

    Han, Kun Soo; Chang, Jae Chun; Park, Bok Hwan

    1993-01-01

    Congenital agenesis of the right lobe of liver is a rare anomaly and only 33 cases have been reported. CT showed absence of the right lobe of liver and compensatory hypertrophy of the other lobe. We report the CT findings a new case of this anomaly with a review of the literatures

  10. The extratemporal lobe epilepsies in the epilepsy monitoring unit

    Science.gov (United States)

    Dash, Deepa; Tripathi, Manjari

    2014-01-01

    Extratemporal lobe epilepsies (ETLE) are characterized by the epileptogenic foci outside the temporal lobe. They have a wide spectrum of semiological presentation depending upon the site of origin. They can arise from frontal, parietal, occipital lobes and from hypothalamic hamartoma. We discuss in this review the semiology of different types of ETLE encountered in the epilepsy monitoring unit. PMID:24791090

  11. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

    Directory of Open Access Journals (Sweden)

    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  12. The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

    2014-01-01

    Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  13. Frontal lobe epileptic seizures are accompanied by elevated pitch during verbal communication.

    Science.gov (United States)

    Speck, Iva; Echternach, Matthias; Sammler, Daniela; Schulze-Bonhage, Andreas

    2018-01-31

    The objective of our study was to assess alterations in speech as a possible localizing sign in frontal lobe epilepsy. Ictal speech was analyzed in 18 patients with frontal lobe epilepsy (FLE) during seizures and in the interictal period. Matched identical words were analyzed regarding alterations in fundamental frequency (ƒo) as an approximation of pitch. In patients with FLE, ƒo of ictal utterances was significantly higher than ƒo in interictal recordings (p = 0.016). Ictal ƒo increases occurred in both FLE of right and left seizure origin. In contrast, a matched temporal lobe epilepsy (TLE) group showed less pronounced increases in ƒo, and only in patients with right-sided seizure foci. This study for the first time shows significant voice alterations in ictal speech in a cohort of patients with FLE. This may contribute to the localization of the epileptic focus. Increases in ƒo were interestingly found in frontal lobe seizures with origin in either hemisphere, suggesting a bilateral involvement to the planning of speech production, in contrast to a more right-sided lateralization of pitch perception in prosodic processing. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

  14. Cephalic aura after frontal lobe resection.

    Science.gov (United States)

    Kakisaka, Yosuke; Jehi, Lara; Alkawadri, Rafeed; Wang, Zhong I; Enatsu, Rei; Mosher, John C; Dubarry, Anne-Sophie; Alexopoulos, Andreas V; Burgess, Richard C

    2014-08-01

    A cephalic aura is a common sensory aura typically seen in frontal lobe epilepsy. The generation mechanism of cephalic aura is not fully understood. It is hypothesized that to generate a cephalic aura extensive cortical areas need to be excited. We report a patient who started to have cephalic aura after right frontal lobe resection. Magnetoencephalography (MEG) showed interictal spike and ictal change during cephalic aura, both of which were distributed in the right frontal region, and the latter involved much more widespread areas than the former on MEG sensors. The peculiar seizure onset pattern may indicate that surgical modification of the epileptic network was related to the appearance of cephalic aura. We hypothesize that generation of cephalic aura may be associated with more extensive cortical involvement of epileptic activity than that of interictal activity, in at least a subset of cases. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Dynamic perfusion patterns in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Dupont, Patrick; Paesschen, Wim van [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); Zaknun, John J. [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Maes, Alex [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); AZ Groeninge, Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn; Locharernkul, Chaichon [Chulalongkorn University, Nuclear Medicine and Neurology, Bangkok (Thailand); Vasquez, Silvia; Carpintiero, Silvina [Fleni Instituto de Investigaciones Neurologicas, Nuclear Medicine, Buenos Aires (Argentina); Bal, C.S. [All India Institute of Medical Sciences, Nuclear Medicine, New Delhi (India); Dondi, Maurizio [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); Ospedale Maggiore, Nuclear Medicine, Bologna (Italy)

    2009-05-15

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  16. Nocturnal frontal lobe epilepsy in mucopolysaccharidosis.

    Science.gov (United States)

    Bonanni, Paolo; Volzone, Anna; Randazzo, Giovanna; Antoniazzi, Lisa; Rampazzo, Angelica; Scarpa, Maurizio; Nobili, Lino

    2014-10-01

    Nocturnal frontal lobe epilepsy (NFLE) is an epileptic syndrome that is primarily characterized by seizures with motor signs occurring almost exclusively during sleep. We describe 2 children with mucopolysaccharidosis (MPS) who were referred for significant sleep disturbance. Long term video-EEG monitoring (LT-VEEGM) demonstrated sleep-related hypermotor seizures consistent with NFLE. No case of sleep-related hypermotor seizures has ever been reported to date in MPS. However, differential diagnosis with parasomnias has been previously discussed. The high frequency of frontal lobe seizures causes sleep fragmentation, which may result in sleep disturbances observed in at least a small percentage of MPS patients. We suggest monitoring individuals with MPS using periodic LT-VEEGM, particularly when sleep disorder is present. Moreover, our cases confirm that NFLE in lysosomal storage diseases may occur, and this finding extends the etiologic spectrum of NFLE. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  17. MR imaging of temporal lobe meningoencephalocele

    International Nuclear Information System (INIS)

    Tampieri, D.; Leblanc, R.; Melangon, D.; del-Carpio-O'Donovan, R.; Ethier, R.

    1991-01-01

    Basal meningoencephaloceles represent a rare entity, and they may be associated with a variety of midline cerebral abnormalities. The classification of basal meningoencephaloceles is related to their anatomic location. This paper reports experience in 3 patients, 2 who have temporal lobe epilepsy and a bone defect in the region of the foramen rotondum. In these 2 patients the encephalocele and its covering were protruding into the pterygopalatine fossa without any orbital involvement. The third patient presented with cerebrospinal fluid rhinorrhea caused by a transsphenoidal meningoencephalocele. MR imaging is the examination of choice for detecting these lesions since it allows for the visualization of the encephalocele and its meningeal covering as well as the bone defect and associated lesions in the temporal lobes

  18. Dimorphic olfactory lobes in the arthropoda.

    Science.gov (United States)

    Strausfeld, Nicholas; Reisenman, Carolina E

    2009-07-01

    Specialized olfactory lobe glomeruli relating to sexual or caste differences have been observed in at least five orders of insects, suggesting an early appearance of this trait in insect evolution. Dimorphism is not limited to nocturnal species, but occurs even in insects that are known to use vision for courtship. Other than a single description, there is no evidence for similar structures occurring in the Crustacea, suggesting that the evolution of dimorphic olfactory systems may typify terrestrial arthropods.

  19. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-02-01

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones.

  20. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    International Nuclear Information System (INIS)

    Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo

    2004-01-01

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones

  1. Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

    Energy Technology Data Exchange (ETDEWEB)

    Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio [Fukushima Medical Coll. (Japan)

    1998-02-01

    In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p

  2. Interictal epileptic discharge correlates with global and frontal cognitive dysfunction in temporal lobe epilepsy.

    Science.gov (United States)

    Dinkelacker, Vera; Xin, Xu; Baulac, Michel; Samson, Séverine; Dupont, Sophie

    2016-09-01

    Temporal lobe epilepsy (TLE) with hippocampal sclerosis has widespread effects on structural and functional connectivity and often entails cognitive dysfunction. EEG is mandatory to disentangle interactions in epileptic and physiological networks which underlie these cognitive comorbidities. Here, we examined how interictal epileptic discharges (IEDs) affect cognitive performance. Thirty-four patients (right TLE=17, left TLE=17) were examined with 24-hour video-EEG and a battery of neuropsychological tests to measure intelligence quotient and separate frontal and temporal lobe functions. Hippocampal segmentation of high-resolution T1-weighted imaging was performed with FreeSurfer. Partial correlations were used to compare the number and distribution of clinical interictal spikes and sharp waves with data from imagery and psychological tests. The number of IEDs was negatively correlated with executive functions, including verbal fluency and intelligence quotient (IQ). Interictal epileptic discharge affected cognitive function in patients with left and right TLE differentially, with verbal fluency strongly related to temporofrontal spiking. In contrast, IEDs had no clear effects on memory functions after corrections with partial correlations for age, age at disease onset, disease duration, and hippocampal volume. In patients with TLE of long duration, IED occurrence was strongly related to cognitive deficits, most pronounced for frontal lobe function. These data suggest that IEDs reflect dysfunctional brain circuitry and may serve as an independent biomarker for cognitive comorbidity. Copyright © 2016. Published by Elsevier Inc.

  3. Activations in temporal areas using visual and auditory naming stimuli: A language fMRI study in temporal lobe epilepsy.

    Science.gov (United States)

    Gonzálvez, Gloria G; Trimmel, Karin; Haag, Anja; van Graan, Louis A; Koepp, Matthias J; Thompson, Pamela J; Duncan, John S

    2016-12-01

    Verbal fluency functional MRI (fMRI) is used for predicting language deficits after anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE), but primarily engages frontal lobe areas. In this observational study we investigated fMRI paradigms using visual and auditory stimuli, which predominately involve language areas resected during ATLR. Twenty-three controls and 33 patients (20 left (LTLE), 13 right (RTLE)) were assessed using three fMRI paradigms: verbal fluency, auditory naming with a contrast of auditory reversed speech; picture naming with a contrast of scrambled pictures and blurred faces. Group analysis showed bilateral temporal activations for auditory naming and picture naming. Correcting for auditory and visual input (by subtracting activations resulting from auditory reversed speech and blurred pictures/scrambled faces respectively) resulted in left-lateralised activations for patients and controls, which was more pronounced for LTLE compared to RTLE patients. Individual subject activations at a threshold of T>2.5, extent >10 voxels, showed that verbal fluency activated predominantly the left inferior frontal gyrus (IFG) in 90% of LTLE, 92% of RTLE, and 65% of controls, compared to right IFG activations in only 15% of LTLE and RTLE and 26% of controls. Middle temporal (MTG) or superior temporal gyrus (STG) activations were seen on the left in 30% of LTLE, 23% of RTLE, and 52% of controls, and on the right in 15% of LTLE, 15% of RTLE, and 35% of controls. Auditory naming activated temporal areas more frequently than did verbal fluency (LTLE: 93%/73%; RTLE: 92%/58%; controls: 82%/70% (left/right)). Controlling for auditory input resulted in predominantly left-sided temporal activations. Picture naming resulted in temporal lobe activations less frequently than did auditory naming (LTLE 65%/55%; RTLE 53%/46%; controls 52%/35% (left/right)). Controlling for visual input had left-lateralising effects. Auditory and picture naming activated

  4. Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative acute kidney injury.

    Science.gov (United States)

    Mita, Naoji; Kawahito, Shinji; Soga, Tomohiro; Takaishi, Kazumi; Kitahata, Hiroshi; Matsuhisa, Munehide; Shimada, Mitsuo; Kinoshita, Hiroyuki; Tsutsumi, Yasuo M; Tanaka, Katsuya

    2017-03-01

    The aim of the present study was to evaluate the usefulness of a closed-loop system (STG-55; Nikkiso, Tokyo, Japan), a type of artificial endocrine pancreas for the continuous monitoring and control of intraoperative blood glucose, for preventing postoperative acute kidney injury (AKI) in patients undergoing hepatectomy. Thirty-eight patients were enrolled in this study. Glucose concentrations were controlled with either a manual injection of insulin based on a commonly used sliding scale (manual insulin group, n = 19) or the programmed infusion of insulin determined by the control algorithm of the artificial endocrine pancreas (programmed insulin group, n = 19). After the induction of anesthesia, a 20-G intravenous catheter was inserted into the peripheral forearm vein of patients in the programmed insulin group and connected to an artificial endocrine pancreas (STG-55). The target range for glucose concentrations was set to 100-150 mg/dL. The mean serum creatinine concentrations of preoperative, postoperative 24 and 48 h were 0.72, 0.78, and 0.79 mg/dL in the programmed insulin group, and 0.81, 0.95, and 1.03 mg/dL in the manual insulin group, respectively. Elevations in serum creatinine concentrations postoperative 48 h were significantly suppressed in the programmed insulin group. The STG-55 closed-loop system was effective for maintaining strict blood glucose control during hepatectomy with minimal variability in blood glucose concentrations and for suppressing elevations in serum creatinine concentrations. Strict blood glucose control by an artificial endocrine pancreas during hepatectomy may prevent postoperative AKI.

  5. Oval cell response is attenuated by depletion of liver resident macrophages in the 2-AAF/partial hepatectomy rat.

    Directory of Open Access Journals (Sweden)

    Shuai Xiang

    Full Text Available BACKGROUND/AIMS: Macrophages are known to play an important role in hepatocyte mediated liver regeneration by secreting inflammatory mediators. However, there is little information available on the role of resident macrophages in oval cell mediated liver regeneration. In the present study we aimed to investigate the role of macrophages in oval cell expansion induced by 2-acetylaminofluorene/partial hepatectomy (2-AAF/PH in rats. METHODOLOGY/PRINCIPAL FINDINGS: We depleted macrophages in the liver of 2-AAF/PH treated rats by injecting liposome encapsulated clodronate 48 hours before PH. Regeneration of remnant liver mass, as well as proliferation and differentiation of oval cells were measured. We found that macrophage-depleted rats suffered higher mortality and liver transaminase levels. We also showed that depletion of macrophages yielded a significant decrease of EPCAM and PCK positive oval cells in immunohistochemical stained liver sections 9 days after PH. Meanwhile, oval cell differentiation was also attenuated as a result of macrophage depletion, as large foci of small basophilic hepatocytes were observed by day 9 following hepatectomy in control rats whereas they were almost absent in macrophage depleted rats. Accordingly, real-time polymerase chain reaction analysis showed lower expression of albumin mRNA in macrophage depleted livers. Then we assessed whether macrophage depletion may affect hepatic production of stimulating cytokines for liver regeneration. We showed that macrophage-depletion significantly inhibited hepatic expression of tumor necrosis factor-α and interleukin-6, along with a lack of signal transducer and activator of transcription 3 phosphorylation during the early period following hepatectomy. CONCLUSIONS: These data indicate that macrophages play an important role in oval cell mediated liver regeneration in the 2-AAF/PH model.

  6. Comparison of postoperative coagulation profiles and outcome for sugammadex versus pyridostigmine in 992 living donors after living-donor hepatectomy.

    Science.gov (United States)

    Moon, Young-Jin; Kim, Sung-Hoon; Kim, Jae-Won; Lee, Yoon-Kyung; Jun, In-Gu; Hwang, Gyu-Sam

    2018-03-01

    Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed. For reversal of rocuronium-induced neuromuscular blockade, donors received sugammadex 4 mg/kg or pyridostigmine 0.25 mg/kg. The primary end-points were laboratory findings (PT, aPTT, hemoglobin, platelet count) and clinically evaluated postoperative bleeding (relaparotomy for bleeding, cumulative volume collected in drains). Secondary outcomes were anesthesia time, postoperative hospital day.Of 992 donors, 383 treated with sugammadex and 609 treated with pyridostigmine for the reversal of neuromuscular blockade. There were no significant differences between both groups for drop in hemoglobin and platelet, prolongation in PT, aPTT, and the amount of 24-h drain volume. Bleeding events within 24 h were reported in 2 (0.3%) for pyridostigmine group and 0 (0%) for sugammadex group (P = .262). Anesthesia time was significantly longer in pyridostigmine group than that in sugammadex group (438.8 ± 71.4 vs. 421.3 ± 62.3, P < .001). Postoperative hospital stay was significantly longer in pyridostigmine group than that in sugammadex group (P = .002).Sugammadex 4 mg/kg was not associated with increased bleeding tendency, but associated with reduced anesthesia time and hospital stay. Therefore, sugammadex may be safely used and will decrease morbidity in donor undergoing living-donor hepatectomy.

  7. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA...... was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  8. TRANEXAMIC ACID ACTION ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY: EXPERIMENTAL MODEL IN RATS.

    Science.gov (United States)

    Sobral, Felipe Antonio; Daga, Henrique; Rasera, Henrique Nogueira; Pinheiro, Matheus da Rocha; Cella, Igor Furlan; Morais, Igor Henrique; Marques, Luciana de Oliveira; Collaço, Luiz Martins

    2016-01-01

    Different lesions may affect the liver resulting in harmful stimuli. Some therapeutic procedures to treat those injuries depend on liver regeneration to increase functional capacity of this organ. Evaluate the effects of tranexamic acid on liver regeneration after partial hepatectomy in rats. 40 rats (Rattus norvegicus albinus, Rodentia mammalia) of Wistar-UP lineage were randomly divided into two groups named control (CT) and tranexamic acid (ATX), with 20 rats in each. Both groups were subdivided, according to liver regeneration time of 32 h or seven days after the rats had been operated. The organ regeneration was evaluated through weight and histology, stained with HE and PCNA. The average animal weight of ATX and CT 7 days groups before surgery were 411.2 g and 432.7 g, and 371.3 g and 392.9 g after the regeneration time, respectively. The average number of mitotic cells stained with HE for the ATX and CT 7 days groups were 33.7 and 32.6 mitosis, and 14.5 and 14.9 for the ATX and CT 32 h groups, respectively. When stained with proliferating cell nuclear antigen, the numbers of mitotic cells counted were 849.7 for the ATX 7 days, 301.8 for the CT 7 days groups, 814.2 for the ATX 32 hand 848.1 for the CT 32 h groups. Tranexamic acid was effective in liver regeneration, but in longer period after partial hepatectomy. Muitas são as injúrias que acometem o fígado e levam a estímulo lesivo. Alguns procedimentos terapêuticos para tratamento dessas lesões dependem da regeneração hepática para aumentar a sua capacidade funcional. Avaliar o efeito do ácido tranexâmico na regeneração hepática após hepatectomia parcial em ratos. Foram utilizados 40 ratos (Rattus norvegicus albinus, Rodentia mammalia) convencionais da linhagem Wistar-UP. Foram divididos aleatoriamente em dois grupos de 20: grupo controle (CT) e grupo ácido tranexâmico (ATX). Cada um deles foi divido em dois subgrupos para avaliar a regeneração hepática no tempo de 32 h e 7 dias do p

  9. ALPPS Improves Resectability Compared With Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastasis

    DEFF Research Database (Denmark)

    Sandström, Per; Røsok, Bård I; Sparrelid, Ernesto

    2018-01-01

    resection offers the only chance of a cure for patients with metastatic colorectal cancer. Patients with colorectal liver metastasis (CRLM) and an insufficient future liver remnant (FLR) volume are traditionally treated with chemotherapy with portal vein embolization or ligation followed by hepatectomy (TSH...... of patients completing both stages of the treatment. Secondary outcomes were complications, radicality, and 90-day mortality measured from the final intervention. RESULTS: Baseline characteristics, besides body mass index, did not differ between the groups. The RR was 92% [95% confidence interval (CI) 84...

  10. Liver is the major source of elevated serum lipocalin-2 levels after bacterial infection or partial hepatectomy

    DEFF Research Database (Denmark)

    Xu, Ming-Jiang; Feng, Dechun; Wu, Hailong

    2015-01-01

    knockout (Lcn2(Hep-/-)) mice were generated and subjected to bacterial infection (with Klesbsiella pneumoniae or Escherichia coli) or partial hepatectomy (PHx). Studies of Lcn2(Hep-/-) mice revealed that hepatocytes contributed to 25% of the low basal serum level of LCN2 protein (∼ 62 ng/mL) but were...... or E. coli. These mice also had increased enteric bacterial translocation from the gut to the mesenteric lymph nodes and exhibited reduced liver regeneration after PHx. Treatment with interleukin (IL)-6 stimulated hepatocytes to produce LCN2 in vitro and in vivo. Hepatocyte-specific ablation of the IL...

  11. Use of contact Nd:YAG sapphire-laser system for performing partial hepatectomy and splenectomy in dogs

    Science.gov (United States)

    Yu, Chibing; Jing, Shujuan; Cai, Huimin; Shao, Lanxing; Zou, Hegui

    1993-03-01

    An Nd:YAG Sapphire laser blade was used for performing hepatectomy and splenectomy in dogs. The results suggest that a laser blade provides a new way to reduce intraoperative bleeding and to minimize tissue damage. In recent years, there have been some reports on performing surgical procedures using a contact Nd:YAG Sapphire laser system. The current animal study was conducted in order to explore the capability of incision and excision of the laser tip, the damage to the tissue, and the recovery course.

  12. The effect of white matter hyperintensities on verbal memory: Mediation by temporal lobe atrophy.

    Science.gov (United States)

    Swardfager, Walter; Cogo-Moreira, Hugo; Masellis, Mario; Ramirez, Joel; Herrmann, Nathan; Edwards, Jodi D; Saleem, Mahwesh; Chan, Parco; Yu, Di; Nestor, Sean M; Scott, Christopher J M; Holmes, Melissa F; Sahlas, Demetrios J; Kiss, Alexander; Oh, Paul I; Strother, Stephen C; Gao, Fuqiang; Stefanovic, Bojana; Keith, Julia; Symons, Sean; Swartz, Richard H; Lanctôt, Krista L; Stuss, Donald T; Black, Sandra E

    2018-02-20

    To determine the relationship between white matter hyperintensities (WMH) presumed to indicate disease of the cerebral small vessels, temporal lobe atrophy, and verbal memory deficits in Alzheimer disease (AD) and other dementias. We recruited groups of participants with and without AD, including strata with extensive WMH and minimal WMH, into a cross-sectional proof-of-principle study (n = 118). A consecutive case series from a memory clinic was used as an independent validation sample (n = 702; Sunnybrook Dementia Study; NCT01800214). We assessed WMH volume and left temporal lobe atrophy (measured as the brain parenchymal fraction) using structural MRI and verbal memory using the California Verbal Learning Test. Using path modeling with an inferential bootstrapping procedure, we tested an indirect effect of WMH on verbal recall that depends sequentially on temporal lobe atrophy and verbal learning. In both samples, WMH predicted poorer verbal recall, specifically due to temporal lobe atrophy and poorer verbal learning (proof-of-principle -1.53, 95% bootstrap confidence interval [CI] -2.45 to -0.88; and confirmation -0.66, 95% CI [-0.95 to -0.41] words). This pathway was significant in subgroups with (-0.20, 95% CI [-0.38 to -0.07] words, n = 363) and without (-0.71, 95% CI [-1.12 to -0.37] words, n = 339) AD. Via the identical pathway, WMH contributed to deficits in recognition memory (-1.82%, 95% CI [-2.64% to -1.11%]), a sensitive and specific sign of AD. Across dementia syndromes, WMH contribute indirectly to verbal memory deficits considered pathognomonic of Alzheimer disease, specifically by contributing to temporal lobe atrophy. © 2018 American Academy of Neurology.

  13. Lateralizing value of semiology in medial temporal lobe epilepsy.

    Science.gov (United States)

    Dupont, S; Samson, Y; Nguyen-Michel, V-H; Zavanone, C; Navarro, V; Baulac, M; Adam, C

    2015-12-01

    Analysing the clinical characteristics of seizures constitutes a fundamental aspect of the presurgical evaluation of patients with medial temporal lobe epilepsy and unilateral hippocampal sclerosis (MTLE-HS), the most frequent form of focal epilepsy accessible to surgery. We sought to retrospectively determine whether objective manifestations could have a reliable lateralizing value in a large population of MTLE-HS patients and if their presence could help to identify those patients who would be seizure free after surgery. We analysed the frequency and predictive lateralizing value of objective ictal and postictal signs in 391 patients with MTLE-HS (183 left/208 right). Data were derived from chart review and not from blinded videoEEG analysis. Correlation between the presence of reliable lateralizing signs and postoperative outcome was performed in a subgroup of 302 patients who underwent surgery. Contralateral dystonic posturing was the most frequent and reliable lateralizing sign that correctly lateralized the focus in 96% of patients. Unilateral head/eye deviation was noted in 42% of the patients and predicted unilateral focus in 67%. Ipsilateral postictal nose wiping, contralateral clonus and hypokinesia correctly lateralized the focus in 75%, 81%, respectively, and 100 of patients but were less frequently depicted. Postictal aphasia was a strong lateralizing sign for left MLE-HS. The presence of reliable lateralizing signs was not a predictor of seizure freedom. Seizure semiology is a simple tool that may permit reliable lateralization of the seizure focus in MTLE-HS. The presence of reliable lateralizing signs is not associated with a better postoperative outcome. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. The selectivity and functional connectivity of the anterior temporal lobes.

    Science.gov (United States)

    Simmons, W Kyle; Reddish, Mark; Bellgowan, Patrick S F; Martin, Alex

    2010-04-01

    One influential account asserts that the anterior temporal lobe (ATL) is a domain-general hub for semantic memory. Other evidence indicates it is part of a domain-specific social cognition system. Arbitrating these accounts using functional magnetic resonance imaging has previously been difficult because of magnetic susceptibility artifacts in the region. The present study used parameters optimized for imaging the ATL, and had subjects encode facts about unfamiliar people, buildings, and hammers. Using both conjunction and region of interest analyses, person-selective responses were observed in both the left and right ATL. Neither building-selective, hammer-selective nor domain-general responses were observed in the ATLs, although they were observed in other brain regions. These findings were supported by "resting-state" functional connectivity analyses using independent datasets from the same subjects. Person-selective ATL clusters were functionally connected with the brain's wider social cognition network. Rather than serving as a domain-general semantic hub, the ATLs work in unison with the social cognition system to support learning facts about others.

  15. Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

    Directory of Open Access Journals (Sweden)

    M. Noulhiane

    2008-01-01

    Full Text Available This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task. Results revealed that the two patient groups (left and right temporal resection gave reduced sense of reliving (R responses and more familiarity (K responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness.

  16. Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

    Science.gov (United States)

    Noulhiane, M.; Piolino, P.; Hasboun, D.; Clemenceau, S.; Baulac, M.; Samson, S.

    2008-01-01

    This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K) paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task). Results revealed that the two patient groups (left and right temporal resection) gave reduced sense of reliving (R) responses and more familiarity (K) responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness. PMID:18413911

  17. Memory for emotional material in temporal lobe epilepsy.

    Science.gov (United States)

    Múnera, Claudia P; Lomlomdjian, Carolina; Terpiluk, Verónica; Medel, Nancy; Solís, Patricia; Kochen, Silvia

    2015-11-01

    Several studies suggest that highly emotional information could facilitate long-term memory encoding and consolidation processes via an amygdala-hippocampal network. Our aim was to assess emotional perception and episodic memory for emotionally arousing material in patients with temporal lobe epilepsy (TLE) who are candidates for surgical treatment. We did this by using an audiovisual paradigm. Forty-six patients with medically resistant TLE (26 with left TLE and 20 with right TLE) and 19 healthy controls were assessed with a standard narrative test of emotional memory. The experimental task consisted of sequential picture slides with an accompanying narrative depicting a story that has an emotional central section. Subjects were asked to rate their emotional arousal reaction to each stimulus after the story was shown, while emotional memory (EM) was assessed a week later with a multiple choice questionnaire and a visual recognition task. Our results showed that ratings for emotional stimuli for the patients with TLE were significantly higher than for neutral stimuli (p=0.000). It was also observed that patients with TLE recalled significantly less information from each slide compared with controls, with a trend to lower scores on the questionnaire task for the group with LTLE, as well as poorer performance on the visual recognition task for the group with RLTE. Emotional memory was preserved in patients with RTLE despite having generally poorer memory performance compared with controls, while it was found to be impaired in patients with LTLE. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Anterior Temporal Lobe Tracks the Formation of Prejudice.

    Science.gov (United States)

    Spiers, Hugo J; Love, Bradley C; Le Pelley, Mike E; Gibb, Charlotte E; Murphy, Robin A

    2017-03-01

    Despite advances in understanding the brain structures involved in the expression of stereotypes and prejudice, little is known about the brain structures involved in their acquisition. Here, we combined fMRI, a task involving learning the valence of different social groups, and modeling of the learning process involved in the development of biases in thinking about social groups that support prejudice. Participants read descriptions of valenced behaviors performed by members of novel social groups, with majority groups being more frequently encountered during learning than minority groups. A model-based fMRI analysis revealed that the anterior temporal lobe tracked the trial-by-trial changes in the valence associated with each group encountered in the task. Descriptions of behavior by group members that deviated from the group average (i.e., prediction errors) were associated with activity in the left lateral PFC, dorsomedial PFC, and lateral anterior temporal cortex. Minority social groups were associated with slower acquisition rates and more activity in the ventral striatum and ACC/dorsomedial PFC compared with majority groups. These findings provide new insights into the brain regions that (a) support the acquisition of prejudice and (b) detect situations in which an individual's behavior deviates from the prejudicial attitude held toward their group.

  19. Learning and memory and its relationship with the lateralization of epileptic focus in subjects with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Daniel Fuentes

    2014-04-01

    Full Text Available Background : In medial temporal lobe epilepsy (MTLE, previous studies addressing the hemispheric laterality of epileptogenic focus and its relationship with learning and memory processes have reported controversial findings. Objective : To compare the performance of MTLE patients according to the location of the epileptogenic focus on the left (MTLEL or right temporal lobe (MTLER on tasks of episodic learning and memory for verbal and visual content. Methods : One hundred patients with MTLEL and one hundred patients with MTLER were tested with the following tasks: the Rey Auditory Verbal Learning Test (RAVLT and the Logical Memory-WMS-R to evaluate verbal learning and memory; and the Rey Visual Design Learning Test (RVDLT and the Visual Reproduction-WMS-R to evaluate visual learning and memory. Results : The MTLEL sample showed significantly worse performance on the RAVLT (p < 0.005 and on the Logical Memory tests (p < 0.01 than MTLER subjects. However, there were no significant between-group differences in regard to the visual memory tests. Discussion : Our findings suggest that verbal learning and memory abilities are dependent on the structural and functional integrity of the left temporal lobe, while visual abilities are less dependent on the right temporal lobe.

  20. Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature.

    Science.gov (United States)

    Marangoni, Gabriele; Hakeem, Abdul; Khan, Atif; Rotimi, Olorunda; Lodge, J Peter

    2015-11-01

    Liver resection in patients with inferior vena cava (IVC) involvement is becoming more common with the adoption of vascular exclusion techniques and replacement of the IVC. Repeat hepatectomy and an aggressive surgical approach can offer satisfactory disease-free survival and a cure in selected patients. We herein describe a case of repeat hepatectomy with en bloc re-do IVC resection and reconstruction with Gore-Tex graft for recurrent colorectal liver disease. The patient had previously undergone non-anatomical right liver resection with IVC partial excision and reconstruction with a porcine pericardial patch. The patient is currently disease-free at 12 months' follow-up. Surgical treatment of liver tumors involving the IVC offers the only hope for prolonged survival. Re-do liver surgery with concomitant re-excision of the IVC is feasible and can be contemplated when macroscopic removal of the tumor is expected. Management of these complex cases by a specialist team with expertise in liver transplantation and vascular techniques is advised.

  1. Anterior Temporal Lobe Morphometry Predicts Categorization Ability

    Directory of Open Access Journals (Sweden)

    Béatrice Garcin

    2018-02-01

    Full Text Available Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  2. Prospective memory and frontal lobe function.

    Science.gov (United States)

    Neulinger, Kerryn; Oram, Joanne; Tinson, Helen; O'Gorman, John; Shum, David H K

    2016-01-01

    The study sought to examine the role of frontal lobe functioning in focal prospective memory (PM) performance and its relation to PM deficit in older adults. PM and working memory (WM) differences were studied in younger aged (n = 21), older aged (n = 20), and frontal injury (n = 14) groups. An event-based focal PM task was employed and three measures of WM were administered. The younger aged group differed from the other two groups in showing significantly higher scores on PM and on one of the WM measures, but there were no differences at a statistically significant level between the older aged group and the frontal injury groups on any of the memory measures. There were, however, some differences in correlations with a WM measure between groups. It is concluded that there are similarities and differences in the deficits in PM between older adults and patients with frontal lobe injury on focal as well as nonfocal PM tasks.

  3. [Normal aging of frontal lobe functions].

    Science.gov (United States)

    Calso, Cristina; Besnard, Jérémy; Allain, Philippe

    2016-03-01

    Normal aging in individuals is often associated with morphological, metabolic and cognitive changes, which particularly concern the cerebral frontal regions. Starting from the "frontal lobe hypothesis of cognitive aging" (West, 1996), the present review is based on the neuroanatomical model developed by Stuss (2008), introducing four categories of frontal lobe functions: executive control, behavioural and emotional self-regulation and decision-making, energization and meta-cognitive functions. The selected studies only address the changes of one at least of these functions. The results suggest a deterioration of several cognitive frontal abilities in normal aging: flexibility, inhibition, planning, verbal fluency, implicit decision-making, second-order and affective theory of mind. Normal aging seems also to be characterised by a general reduction in processing speed observed during neuropsychological assessment (Salthouse, 1996). Nevertheless many cognitive functions remain preserved such as automatic or non-conscious inhibition, specific capacities of flexibility and first-order theory of mind. Therefore normal aging doesn't seem to be associated with a global cognitive decline but rather with a selective change in some frontal systems, conclusion which should be taken into account for designing caring programs in normal aging.

  4. Surgery for Temporal Lobe Epilepsy in Children

    Directory of Open Access Journals (Sweden)

    Mohammad Faraji-rad

    2017-12-01

    Full Text Available This study aimed to assess the efficacy of magnetic resonance imaging (MRI and single-photon emission computed tomography (SPECT in localizing epileptic foci in children with temporal lobe epilepsy (TLE. This prospective study was conducted on 12 patients including five males and seven females aged between 2 and 16 years old with a clinical diagnosis of TLE. All the patients underwent high-resolution MRI and if no abnormality was identified, SPECT was used for further assessment. In all the patients, visual inspection identified unilateral mesial temporal sclerosis, and the patients underwent craniotomy and lesionectomy.According to the results, eight patients were categorized in class I and two cases were classifies as class II, and all the patients survived. About 25% of the patients showed adequate memory function on the non-operated temporal lobe, and general intelligence quotient increased by 10% in 50% of the patients.According to the results, in patients with clinically suspected TLE, MRI alone is not able to localize the epileptic foci correctly, and SPECT can be helpful to localize these lesions.

  5. [Dynamics of functional MRI and speech function in patients after resection of frontal and temporal lobe tumors].

    Science.gov (United States)

    Buklina, S B; Batalov, A I; Smirnov, A S; Poddubskaya, A A; Pitskhelauri, D I; Kobyakov, G L; Zhukov, V Yu; Goryaynov, S A; Kulikov, A S; Ogurtsova, A A; Golanov, A V; Varyukhina, M D; Pronin, I N

    2017-01-01

    There are no studies on application of functional MRI (fMRI) for long-term monitoring of the condition of patients after resection of frontal and temporal lobe tumors. The study purpose was to correlate, using fMRI, reorganization of the speech system and dynamics of speech disorders in patients with left hemisphere gliomas before surgery and in the early and late postoperative periods. A total of 20 patients with left hemisphere gliomas were dynamically monitored using fMRI and comprehensive neuropsychological testing. The tumor was located in the frontal lobe in 12 patients and in the temporal lobe in 8 patients. Fifteen patients underwent primary surgery; 5 patients had repeated surgery. Sixteen patients had WHO Grade II and Grade III gliomas; the others had WHO Grade IV gliomas. Nineteen patients were examined preoperatively; 20 patients were examined at different times after surgery. Speech functions were assessed by a Luria's test; the dominant hand was determined using the Annette questionnaire; a family history of left-handedness was investigated. Functional MRI was performed on an HDtx 3.0 T scanner using BrainWavePA 2.0, Z software for fMRI data processing program for all calculations >7, pfrontal lobe tumors than in those with temporal lobe tumors. No additional activation foci in the left hemisphere were found at the thresholds used to process fMRI data. Recovery of the speech function, to a certain degree, occurred in all patients, but no clear correlation with fMRI data was found. Complex fMRI and neuropsychological studies in 20 patients after resection of frontal and temporal lobe tumors revealed individual features of speech system reorganization within one year follow-up. Probably, activation of right-sided homologues of the speech areas in the presence of left hemisphere tumors depends not only on the severity of speech disorder but also reflects individual involvement of the right hemisphere in enabling speech function. This is confirmed by

  6. Accessory hepatic lobe in right lumbar region - an incidental finding.

    Science.gov (United States)

    Shrestha, M K; Ghartimagar, D; Ghosh, A

    2014-01-01

    An accessory lobe of liver is a rare congenital anomaly which can be detected incidentally or can even present as acute surgical emergency due to torsion. We report a case of accessory hepatic lobe in right lumbar region in a 21years old female who came for a ultrasound abdomen for lower abdominal pain. We report the importance of ultrasonography and Computed Tomogram (CT) scan for the diagnosis of accessory hepatic lobe.

  7. Preexposure to Olive Oil Polyphenols Extract Increases Oxidative Load and Improves Liver Mass Restoration after Hepatectomy in Mice via Stress-Sensitive Genes

    Directory of Open Access Journals (Sweden)

    Jelena Marinić

    2016-01-01

    Full Text Available Polyphenols can act as oxidants in some conditions, inducing redox-sensitive genes. We investigated the effect of preexposure to the olive oil polyphenols extract (PFE on time-dependent changes in the hepatic oxidative state in a model of liver regeneration—a process in which oxidative stress associated with the metabolic overload accounts for the early events that contribute to the onset of liver self-repair. Liver regeneration was induced by one-third hepatectomy in mice. Prior to hepatectomy, mice were intraperitoneally given either PFE (50 mg/kg body weight or saline for seven consecutive days, while respective controls received vehicle alone. Redox state-regulating enzymes and thiol proteins along with the mRNA levels of Nrf2 gene and its targets γ-glutamylcysteine synthetase and heme oxygenase-1 were determined at different time intervals after hepatectomy. The liver mass restoration was calculated to assess hepatic regeneration. The resulting data demonstrate the effectiveness of preexposure to PFE in stimulating liver regeneration in a model of a small tissue loss which may be ascribed to the transient increase in oxidant load during the first hours after hepatectomy and associated induction of stress response gene-profiles under the control of Nrf2.

  8. Splenectomy after partial hepatectomy accelerates liver regeneration in mice by promoting tight junction formation via polarity protein Par 3-aPKC.

    Science.gov (United States)

    Liu, Guoxing; Xie, Chengzhi; Fang, Yu; Qian, Ke; Liu, Qiang; Liu, Gao; Cao, Zhenyu; Du, Huihui; Fu, Jie; Xu, Xundi

    2018-01-01

    Several experimental studies have demonstrated that removal of the spleen accelerates liver regeneration after partial hepatectomy. While the mechanism of splenectomy promotes liver regeneration by the improvement of the formation of tight junction and the establishment of hepatocyte polarity is still unknown. We analyzed the cytokines, genes and proteins expression between 70% partial hepatectomy mice (PHx) and simultaneous 70% partial hepatectomy and splenectomy mice (PHs) at predetermined timed points. Compared with the PHx group mice, splenectomy accelerated hepatocyte proliferation in PHs group. The expression of Zonula occludens-1 (ZO-1) indicated that splenectomy promotes the formation of tight junction during liver regeneration. TNF-α, IL-6, HGF, TSP-1 and TGF-β1 were essential factors for the formation of tight junction and the establishment of hepatocytes polarity in liver regeneration. After splenectomy, Partitioning defective 3 homolog (Par 3) and atypical protein kinase C (aPKC) regulate hepatocyte localization and junctional structures in regeneration liver. Our data suggest that the time course expression of TNF-α, IL-6, HGF, TSP-1, and TGF-β1 and the change of platelets take part in liver regeneration. Combination with splenectomy accelerates liver regeneration by improvement of the tight junction formation which may help to establish hepatocyte polarity via Par 3-aPKC. This may provide a clue for us that splenectomy could accelerate liver regeneration after partial hepatectomy of hepatocellular carcinoma and living donor liver transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Primary Meningeal Melanocytoma in the Left Temporal Lobe Associated with Nevus Ota

    DEFF Research Database (Denmark)

    Samadian, Mohammad; Nejad, Ali Mousavi; Bakhtevari, Mehrdad Hosseinzadeh

    2015-01-01

    BACKGROUND: Primary melanocytic neoplasms of the central nervous system are rare lesions arising from melanocytes of the leptomeninge that are found at highest density underneath the brain stem and along the upper cervical spinal cord. Thus most reported cases of meningeal melanocytomas are locat...

  10. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    International Nuclear Information System (INIS)

    Erol, Ilknur; Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

    2006-01-01

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

  11. Fibrous dysplasia of the frontal sinus: an uncommon cause of frontal lobe abscess.

    Science.gov (United States)

    Aygun, D; Sahin, H

    2004-11-01

    Fibrous dysplasia of the cranial air sinuses is rarely reported in the literature. This is the first report of frontal lobe abscess (FLA) associated with fibrous dysplasia of the frontal sinus (FDFS). A 29-year-old female presented with seizures and acute confusion. Cranial computed tomography (CT) revealed fibrous dysplasia of the left frontal sinus and associated FLA. She was referred to the neurosurgical service and the abscess and dysplastic tissue were removed. Histological examination confirmed fibrous dysplasia. We review the radiological appearance of FDFS with FLA. Clinicians should be aware of the association between these two conditions.

  12. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

    Science.gov (United States)

    Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

    2018-04-01

    In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

  13. Non-bronchial collateral supply from the left gastric artery in massive haemoptysis

    International Nuclear Information System (INIS)

    Sellars, N.; Belli, A.M.

    2001-01-01

    Two patients presented with recurrent, massive haemoptysis. Arteriography, including thoracoabdominal aortograms, revealed in both cases large non-bronchial collaterals arising from the left gastric artery. In the first case the non-bronchial collateral supplied the upper left lobe and in the second case it supplied the middle right lobe. Percutaneous embolisation of bronchial and non-bronchial collateral branches has become an accepted procedure in controlling massive or recurrent haemoptysis. Accurate identification of the non-bronchial collateral arterial feeders is essential for successful embolotherapy. (orig.)

  14. Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Warren W. Boling

    2018-02-01

    Full Text Available Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis.

  15. Channel systems and lobe construction in the Mississippi Fan

    Science.gov (United States)

    Garrison, L. E.; Kenyon, Neil H.; Bouma, A.H.

    1982-01-01

    Morphological features on the Mississippi Fan in the eastern Gulf of Mexico were mapped using GLORIA II, a long-range side-scan sonar system. Prominent is a sinuous channel flanked by well-developed levees and occasional crevasse splays. The channel follows the axis and thickest part of the youngest fan lobe; seismic-reflection profiles offer evidence that its course has remained essentially constant throughout lobe development. Local modification and possible erosion of levees by currents indicates a present state of inactivity. Superficial sliding has affected part of the fan lobe, but does not appear to have been a factor in lobe construction. ?? 1982 A. M. Dowden, Inc.

  16. Occurrence of the lobe plasma at lunar distance

    International Nuclear Information System (INIS)

    Hardy, D.A.; Hills, H.K.; Freeman, J.W.

    1979-01-01

    Recent analysis has confirmed and expanded the characterization of the lobe plasma, the extension of the 'boundary layer' and 'plasma mantle' to lunar distances. Careful statistical analysis has verified that Magnetic Field (1MF). When the moon is in the dawnside of the northern lobe or duskside of the southern lobe, the probability for observation of the lobe plasma is greatly increased when, in the hour preceding, the IMF has had a positive y component. Conversely, when the moon is in the duskside of the northern lobe or dawnside of the southern lobe, the probability for observation is much increased when the IMF has a negative y component. Analysis of lobe plasma data in conjunction with high time resolution IMF data has shown the probability of observation also is greater with a southward pointing IMF. The observed correlations with the y and z components the IMF reflect the fact that the asymmetry and changes in magnitude of the polar cap electric field induced by the IMF extends to lunar distances and determines the depth into the tail to which the ions can drift. Generally, the lobe plasma is observed sporadically for a full day after the moon has entered the tail and a full day before the last magnetopause crossing as it exits the tail. An average extent of approx.8--10R/sub e/ inward from the magnetopause is inferred; however, the lobe plasma has been seen all across the tail

  17. Blunt rupture of the right hemidiaphragm with herniation of the right colon and right lobe of the liver

    Directory of Open Access Journals (Sweden)

    Bairagi Anjana

    2010-01-01

    Full Text Available Acute right hemidiaphragm rupture with abdominal visceral herniation is reportedly less common than on the left. We present a complex case of blunt rupture of the right hemidiaphragm with herniation of the right colon and right lobe of the liver in a multiply injured patient. The diagnostic approach, with specific reference to the imaging studies, and surgical management is discussed, followed by a brief literature review highlighting the complexities of the case.

  18. Fetal intermediate lobe is stimulated by parturition.

    Science.gov (United States)

    Facchinetti, F; Lanzani, A; Genazzani, A R

    1989-11-01

    The fetal pituitary gland secretes beta-endorphin in blood in response to delivery. However, other forms of endorphin have recently been observed in the fetal pituitary, such as N-acetyl-beta-endorphin, which is devoid of opiate activity, and a desacetylated form of alpha-melanocyte-stimulating hormone. Both endorphins originate in the pituitary intermediate lobe. The sensitivity of this lobe to labor stress was assessed by the evaluation of beta-endorphin, N-acetyl-beta-endorphin, melanocyte-stimulating hormone, and desacetylated alpha-melanocyte-stimulating hormone in maternal plasma and cord blood in 11 cases of vaginal delivery and 10 cases of elective cesarean section without labor. Plasma peptide levels were determined by specific radioimmunoassays after extraction on Sep-Pak C-18 cartridges and high-performance liquid chromatography fractionation. Cord blood samples of infants delivered vaginally showed higher beta-endorphin (8.5 +/- 1.6 pmol/L, mean +/- SE) and desacetylated alpha-melanocyte-stimulating hormone (13.6 +/- 3.2 pmol/L) levels than those delivered by elective cesarean section (3.7 +/- 0.8 and 4.2 +/- 1.1 pmol/L, for beta-endorphin and desacetylated alpha-melanocyte-stimulating hormone, respectively). N-acetyl-beta-endorphin and alpha-melanocyte-stimulating hormone levels do not differ in relation to the mode of delivery. In maternal circulation beta-endorphin levels were higher in those delivered vaginally (5.2 pm 1) than in women who had cesarean sections (2.5 +/- 0.5 pmol/L), whereas no changes were found for the other peptides. In vaginal deliveries, the level of desacetylated alpha-melanocyte-stimulating hormone was higher in cord blood (13.6 +/- 3.2 pmol/L) than in maternal plasma (6.5 +/- 3 pmol/L); there were no significant differences with regard to the other peptides. Fetal and maternal levels of all the peptides were similar in cases of cesarean section. We conclude that parturition activates proopiomelanocortin peptide release from

  19. Do children with aggressive behavior have temporal lobe changes?

    International Nuclear Information System (INIS)

    Thomas, Carmen; Godberg, Michael

    2003-01-01

    Aggressive behavior and mood disorders frequently appear in childhood. There is often lack of objective data to support a specific clinical diagnosis. Ultimately it is likely that alterations in production, concentration, storage, release, reuptake and degradation of neurotransmitters such as serotonin, dopamine, acetylcholine and gamma-aminobutyric acid play key roles in the manifestations of mood disorders. We sought to determine if more gross anatomic patterns of regional brain activation in a 'baseline' state might also supply an objective means of verifying the presence of a mood disorder characterized by anger or aggressive behavior. We studied 8 patients, 3 girls and 5 boys, ages ranging from 6 to 12, referred for SPECT brain imaging with the diagnosis of an attention deficit disorder or autism. All had been reported as having temper problems on the routine questionnaire completed by the parents prior to SPECT imaging. The patients, who were not sedated, had absolute cerebral blood flow measured by the xenon 133 gas inhalation technique followed by intravenous injection of Tc-99m HMPAO with an administered dose calculated according to patient age and weight. One hour following the injection, high resolution brain SPECT imaging was performed using a Picker triple headed camera with fan beam collimators. We analyzed the brain SPECT studies using 3D volume rendered semi-transparent images with dual cut off windows of 88 percent (high) and 60-65 percent (lower value depending on the patient absolute mean cortical blood flow), as well as the traditional transverse, coronal and sagittal sections. The dual window 3D display helped demonstrate increased perfusion or activation of either or both right and left temporal lobes in all 8 of the patients. This pattern was not seen in children with similar clinical diagnoses but whose parents did not report temper problems. These preliminary findings support the proposition that an increase in perfusion to the temporal

  20. Effects of prior exposure on music liking and recognition in patients with temporal lobe lesions.

    Science.gov (United States)

    Samson, Séverine; Peretz, Isabelle

    2005-12-01

    Prior exposure to music typically increases liking. This manifestation of implicit memory can be dissociated from explicit memory recognition. To examine the contribution of the medial temporal lobe to musical preference and recognition, we tested patients with either left (LTL) or right (RTL) temporal lobe lesions as well as normal control (NC) participants using the procedure of Peretz et al. The results in the affect task showed that NC and LTL participants preferred the studied over nonstudied melodies, thereby demonstrating an implicit exposure effect on liking judgments, whereas RTL patients failed to exhibit this effect. Explicit recognition was impaired in both LTL and RTL patients as compared to NC participants. On the basis of these findings, we suggest that RTL structures play a critical role in the formation of melody representations that support both priming and memory recognition, whereas LTL structures are more involved in the explicit retrieval of melodies. Furthermore, we were able to test an amnesic patient (PC) with bilateral lesions of the temporal lobe. In this case, the exposure effect on liking was also absent. However, repeated exposure to melodies was found to enhance both liking and recognition judgments. This remarkable sparing of memory observed through melody repetition suggests that extensive exposure may assist both implicit and explicit memory in the presence of global amnesia.

  1. Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study.

    Science.gov (United States)

    de Araújo Filho, Gerardo Maria; Lin, Katia; Lin, Jaime; Peruchi, Mirella M; Caboclo, Luís Otávio S F; Guaranha, Mirian S B; Guilhoto, Laura M F F; Carrete, Henrique; Yacubian, Elza Márcia T

    2009-05-01

    Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. In this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME. Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively). A significant reduction of N-acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. In addition, a significant increase in the glutamate-glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group. These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.

  2. Video electroencephalogram telemetry in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Jayanti Mani

    2014-01-01

    Full Text Available Temporal lobe epilepsy (TLE is the most commonly encountered medically refractory epilepsy. It is also the substrate of refractory epilepsy that gives the most gratifying results in any epilepsy surgery program, with a minimum use of resources. Correlation of clinical behavior and the ictal patterns during ictal behavior is mandatory for success at epilepsy surgery. Video electroencephalogram (EEG telemetry achieves this goal and hence plays a pivotal role in pre-surgical assessment. The role of telemetry is continuously evolving with the advent of digital EEG technology, of high-resolution volumetric magnetic resonance imaging and other functional imaging techniques. Most of surgical selection in patients with TLE can be done with a scalp video EEG monitoring. However, the limitations of the scalp EEG technique demand invasive recordings in a selected group of TLE patients. This subset of the patients can be a challenge to the epileptologist.

  3. The mirror mechanism in the parietal lobe.

    Science.gov (United States)

    Rizzolatti, Giacomo; Rozzi, Stefano

    2018-01-01

    The mirror mechanism is a basic mechanism that transforms sensory representations of others' actions into motor representations of the same actions in the brain of the observer. The mirror mechanism plays an important role in understanding actions of others. In the present chapter we discuss first the basic organization of the posterior parietal lobe in the monkey, stressing that it is best characterized as a motor scaffold, on the top of which sensory information is organized. We then describe the location of the mirror mechanism in the posterior parietal cortex of the monkey, and its functional role in areas PFG, and anterior, ventral, and lateral intraparietal areas. We will then present evidence that a similar functional organization is present in humans. We will conclude by discussing the role of the mirror mechanism in the recognition of action performed with tools. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Frontal Lobe Function in Chess Players

    Directory of Open Access Journals (Sweden)

    Vahid Nejati

    2012-05-01

    Full Text Available Chess is considered as a cognitive game because of severe engagement of the mental resources during playing. The purpose of this study is evaluation of frontal lobe function of chess players with matched non-players. Wisconsin Card Sorting Test (WCST data showed no difference between the player and non-player groups in preservation error and completed categories but surprisingly showed significantly lower grade of the player group in correct response. Our data reveal that chess players dont have any preference in any stage of Stroop test. Chess players dont have any preference in selective attention, inhibition and executive cognitive function. Chess players' have lower shifting abilities than non-players.

  5. Monocarboxylate transporters in temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Lauritzen, Fredrik; Eid, Tore; Bergersen, Linda H

    2013-01-01

    Epilepsy is a serious neurological disorder that affects approximately 1 % of the general population, making it one of the most common disorders of the central nervous system. Furthermore, up to 40 % of all patients with epilepsy cannot control their seizures with current medications. More...... efficacious treatments for medication refractory epilepsy are therefore needed. A better understanding of the mechanisms that cause this disorder is likely to facilitate the discovery of such treatments. Impairment in cerebral energy metabolism has been proposed as a possible causative factor...... in the pathogenesis of temporal lobe epilepsy (TLE), which is one of the most common types of medication-refractory epilepsies in adults. In this review, we will discuss some of the current hypotheses regarding the possible causal relationship between brain energy metabolism and TLE. Emphasis will be placed...

  6. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Benhou Zhang

    2018-01-01

    Full Text Available Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex group (DEX infusion at an initial loading dose of 0.5 μg⋅kg-1 over 10 min before intubation then adjusted to a maintenance dose of 0.3 μg⋅kg-1⋅h-1 until incision suturing or control (Con group (0.9% sodium chloride was administered. Patient-controlled analgesia was administered for 48 h after surgery (Dex group: 60 mg oxycodone and 360 μg DEX diluted to 120 ml and administered at a bolus dose of 2 ml, with 5 min lockout interval and a 1 h limit of 20 ml. Con group: 60 mg oxycodone alone with the same regimen. The primary outcome was post-operative oxycodone consumption. The secondary outcomes included requirement of narcotic and vasoactive drugs, hemodynamics, incidence of adverse effects, satisfaction, first exhaust time, pain intensity, and the Ramsay Sedation Scale.Results: Post-operative oxycodone consumption was significantly reduced in Dex group from 4 to 48 h after surgery (P < 0.05. Heart rate in Dex group was statistically decreased from T1 (just before intubation to T6 (20 min after arriving at the post-anesthesia care unit, while mean arterial pressure was significantly decreased from T1 to T3 (during surgical incision; P < 0.05. The consumption of propofol and remifentanil were significantly decreased in Dex group (P < 0.05. The VAS scores at rest at 1, 4, and 8 h and with cough at 24, and 48 h after surgery were lower, the first exhaust time were shorter, satisfaction with pain control was statistically higher and the incidence of nausea

  7. Executive functioning and depressed mood before and after unilateral frontal lobe resection for intractable epilepsy.

    Science.gov (United States)

    Dulay, Mario F; Busch, Robyn M; Chapin, Jessica S; Jehi, Lara; Najm, Imad

    2013-06-01

    Executive dysfunction occurs in a variety of patients who have sustained damage to the frontal lobes. In individuals with frontal lobe epilepsy (FLE) or after unilateral frontal lobe resection (FLR), a unique neuropsychological profile linking executive functions (EF) with the frontal lobe has been elusive, with conflicting findings in the literature. Some studies show greater risk of executive impairment with left-sided FLE or FLR, while others report greater risk for right-sided patients. Some studies report no relationship between FLE and EF impairment, while others show EF impairment regardless of side of seizure foci or surgery. In patients with temporal lobe epilepsy, executive dysfunction is associated with depressed mood possibly reflecting disruption of cortical-limbic pathways and/or frontal-striatal circuitry. Although not previously examined, depression level may affect executive functioning in those with FLE or FLR. We hypothesized that FLE patients with poor mood state would show greater executive dysfunction than FLE patients without poor mood state. The relationship among EF, side of surgery and depressed mood before and 8 months after unilateral FLR was evaluated in 64 patients using validated measures of EF and mood state (Beck Depression Inventory-II). Results indicated that individuals with depressed mood before surgery had greater difficulty on a task of mental flexibility compared to patients without preoperative depressed mood. Further, individuals with depressed mood before surgery had significant increases in perseverative responding and completed fewer categories on a card-sorting task after surgery compared to patients without preoperative depressed mood. Regression analyses showed that among side of surgery, seizure freedom status after surgery and depression status, only pre-surgical depression status explained a significant amount of variance in executive functioning performance after surgery. Results suggest that clinically elevated

  8. Why Are the Right and Left Hemisphere Conceptual Representations Different?

    Directory of Open Access Journals (Sweden)

    Guido Gainotti

    2014-01-01

    Full Text Available The present survey develops a previous position paper, in which I suggested that the multimodal semantic impairment observed in advanced stages of semantic dementia is due to the joint disruption of pictorial and verbal representations, subtended by the right and left anterior temporal lobes, rather than to the loss of a unitary, amodal semantic system. The main goals of the present review are (a to survey a larger set of data, in order to confirm the differences in conceptual representations at the level of the right and left hemispheres, (b to examine if language-mediated information plays a greater role in left hemisphere semantic knowledge than sensory-motor information in right hemisphere conceptual knowledge, and (c to discuss the models that could explain both the differences in conceptual representations at the hemispheric level and the prevalence of the left hemisphere language-mediated semantic knowledge over the right hemisphere perceptually based conceptual representations.

  9. Rotating superconductor magnet for producing rotating lobed magnetic field lines

    Science.gov (United States)

    Hilal, Sadek K.; Sampson, William B.; Leonard, Edward F.

    1978-01-01

    This invention provides a rotating superconductor magnet for producing a rotating lobed magnetic field, comprising a cryostat; a superconducting magnet in the cryostat having a collar for producing a lobed magnetic field having oppositely directed adjacent field lines; rotatable support means for selectively rotating the superconductor magnet; and means for energizing the superconductor magnet.

  10. Surgical anatomy of the pyramidal lobe and its significance in ...

    African Journals Online (AJOL)

    In diffuse thyroid diseases, the lobes were always pathologically involved and significantly longer. Conclusion. Since the pyramidal lobe is a normal component of the thyroid gland, of varying position and size, with pathological changes in benign and malignant diseases, it should always be examined during thyroid surgery ...

  11. Altered anterior-posterior connectivity through the arcuate fasciculus in temporal lobe epilepsy.

    Science.gov (United States)

    Takaya, Shigetoshi; Liu, Hesheng; Greve, Douglas N; Tanaka, Naoaki; Leveroni, Catherine; Cole, Andrew J; Stufflebeam, Steven M

    2016-12-01

    How the interactions between cortices through a specific white matter pathway change during cognitive processing in patients with epilepsy remains unclear. Here, we used surface-based structural connectivity analysis to examine the change in structural connectivity with Broca's area/the right Broca's homologue in the lateral temporal and inferior parietal cortices through the arcuate fasciculus (AF) in 17 patients with left temporal lobe epilepsy (TLE) compared with 17 healthy controls. Then, we investigated its functional relevance to the changes in task-related responses and task-modulated functional connectivity with Broca's area/the right Broca's homologue during a semantic classification task of a single word. The structural connectivity through the AF pathway and task-modulated functional connectivity with Broca's area decreased in the left midtemporal cortex. Furthermore, task-related response decreased in the left mid temporal cortex that overlapped with the region showing a decrease in the structural connectivity. In contrast, the region showing an increase in the structural connectivity through the AF overlapped with the regions showing an increase in task-modulated functional connectivity in the left inferior parietal cortex. These structural and functional changes in the overlapping regions were correlated. The results suggest that the change in the structural connectivity through the left frontal-temporal AF pathway underlies the altered functional networks between the frontal and temporal cortices during the language-related processing in patients with left TLE. The left frontal-parietal AF pathway might be employed to connect anterior and posterior brain regions during language processing and compensate for the compromised left frontal-temporal AF pathway. Hum Brain Mapp 37:4425-4438, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Asymmetrical hippocampal connectivity in mesial temporal lobe epilepsy: evidence from resting state fMRI

    Directory of Open Access Journals (Sweden)

    Castellano Gabriela

    2010-06-01

    Full Text Available Abstract Background Mesial temporal lobe epilepsy (MTLE, the most common type of focal epilepsy in adults, is often caused by hippocampal sclerosis (HS. Patients with HS usually present memory dysfunction, which is material-specific according to the hemisphere involved and has been correlated to the degree of HS as measured by postoperative histopathology as well as by the degree of hippocampal atrophy on magnetic resonance imaging (MRI. Verbal memory is mostly affected by left-sided HS, whereas visuo-spatial memory is more affected by right HS. Some of these impairments may be related to abnormalities of the network in which individual hippocampus takes part. Functional connectivity can play an important role to understand how the hippocampi interact with other brain areas. It can be estimated via functional Magnetic Resonance Imaging (fMRI resting state experiments by evaluating patterns of functional networks. In this study, we investigated the functional connectivity patterns of 9 control subjects, 9 patients with right MTLE and 9 patients with left MTLE. Results We detected differences in functional connectivity within and between hippocampi in patients with unilateral MTLE associated with ipsilateral HS by resting state fMRI. Functional connectivity resulted to be more impaired ipsilateral to the seizure focus in both patient groups when compared to control subjects. This effect was even more pronounced for the left MTLE group. Conclusions The findings presented here suggest that left HS causes more reduction of functional connectivity than right HS in subjects with left hemisphere dominance for language.

  13. Assessment of working memory in patients with mesial temporal lobe epilepsy associated with unilateral hippocampal sclerosis.

    Science.gov (United States)

    Tudesco, Ivanda de Souza Silva; Vaz, Leonardo José; Mantoan, Marcele Araújo Silva; Belzunces, Erich; Noffs, Maria Helena; Caboclo, Luís Otávio Sales Ferreira; Yacubian, Elza Márcia Targas; Sakamoto, Américo Ceiki; Bueno, Orlando Francisco Amodeo

    2010-07-01

    The aim of the present study was to investigate whether working memory is impaired in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), a controversial and largely unexplored matter. Twenty subjects with left MTLE-HS, 19 with right MTLE-HS, and 21 control right-handed subjects underwent neuropsychological assessment of episodic and semantic memory, executive functions, and specific working memory components. Left and right epileptogenic foci resulted in impairment of verbal and nonverbal episodic memory (verbal memory deficit greater in left MTLE-HS than in right MTLE-HS). In addition, patients with left MTLE-HS were impaired in learning paired associates, verbal fluency, and Trail Making. No differences were seen in the tests carried out to evaluate the working memory components (except visuospatial short-term memory in right MTLE-HS). In this study we did not detect reliable working memory impairment in patients with MTLE-HS with either a left or right focus in most tasks considered as tests of working memory components. Copyright 2010 Elsevier Inc. All rights reserved.

  14. Comprehension and production of nouns and verbs in temporal lobe epilepsy.

    Science.gov (United States)

    Yurchenko, Anna; Golovteev, Alexander; Kopachev, Dmitry; Dragoy, Olga

    2017-10-01

    Previous research on linguistic performance at the single-word level in patients with temporal lobe epilepsy (TLE) has mostly been limited to the comprehension and production of nouns, and findings have been inconsistent. Results are likewise limited and controversial regarding the lateralization of the epileptogenic focus. The present study investigates comprehension and production of nouns and verbs in patients with left and right TLE (12 in each group). We designed a comprehension (word-picture matching) test and a production (naming) test, matched on a range of psycholinguistic parameters for the two word classes. The results showed impaired verb comprehension in patients with left TLE and impaired noun and verb production in both groups of patients compared to the control group. Patients with left and right TLE differed significantly on verb comprehension and noun production, whereas verb production was equally impaired in the two groups of patients. These findings suggest difficulties with single-word processing in patients with both left and right TLE, which are more prominent for verbs than for nouns in patients with left TLE. The verb production (action naming) test turned out to be the most effective tool for assessing linguistic difficulties at the single-word level in patients with TLE. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Frontal lobe regulation of blood glucose levels: support for the limited capacity model in hostile violence-prone men.

    Science.gov (United States)

    Walters, Robert P; Harrison, Patti Kelly; Campbell, Ransom W; Harrison, David W

    2016-12-01

    Hostile men have reliably displayed an exaggerated sympathetic stress response across multiple experimental settings, with cardiovascular reactivity for blood pressure and heart rate concurrent with lateralized right frontal lobe stress (Trajanoski et al., in Diabetes Care 19(12):1412-1415, 1996; see Heilman et al., in J Neurol Neurosurg Psychiatry 38(1):69-72, 1975). The current experiment examined frontal lobe regulatory control of glucose in high and low hostile men with concurrent left frontal lobe (Control Oral Word Association Test [verbal]) or right frontal lobe (Ruff Figural Fluency Test [nonverbal]) stress. A significant interaction was found for Group × Condition, F (1,22) = 4.16, p ≤ .05 with glucose levels (mg/dl) of high hostile men significantly elevated as a function of the right frontal stressor (M = 101.37, SD = 13.75) when compared to the verbal stressor (M = 95.79, SD = 11.20). Glucose levels in the low hostile group remained stable for both types of stress. High hostile men made significantly more errors on the right frontal but not the left frontal stressor (M = 17.18, SD = 19.88) when compared to the low hostile men (M = 5.81, SD = 4.33). These findings support our existing frontal capacity model of hostility (Iribarren et al., in J Am Med Assoc 17(19):2546-2551, 2000; McCrimmon et al., in Physiol Behav 67(1):35-39, 1999; Brunner et al., in Diabetes Care 21(4):585-590, 1998), extending the role of the right frontal lobe to regulatory control over glucose mobilization.

  16. Supplementary CT temporal lobe cuts confer no worthwhile benefit

    International Nuclear Information System (INIS)

    Straiton, J.A.; Macpherson, P.; Teasdale, E.M.

    1991-01-01

    The value of angled temporal lobe cuts as a supplement to conventional head computed tomography (CT) has been assessed by comparing the diagnostic yield of standard axial and specific temporal lobe images (TLCT) in 62 patients with temporal lobe epilepsy and 87 with Alzheimer-type senile dementia. Fewer than one patient in six had structural abnormality in the temporal lobe most readily demonstrated by axial CT. Five patients with epilepsy and ten with dementia had changes demonstrated only by TLCT, reported on by one or other of a pair of observers. However such changes were of dubious clinical relevance, or arose as a result of artefact. In one patient with epilepsy and underlying neoplasm, axial CT was positive and TLCT false-negative. The routine addition of temporal lobe cuts to a conventional axial examination confers no added benefit to justify the prolonged examination time and increased radiation dose to the lens of the eye. (orig.)

  17. An Efficient Approach for Identifying Stable Lobes with Discretization Method

    Directory of Open Access Journals (Sweden)

    Baohai Wu

    2013-01-01

    Full Text Available This paper presents a new approach for quick identification of chatter stability lobes with discretization method. Firstly, three different kinds of stability regions are defined: absolute stable region, valid region, and invalid region. Secondly, while identifying the chatter stability lobes, three different regions within the chatter stability lobes are identified with relatively large time intervals. Thirdly, stability boundary within the valid regions is finely calculated to get exact chatter stability lobes. The proposed method only needs to test a small portion of spindle speed and cutting depth set; about 89% computation time is savedcompared with full discretization method. It spends only about10 minutes to get exact chatter stability lobes. Since, based on discretization method, the proposed method can be used for different immersion cutting including low immersion cutting process, the proposed method can be directly implemented in the workshop to promote machining parameters selection efficiency.

  18. PET imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2006-01-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  19. Laminin A, B1, B2, S and M subunits in the postnatal rat liver development and after partial hepatectomy

    DEFF Research Database (Denmark)

    Wewer, U M; Engvall, E; Paulsson, M

    1992-01-01

    The expression of laminin subunits (A, B1, B2, S and M) in the perisinusoidal space of the rat liver was studied in early postnatal life, in the adult, and after partial hepatectomy. In the perisinusoidal space of the normal adult rat, laminin was detected with polyclonal antibodies only in small...... streaks of basement membranes extending from the portobiliary tract and to a lesser degree from the central vein. Occasionally, droplets of laminin immunoreactivity were also found along the intervening portions of the perisinusoidal spaces. All morphologically identifiable basement membranes of the rat...... liver (biliary ducts and blood vessels) irrespective of the age of animals exhibited B1, B2 and S immunoreactivity. Laminin A was restricted to the larger blood vessels and could not be detected in the biliary ducts. In the adult rat, immunoreactivity for the A-like M subunit was absent except for some...

  20. Temporal lobe association fiber tractography as compared to histology and dissection.

    Science.gov (United States)

    Holl, Nathalie; Noblet, Vincent; Rodrigo, Sébastian; Dietemann, Jean L; Mekhbi, Mustapha Ben; Kehrli, Pierre; Wolfram-Gabel, Renée; Braun, Marc; Kremer, Stéphane

    2011-10-01

    To compare the temporal lobe white matter fiber bundles obtained by diffusion tensor imaging-based tractography to that by histology and dissection, and to study the interindividual variability of the obtained tracts. DTI (diffusion tensor imaging) acquisitions (30 directions) were obtained from nine healthy volunteers. Imaging post-processing was performed with FSL (FMRIB Software Library) software. Uncinate fasciculus, longitudinal inferior fasciculus and optic radiations were tracked after positioning of the region of interest (ROI) in predetermined anatomical landmarks. Histological data were obtained by cutting 15 µm coronal sections in one left brain hemisphere and staining with modified Heidenhain-Woelcke myelin stain. Dissection was performed on the left brain hemisphere prepared in accordance with the Klingler method. Tractography of each bundle was compared to histology and dissection data. To highlight the interindividual variability of the considered fiber tracts, all the images were affinely registered on an arbitrarily chosen reference image by considering the B0 images. Fiber tracts were then warped according to the corresponding estimated transformation and an average fiber tract image was then computed. Our results demonstrated a good concordance between tractography of the temporal lobe white matter bundles and dissection and histological data. The interindividual reproducibility of each tract seemed to be good, particularly in the middle part. The variability was more important at both ends, probably in relation to the dispersion of fiber bundles. Diffusion tensor imaging-based tractography of temporal lobe white matter tracts seemed to be in accordance with histological and dissection data. Taking into account some limitations, it could be of particular interest for the presurgical planning of temporal lobectomy.

  1. Emotion recognition and social cognition in temporal lobe epilepsy and the effect of epilepsy surgery.

    Science.gov (United States)

    Amlerova, Jana; Cavanna, Andrea E; Bradac, Ondrej; Javurkova, Alena; Raudenska, Jaroslava; Marusic, Petr

    2014-07-01

    The abilities to identify facial expression from another person's face and to attribute mental states to others refer to preserved function of the temporal lobes. In the present study, we set out to evaluate emotion recognition and social cognition in presurgical and postsurgical patients with unilateral refractory temporal lobe epilepsy (TLE). The aim of our study was to investigate the effects of TLE surgery and to identify the main risk factors for impairment in these functions. We recruited 30 patients with TLE for longitudinal data analysis (14 with right-sided and 16 with left-sided TLE) and 74 patients for cross-sectional data analysis (37 with right-sided and 37 with left-sided TLE) plus 20 healthy controls. Besides standard neuropsychological assessment, we administered an analog of the Ekman and Friesen test and the Faux Pas Test to assess emotion recognition and social cognition, respectively. Both emotion recognition and social cognition were impaired in the group of patients with TLE, irrespective of the focus side, compared with healthy controls. The performance in both tests was strongly dependent on the intelligence level. Beyond intelligence level, earlier age at epilepsy onset, longer disease duration, and history of early childhood brain injury predicted social cognition problems in patients with TLE. Epilepsy surgery within the temporal lobe seems to have neutral effect on patients' performances in both domains. However, there are a few individual patients who appear to be at risk of postoperative decline, even when seizure freedom is achieved following epilepsy surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Changes in highly sensitive alpha-fetoprotein for the prediction of the outcome in patients with hepatocellular carcinoma after hepatectomy

    International Nuclear Information System (INIS)

    Toyoda, Hidenori; Kumada, Takashi; Tada, Toshifumi; Ito, Takanori; Maeda, Atsuyuki; Kaneoka, Yuji; Kagebayashi, Chiaki; Satomura, Shinji

    2014-01-01

    We investigated changes in highly sensitive lens culinaris agglutinin A-reactive fraction of alpha-fetoprotein (hsAFP-L3) measured using a novel method and its predictive ability for prognosis in patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy, comparing to other HCC tumor markers, that is, AFP, des-gamma-carboxy prothrombin (DCP), and AFP-L3 measured with conventional method (cAFP-L3). AFP, DCP, and AFP-L3 including both cAFP-L3 and hsAFP-L3 were measured before and after curative hepatectomy in 187 patients. The percentage of patients with elevated tumor marker levels pre- and postoperatively was compared, and recurrence-free and overall survival rates were analyzed based on changes in tumor markers. The percentages of patients with elevated AFP, DCP, and cAFP-L3 decreased postoperatively. In contrast, the percentage of patients with elevated hsAFP-L3 did not decrease postoperatively. Both recurrence-free and overall survival rates were significantly lower in patients whose tumor marker levels remained elevated postoperatively than patients without tumor marker elevation postoperatively. Recurrence-free and overall survival rates of patients in whom hsAFP-L3 became elevated postoperatively despite normal preoperative hsAFP-L3 levels were significantly lower than those of patients with normal hsAFP-L3 postoperatively, and were similar to those of patients with persistent elevation. Preoperative elevations of AFP, DCP, and cAFP normalized in many patients postoperatively, but not for hsAFP-L3. The elevation of hsAFP-L3 identifies patients with poor prognosis despite the normalization of AFP and DCP

  3. Drop-out between the two liver resections of two-stage hepatectomy. Patient selection or loss of chance?

    Science.gov (United States)

    Viganò, L; Torzilli, G; Cimino, M; Imai, K; Vibert, E; Donadon, M; Castaing, D; Adam, R

    2016-09-01

    Two-stage hepatectomy (TSH) is the present standard for multiple bilobar colorectal liver metastases (CLM), but 25-35% of patients fail to complete the scheduled procedure (drop-out). To elucidate if drop-out of TSH is a patient selection (as usually considered) or a loss of chance. All the consecutive patients scheduled for a TSH at the Paul Brousse Hospital between 2000 and 2012 were considered. TSH patients were matched 1:1 with patients receiving a one-stage ultrasound-guided hepatectomy (OSH) at the Humanitas Research Hospital in the same period. Matching criteria were: primary tumor N status; timing of CLM diagnosis; CLM number and distribution into the liver. Sixty-three pairs of patients were analyzed. Demographic and tumor characteristics were similar (median 7 CLM), except for more chemotherapy lines and adjuvant chemotherapy in TSH. Drop-out rate of TSH was 38.1% (0% of OSH). The two groups had similar R0 resection rate (19.0% OSH vs. 15.9% TSH). OSH and completed TSH had similar five-year survival (from CLM diagnosis 49.8% vs. 49.7%, from liver resection 36.1% vs. 44.3%), superior to drop-out (10% three-year survival, p loss of chance rather than a criteria for patient selection. "Unselected" OSH patients had the same outcomes of selected patients who completed TSH. A complete resection is the main determinant of prognosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Pure Laparoscopic Right Hepatectomy Using Modified Liver Hanging Maneuver: Technical Evolution from Caudal Approach Toward Ventral Approach.

    Science.gov (United States)

    Kim, Ji Hoon

    2018-03-12

    The liver hanging maneuver during right hepatectomy is a useful technique for parenchymal transection. The laparoscopic caudal approach is totally different from the laparoscopic ventral approach because of the direction of parenchymal transection. There are differences in the application and effectiveness of liver hanging maneuver between two approaches. This study evaluated the surgical techniques and outcomes of the ventral approach comparison with the caudal approach in laparoscopic right hemihepatectomy using liver hanging maneuver. From February 2013 to February 2018, 16 patients underwent laparoscopic right hepatectomy using liver hanging maneuver. The caudal approach was used in 10 patients and the ventral approach in six. We adopted a different avascular plane located between the right adrenal gland and the vena cava for the hanging tape placement. In the caudal approach, the liver parenchyma were transected from the caudal to cranial side, pulling the hanging tape caudally. In the ventral approach, the parenchyma were transected from the ventral to the dorsal side, pulling the hanging tape superiorly. The clinical data and patient characteristics of both groups were similar. The median operation time was comparable between the two groups (275 vs. 278 min, p = 0.958). The median blood loss was significantly lower using the ventral approach group than the caudal approach group (375 vs. 190 ml, p = 0.016). The difference in median postoperative hospital stay was not statistically significant (9 vs. 8 days, p = 0.713). This ventral approach with liver hanging maneuver is a feasible and useful technique for laparoscopic right hemihepatectomy.

  5. Extrahippocampal Desynchronization in Nonlesional Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Jesús Pastor

    2012-01-01

    Full Text Available Although temporal lobe epilepsy (TLE is traditionally associated with both hypersynchronous activity in the form of interictal epileptic discharges and hippocampal sclerosis, recent findings suggest that desynchronization also plays a central role in the dynamics of this pathology. The objective of this work is to show the imbalance existing between mesial activities in patients suffering from mesial TLE, with normal mesial structures. Foramen ovale recordings from six patients with mesial TLE and one with lateral TLE were analyzed through a cluster analysis and synchronization matrices. None of the patients present findings in the MRI presurgical evaluation. Numerical analysis was carried out in three different situations: awake and sleep interictal and also during the preictal stage. High levels of desynchronization ipsilateral to the epileptic side were present in mesial TLE patients. Low levels of desynchronization were present in the lateral TLE patient during the interictal stage and almost zero in the preictal stage. Implications of these findings in relation with seizure spreading are discussed.

  6. 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....

  7. Errors on the Trail Making Test Are Associated with Right Hemispheric Frontal Lobe Damage in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Bruno Kopp

    2015-01-01

    Full Text Available Measures of performance on the Trail Making Test (TMT are among the most popular neuropsychological assessment techniques. Completion time on TMT-A is considered to provide a measure of processing speed, whereas completion time on TMT-B is considered to constitute a behavioral measure of the ability to shift between cognitive sets (cognitive flexibility, commonly attributed to the frontal lobes. However, empirical evidence linking performance on the TMT-B to localized frontal lesions is mostly lacking. Here, we examined the association of frontal lesions following stroke with TMT-B performance measures (i.e., completion time and completion accuracy measures using voxel-based lesion-behavior mapping, with a focus on right hemispheric frontal lobe lesions. Our results suggest that the number of errors, but not completion time on the TMT-B, is associated with right hemispheric frontal lesions. This finding contradicts common clinical practice—the use of completion time on the TMT-B to measure cognitive flexibility, and it underscores the need for additional research on the association between cognitive flexibility and the frontal lobes. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether our observation is specific for right frontal lesions.

  8. Concomitant fractional anisotropy and volumetric abnormalities in temporal lobe epilepsy: cross-sectional evidence for progressive neurologic injury.

    Directory of Open Access Journals (Sweden)

    Simon S Keller

    Full Text Available BACKGROUND: In patients with temporal lobe epilepsy and associated hippocampal sclerosis (TLEhs there are brain abnormalities extending beyond the presumed epileptogenic zone as revealed separately in conventional magnetic resonance imaging (MRI and MR diffusion tensor imaging (DTI studies. However, little is known about the relation between macroscopic atrophy (revealed by volumetric MRI and microstructural degeneration (inferred by DTI. METHODOLOGY/PRINCIPAL FINDINGS: For 62 patients with unilateral TLEhs and 68 healthy controls, we determined volumes and mean fractional anisotropy (FA of ipsilateral and contralateral brain structures from T1-weighted and DTI data, respectively. We report significant volume atrophy and FA alterations of temporal lobe, subcortical and callosal regions, which were more diffuse and bilateral in patients with left TLEhs relative to right TLEhs. We observed significant relationships between volume loss and mean FA, particularly of the thalamus and putamen bilaterally. When corrected for age, duration of epilepsy was significantly correlated with FA loss of an anatomically plausible route - including ipsilateral parahippocampal gyrus and temporal lobe white matter, the thalamus bilaterally, and posterior regions of the corpus callosum that contain temporal lobe fibres - that may be suggestive of progressive brain degeneration in response to recurrent seizures. CONCLUSIONS/SIGNIFICANCE: Chronic TLEhs is associated with interrelated DTI-derived and volume-derived brain degenerative abnormalities that are influenced by the duration of the disorder and the side of seizure onset. This work confirms previously contradictory findings by employing multi-modal imaging techniques in parallel in a large sample of patients.

  9. Errors on the Trail Making Test Are Associated with Right Hemispheric Frontal Lobe Damage in Stroke Patients.

    Science.gov (United States)

    Kopp, Bruno; Rösser, Nina; Tabeling, Sandra; Stürenburg, Hans Jörg; de Haan, Bianca; Karnath, Hans-Otto; Wessel, Karl

    2015-01-01

    Measures of performance on the Trail Making Test (TMT) are among the most popular neuropsychological assessment techniques. Completion time on TMT-A is considered to provide a measure of processing speed, whereas completion time on TMT-B is considered to constitute a behavioral measure of the ability to shift between cognitive sets (cognitive flexibility), commonly attributed to the frontal lobes. However, empirical evidence linking performance on the TMT-B to localized frontal lesions is mostly lacking. Here, we examined the association of frontal lesions following stroke with TMT-B performance measures (i.e., completion time and completion accuracy measures) using voxel-based lesion-behavior mapping, with a focus on right hemispheric frontal lobe lesions. Our results suggest that the number of errors, but not completion time on the TMT-B, is associated with right hemispheric frontal lesions. This finding contradicts common clinical practice-the use of completion time on the TMT-B to measure cognitive flexibility, and it underscores the need for additional research on the association between cognitive flexibility and the frontal lobes. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether our observation is specific for right frontal lesions.

  10. Mental Number Line Disruption in a Right-Neglect Patient after a Left-Hemisphere Stroke

    Science.gov (United States)

    Pia, Lorenzo; Corazzini, Luca Latini; Folegatti, Alessia; Gindri, Patrizia; Cauda, Franco

    2009-01-01

    A right-neglect patient with focal left-hemisphere damage to the posterior superior parietal lobe was assessed for numerical knowledge and tested on the bisection of numerical intervals and visual lines. The semantic and verbal knowledge of numbers was preserved, whereas the performance in numerical tasks that strongly emphasize the visuo-spatial…

  11. Improved Spatial Ability Correlated with Left Hemisphere Dysfunction in Turner's Syndrome. Implications for Mechanism.

    Science.gov (United States)

    Rovet, Joanne F.

    This study contrasts the performance of a 17-year-old female subject with Turner's syndrome before and after developing left temporal lobe seizures, as a means of identifying the mechanism responsible for the Turner's syndrome spatial impairment. The results revealed a deficit in spatial processing before onset of the seizure disorder. Results…

  12. Temporal lobe epilepsy and surgery selectively alter the dorsal, not the ventral, default-mode network

    Directory of Open Access Journals (Sweden)

    Gaelle Eve Doucet

    2014-03-01

    Full Text Available The default-mode network (DMN is a major resting-state network. It can be divided in 2 distinct networks: one is composed of dorsal and anterior regions (referred to as the dorsal DMN, dDMN, while the other involves the more posterior regions (referred to as the ventral DMN, vDMN. To date, no studies have investigated the potentially distinct impact of temporal lobe epilepsy (TLE on these networks. In this context, we explored the effect of TLE and anterior temporal lobectomy (ATL on the dDMN and vDMN. We utilized 2 resting-state fMRI sessions from left, right TLE patients (pre-/post-surgery and normal controls (NCs, sessions 1/2. Using independent component analysis, we identified the 2 networks. We then evaluated for differences in spatial extent for each network between the groups, and across the scanning sessions. The results revealed that, pre-surgery, the dDMN showed larger differences between the three groups than the vDMN, and more particularly between right and left TLE than between the TLE patients and controls. In terms of change post-surgery, in both TLE groups, the dDMN also demonstrated larger changes than the vDMN. For the vDMN, the only changes involved the resected temporal lobe for each ATL group. For the dDMN, the left ATL group showed post-surgical increases in several regions outside the ictal temporal lobe. In contrast, the right ATL group displayed a large reduction in the frontal cortex. The results highlight that the 2 DMNs are not impacted by TLE and ATL in an equivalent fashion. Importantly, the dDMN was the more affected, with right ATL having a more deleterious effects on the dDMN than left ATL. We are the first to highlight that the dDMN more strongly bears the negative impact of TLE than the vDMN, suggesting there is an interaction between the side of pathology and DM subnetwork activity. Our findings have implications for understanding the impact TLE and subsequent ATL on the functions implemented by the distinct

  13. Papillary Carcinoma Arising from the Pyramidal Lobe of the Thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Gi; Lee, Sarah; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    The authors present a rare case of papillary carcinoma arising from the pyramidal lobe of the thyroid in a 54-year-old woman, who presented with a right submental palpable mass. An ultrasound evaluation depicted a 3 cm mixed echoic mass from the thyroid cartilage level without a focal lesion in the thyroid gland. Surgical specimens obtained during bilateral thyroidectomy confirmed papillary carcinoma of the pyramidal lobe. To the authors' knowledge, this is the first case report to describe papillary carcinoma arising from the pyramidal lobe of the thyroid gland

  14. Abnormal temporal lobe response in Alzheimer's disease during cognitive processing as measured by 11C-2-deoxy-D-glucose and PET

    International Nuclear Information System (INIS)

    Miller, J.D.; de Leon, M.J.; Ferris, S.H.; Kluger, A.; George, A.E.; Reisberg, B.; Sachs, H.J.; Wolf, A.P.

    1987-01-01

    Elderly controls and probable Alzheimer's disease patients underwent serial positron emission tomography (PET) studies during a baseline condition and while performing a verbal memory task. For the temporal lobes, all 7 Alzheimer patients demonstrated a relative shift in glucose metabolic rates to the right hemisphere during the memory condition relative to baseline, and 5 of 7 controls showed a shift to the left hemisphere. Baseline absolute regional metabolic rates replicate previous findings and were somewhat less useful than the memory challenge in differentiating patients from controls. These results indicate that a temporal lobe abnormality in Alzheimer's disease is related to memory performance

  15. LobeFinder: A Convex Hull-Based Method for Quantitative Boundary Analyses of Lobed Plant Cells.

    Science.gov (United States)

    Wu, Tzu-Ching; Belteton, Samuel A; Pack, Jessica; Szymanski, Daniel B; Umulis, David M

    2016-08-01

    Dicot leaves are composed of a heterogeneous mosaic of jigsaw puzzle piece-shaped pavement cells that vary greatly in size and the complexity of their shape. Given the importance of the epidermis and this particular cell type for leaf expansion, there is a strong need to understand how pavement cells morph from a simple polyhedral shape into highly lobed and interdigitated cells. At present, it is still unclear how and when the patterns of lobing are initiated in pavement cells, and one major technological bottleneck to addressing the problem is the lack of a robust and objective methodology to identify and track lobing events during the transition from simple cell geometry to lobed cells. We developed a convex hull-based algorithm termed LobeFinder to identify lobes, quantify geometric properties, and create a useful graphical output of cell coordinates for further analysis. The algorithm was validated against manually curated images of pavement cells of widely varying sizes and shapes. The ability to objectively count and detect new lobe initiation events provides an improved quantitative framework to analyze mutant phenotypes, detect symmetry-breaking events in time-lapse image data, and quantify the time-dependent correlation between cell shape change and intracellular factors that may play a role in the morphogenesis process. © 2016 American Society of Plant Biologists. All Rights Reserved.

  16. Temporal Lobe and Frontal-Subcortical Dissociations in Non-Demented Parkinson's Disease with Verbal Memory Impairment.

    Science.gov (United States)

    Tanner, Jared J; Mareci, Thomas H; Okun, Michael S; Bowers, Dawn; Libon, David J; Price, Catherine C

    2015-01-01

    The current investigation examined verbal memory in idiopathic non-dementia Parkinson's disease and the significance of the left entorhinal cortex and left entorhinal-retrosplenial region connections (via temporal cingulum) on memory impairment in Parkinson's disease. Forty non-demented Parkinson's disease patients and forty non-Parkinson's disease controls completed two verbal memory tests--a wordlist measure (Philadelphia repeatable Verbal Memory Test) and a story measure (Logical Memory). All participants received T1-weighted and diffusion magnetic resonance imaging (3T; Siemens) sequences. Left entorhinal volume and left entorhinal-retrosplenial connectivity (temporal cingulum edge weight) were the primary imaging variables of interest with frontal lobe thickness and subcortical structure volumes as dissociating variables. Individuals with Parkinson's disease showed worse verbal memory, smaller entorhinal volumes, but did not differ in entorhinal-retrosplenial connectivity. For Parkinson's disease entorhinal-retrosplenial edge weight had the strongest associations with verbal memory. A subset of Parkinson's disease patients (23%) had deficits (z-scores frontal-subcortical gray or frontal white matter regions. These findings argue for additional investigation into medial temporal lobe gray and white matter connectivity for understanding memory in Parkinson's disease.

  17. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Eliane; Guerreiro, Carlos A.M.; Cendes, Fernando [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Neurologia]. E-mail: fcendes@unicamp.br

    2001-06-01

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  18. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    International Nuclear Information System (INIS)

    Kobayashi, Eliane; Guerreiro, Carlos A.M.; Cendes, Fernando

    2001-01-01

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  19. Magnetoencephalographic correlates of different types of aura in temporal lobe epilepsy.

    Science.gov (United States)

    Fukao, Kenjiro; Inoue, Yushi; Yagi, Kazuichi

    2010-09-01

    To estimate magnetoencephalography (MEG) correlates of different types of aura in temporal lobe epilepsy (TLE). MEG study was performed on 57 patients (26 male and 31 female) with TLE, whose ages ranged from 14-46 years (mean 27 years). Interictal magnetoencephalograms showing discharges were analyzed, and spike-dipole clusters were categorized into left and right inferotemporal-horizontal (IH) and superotemporal-vertical (SV) types. Auras were classified into autonomic, auditory, and psychic seizures. The correlation between the four types of interictal spike-dipole and three types of aura was analyzed using Fisher's exact probability test. IH type correlated with autonomic seizures (p = 0.0004), whereas SV type correlated with both auditory (p = 0.0002) and psychic seizures (p = 0.042). When subdivided into left and right, left IH type correlated with autonomic seizures (p = 0.046), but right IH type did not. Right SV type correlated with both auditory (p = 0.014) and psychic seizures (p = 0.002), but left SV did not correlate with either. Both types did not correlate with "no aura." Using our proposed classification of spike-dipoles, MEG distinguishes auras of mesial temporal origin from those of lateral temporal region. Furthermore, by adopting our classification, laterality of spike-dipoles is clearly demonstrated in auditory and psychic seizures. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  20. Abnormalities of hippocampal-cortical connectivity in temporal lobe epilepsy patients with hippocampal sclerosis

    Science.gov (United States)

    Li, Wenjing; He, Huiguang; Lu, Jingjing; Wang, Chunheng; Li, Meng; Lv, Bin; Jin, Zhengyu

    2011-03-01

    Hippocampal sclerosis (HS) is the most common damage seen in the patients with temporal lobe epilepsy (TLE). In the present study, the hippocampal-cortical connectivity was defined as the correlation between the hippocampal volume and cortical thickness at each vertex throughout the whole brain. We aimed to investigate the differences of ipsilateral hippocampal-cortical connectivity between the unilateral TLE-HS patients and the normal controls. In our study, the bilateral hippocampal volumes were first measured in each subject, and we found that the ipsilateral hippocampal volume significantly decreased in the left TLE-HS patients. Then, group analysis showed significant thinner average cortical thickness of the whole brain in the left TLE-HS patients compared with the normal controls. We found significantly increased ipsilateral hippocampal-cortical connectivity in the bilateral superior temporal gyrus, the right cingulate gyrus and the left parahippocampal gyrus of the left TLE-HS patients, which indicated structural vulnerability related to the hippocampus atrophy in the patient group. However, for the right TLE-HS patients, no significant differences were found between the patients and the normal controls, regardless of the ipsilateral hippocampal volume, the average cortical thickness or the patterns of hippocampal-cortical connectivity, which might be related to less atrophies observed in the MRI scans. Our study provided more evidence for the structural abnormalities in the unilateral TLE-HS patients.

  1. Cerebral Hemispheric Lateralization Associated with Hippocampal Sclerosis May Affect Interictal Cardiovascular Autonomic Functions in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Rokia Ghchime

    2016-01-01

    Full Text Available It is well established that the temporal lobe epilepsy (TLE is linked to the autonomic nervous system dysfunctions. Seizures alter the function of different systems such as the respiratory, cardiovascular, gastrointestinal, and urogenital systems. The aim of this work was to evaluate the possible factors which may be involved in interictal cardiovascular autonomic function in temporal lobe epilepsy with complex partial seizures, and with particular attention to hippocampal sclerosis. The study was conducted in 30 patients with intractable temporal lobe epilepsy (19 with left hippocampal sclerosis, 11 with right hippocampal sclerosis. All subjects underwent four tests of cardiac autonomic function: heart rate changes in response to deep breathing, heart rate, and blood pressure variations throughout resting activity and during hand grip, mental stress, and orthostatic tests. Our results show that the right cerebral hemisphere predominantly modulates sympathetic activity, while the left cerebral hemisphere mainly modulates parasympathetic activity, which mediated tachycardia and excessive bradycardia counterregulation, both of which might be involved as a mechanism of sudden unexpected death in epilepsy patients (SUDEP.

  2. Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study.

    Science.gov (United States)

    Chong, C C N; Wong, G L H; Wong, V W S; Ip, P C T; Cheung, Y S; Wong, J; Lee, K F; Lai, P B S; Chan, H L Y

    2015-01-01

    The effect of antiviral therapy on the post-hepatectomy long-term survival in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remains uncertain. To evaluate the effect of antiviral therapy on post-hepatectomy survival and recurrence in patients with HBV-related HCC. This was a prospective-retrospective study of a total of 404 patients who underwent hepatectomy for HBV-related HCC in a tertiary academic hospital. Data on patient and tumour characteristics, tumour recurrence, treatment for recurrence and survival were compared between antiviral and no antiviral groups. Patient's and tumour characteristics were comparable between the two groups, except a higher proportion of patients with cirrhosis in the antiviral group. With a mean follow-up time of 52.4 months, antiviral group had a better 5-year overall survival (66.7% vs. 56.0%, P = 0.001) while there was no significant difference in the 5-year disease-free survival (44.7% vs. 38.1%, P = 0.166). Use of antiviral therapy was associated with better liver function reserve at the time of recurrence and a greater proportion of patients could receive curative treatment for recurrence (38.5% vs. 24.3%, P = 0.041). There was no significant different in the hazard ratios of patients who started antiviral therapy before or after operation (P = 0.054). Use of antiviral therapy improves the long-term post-hepatectomy survival in patients with HBV-related HCC. With a better liver function reserve at the time of recurrence, a greater proportion of patients in antiviral group could receive curative treatment for recurrence. © 2014 John Wiley & Sons Ltd.

  3. Distinct frontal lobe morphology in girls and boys with ADHD

    Directory of Open Access Journals (Sweden)

    Benjamin Dirlikov

    2015-01-01

    Conclusions: These results elucidate sex-based differences in cortical morphology of functional subdivisions of the frontal lobe and provide additional evidence of associations among SA and symptom severity in children with ADHD.

  4. Patterns of verbal learning and memory in children with intractable temporal lobe or frontal lobe epilepsy.

    Science.gov (United States)

    Fuentes, Amanda; Smith, Mary Lou

    2015-12-01

    The objective of this study was to provide a better understanding of the verbal learning and memory (VLM) patterns that might differentiate children with frontal lobe epilepsy (FLE) from children with temporal lobe epilepsy (TLE) and to examine the impact of variables thought to influence outcomes (seizure laterality, age at seizure onset, age at assessment, epilepsy duration, number of antiepileptic drugs). Retrospective analyses were carried out for children with intractable unilateral TLE (n=100) and FLE (n=27) who completed standardized measures of VLM entailing lists of single words or lists of word pairs. Mean intelligent quotients and VLM scores on single words fell within the average range for both groups, whereas scores fell within the low average to borderline range on word pairs. No significant overall differences in VLM were found between the group with TLE and the group with FLE. Older age at assessment and older age at seizure onset were generally associated with better VLM in both groups but were related to better performance in a number of indices in the group with TLE and only fewer intrusions in the group with FLE. The VLM profiles of children with TLE and FLE are generally similar. Older age at assessment and older age at seizure onset have a favorable impact on both groups but are related to better encoding, retrieval, and monitoring processes for the group with TLE and improved memory monitoring (i.e., as indicated by fewer intrusions) in the group with FLE. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. [Morphological abnormalities of limbic lobe structures in partial temporal lobe epilepsy].

    Science.gov (United States)

    Krémer, S; Braun, M; Kahane, P; Teil, E; Pasquier, B; Benabid, A L; Le Bas, J

    2001-04-01

    To evaluate lesions of the different structures of the Papez circuit in association with hippocampal sclerosis. and methods. 13 patients (32.1+/-8.2 y.o.) suffering from partial, temporal lobe, drug-resistant epilepsy and 20 normal volunteers (31.8+/-7.7 y.o.) were evaluated by MRI on a 1.5 T scanner (Philips): axial T1w 3D Gradient Echo acquisitions, thickness: 1.5mm. Hippocampus and cingulate gyrus volume were calculated after semi-automated segmentation of intrasulcal gray matter using the "Surgiscope Scopeplan" Elekta((R)). The thickness of the posterior column of the fornix and the thickness of the mamillary bodies were also measured. We found 10 cases of ipsolateral hippocampal sclerosis, 6 cases of ipsolateral atrophy of the mamillary body and 4 cases of ipsolateral atrophy of the fornix. We did not find any atrophy of the cingulate gyrus. Hippocampal sclerosis can be associated with lesions of limbic lobe structures (fornix and mamillary body), excluding the cingulate gyrus.

  6. Right anterior temporal lobe dysfunction underlies theory of mind impairments in semantic dementia.

    Science.gov (United States)

    Irish, Muireann; Hodges, John R; Piguet, Olivier

    2014-04-01

    Semantic dementia is a progressive neurodegenerative disorder characterized by the amodal and profound loss of semantic knowledge attributable to the degeneration of the left anterior temporal lobe. Although traditionally conceptualized as a language disorder, patients with semantic dementia display significant alterations in behaviour and socioemotional functioning. Recent evidence points to an impaired capacity for theory of mind in predominantly left-lateralized cases of semantic dementia; however, it remains unclear to what extent semantic impairments contribute to these deficits. Further the neuroanatomical signature of such disturbance remains unknown. Here, we sought to determine the neural correlates of theory of mind performance in patients with left predominant semantic dementia (n=11), in contrast with disease-matched cases with behavioural-variant frontotemporal dementia (n=10) and Alzheimer's disease (n=10), and healthy older individuals (n=14) as control participants. Participants completed a simple cartoons task, in which they were required to describe physical and theory of mind scenarios. Irrespective of subscale, patients with semantic dementia exhibited marked impairments relative to control subjects; however, only theory of mind deficits persisted when we covaried for semantic comprehension. Voxel-based morphometry analyses revealed that atrophy in right anterior temporal lobe structures, including the right temporal fusiform cortex, right inferior temporal gyrus, bilateral temporal poles and amygdalae, correlated significantly with theory of mind impairments in the semantic dementia group. Our results point to the marked disruption of cognitive functions beyond the language domain in semantic dementia, not exclusively attributable to semantic processing impairments. The significant involvement of right anterior temporal structures suggests that with disease evolution, the encroachment of pathology into the contralateral hemisphere heralds the

  7. Relation of callosal structure to cognitive abilities in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Christine eSchneider

    2014-02-01

    Full Text Available The main objective of this paper is to analyse the influence of mesial temporal lobe epilepsy (TLE on the morphology of the corpus callosum (CC and its relation to cognitive abilities. More specifically, we investigated correlations between intellectual abilities and callosal morphology, while additionally exploring the modulating impact of (a side of seizure onset (b age of disease onset.For this reason a large representative sample of patients with hippocampal sclerosis (n=79; 35 males; 44 females; age: 18-63 years with disease onset ranging from 0 to 50 years of age, and consisting of 46 left and 33 right TLE patients was recruited. Intelligence was measured using the Wechsler Adult Intelligence Scale Revised (WAIS-R.To get localizations of correlations with high anatomic precision, callosal morphology was examined using computational mesh-based modeling methods, applied to anatomical brain MRI scans.Intellectual performance was positively associated with callosal thickness in anterior and midcallosal callosal regions, with anterior parts being slightly more affected by age of disease onset and side of seizure onset than posterior parts. Earlier age at onset of epilepsy was associated with lower thickness in anterior and midcallosal regions. In addition, laterality of seizure onset had a significant influence on anterior CC morphology, with left hemispheric origin having stronger effects.We found that in TLE, anterior and midcallosal CC morphology are related to cognitive performance. The findings support recent findings of detrimental effects of early onset mTLE on anterior brain regions and of a distinct effect particularly of left TLE on frontal lobe functioning and structure. The causal nature of the relationship remains an open question, i.e., whether CC morphology impacts IQ development or whether IQ development impacts CC morphology, or both.

  8. Functional and structural correlates of memory in patients with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Alexander James Barnett

    2015-05-01

    Full Text Available Individuals with medial temporal lobe epilepsy (mTLE often show material-specific memory impairment (verbal for left, visuospatial for right hemisphere which can be exacerbated following surgery aimed at the epileptogenic regions of medial and anterolateral temporal cortex. There is a growing body of evidence suggesting that characterization of structural and functional integrity of these regions using MRI can aid in prediction of post-surgical risk of further memory decline. We investigated the nature of the relationship between structural and functional indices of hippocampal integrity with preoperative memory performance in a group of 26 patients with unilateral mTLE. Structural integrity was assessed using hippocampal volumes, while functional integrity was assessed using hippocampal activation during the encoding of novel scenes. We quantified structural and functional integrity in terms of asymmetry, calculated as (L - R / (L + R. Factor scores for verbal and visual memory were calculated from a clinical database and an asymmetry score (verbal – visual was used to characterize memory performance. We found, as expected, a significant difference between left and right mTLE groups for hippocampal volume asymmetry, with each group showing an asymmetry favoring the unaffected temporal lobe. Encoding activation asymmetry showed a similar pattern, with left mTLE patients showing activation preferential to the right hemisphere and right mTLE patients showing the reverse. Finally, we demonstrated that functional integrity mediated the relationship between structural integrity and memory performance for memory asymmetry, suggesting that even if structural changes are evident, ultimately it is the functional integrity of the tissue that most closely explains behavioral performance. Our findings argue for the incorporation of functional imaging data in clinical protocols aimed at determining the functional integrity of the MTL in surgical planning.

  9. Surgical techniques for the treatment of temporal lobe epilepsy.

    Science.gov (United States)

    Al-Otaibi, Faisal; Baeesa, Saleh S; Parrent, Andrew G; Girvin, John P; Steven, David

    2012-01-01

    Temporal lobe epilepsy (TLE) is the most common form of medically intractable epilepsy. Advances in electrophysiology and neuroimaging have led to a more precise localization of the epileptogenic zone within the temporal lobe. Resective surgery is the most effective treatment for TLE. Despite the variability in surgical techniques and in the extent of resection, the overall outcomes of different TLE surgeries are similar. Here, we review different surgical interventions for the management of TLE.

  10. 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 ...

  11. Transient simulation in interior flow field of lobe pump

    International Nuclear Information System (INIS)

    Li, Y B; Sang, X H; Shen, H; Jia, K; Meng, Q W

    2013-01-01

    The subject of this paper is mainly focused on the development and control of the double folium and trifolium lobe pump profiles by using the principle of involute engagement and use CAD to get an accurate involute profile. We use the standard k-ε turbulence model and PISO algorithm based on CFD software FLUENT. The dynamic mesh and UDF technology is introduced to simulate the interior flow field inside a lobe pump, and the variation of interior flow field under the condition of the lobe rotating is analyzed. We also analyse the influence produced by the difference in lobes, and then reveal which lobe is best. The results show that dynamic variation of the interior flow field is easily obtained by dynamic mesh technology and the distribution of its pressure and velocity. Because of the small gaps existing between the rotors and pump case, the higher pressure area will flow into the lower area though the small gaps which cause the working area keep with higher pressure all the time. Both of the double folium and trifolium are existing the vortex during the rotting time and its position, size and shape changes all the time. The vortexes even disappear in a circle period and there are more vortexes in double folium lobe pump. The velocity and pressure pulsation of trifolium pump are lower than that of the double folium

  12. Bicavitary effusion secondary to liver lobe torsion in a dog

    Directory of Open Access Journals (Sweden)

    Khan Z

    2016-04-01

    Full Text Available Zaheda Khan,1 Kathryn Gates,2 Stephen A Simpson,31Emergency and Critical Care, Animal Specialty and Emergency Center, Los Angeles, CA, 2Emergency and Critical Care, Advanced Critical Care, Emergency and Specialty Services, Culver City, CA 3Emergency and Critical Care, Southern California Veterinary Specialty Hospital, Irvine, CA, USA Abstract: We described the diagnosis and successful treatment of pleural and peritoneal effusion secondary to liver lobe torsion in a dog. A 12-year-old female spayed Borzoi dog was referred for heart failure. Emergency room thoracic and abdominal ultrasound showed a large volume of pleural effusion with mild peritoneal effusion and an abdominal mass. Pleural fluid analysis classified the effusion as exudative. A complete ultrasound revealed mild peritoneal effusion and decreased blood flow to the right liver lobe. Other causes of bicavitary effusion were ruled out based on blood work, ultrasound, echocardiogram, and computed tomography. The patient was taken to surgery and diagnosed with caudate liver lobe torsion and had a liver lobectomy. At the 2-week postoperative recheck, the patient was doing well and there was complete resolution of the pleural effusion. Liver lobe torsion is a rare occurrence in dogs and can be difficult to diagnose. Clinical signs are nonspecific for liver lobe torsion and patients may present in respiratory distress with significant pleural fluid accumulation. When assessing patients with pleural and peritoneal effusion, liver lobe torsion should be considered as a differential diagnosis.Keywords: pleural effusion, peritoneal effusion, hepatic torsion

  13. Medical image of the week: right middle lobe syndrome

    Directory of Open Access Journals (Sweden)

    Cristan EA

    2016-05-01

    Full Text Available No abstract available. Article truncated at 150 words. A 73 year-old woman, a lifetime non-smoker, presented to the pulmonary clinic with chronic dyspnea on exertion and cough. Physical exam was unremarkable and pulmonary function testing showed normal spirometry. A chest radiograph revealed calcified mediastinal adenopathy and increased density in the right middle lobe region (Figure 1. A computed tomography scan of the chest revealed significant narrowing of the right middle lobe bronchus with partial atelectasis and prominent calcified mediastinal lymphadenopathy (Figure 2. Bronchoscopy showed no endobronchial lesions but there was evidence of extrinsic compression surrounding the right middle lobe orifice. An endobronchial biopsy revealed noncaseating granulomas. Bronchoscopy cultures and cytology were negative and this was presumed to be from a previous infection with histoplasmosis given the patient’s long-term residence in an endemic area. Given chronic narrowing of right middle lobe bronchus with persistent atelectasis of the right middle lobe, the patient was diagnosed with right middle lobe syndrome. ...

  14. [A case of successful surgical resection after repeated transcatheter arterial chemoembolization for far advanced multiple hepatocellular carcinomas in both lobes associated with Vp₂ portal vein tumor thrombus].

    Science.gov (United States)

    Maeda, Sakae; Eguchi, Hidetoshi; Wada, Hiroshi; Kobayashi, Shogo; Marubashi, Shigeru; Tanemura, Masahiro; Umeshita, Koji; Doki, Yuichirou; Mori, Masaki; Nagano, Hiroaki

    2011-11-01

    Treatments for hepatocellular carcinoma (HCC) include surgical resection, transcatheter arteral chemoembolization (TACE), percutaneous local therapy and systemic chemotherapy. However, it is difficult to perform a curative treatment for patients with far advanced multiple hepatocellular carcinomas. Here we report a case of successful surgical resection after repeated TACE for far advanced multiple hepatocellular carcinomas in both lobes associated with Vp₂ portal vein tumor thrombus. A 54-year-old male who had multiple HCC lesions in lateral, median and right lobes with portal vein tumor thrombus was admitted to our hospital. Three attempts of TACE resulted in a successful control of the tumors in the right lobe. Left hepatic lobectomy was therefore performed, and a relapse-free survival was obtained for over 5 years after surgery.

  15. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    International Nuclear Information System (INIS)

    Won, Kyoung Sook; Zeon, Seok Kil

    2004-01-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity

  16. Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation.

    Science.gov (United States)

    Komatsu, Tetsuya; Kunieda, Etsuo; Kitahara, Tadashi; Akiba, Takeshi; Nagao, Ryuta; Fukuzawa, Tsuyoshi

    2016-01-01

    More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  17. Computer aided diagnosis and localization of lateralized temporal lobe epilepsy using interictal FDG-PET

    Directory of Open Access Journals (Sweden)

    Wesley Thomas Kerr

    2013-04-01

    Full Text Available Interictal FDG-PET (iPET is a core tool for localizing the epileptogenic focus, potentially before structural MRI, that does not require rare and transient epileptiform discharges or seizures on EEG. The visual interpretation of iPET is challenging and requires years of epilepsy-specific expertise. We have developed an automated computer-aided diagnostic (CAD tool that has the potential to work both independent of and synergistically with expert analysis. Our tool operates on distributed metabolic changes across the whole brain measured by iPET to both diagnose and lateralize temporal lobe epilepsy. When diagnosing left temporal lobe epilepsy (LTLE or right TLE (RTLE versus non-epileptic seizures (NES, our accuracy in reproducing the results of the gold standard long term video-EEG monitoring was 82% (95% confidence interval [CI] 69-90% or 88% (95% CI 76-94%, respectively. The classifier that both diagnosed and lateralized the disease had overall accuracy of 76% (95% CI 66-84%, where 89% (95% CI 77-96% of patients correctly identified with epilepsy were correctly lateralized. When identifying LTLE, our CAD tool utilized metabolic changes across the entire brain. By contrast, only temporal regions and the right frontal lobe cortex, were needed to identify RTLE accurately, a finding consistent with clinical observations and indicative of a potential pathophysiological difference between RTLE and LTLE. The goal of CADs is to complement—not replace—expert analysis. In our dataset, the accuracy of manual analysis of iPET (~80% was similar to CAD. The square correlation between our CAD tool and manual analysis, however, was only 30%, indicating that our CAD tool does not recreate manual analysis. The addition of clinical information to our CAD, however, did not substantively change performance. These results suggest that automated analysis might provide clinically valuable information to focus treatment more effectively.

  18. Isolated amygdala enlargement in temporal lobe epilepsy: A systematic review.

    Science.gov (United States)

    Beh, S M Jessica; Cook, Mark J; D'Souza, Wendyl J

    2016-07-01

    The objective of this study was to compare the seizure characteristics and treatment outcomes in patient groups with temporal lobe epilepsy (TLE) identified with isolated amygdala enlargement (AE) on magnetic resonance imaging studies. PubMed, Embase, and the Cochrane Library were searched for relevant studies using the keywords 'amygdala enlargement', 'epilepsy', and 'seizures' in April 2015. Human studies, written in English, that investigated cohorts of patients with TLE and AE were included. Of 204 abstracts initially identified using the search strategy, 14 studies met the inclusion criteria (11 epilepsy studies and 3 psychiatry studies). Ultimately, 8 full studies on AE and TLE involving 107 unique patients were analyzed. Gender distribution consisted of 50 males and 57 females. Right amygdala enlargement was seen in 39 patients, left enlargement in 58 patients, and bilateral enlargement in 7 patients. Surgical resection was performed in 28 patients, with the most common finding being dysplasia/hamartoma or focal cortical dysplasia. Most studies involved small samples of less than 12 patients. There was a wide discrepancy in the methods used to measure amygdala volume, in both patients and controls, hindering comparisons. Most TLE with AE studies observed a later age of seizure onset (mean: 32.2years) compared with studies involving TLE with HS (mean of mid- to late childhood). A higher frequency of complex partial seizures compared with that of convulsive seizures is seen in patients with AE (67-100% vs. 26-47%), and they have an excellent response to antiepileptic drugs (81.8%-100% of seizure-free patients). All studies that included controls also found a significant difference in frequency of seizure types between their cases and controls. Reliable assessment of amygdala volume remains a critical issue hindering better understanding of the clinical management and research of this focal epilepsy syndrome. Within these limitations, the literature suggests

  19. Embolizace portální žíly poly(2-hydroxyethylmethakrylátem) před rozsáhlou hepatektomií

    Czech Academy of Sciences Publication Activity Database

    Peregrin, J. H.; Kováč, J.; Kautznerová, D.; Honsová, E.; Oliverius, M.; Köcher, M.; Černá, M.; Válek, V.; Andrašina, T.; Přádný, Martin; Michálek, Jiří

    2014-01-01

    Roč. 68, č. 2 (2014), s. 113-119 ISSN 1210-7883 Institutional support: RVO:61389013 Keywords : extended right hepatectomy portal vein embolization * embolization iduced left liver lobe hypertrophy Subject RIV: CD - Macromolecular Chemistry http://www.cesradiol.cz/detail.php?stat=463

  20. ISSN 2073-9990 East Cent. Afr. J. surg. (Online)

    African Journals Online (AJOL)

    dell

    18 N0.1. HOW I DO IT: Technique of Hepatectomy for Primary Liver Cell Carcinoma in a. Developing Country. ... confirmed hepatocellular carcinoma confined to the left lobe by surgical resection of the liver, using the .... subjected to chronic stimulation, usually by environmental or biologic toxins that result in hepatocellular ...

  1. A CLINICORADIOLOGICAL STUDY OF MIDDLE LOBE SYNDROME DUE TO TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Saurabh Karmakar

    2016-09-01

    Full Text Available BACKGROUND Although pulmonary tuberculosis is a common disease in India, tuberculosis of right middle lobe is infrequent. Tuberculosis of the right middle lobe leading to chronic collapse is a cause of Right Middle Lobe syndrome. METHODS The patients attended Pulmonary Medicine Outdoor at Era’s Lucknow Medical College, Lucknow from April 2015 to March 2016. The purpose of this study is to describe the clinicoradiological features of patients of middle lobe syndrome due to tuberculosis. All patients presented with cough with or without expectoration, fever, chest pain, haemoptysis and constitutional symptoms like loss of appetite and weight. Chest X-ray PA view revealed ill-defined opacity abutting the right cardiac border. HRCT thorax was done in each case. The diagnosis of tuberculous aetiology was based on (1 History of chronic cough and fever, not responding to antibiotic therapy and constitutional symptoms, (2 A positive tuberculin test using 2 TU of PPD RT 23 and (3 Detection of acid fast bacilli by direct smear or Mycobacterium tuberculosis by polymerase chain reaction in bronchoalveolar lavage. RESULTS Out of 10 patients, 4 (40% were males and 6 (60% were females. The mean ages of the males were 55.8 years and females were 60.8 years and overall mean age was 59 years. Most of the patients were females and belonged to the middle age and old age group. ATT was started in all the patients. CONCLUSIONS Right middle lobe syndrome predominantly affects the older population and the female gender. Although tuberculosis is a common disease in India, Middle Lobe Syndrome is a very rare presentation of the disease. Due to non-specific symptoms and usually normal chest X-ray PA view in Right Middle Lobe Syndrome, we should keep a high index of suspicion to diagnose the condition.

  2. Impact of split completeness on future liver remnant hypertrophy in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma: Complete-ALPPS versus partial-ALPPS.

    Science.gov (United States)

    Chan, Albert C Y; Chok, Kenneth; Dai, Jeff W C; Lo, Chung Mau

    2017-02-01

    Recent evidence suggested that associating liver partition and portal vein ligation for staged hepatectomy with a partial split could effectively induce the same degree of future liver remnant hypertrophy as a complete split in non-cirrhotic and non-cholestatic livers with better postoperative safety profiles. Our aim was to evaluate if the same phenomenon could be applied to hepatitis-related chronic liver diseases. In the study, 25 patients who underwent associating liver partition and portal vein ligation for staged hepatectomy from October 2013 to January 2016 for hepatocellular carcinoma were analyzed. Partial-associating liver partition and portal vein ligation for staged hepatectomy (n = 12) was defined as 50-80% of the transection surface split and complete-associating liver partition and portal vein ligation for staged hepatectomy (n = 13) was split down to inferior vena cava. Perioperative outcomes stratified by split completeness were evaluated. There was no significant difference in operating times and blood loss for stage I and II operations between complete-associating liver partition and portal vein ligation for staged hepatectomy and partial-associating liver partition and portal vein ligation for staged hepatectomy. All patients underwent stage II operation without any inter-stage complications. Complete split induced greater future liver remnant hypertrophy than partial split (hypertrophy rate: 31.2 vs 17.5 mL/day, P = .022) with more pronounced effect in chronic hepatitis (P = .007) than cirrhosis (P = .283). Complete-associating liver partition and portal vein ligation for staged hepatectomy was more likely to attain a future liver remnant/estimated standard liver volume ratio >35% within 10 days (76.9% vs 33.3%, P = .024) and proceed to stage II within 14 days after stage I (100% vs 58.4%, P = .009). The overall postoperative morbidity (≥grade 3a) after stage II was 16% (complete versus partial split: 7.7% vs 25%, P = .238

  3. Isolated left-sided partial anomalous pulmonary venous connection in a child.

    Science.gov (United States)

    Onan, İsmihan Selen; Sen, Onur; Gökalp, Selman; Onan, Burak

    2017-09-01

    Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described.

  4. Creating Colored Letters: Familial Markers of Grapheme-Color Synesthesia in Parietal Lobe Activation and Structure.

    Science.gov (United States)

    Colizoli, Olympia; Murre, Jaap M J; Scholte, H Steven; Rouw, Romke

    2017-07-01

    Perception is inherently subjective, and individual differences in phenomenology are well illustrated by the phenomenon of synesthesia (highly specific, consistent, and automatic cross-modal experiences, in which the external stimulus corresponding to the additional sensation is absent). It is unknown why some people develop synesthesia and others do not. In the current study, we tested whether neural markers related to having synesthesia in the family were evident in brain function and structure. Relatives of synesthetes (who did not have any type of synesthesia themselves) and matched controls read specially prepared books with colored letters for several weeks and were scanned before and after reading using magnetic resonance imaging. Effects of acquired letter-color associations were evident in brain activation. Training-related activation (while viewing black letters) in the right angular gyrus of the parietal lobe was directly related to the strength of the learned letter-color associations (behavioral Stroop effect). Within this obtained angular gyrus ROI, the familial trait of synesthesia related to brain activation differences while participants viewed both black and colored letters. Finally, we compared brain structure using voxel-based morphometry and diffusion tensor imaging to test for group differences and training effects. One cluster in the left superior parietal lobe had significantly more coherent white matter in the relatives compared with controls. No evidence for experience-dependent plasticity was obtained. For the first time, we present evidence suggesting that the (nonsynesthete) relatives of grapheme-color synesthetes show atypical grapheme processing as well as increased brain connectivity.

  5. Mixed neuronal-glial tumor in the temporal lobe of an infant: a case report.

    Science.gov (United States)

    Yano, Hirohito; Saigoh, Chiemi; Nakayama, Noriyuki; Hirose, Yoshinobu; Abe, Masato; Ohe, Naoyuki; Ozeki, Michio; Shinoda, Jun; Iwama, Toru

    2013-10-02

    Tumors that arise in the temporal lobes of infants and spread to the neural system are limited to several diagnoses. Herein, we present an infantile case of a temporal tumor showing neuronal and glial differentiation. The patient was a 9-month-old boy with low body weight due to intrauterine growth retardation. At 9 months after birth, he presented partial seizures. Computed tomography scanning revealed a mass (35 * 40 mm) in the left temporal lobe. Isointensity was noted on magnetic resonance T1-weighted images and fluid attenuation inversion recovery images. The tumor was heterogeneously enhanced with gadolinium. Positron emission tomography showed high methionine uptake in the tumor. During surgery, the tumor, which was elastic and soft and bled easily, was gross totally resected. A moderately clear boundary was noted between the tumor and normal brain parenchyma. Histologically, the tumor mainly comprised a ganglioglioma-like portion and short spindle cells at different densities. The former was immunohistochemically positive for some kinds of neuronal markers including synaptophysin. The spindle cells were positive for glial fibrillary acidic protein, but desmoplasia was not observed. The tumor contained both neuronal and glial elements; the former were the main constituents of the tumor and included several ganglion-like cells. Because neuronal elements gradually transited to glial cells, a mixed neuronal-glial tumor was diagnosed. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2045126100982604.

  6. Type β transforming growth factor reversibly inhibits the early proliferative responsive to partial hepatectomy in the rat

    International Nuclear Information System (INIS)

    Russell, W.E.; Coffey, R.J. Jr.; Ouellette, A.J.; Moses, H.L.

    1988-01-01

    Type β transforming growth factor (TGF-β), a factor produced by many cell types, is a potent inhibitor of hepatocyte DNA synthesis in vitro. To determine whether TGF-β can influence hepatocyte proliferation in vivo, its effects were examined on the regenerative response of liver to partial hepatectomy (PH) in the rat. Porcine platelet-derived TGF-β1, administered intravenously at the time of PH and 11 hr later, reduced the fraction of hepatocytes engaged in DNA synthesis 22 hr after PH by 67% and inhibited the rate of hepatic [ 3 H]thymidine incorporation by 50%. TGF-β2 produced a similar effect. Although sensitive to TGF-β administered 11 hr after PH, late in the G 1 phase of the cell cycle, a single does of 0.5 μg given at the time of PH did not significantly influence DNA synthesis 22 hr after PH. The inhibitory effects of TGF-β were transient. The nuclear labeling index of the TGF-β-treated animals was significantly higher than that of the controls. There was no evidence of cytotoxicity from TGF-β, as determined by liver histology and plasma concentrations of glucose, insulin-like growth factor I, and two hepatic enzymes. Thus, TGF-β1 and TGF-β2 reversibly inhibit the proliferative response of liver to PH and may be important in the modulation of normal liver growth and repair

  7. An integrated multigene expression panel to predict long-term survival after curative hepatectomy in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Kanda, Mitsuro; Murotani, Kenta; Sugimoto, Hiroyuki; Miwa, Takashi; Umeda, Shinichi; Suenaga, Masaya; Hayashi, Masamichi; Hattori, Norifumi; Tanaka, Chie; Kobayashi, Daisuke; Yamada, Suguru; Fujiwara, Michitaka; Kodera, Yasuhiro

    2017-09-19

    Hepatocellular carcinoma (HCC) frequently recurs even after curative hepatectomy. To develop an integrated multigene expression panel, 144 patients were randomly assigned to either discovery or validation set in a 1:2 ratio. Using surgically resected HCC specimens, expression levels of 12 candidate molecular markers were determined using quantitative reverse-transcriptase PCR. In the discovery set, an expression panel was developed according to the concordance index (C-index) values for overall survival from all 4095 combinations of the 12 candidate molecular markers. Expression scores was determined with weighting according to the coefficient in a Cox regression, and patients were classified into grade 1, 2 and 3. Reproducibility was then tested in the validation set. A panel consisting of four markers, PRMT5 , MAGED4 , DPYSL3 and AJAP1 was selected as the optimal and most well-balanced set with a C-index value of 0.707. Patient prognosis was clearly stratified by the expression grade using this panel. In the validation set, both overall and disease-free survival rates decreased incrementally with as the grade increased. Higher grades were significantly associated with tumor multiplicity and vessel invasion. The prevalence of extrahepatic recurrences was increased in grade 3 patients. The integrated multigene expression panel clearly stratified HCC patients into low, intermediate and high risk.

  8. Correlations between limbic white matter and cognitive function in temporal lobe epilepsy, preliminary findings

    Directory of Open Access Journals (Sweden)

    Ryan PD Alexander

    2014-06-01

    Full Text Available The limbic system is presumed to have a central role in cognitive performance, in particular memory. The purpose of this study was to investigate the relationship between limbic white matter microstructure and neuropsychological function in temporal lobe epilepsy (TLE patients using diffusion tensor imaging (DTI. Twenty-one adult TLE patients, including seven non-lesional (nlTLE and fourteen with unilateral mesial temporal sclerosis (uTLE, were studied with both DTI and hippocampal T2 relaxometry. Correlations were performed between fractional anisotropy (FA of the bilateral fornix and cingulum, hippocampal T2, neuropsychological tests. Positive correlations were observed in the whole group for the left fornix and Processing Speed Index. In contrast, memory tests did not show significant correlations with DTI findings. Subgroup analysis demonstrated an association between the left fornix and Processing Speed in nlTLE but not uTLE. No correlations were observed between hippocampal T2 and test scores in either the TLE group as a whole or after subgroup analysis. Our findings suggest that integrity of the left fornix specifically is an important anatomical correlate of cognitive function in TLE patients, in particular patients with nlTLE.

  9. [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.

  10. Frontal lobe atrophy of the brain in schizophrenia

    International Nuclear Information System (INIS)

    Hara, Tomio

    1981-01-01

    Reported here are the CT findings on cerebral atrophic lesion chiefly developed in the frontal lobe in schizophrenics with unusual organic encephalopathy. Encephalopathy was recognized in 84 (73%) of 115 schizophrenics and 13 (33%) of 40 neurotics. In an attempt to exclude the effects of aging on encephalopathy, the ages at CT and at the development of disease, the number of morbid years, subtypical schizophrenia and relation between the clinical severity and the atrophic condition were comparatively studied. As a result, cerebral atrophy tended to increase along with aging, but the findings differed in that atrophia classified by age covered the entire brain in general, whereas atrophia in schizophrenics was found in the frontal lobe. In particular, because of the fact that clinical severity and atrophia in the frontal lobe are high correlated and that severe atrophia is recognized even in young people, schizophrenia and atrophia in the frontal lobe are considered to be closely related to each other. It is therefore suggested that the CT findings are useful to clinicians for finding appropriate methods to deal with the prognosis of schizophrenics in their daily diagnosis and for the therapeutic prevention of encephalatrophy by stimulating the frontal lobe, thereby delaying mental deterioration. (author)

  11. Neuropsychological deficits in temporal lobe epilepsy: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Fengqing Zhao

    2014-01-01

    Full Text Available Temporal lobe epilepsy (TLE is the most prevalent form of complex partial seizures with temporal lobe origin of electrical abnormality. Studies have shown that recurrent seizures affect all aspects of cognitive functioning, including memory, language, praxis, executive functions, and social judgment, among several others. In this article, we will review these cognitive impairments along with their neuropathological correlates in a comprehensive manner. We will see that neuropsychological deficits are prevalent in TLE. Much of the effort has been laid on memory due to the notion that temporal lobe brain structures involved in TLE play a central role in consolidating information into memory. It seems that damage to the mesial structure of the temporal lobe, particularly the amygdale and hippocampus, has the main role in these memory difficulties and the neurobiological plausibility of the role of the temporal lobe in different aspects of memory. Here, we will cover the sub-domains of working memory and episodic memory deficits. This is we will further proceed to evaluate the evidences of executive function deficits in TLE and will see that set-shifting among other EFs is specifically affected in TLE as is social cognition. Finally, critical components of language related deficits are also found in the form of word-finding difficulties. To conclude, TLE affects several of cognitive function domains, but the etiopathogenesis of all these dysfunctions remain elusive. Further well-designed studies are needed for a better understanding of these disorders.

  12. Case Report: A Rare Case Report of Frontal Lobe Syndrome

    Directory of Open Access Journals (Sweden)

    Morteza Nouri- Khajavi

    2003-04-01

    Full Text Available The frontal lobe syndrome is a permanent personality change disorder with characteristic clinical pictures, which followed by frontal lobes damage. Clinical picture include: Affective instability, recurrent aggressive behavior, impaired social judgment, apathy and undifferentiating or suspiciousness and paranoid ideations. According DSM-IV classification frontal lobe syndrome named personality change due to head trauma on Axis I. Herein we report a case of 46 years-old man, who has developed behavioral disturbances following head trauma, about 10 years ago. Main clinical figures in this case are apathy, avolition and, undifferentiating. Clinical pictures are constant during these 10 years. The diagnostic approach has been based on patient’s problems history which, has taken from his family, mental status examination, Neurological examination, Brain imaging and Neuropsychological assessments which related to frontal lobes function. Because of rarity & neglection due to mysterious function of frontal lobes, and also considering that personality change from previous level is prominent figure of this syndrome and also brain imaging findings, which compatible with clinical findings, with this aim, we have reported this case.

  13. Mapping of potential neurogenic niche in the human temporal lobe

    Directory of Open Access Journals (Sweden)

    Adriano Barreto Nogueira

    2014-10-01

    Full Text Available The subgranular zone (SGZ of the dentate gyrus and the subventricular zone (SVZ are known neurogenic niches in adult mammals. Nonetheless, the existence of neurogenic niches in adult humans is controversial. We hypothesized that mapping neurogenic niches in the human temporal lobe could clarify this issue. Neurogenic niches and neurogenesis were investigated in 28 temporal lobes via immunostaining for nestin and doublecortin (DCX, respectively. Nestin was observed in a continuous layer formed by the SVZ, the subpial zone of the medial temporal lobe and the SGZ, terminating in the subiculum. In the subiculum, remarkable DCX expression was observed through the principal efferent pathway of the hippocampus to the fimbria. A possible explanation for the results is that the SVZ, the subpial zone of the medial temporal lobe and the SGZ form a unit containing neural stem cells that differentiate into neurons in the subiculum. Curiously, the area previously identified as the human rostral migratory stream may in truth be the fornix, which contains axons that originate in the subiculum. This study suggests that neurogenesis may occur in an orchestrated manner in a broad area of the human temporal lobe.

  14. Healthy aging attenuates task-related specialization in the human medial temporal lobe

    DEFF Research Database (Denmark)

    Ramsøy, Thomas Z.; Liptrot, Matthew George; Skimminge, Arnold Jesper Møller

    2012-01-01

    Recent research on aging has established important links between the neurobiology of normal aging and age-related decline in episodic memory, yet the exact nature of this relationship is still unknown. Functional neuroimaging of regions such as the medial temporal lobe (MTL) have produced...... whether this greater MTL activation during encoding of objects varies with age. Fifty-four healthy individuals aged between 18 and 81 years underwent functional magnetic resonance imaging while they encoded and subsequently made new-old judgments on objects and positions. Region of interest (ROI) analysis...... hemisphere were defined as ROIs. Aging had an adverse effect on memory performance that was similar for memorizing objects or positions. In left and right MTL, relatively greater activation for object stimuli was attenuated in older individuals. Age-related attenuation in content specificity was most...

  15. Asymmetrical Blood Flow in the Temporal Lobe in the Charles Bonnet Syndrome: Serial Neuroimaging Study

    Directory of Open Access Journals (Sweden)

    N. Adachi

    1994-01-01

    Full Text Available Clinical features and results of neuroimagings of an 86 year old woman with the Charles Bonnet syndrome are reported. She had become completely blind bilaterally due to cataracts and glaucoma. Shortly after an operation for cataracts, she developed visual hallucinations which lasted for 22 years. She had no deterioration of intelligence. Computed tomography (CT and magnetic resonance imaging (MRI showed moderate generalized atrophy, particularly of the temporal lobes. A serial single photon emission computed tomography (SPECT study during visual hallucinations demonstrated hyperperfusion in the left temporal region and the basal ganglia and hypoperfusion in the right temporal region. These findings suggest that asymmetrical blood flow, particularly in the temporal regions, may be correlated with visual hallucination in the Charles Bonnet syndrome.

  16. 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.

  17. Mesial temporal lobe epilepsy with hippocampal sclerosis is a network disorder with altered cortical hubs.

    Science.gov (United States)

    Jin, Seung-Hyun; Jeong, Woorim; Chung, Chun Kee

    2015-05-01

    Electrophysiologic hubs within the large-scale functional networks in mesial temporal lobe epilepsy (mTLE) with hippocampal sclerosis (HS) have not been investigated. We hypothesized that mTLE with HS has different resting-state network hubs in their large-scale functional networks compared to the hubs in healthy controls (HC). We also hypothesized that the hippocampus would be a functional hub in mTLE patients with HS. Resting-state functional networks, identified by using magnetoencephalography (MEG) signals in the theta, alpha, beta, and gamma frequency bands, were evaluated. Networks in 44 mTLE patients with HS (left mTLE = 22; right mTLE = 22) were compared with those in 46 age-matched HC. We investigated betweenness centrality at the source-level MEG network. The main network hubs were at the pole of the left superior temporal gyrus in the beta band, the pole of the left middle temporal gyrus in the beta and gamma bands, left hippocampus in the theta and alpha bands, and right posterior cingulate gyrus in all four frequency bands in mTLE patients; all of which were different from the main network hubs in HC. Only patients with left mTLE showed profound differences from HC at the left hippocampus in the alpha band. Our analysis of resting-state MEG signals shows that altered electrophysiologic functional hubs in mTLE patients reflect pathophysiologic brain network reorganization. Because we detected network hubs in both hippocampal and extrahippocampal areas, it is probable that mTLE is a large-scale network disorder rather than a focal disorder. The hippocampus was a network hub in left mTLE but not in right mTLE patients, which may be due to intrinsic functional and structural asymmetries between left and right mTLE patients. The evaluation of cortical hubs, even in the spike-free resting-state, could be a clinical diagnostic marker of mTLE with HS. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  18. Differences in visual vs. verbal memory impairments as a result of focal temporal lobe damage in patients with traumatic brain injury.

    Science.gov (United States)

    Ariza, Mar; Pueyo, Roser; Junqué, Carme; Mataró, María; Poca, María Antonia; Mena, Maria Pau; Sahuquillo, Juan

    2006-09-01

    The aim of the present study was to determine whether the type of lesion in a sample of moderate and severe traumatic brain injury (TBI) was related to material-specific memory impairment. Fifty-nine patients with TBI were classified into three groups according to whether the site of the lesion was right temporal, left temporal or diffuse. Six-months post-injury, visual (Warrington's Facial Recognition Memory Test and Rey's Complex Figure Test) and verbal (Rey's Auditory Verbal Learning Test) memories were assessed. Visual memory deficits assessed by facial memory were associated with right temporal lobe lesion, whereas verbal memory performance assessed with a list of words was related to left temporal lobe lesion. The group with diffuse injury showed both verbal and visual memory impairment. These results suggest a material-specific memory impairment in moderate and severe TBI after focal temporal lesions and a non-specific memory impairment after diffuse damage.

  19. 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

  20. Unusual ictal foreign language automatisms in temporal lobe epilepsy.

    Science.gov (United States)

    Soe, Naing Ko; Lee, Sang Kun

    2014-12-01

    The distinct brain regions could be specifically involved in different languages and the differences in brain activation depending on the language proficiency and on the age of language acquisition. Speech disturbances are observed in the majority of temporal lobe complex motor seizures. Ictal verbalization had significant lateralization value: 90% of patients with this manifestation had seizure focus in the non-dominant temporal lobe. Although, ictal speech automatisms are usually uttered in the patient's native language, ictal speech foreign language automatisms are unusual presentations of non-dominent temporal lobe epilepsy. The release of isolated foreign language area could be possible depending on the pattern of ictal spreading of non-dominant hemisphere. Most of the case reports in ictal speech foreign language automatisms were men. In this case report, we observed ictal foreign language automatisms in middle age Korean woman.

  1. Usefulness of PET in non-lesional temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Bertuluchi, M.; Arganaraz, R.; Buznick, J.; Pomata, H.

    2011-01-01

    Objective. To evaluate the usefulness of PET in patients with refractory non-lesional temporal lobe epilepsy. Material and methods. We present three patients with features of temporal lobe epilepsy refractory to medication, where high definition MRI was normal. Results. These patients had PET hypometabolism in the temporal areas related to clinical and neurophysiological findings. Two of these patients were implanted with subdural grids to confirm the diagnosis and the third was operated directly based on the findings of PET. Encourage the presentation of the importance in recent years is acquiring the PET. Conclusion. In those patients in clinical neurophysiology and epilepsy with suspected temporal lobe, but in the MRI images show no structural lesions, PET can play an important role defining the diagnosis. (authors)

  2. Astrocyte uncoupling as a cause of human temporal lobe epilepsy.

    Science.gov (United States)

    Bedner, Peter; Dupper, Alexander; Hüttmann, Kerstin; Müller, Julia; Herde, Michel K; Dublin, Pavel; Deshpande, Tushar; Schramm, Johannes; Häussler, Ute; Haas, Carola A; Henneberger, Christian; Theis, Martin; Steinhäuser, Christian

    2015-05-01

    Glial cells are now recognized as active communication partners in the central nervous system, and this new perspective has rekindled the question of their role in pathology. In the present study we analysed functional properties of astrocytes in hippocampal specimens from patients with mesial temporal lobe epilepsy without (n = 44) and with sclerosis (n = 75) combining patch clamp recording, K(+) concentration analysis, electroencephalography/video-monitoring, and fate mapping analysis. We found that the hippocampus of patients with mesial temporal lobe epilepsy with sclerosis is completely devoid of bona fide astrocytes and gap junction coupling, whereas coupled astrocytes were abundantly present in non-sclerotic specimens. To decide whether these glial changes represent cause or effect of mesial temporal lobe epilepsy with sclerosis, we developed a mouse model that reproduced key features of human mesial temporal lobe epilepsy with sclerosis. In this model, uncoupling impaired K(+) buffering and temporally preceded apoptotic neuronal death and the generation of spontaneous seizures. Uncoupling was induced through intraperitoneal injection of lipopolysaccharide, prevented in Toll-like receptor4 knockout mice and reproduced in situ through acute cytokine or lipopolysaccharide incubation. Fate mapping confirmed that in the course of mesial temporal lobe epilepsy with sclerosis, astrocytes acquire an atypical functional phenotype and lose coupling. These data suggest that astrocyte dysfunction might be a prime cause of mesial temporal lobe epilepsy with sclerosis and identify novel targets for anti-epileptogenic therapeutic intervention. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Non Linear Analysis on Multi Lobe Journal Bearings

    Science.gov (United States)

    Udaya Bhaskar, S.; Manzoor Hussian, M.; Yousuf Ali, Md.

    2017-08-01

    Multi lobe journal bearings are used in machines which operate at high speeds and high loads. In this paper the multi lobe bearing are analyzed to determine the effect of surface roughness during non linear loading. A non-linear time transient analysis is performed using the fourth order Runge Kutta method. The finite difference method is used to predict the pressure distribution over the bearing surface. The effect of eccentric ratio is studied and the variation of attitude angle is discussed. The journal center trajectories were calculated and plotted.

  4. Transient response of two lobe aerodynamic journal bearing

    Directory of Open Access Journals (Sweden)

    Saurabh Kumar Yadav

    2018-03-01

    Full Text Available The dynamic behavior of a rotor-dynamic system is greatly affected by the performance of aerodynamic bearing and the performance of bearing is characterized by the stiffness and damping coefficients. In the present work, stiffness and damping coefficients of bearing are computed and the performance of the bearing is greatly changed with the change in bearing air film profile. The effect of lobe offset factors on the transient performance of aerodynamic bearing is presented. Bifurcation and Poincare diagrams of two lobe journal bearing have been presented for different offset factors. A bearing designer can judge the bearing performance based on bifurcation diagrams.

  5. Visual field defects after temporal lobe resection for epilepsy

    DEFF Research Database (Denmark)

    Steensberg, Alvilda T; Olsen, Ane Sophie; Litman, Minna

    2018-01-01

    PURPOSE: To determine visual field defects (VFDs) using methods of varying complexity and compare results with subjective symptoms in a population of newly operated temporal lobe epilepsy patients. METHODS: Forty patients were included in the study. Two patients failed to perform VFD testing...... symptoms were only reported by 28% of the patients with a VFD and in two of eight (sensitivity=25%) with a severe VFD. Most patients (86%) considered VFD information mandatory. CONCLUSION: VFD continue to be a frequent adverse event after epilepsy surgery in the medial temporal lobe and may affect...

  6. Visual search tasks: measurement of dynamic visual lobe and relationship with display movement velocity.

    Science.gov (United States)

    Yang, Lin-Dong; Yu, Rui-Feng; Lin, Xue-Lian; Xie, Ya-Qing; Ma, Liang

    2018-02-01

    Visual lobe is a useful tool for predicting visual search performance. Up till now, no study has focused on dynamic visual lobe. This study developed a dynamic visual lobe measurement system (DVLMS) that could effectively map dynamic visual lobe and calculate visual lobe shape indices. The effects of display movement velocity on lobe shape indices were examined under four velocity conditions: 0, 4, 8 and 16 deg/s. In general, with the increase of display movement velocity, visual lobe area and perimeter became smaller, whereas lobe shape roundness, boundary smoothness, symmetry and regularity deteriorated. The elongation index was not affected by velocity. Regression analyses indicated that display movement velocity was important in determining dynamic visual lobe shape indices. Dynamic visual lobe provides another option for better understanding dynamic vision, in addition to dynamic visual acuity. Findings of this study can provide guidelines for analysing and designing dynamic visual tasks. Practitioner Summary: Dynamic visual lobe is important in reflecting the visual ability of searching for a moving target. We developed a dynamic visual lobe measurement system (DVLMS) and examined display movement velocity's effects on lobe shape. Findings revealed that velocity was a key factor affecting dynamic visual lobe shape indices.

  7. Disorganized behavior on Link's cube test is sensitive to right hemispheric frontal lobe damage in stroke patients

    Science.gov (United States)

    Kopp, Bruno; Rösser, Nina; Tabeling, Sandra; Stürenburg, Hans Jörg; de Haan, Bianca; Karnath, Hans-Otto; Wessel, Karl

    2014-01-01

    One of Luria's favorite neuropsychological tasks for challenging frontal lobe functions was Link's cube test (LCT). The LCT is a cube construction task in which the subject must assemble 27 small cubes into one large cube in such a manner that only the painted surfaces of the small cubes are visible. We computed two new LCT composite scores, the constructive plan composite score, reflecting the capability to envisage a cubical-shaped volume, and the behavioral (dis-) organization composite score, reflecting the goal-directedness of cube construction. Voxel-based lesion-behavior mapping (VLBM) was used to test the relationship between performance on the LCT and brain injury in a sample of stroke patients with right hemisphere damage (N = 32), concentrated in the frontal lobe. We observed a relationship between the measure of behavioral (dis-) organization on the LCT and right frontal lesions. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether this observation is specific for right frontal lesions. PMID:24596552

  8. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    International Nuclear Information System (INIS)

    Deblaere, K.; Vandemaele, P.; Achten, E.; Backes, W.H.; Hofman, P.; Wilmink, J.; Boon, P.A.; Vonck, K.; Boon, P.; Troost, J.; Vermeulen, J.; Aldenkamp, A.

    2002-01-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  9. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deblaere, K.; Vandemaele, P.; Achten, E. [MRI Department -1 K12, Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Backes, W.H.; Hofman, P.; Wilmink, J. [Department of Neuroradiology, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht (Netherlands); Boon, P.A.; Vonck, K. [Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Boon, P. [Department of Medical Psychology, University Hospital Maastricht (Netherlands); Troost, J. [Department of Neurology, University Hospital Maastricht (Netherlands); Vermeulen, J. [S.E.I.N Heemstede, Psychological Laboratory, Achterweg 5, 2103 SW Heemstede (Netherlands); Aldenkamp, A. [Epilepsy Center ' Kempenhaeghe' , Postbus 61, 5900 AB Heeze (Netherlands)

    2002-08-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  10. Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma.

    Science.gov (United States)

    Cheung, Tan To; Chan, See Ching; Chok, Kenneth S H; Chan, Albert C Y; Yu, Wan Ching; Poon, Ronnie T P; Lo, Chung Mau; Fan, Sheung Tat

    2012-06-01

    The indocyanine green (ICG) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly-developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON(®), one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICG retention at 15 minutes measured by traditional spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICGR15 and ICGR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16XICGR15(L)+2.73. The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula.

  11. Effects of Pringle maneuver and partial hepatectomy on the pharmacokinetics and blood-brain barrier permeability of sodium fluorescein in rats.

    Science.gov (United States)

    Miah, Mohammad K; Shaik, Imam H; Bickel, Ulrich; Mehvar, Reza

    2015-08-27

    Liver diseases are known to affect the function of remote organs. The aim of the present study was to investigate the effects of Pringle maneuver, which results in hepatic ischemia-reperfusion (IR) injury, and partial hepatectomy (Hx) on the pharmacokinetics and brain distribution of sodium fluorescein (FL), which is a widely used marker of blood-brain barrier (BBB) permeability. Rats were subjected to Pringle maneuver (total hepatic ischemia) for 20 min with (HxIR) or without (IR) 70% hepatectomy. Sham-operated animals underwent laparotomy only. After 15 min or 8h of reperfusion, a single 25-mg/kg dose of FL was injected intravenously and serial (0-30 min) blood and bile and terminal brain samples were collected. Total and free (ultrafiltration) plasma, total brain homogenate, and bile concentrations of FL and/or its glucuronidated metabolite (FL-Glu) were determined by HPLC. Both IR and HxIR caused significant reductions in the biliary excretions of FL and FL-Glu, resulting in significant increases in the plasma AUC of the marker. Additionally, the free fraction of FL in plasma was significantly increased by HxIR. Although the brain concentrations of FL were increased by almost twofold in both IR and HxIR animals, the brain concentrations corrected by the free FL AUC (and not the total AUC) were similar in both groups at either time points. It is concluded that Pringle maneuver and/or partial hepatectomy substantially alters the hepatobiliary disposition, plasma AUC, plasma free fraction, and brain accumulation of FL without altering the BBB permeability to the marker. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Correlation of vocals and lyrics with left temporal musicogenic epilepsy.

    Science.gov (United States)

    Tseng, Wei-En J; Lim, Siew-Na; Chen, Lu-An; Jou, Shuo-Bin; Hsieh, Hsiang-Yao; Cheng, Mei-Yun; Chang, Chun-Wei; Li, Han-Tao; Chiang, Hsing-I; Wu, Tony

    2018-03-15

    Whether the cognitive processing of music and speech relies on shared or distinct neuronal mechanisms remains unclear. Music and language processing in the brain are right and left temporal functions, respectively. We studied patients with musicogenic epilepsy (ME) that was specifically triggered by popular songs to analyze brain hyperexcitability triggered by specific stimuli. The study included two men and one woman (all right-handed, aged 35-55 years). The patients had sound-triggered left temporal ME in response to popular songs with vocals, but not to instrumental, classical, or nonvocal piano solo versions of the same song. Sentimental lyrics, high-pitched singing, specificity/familiarity, and singing in the native language were the most significant triggering factors. We found that recognition of the human voice and analysis of lyrics are important causal factors in left temporal ME and provide observational evidence that sounds with speech structure are predominantly processed in the left temporal lobe. A literature review indicated that language-associated stimuli triggered ME in the left temporal epileptogenic zone at a nearly twofold higher rate compared with the right temporal region. Further research on ME may enhance understanding of the cognitive neuroscience of music. © 2018 New York Academy of Sciences.

  13. 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.

  14. Administration of Ginkgo biloba Extract (EGb761 Alone and in Combination with FK506 Promotes Liver Regeneration in a Rat Model of Partial Hepatectomy

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    Nahide Ekici Günay

    2018-03-01

    Full Text Available Background: Free radical damage is known to occur during liver regeneration. The Ginkgo biloba extract EGb761 has antioxidant properties due to its ability to scavenge free radicals. FK506 has been widely used as an immunosuppressant that stimulates hepatocyte proliferation following partial hepatectomy. Aims: To explore whether EGb761 enhances liver regeneration after hepatectomy in rats, we investigated the effects of EGb761 alone and in combination with FK506 on the liver regenerative process. Study Design: Animal experimentation. Methods: A total of 75 Wistar albino rats weighing 340.08±11.66 g were randomly divided into five experimental groups: sham, control, FK506, EGb761, and FK506 + EGb761. According to the study groups, rats were administered FK506 at a dose of 0.1 mg/kg/day and EGb761 at 25 mg/kg/day three times via the intraperitoneal route. Then, two-thirds hepatectomy was performed according to the Higgins and Anderson technique in all the rats. At postoperative 48 h, 53 surviving rats were sacrificed. Serum and plasma samples were collected for analyzing thymidine kinase and oxidative stress marker levels. The regenerated liver was entirely resected, weighed, and sectioned. The mitotic index was assessed using hematoxylin-eosin staining. The extent of liver regeneration was calculated using the Child’s formula. The data were statistically analyzed using ANOVA, with a significance level of 5% (p<0.05. Results: Rats who received EGb761 showed significantly higher levels of liver regeneration than those who received FK506 or FK506 + EGb761 (p<0.01. Thymidine kinase level and mitotic index were significantly higher in the EGb761 (p<0.005 and FK506 (p<0.05 groups than in the control and sham groups. In addition, the liver regeneration percentage was significantly higher in the EGb761 group than in the FK506 group (p<0.01. Myeloperoxidase and malondialdehyde levels were significantly correlated between the EGb761 and FK506 groups

  15. Cardiac compression of lung lower lobes after coronary artery bypass graft with cardiopulmonary bypass.

    Directory of Open Access Journals (Sweden)

    Flávio H Neves

    Full Text Available BACKGROUND: Atelectasis is a major cause of hypoxemia after coronary artery bypass grafting (CABG and is commonly ascribed to general anesthesia, high inspiratory oxygen concentration and cardiopulmonary bypass (CPB. The objective of this study was to evaluate the role of heart-induced pulmonary compression after CABG with CPB. METHODS: Seventeen patients without pre-operative cardiac failure who were scheduled for coronary artery bypass graft underwent pre- and postoperative thoracic computed tomography. The cardiac mass, the pressure exerted on the lungs by the right and left heart and the fraction of collapsed lower lobe segments below and outside of the heart limits were evaluated on a computed tomography section 1 cm above the diaphragmatic cupola. RESULTS: In the postoperative period, cardiac mass increased by 32% (117±31 g versus 155±35 g, p<0.001, leading to an increase in the pressure that was exerted on the lungs by the right (2.2±0.6 g.cm(-2 versus 3.2±1.2 g.cm(-2, p<0.05 and left heart (2.4±0.7 g.cm(-2 versus 4.2±1.8 g.cm(-2, p<0.001. The proportion of collapsed lung segments beneath the heart markedly increased [from 6.7% to 32.9% on the right side (p<0.001 and from 6.2% to 29% on the left side (p<0.001], whereas the proportion of collapsed lung segments outside of the heart limits slightly increased [from 0.7% to 10.8% on the right side (p<0.001 and from 1.5% to 12.6% on the left side (p<0.001]. CONCLUSION: The pressure that is exerted by the heart on the lungs increased postoperatively and contributed to the collapse of subjacent pulmonary segments.

  16. Mice lacking thyroid hormone receptor Beta show enhanced apoptosis and delayed liver commitment for proliferation after partial hepatectomy.

    Directory of Open Access Journals (Sweden)

    Raquel López-Fontal

    Full Text Available BACKGROUND: The role of thyroid hormones and their receptors (TR during liver regeneration after partial hepatectomy (PH was studied using genetic and pharmacologic approaches. Roles in liver regeneration have been suggested for T3, but there is no clear evidence distinguishing the contribution of increased amounts of T3 from the modulation by unoccupied TRs. METHODOLOGY/PRINCIPAL FINDINGS: Mice lacking TRalpha1/TRbeta or TRbeta alone fully regenerated liver mass after PH, but showed delayed commitment to the initial round of hepatocyte proliferation and transient but intense apoptosis at 48h post-PH, affecting approximately 30% of the remaining hepatocytes. Pharmacologically induced hypothyroidism yielded similar results. Loss of TR activity was associated with enhanced nitrosative stress in the liver remnant, due to an increase in the activity of the nitric oxide synthase (NOS 2 and 3, caused by a transient decrease in the concentration of asymmetric dimethylarginine (ADMA, a potent NOS inhibitor. This decrease in the ADMA levels was due to the presence of a higher activity of dimethylarginineaminohydrolase-1 (DDAH-1 in the regenerating liver of animals lacking TRalpha1/TRbeta or TRbeta. DDAH-1 expression and activity was paralleled by the activity of FXR, a transcription factor involved in liver regeneration and up-regulated in the absence of TR. CONCLUSIONS/SIGNIFICANCE: We report that TRs are not required for liver regeneration; however, hypothyroid mice and TRbeta- or TRalpha1/TRbeta-deficient mice exhibit a delay in the restoration of liver mass, suggesting a specific role for TRbeta in liver regeneration. Altered regenerative responses are related with a delay in the expression of cyclins D1 and E, and the occurrence of liver apoptosis in the absence of activated TRbeta that can be prevented by administration of NOS inhibitors. Taken together, these results indicate that TRbeta contributes significantly to the rapid initial round of

  17. Portal venous branches to the caudate lobe: number and origin ...

    African Journals Online (AJOL)

    Sixty six livers from adult black Kenyans were obtained during autopsy at the Department of Human Anatomy, University of Nairobi – Kenya. The porta hepatis was carefully dissected and the number and origin of the portal venous branches to the caudate lobe observed and recorded. The collected data was analyzed using ...

  18. The auroral and ionospheric flow signatures of dual lobe reconnection

    Directory of Open Access Journals (Sweden)

    S. M. Imber

    2006-11-01

    Full Text Available We present the first substantial evidence for the occurrence of dual lobe reconnection from ionospheric flows and auroral signatures. The process of dual lobe reconnection refers to an interplanetary magnetic field line reconnecting with lobe field lines in both the northern and southern hemispheres. Two bursts of sunward plasma flow across the noon portion of the open/closed field line boundary (OCB, indicating magnetic flux closure at the dayside, were observed in SuperDARN radar data during a period of strongly northward IMF. The OCB is identified from spacecraft, radar backscatter, and auroral observations. In order for dual lobe reconnection to take place, we estimate that the interplanetary magnetic field clock angle must be within ±10° of zero (North. The total flux crossing the OCB during each burst is small (1.8% and 0.6% of the flux contained within the polar cap for the two flows. A brightening of the noon portion of the northern auroral oval was observed as the clock angle passed through zero, and is thought to be due to enhanced precipitating particle fluxes due to the occurrence of reconnection at two locations along the field line. The number of solar wind protons captured by the flux closure process was estimated to be ~2.5×1030 (4 tonnes by mass, sufficient to populate the cold, dense plasma sheet observed following this interval.

  19. Apolipoprotein E gene and sporadic frontal lobe dementia.

    NARCIS (Netherlands)

    M. Stevens (Martijn); C.M. van Duijn (Cornelia); P. de Knijff (Peter); B.A. Oostra (Ben); M.F. Niermeijer (Martinus); J.C. van Swieten (John); P. Heutink (Peter); C. van Broeckhoven (Christine)

    1997-01-01

    textabstractThe apolipoprotein E gene has been associated with various types of dementia. We studied the connection between the APOE gene and the risk and onset of disease in 34 patients with clinically diagnosed frontal lobe dementia (FLD) derived from a population-based study in the Netherlands. A

  20. Case Report: Frontal lobe tuberculoma: A clinical and imaging ...

    African Journals Online (AJOL)

    Background: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal ...

  1. High density scalp EEG in frontal lobe epilepsy.

    Science.gov (United States)

    Feyissa, Anteneh M; Britton, Jeffrey W; Van Gompel, Jamie; Lagerlund, Terrance L; So, Elson; Wong-Kisiel, Lilly C; Cascino, Gregory C; Brinkman, Benjamin H; Nelson, Cindy L; Watson, Robert; Worrell, Gregory A

    2017-01-01

    Localization of seizures in frontal lobe epilepsy using the 10-20 system scalp EEG is often challenging because neocortical seizure can spread rapidly, significant muscle artifact, and the suboptimal spatial resolution for seizure generators involving mesial frontal lobe cortex. Our aim in this study was to determine the value of visual interpretation of 76 channel high density EEG (hdEEG) monitoring (10-10 system) in patients with suspected frontal lobe epilepsy, and to evaluate concordance with MRI, subtraction ictal SPECT co-registered to MRI (SISCOM), conventional EEG, and intracranial EEG (iEEG). We performed a retrospective cohort study of 14 consecutive patients who underwent hdEEG monitoring for suspected frontal lobe seizures. The gold standard for localization was considered to be iEEG. Concordance of hdEEG findings with MRI, subtraction ictal SPECT co-registered to MRI (SISCOM), conventional 10-20 EEG, and iEEG as well as correlation of hdEEG localization with surgical outcome were examined. hdEEG localization was concordant with iEEG in 12/14 and was superior to conventional EEG 3/14 (pfrontal epilepsy requiring localization of epileptogenic brain. hdEEG may assist in developing a hypothesis for iEEG monitoring and could potentially augment EEG source localization. Published by Elsevier B.V.

  2. Time Ordering in Frontal Lobe Patients: A Stochastic Model Approach

    Science.gov (United States)

    Magherini, Anna; Saetti, Maria Cristina; Berta, Emilia; Botti, Claudio; Faglioni, Pietro

    2005-01-01

    Frontal lobe patients reproduced a sequence of capital letters or abstract shapes. Immediate and delayed reproduction trials allowed the analysis of short- and long-term memory for time order by means of suitable Markov chain stochastic models. Patients were as proficient as healthy subjects on the immediate reproduction trial, thus showing spared…

  3. Charting the Maturation of the Frontal Lobe: An Electrophysiological Strategy

    Science.gov (United States)

    Segalowitz, S. J.; Davies, Patricia L.

    2004-01-01

    Tracking the functional development of specific regions of the prefrontal cortex in children using event-related potentials (ERPs) is challenging for both technical and conceptual reasons. In this paper we outline our strategy for studying frontal lobe development and present preliminary results from children aged 7-17 years and young adults using…

  4. Multidetector CT evaluation of potential right lobe living donors for ...

    African Journals Online (AJOL)

    Mohamed Saied Abdelgawad

    Multidetector CT evaluation of potential right lobe living donors for liver transplantation. Mohamed Saied Abdelgawad *, Osama L. El-Abd. National Liver Institute, El-Menoufiya University, Shebein El-Koom, Alexandria, Egypt. Received 4 June 2011; accepted 18 June 2011. KEYWORDS. Liver transplantation;. Multidetector ...

  5. Surgical anatomy of the pyramidal lobe and its significance in ...

    African Journals Online (AJOL)

    33:35-37. 10. Harjeet A, Shani D, Jit I, Aggarwal AK. Shape, measurements and weight of the thyroid gland in northwest Indians. Surg Radiol Anat 2004;26:91-95. TABLE III. INVOLVEMENT OF THE PYRAMIDAL LOBE IN VARIOUS THYROID ...

  6. Torsion of right middle lobe after a right upper lobectomy

    Directory of Open Access Journals (Sweden)

    Chen Tung-Ying

    2009-04-01

    Full Text Available Abstract Lobar torsion after lung resection is a quite rare complication. A 50-year-old woman presented typical features on chest radiographs and CT(computed tomography scan of lobar torsion after a right upper lobectomy. After emergency lobectomy of right middle lobe, the patient recovered well and discharged 10 days after the second operation.

  7. Complications after mesial temporal lobe surgery via inferiortemporal gyrus approach.

    Science.gov (United States)

    Vale, Fernando L; Reintjes, Stephen; Garcia, Hermes G

    2013-06-01

    The purpose of this study was to identify the complications associated with the inferior temporal gyrus approach to anterior mesial temporal lobe resection for temporal lobe epilepsy. This retrospective study examined complications experienced by 483 patients during the 3 months after surgery. All surgeries were performed during 1998-2012 by the senior author (F.L.V.). A total of 13 complications (2.7%) were reported. Complications were 8 delayed subdural hematomas (1.6%), 2 superficial wound infections (0.4%), 1 delayed intracranial hemorrhage (0.2%), 1 small lacunar stroke (0.2%), and 1 transient frontalis nerve palsy (0.2%). Three patients with subdural hematoma (0.6%) required readmission and surgical intervention. One patient (0.2%) with delayed intracranial hemorrhage required readmission to the neuroscience intensive care unit for observation. No deaths or severe neurological impairments were reported. Among the 8 patients with subdural hematoma, 7 were older than 40 years (87.5%); however, this finding was not statistically significant (p = 0.198). The inferior temporal gyrus approach to mesial temporal lobe resection is a safe and effective method for treating temporal lobe epilepsy. Morbidity and mortality rates associated with this procedure are lower than those associated with other neurosurgical procedures. The finding that surgical complications seem to be more common among older patients emphasizes the need for early surgical referral of patients with medically refractory epilepsy.

  8. Bilingualism Alters Children's Frontal Lobe Functioning for Attentional Control

    Science.gov (United States)

    Arredondo, Maria M.; Hu, Xiao-Su; Satterfield, Teresa; Kovelman, Ioulia

    2017-01-01

    Bilingualism is a typical linguistic experience, yet relatively little is known about its impact on children's cognitive and brain development. Theories of bilingualism suggest that early dual-language acquisition can improve children's cognitive abilities, specifically those relying on frontal lobe functioning. While behavioral findings present…

  9. Memory Functions following Surgery for Temporal Lobe Epilepsy in Children

    Science.gov (United States)

    Jambaque, Isabelle; Dellatolas, Georges; Fohlen, Martine; Bulteau, Christine; Watier, Laurence; Dorfmuller, Georg; Chiron, Catherine; Delalande, Olivier

    2007-01-01

    Surgical treatment appears to improve the cognitive prognosis in children undergoing surgery for temporal lobe epilepsy (TLE). The beneficial effects of surgery on memory functions, particularly on material-specific memory, are more difficult to assess because of potentially interacting factors such as age range, intellectual level,…

  10. Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy

    Science.gov (United States)

    Trebuchon-Da Fonseca, Agnes; Guedj, Eric; Alario, F-Xavier; Laguitton, Virginie; Mundler, Olivier; Chauvel, Patrick; Liegeois-Chauvel, Catherine

    2009-01-01

    Word finding difficulties are often reported by epileptic patients with seizures originating from the language dominant cerebral hemisphere, for example, in temporal lobe epilepsy. Evidence regarding the brain regions underlying this deficit comes from studies of peri-operative electro-cortical stimulation, as well as post-surgical performance.…

  11. Memory, Metamemory and Their Dissociation in Temporal Lobe Epilepsy

    Science.gov (United States)

    Howard, Charlotte E.; Andres, Pilar; Broks, Paul; Noad, Rupert; Sadler, Martin; Coker, Debbie; Mazzoni, Giuliana

    2010-01-01

    Patients with temporal-lobe epilepsy (TLE) present with memory difficulties. The aim of the current study was to determine to what extent these difficulties could be related to a metamemory impairment. Fifteen patients with TLE and 15 matched healthy controls carried out a paired-associates learning task. Memory recall was measured at intervals of…

  12. ROLE OF YOGA IN ALIENATING THE MEMORY DECLINE AND FRONTAL LOBE METABOLITE CHANGES IN TYPE 2 DIABETES.

    Science.gov (United States)

    Santhakumari, Rajani; Reddy, Indla Yogananda; Archana, R; Rajesh, P

    2016-01-01

    Recent research studies have established the fact, that glycosylation is causing the memory decline and this is further supported by the alteration of brain metabolite concentrations in diabetes. The present study is hypothesized that yoga is having alienating ability of memory decline and alteration of frontal lobe metabolite concentrations, which are the result of glycosylation in type 2 diabetes. Five type 2 diabetic subjects of both the sex, aged between 35-55 years, who practiced yoga over a period of six months in a yoga institute, were recruited as test group. Age and sex matched five type 2 diabetic subjects were recruited as control group, both the group subjects are on oral hypoglycaemic agents. Glycosylated haemoglobin percentage was estimated with Bio-Rad instrument, frontal lobe metabolites were estimated with Proton Magnetic Resonance Spectroscopy (H-MRS), memory was calculated with PGI-Memory Scale (PGIMS) that is a part of PGI-Battery of Brain Dysfunction (PGI-BBD), which is a neuropsychological battery. Mean glycosylated haemoglobin percentage and memory dysfunction rating in control and test group subjects are 6.9±0.4 & 7.8±1.84 (p=0.03), and 14±1& 6±1 (p=0.0001) respectively. Right and left frontal lobe N-Acetyl Aspartate (NAA) and Myoionositol (mI) concentrations were more or less similar in both the groups. Yoga is having a significant role in alienating the decline in memory caused by glycosylation in type 2 diabetes but not on the alteration of frontal lobe NAA and mI concentrations.

  13. 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.)

  14. Cortical Activation during a Cognitive Challenge in Patients with Chronic Temporal Lobe Epilepsy—A Dynamic SPECT Study

    Directory of Open Access Journals (Sweden)

    P. J. Kirkpatrick

    1993-01-01

    Full Text Available In a pilot group of six patients suffering from chronic temporal lobe epilepsy, single photon emission computerized tomography (SPECT has been used to image the changes in relative cerebral blood flow between rest (static scan and conditions of cognitive activation (activated scan. The cognitive challenge used during activation comprised a test of word memory, and the performance was expressed as a word memory score (WMS for each individual. An activation index (AI was calculated from the mean normalized density counts in specific regions of interest (ROIs, and values obtained were analysed for correlation with the WMS. The mean AI was increased significantly in the right lateral temporal cortex, the right and left inferior frontal regions, the left temporal pole, and the right medial temporal cortex. A positive correlation with the WMS was found in the medial temporal cortices, and this relationship was significant for the right medial temporal ROI.

  15. Verbal learning and memory outcome in selective amygdalohippocampectomy versus temporal lobe resection in patients with hippocampal sclerosis

    DEFF Research Database (Denmark)

    Foged, Mette Thrane; Vinter, Kirsten; Stauning, Louise

    2018-01-01

    on intraoperative electrocorticography. Verbal learning and verbal memory were tested pre- and postsurgery. RESULTS: Seizure outcome did not differ between patients operated using the SAH versus the TLR at 1year (p=0.951) nor at 7years (p=0.177). Verbal learning was more affected in patients resected in the left...... hemisphere than in the right (p=0.002). In patients with left-sided TLR, a worsening in verbal memory performance was found (p=0.011). Altogether, 73% were seizure-free for 1year and 64% for 7years after surgery. CONCLUSION: In patients with drug-resistant focal MTLE, HS and no magnetic resonance imaging...... (MRI) signs of dual pathology, selective amygdalohippocampectomy results in sustained seizure freedom and better memory function compared with patients operated with nonselective temporal lobe resection....

  16. Frontal mucocele with intracranial extension causing frontal lobe syndrome.

    Science.gov (United States)

    Weidmayer, Sara

    2015-06-01

    Mucoceles are mucus-containing cysts that form in paranasal sinuses; although mucoceles themselves are benign, this case report highlights the extensive damage they can cause as their expansion may lead to bony erosion and extension of the mucocele into the orbit and cranium; it also presents a rarely reported instance of frontal sinus mucocele leading to frontal lobe syndrome. A thorough discussion and review of mucoceles is included. A 68-year-old white man presented with intermittent diplopia and a pressure sensation in the right eye. He had a history of chronic sinusitis and had had endoscopic sinus surgery 5 years prior. A maxillofacial computed tomography scan revealed a large right frontal sinus mucocele, which had caused erosion along the medial wall of the right orbit and the outer and inner tables of the right frontal sinus. The mucocele had protruded both into the right orbit and intracranially, causing mass effect on the frontal lobe, which led to frontal lobe syndrome. The patient was successfully treated with endoscopic right ethmoidectomy, radial frontal sinusotomy, marsupialization of the mucocele, and transcutaneous irrigation. Paranasal sinus mucoceles may expand and lead to bony erosion and can become very invasive in surrounding structures such as the orbit and cranium. This case not only exhibits a very rare presentation of frontal sinus mucocele with intracranial extension and frontal lobe mass effect causing a frontal lobe syndrome but also demonstrates many of the ocular and visual complications commonly associated with paranasal sinus mucoceles. Early identification and surgical intervention is vital for preventing and reducing morbidity associated with invasive mucoceles, and the patient must be followed regularly to monitor for recurrence.

  17. Ligadura da veia porta associada à bipartição do fígado para hepatectomia em dois estágios (ALPPS: experiência brasileira Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS: the Brazilian experience

    Directory of Open Access Journals (Sweden)

    Orlando Jorge Martins Torres

    2013-03-01

    liver resections. To induce rapid and significant hepatic hypertrophy, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS has been recently developed for patients which tumor is previously considered unresectable. AIM: To present the Brazilian experience with ALPPS approach. METHOD: Were analyzed 39 patients who underwent hepatic resection using ALPPS in nine hospitals. The procedure was performed in two steps. The first operation was portal vein ligation and in situ splitting. In the second operation the right hepatic artery, right bile duct and the right hepatic vein were isolated and ligated. The extended right lobe was removed. There were 22 male (56.4% and 17 female (43.6%. At the time of the first operation, the median age was 57.3 years (range: 20-83 years. RESULTS: The most common indication was liver metastasis in 32 patients (82.0%, followed by cholangiocarcinoma in three (7.7%. Two patients died (5.2% during this period and did not undergo the second operation. The mean interval between the first and the second operation was 14.1 days (range: 5-30 days. The volume of the left lateral segment of the liver increased 83% (range 47-211.9%. Significant morbidity after ALPPS was seen in 23 patients (59.0%. The mortality rate was 12.8% (five patients. CONCLUSION: The ALPPS approach can enable resection in patients with lesions previously considered unresectable. It induces rapid liver hypertrophy avoiding liver failure in most patients. However still has high morbidity and mortality.

  18. Excitatory amino acid transporters EAAT-1 and EAAT-2 in temporal lobe and hippocampus in intractable temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Sarac, Sinan; Afzal, Shoaib; Broholm, Helle

    2009-01-01

    extra-cellular clearance of glutamate by excitatory amino acid transporters (EAAT-1 to EAAT-5). EAAT-1 and EAAT-2 are mainly expressed on astroglial cells for the reuptake of glutamate from the extra-cellular space. We have studied the expression of EAAT-1 and EAAT-2 in the hippocampus and temporal lobe...

  19. Altered basal ganglia-cortical functional connections in frontal lobe epilepsy: A resting-state fMRI study.

    Science.gov (United States)

    Dong, Li; Wang, Pu; Peng, Rui; Jiang, Sisi; Klugah-Brown, Benjamin; Luo, Cheng; Yao, Dezhong

    2016-12-01

    The purpose of this study was to investigate alterations of basal ganglia-cortical functional connections in patients with frontal lobe epilepsy (FLE). Resting-state functional magnetic resonance imaging (fMRI) data were gathered from 19 FLE patients and 19 age- and gender-matched healthy controls. Functional connectivity (FC) analysis was used to assess the functional connections between basal ganglia and cerebral cortex. Regions of interest, including the left/right caudate, putamen, pallidum and thalamus, were selected as the seeds. Two sample t-test was used to determine the difference between patients and controls, while controlling the age, gender and head motions. Compared with controls, FLE patients demonstrated increased FCs between basal ganglia and regions including the right fusiform gyrus, the bilateral cingulate gyrus, the precuneus and anterior cingulate gyrus. Reduced FCs were mainly located in a range of brain regions including the bilateral middle occipital gyrus, the ventral frontal lobe, the right putamen, the left fusiform gyrus and right rolandic operculum. In addition, the relationships between basal ganglia-cingulate connections and durations of epilepsy were also found. The alterations of functional integrity within the basal ganglia, as well as its connections to limbic and ventral frontal areas, indicate the important roles of the basal ganglia-cortical functional connections in FLE, and provide new insights in the pathophysiological mechanism of FLE. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Detection of whole-brain abnormalities in temporal lobe epilepsy using tensor-based morphometry with DARTEL

    Science.gov (United States)

    Li, Wenjing; He, Huiguang; Lu, Jingjing; Lv, Bin; Li, Meng; Jin, Zhengyu

    2009-10-01

    Tensor-based morphometry (TBM) is an automated technique for detecting the anatomical differences between populations by examining the gradients of the deformation fields used to nonlinearly warp MR images. The purpose of this study was to investigate the whole-brain volume changes between the patients with unilateral temporal lobe epilepsy (TLE) and the controls using TBM with DARTEL, which could achieve more accurate inter-subject registration of brain images. T1-weighted images were acquired from 21 left-TLE patients, 21 right-TLE patients and 21 healthy controls, which were matched in age and gender. The determinants of the gradient of deformation fields at voxel level were obtained to quantify the expansion or contraction for individual images relative to the template, and then logarithmical transformation was applied on it. A whole brain analysis was performed using general lineal model (GLM), and the multiple comparison was corrected by false discovery rate (FDR) with p<0.05. For left-TLE patients, significant volume reductions were found in hippocampus, cingulate gyrus, precentral gyrus, right temporal lobe and cerebellum. These results potentially support the utility of TBM with DARTEL to study the structural changes between groups.

  1. 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

  2. Granule cell dispersion is associated with memory impairment in right mesial temporal lobe epilepsy.

    Science.gov (United States)

    Neves, Rafael Scarpa da Costa; de Souza Silva Tudesco, Ivanda; Jardim, Anaclara Prada; Caboclo, Luís Otávio Sales Ferreira; Lancellotti, Carmen; Ferrari-Marinho, Taíssa; Hamad, Ana Paula; Marinho, Murilo; Centeno, Ricardo Silva; Cavalheiro, Esper Abrão; Scorza, Carla Alessandra; Yacubian, Elza Márcia Targas

    2012-11-01

    We analyzed the association of granule cell dispersion (GCD) with memory performance, clinical data and surgical outcome in a series of patients with mesial temporal lobe epilepsy (MTLE) and mesial temporal sclerosis (MTS). Hippocampal specimens from 54 patients with MTLE (27 patients with right MTLE and 27 with left MTLE) and unilateral MTS, who were separated into GCD and no-GCD groups and thirteen controls were studied. Quantitative neuropathological evaluation was performed using hippocampal sections stained with NeuN. Patients' neuropsychological measures, clinical data, type of MTS and surgical outcome were reviewed. GCD occurred in 28 (51.9%) patients. No correlation between GCD and MTS pattern, clinical data or surgical outcome was found. The presence of GCD was correlated with worse visuospatial memory performance in right MTLE, but not with memory performance in left MTLE. GCD may be related to memory impairment in right MTLE-MTS patients. However, the role of GCD in memory function is not precisely defined. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis.

    Science.gov (United States)

    Marques, Carolina Mattos; Caboclo, Luís Otávio Sales Ferreira; da Silva, Tatiana Indelicato; Noffs, Maria Helena da Silva; Carrete, Henrique; Lin, Katia; Lin, Jaime; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2007-05-01

    We assessed the cognitive performance of patients with temporal lobe epilepsy (TLE) caused by unilateral hippocampal sclerosis (HS), in comparison with that of matched, healthy controls. We report the relationship between cognitive measures and duration of epilepsy, correlating with hippocampal volumes, and the impact of educational level on cognitive decline. This study involved 61 outpatients (40 with 8 years of formal education) with unilateral HS and 61 controls. Volumetric MRI was performed on all patients and 10 controls. The results (mean, SD) of the neuropsychological tests of healthy subjects and patients were compared using the Student t and Mann-Whitney tests. Patients performed worse than controls in the neuropsychological evaluation. When adjusted z scores were used to calculate the impairment index, patients had a greater percentage of abnormal tests compared with controls. The cognitive decline, assessed through the impairment index, correlated with duration of epilepsy. Higher level of education did not protect against this decline, thus not supporting the hypothesis of cerebral reserve in this population. A significant correlation between hippocampal volumetric measures and duration of epilepsy was observed only in patients with left HS. Patients with TLE caused by HS present with cognitive morbidity that extends beyond memory deficits. Cognitive decline is associated with duration of epilepsy, and in patients with left-sided HS, duration may correlate with volumetric hippocampal loss.

  4. Relational vs. attributive interpretation of nominal compounds differentially engages angular gyrus and anterior temporal lobe.

    Science.gov (United States)

    Boylan, Christine; Trueswell, John C; Thompson-Schill, Sharon L

    2017-06-01

    The angular gyrus (AG) and anterior temporal lobe (ATL) have been found to respond to a number of tasks involving combinatorial processing. In this study, we investigate the conceptual combination of nominal compounds, and ask whether ATL/AG activity is modulated by the type of combinatorial operation applied to a nominal compound. We compare relational and attributive interpretations of nominal compounds and find that ATL and AG both discriminate these two types, but in distinct ways. While right AG demonstrated greater positive task-responsive activity for relational compounds, there was a greater negative deflection in the BOLD response in left AG for relational compounds. In left ATL, we found an earlier peak in subjects' BOLD response curves for attributive interpretations. In other words, we observed dissociations in both AG and ATL between relational and attributive nominal compounds, with regard to magnitude in the former and to timing in the latter. These findings expand on prior studies that posit roles for both AG and ATL in conceptual processing generally, and in conceptual combination specifically, by indicating possible functional specializations of these two regions within a larger conceptual knowledge network. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland

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    Manuele Casale

    2016-12-01

    Full Text Available The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with “Warthin tumor.” We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.

  6. Liver Lobe Based Multi-Echo Gradient Recalled Echo T2*-Weighted Imaging in Chronic Hepatitis B-Related Cirrhosis: Association with the Presence and Child-Pugh Class of Cirrhosis.

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    Dan Wang

    Full Text Available To investigate whether liver lobe based T2* values measured on gradient recalled echo T2*-weighted imaging are associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis.Fifty-six patients with hepatitis B-related cirrhosis and 23 healthy control individuals were enrolled in this study and underwent upper abdominal T2*-weighted magnetic resonance imaging. T2* values of the left lateral lobe (LLL, left medial lobe (LML, right lobe (RL and caudate lobe (CL were measured on T2*-weighted imaging. Statistical analyses were performed to determine the association between liver lobe based T2* values and the presence and Child-Pugh class of cirrhosis.The T2* values of the LLL, LML and RL decreased with the progression of cirrhosis from Child-Pugh class A to C (r = -0.231, -0.223, and -0.395, respectively; all P 0.05. To a certain extent, Mann-Whitney U tests with Bonferroni correction for multigroup comparisons showed that the T2* values of the LLL, LML and RL could distinguish cirrhotic liver from healthy liver (all P 0.05. Receiver operating characteristic analysis demonstrated that the T2* value of the RL could best distinguish cirrhosis from healthy liver, with an area under the receiver operating characteristic curve (AUC of 0.713 among T2* values of the liver lobes, and that only the T2* value of the RL could distinguish Child-Pugh class C from A-B, with an AUC of 0.697 (all P < 0.05.The T2* value of the RL can be associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis.

  7. Mesenchymal Stem Cells Transplantation following Partial Hepatectomy: A New Concept to Promote Liver Regeneration-Systematic Review of the Literature Focused on Experimental Studies in Rodent Models.

    Science.gov (United States)

    Papanikolaou, Ioannis G; Katselis, Charalambos; Apostolou, Konstantinos; Feretis, Themistoklis; Lymperi, Maria; Konstadoulakis, Manousos M; Papalois, Apostolos E; Zografos, George C

    2017-01-01

    Mesenchymal stem cells (MSCs) are an attractive source for regenerative medicine because they are easily accessible through minimally invasive methods and have the potential to enhance liver regeneration (LG) and improve liver function, following partial hepatectomy (PH) and acute or chronic liver injury. A systematic review of the literature was conducted for articles published up to September 1st, 2016, using the MEDLINE database. The keywords that were used in various combinations were as follows: "Mesenchymal stem cells", "transplantation", "stem cells", "adipose tissue derived stem cells", "bone marrow-derived stem cells", "partial hepatectomy", "acute liver failure", "chronic liver failure", "liver fibrosis", "liver cirrhosis", "rats", "mice", and "liver regeneration". All introduced keywords were searched for separately in MeSH Database to control relevance and terminological accuracy and validity. A total of 41 articles were identified for potential inclusion and reviewed in detail. After a strict selection process, a total of 28 articles were excluded, leaving 13 articles to form the basis of this systematic review. MSCs transplantation promoted LG and improved liver function. Furthermore, MSCs had the ability to differentiate in hepatocyte-like cells, increase survival, and protect hepatocytes by paracrine mechanisms. MSCs transplantation may provide beneficial effects in the process of LG after PH and acute or chronic liver injury. They may represent a new therapeutic option to treat posthepatectomy acute liver failure.

  8. Effects of antiviral therapy on post-hepatectomy HBV reactivation and liver function in HBV DNA-negative patients with HBV-related hepatocellular carcinoma.

    Science.gov (United States)

    Gong, Wen-Feng; Zhong, Jian-Hong; Lu, Shi-Dong; Wang, Xiao-Bo; Zhang, Qiu-Ming; Ma, Liang; Zhang, Zhi-Ming; Xiang, Bang-De; Li, Le-Qun

    2017-02-28

    The ability of antiviral therapy to reduce risk of post-hepatectomy hepatitis B virus (HBV) reactivation in patients negative for viral DNA is unclear. This prospective study involved 174 consecutive patients with hepatitis B virus related hepatocellular carcinoma who were negative for hepatitis B virus DNA in serum and who underwent hepatic resection. Hepatitis B virus reactivation occurred in 30 patients in the non-antiviral group (27.8%) but in only 2 patients in the antiviral group (3.0%, P antiviral therapy. Liver function indicators at one week after resection did not differ significantly between the two groups, or between patients who experienced hepatitis B virus reactivation or not. Nevertheless, alanine aminotransferase and albumin at 1 month after resection were significantly higher in the antiviral group than in the non-antiviral group, and they were significantly higher in patients who did not experience hepatitis B virus reactivation than in those who did. Therefore, patients with hepatitis B virus related hepatocellular carcinoma face substantial risk of hepatitis B virus reactivation after hepatectomy, even if they are negative for viral DNA at baseline. Antiviral therapy can reduce the risk of reactivation, helping improve liver function after surgery.

  9. Post-operative delayed elevation of ALT correlates with early death in patients with HBV-related hepatocellular carcinoma and Post-hepatectomy Liver Failure.

    Science.gov (United States)

    Yu, Liang-He; Yu, Wen-Long; Zhao, Teng; Wu, Meng-Chao; Fu, Xiao-Hui; Zhang, Yong-Jie

    2018-01-16

    Post-hepatectomy Liver Failure (PHLF) remains the primary cause of perioperative death. The kinetics of transaminase levels are usually measured as markers of hepatocellular injury following partial hepatectomy, but their correlation with PHLF and post-operative mortality is unclear. The aim of study was to compare the post-operative transaminase kinetics with short term survival in those patients that developed PHLF. A retrospective review of patients with HBV-related HCC and who developed PHLF was performed. Logistic regression analysis was conducted to analyze risk factors for postoperative delayed elevation of ALT (PDE-ALT) PHLF and lethal PHLF. Of the 69 patients who developed PHLF 36 (52%) died. In those patients who died the mean ± SD ALT and AST rose from day (POD) 1-3 and continued to fluctuate with highly abnormal levels beyond day 3 with a mean ± SD peak ALT level beyond POD 3 of 1851 ± 1644 U/L (p ALT indicates an increased risk of death in HBV-related HCC patients with PHLF. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  10. Biliary Stricture Following Hepatic Resection

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    Jeffrey B. Matthews

    1991-01-01

    Full Text Available Anatomic distortion and displacement of hilar structures due to liver lobe atrophy and hypertrophy occasionally complicates the surgical approach for biliary stricture repair. Benign biliary stricture following hepatic resection deserves special consideration in this regard because the inevitable hypertrophy of the residual liver causes marked rotation and displacement of the hepatic hilum that if not anticipated may render exposure for repair difficult and dangerous. Three patients with biliary stricture after hepatectomy illustrate the influence of hepatic regeneration on attempts at subsequent stricture repair. Following left hepatectomy, hypertrophy of the right and caudate lobes causes an anteromedial rotation and displacement of the portal structures. After right hepatectomy, the rotation is posterolateral, and a thoracoabdominal approach may be necessary for adequate exposure. Radiographs obtained in the standard anteroposterior projection may be deceptive, and lateral views are recommended to aid in operative planning.

  11. Comparison of rCBF between patients with medial temporal lobe epilepsy and normal controls using H215O PET

    International Nuclear Information System (INIS)

    Kang, Eun Joo; Lee, Jae Sung; Nam, Hyun Woo; Lee, Sang Kun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

    2002-01-01

    The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using H 2 15 O-PET. 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was performed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Duirng the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal regions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal regions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Epilepsy induced changes were found not only in relative increase/ decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period

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  20. A tale of two hemispheres: Contrasting socioemotional dysfunction in right- versus left-lateralised semantic dementia

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    Muireann Irish

    Full Text Available ABSTRACT Objective: Semantic dementia, a subtype of frontotemporal lobar degeneration, is characterised by cross-modal loss of conceptual knowledge attributable to progressive degeneration of the left anterior temporal lobe. Much less is known regarding the clinical presentation of SD patients with predominantly right-lateralised atrophy. Recent reports emphasise marked socioemotional and behavioural disturbances in such cases. Given the importance of the right anterior temporal lobes in social cognition, we hypothesised that socioemotional functioning would be disproportionately affected in right versus left-lateralised SD cases. Methods: We assessed well-characterised cases of predominantly right (n=10 and left (n=12 SD and 20 matched healthy controls on tests of emotion processing and interpersonal functioning. Results: Right SD cases showed disproportionate difficulties in the recognition of positive and negative facial emotions, specifically happiness and anger, compared with left SD cases. Deficits in anger recognition persisted in right SD despite covarying for facial and semantic processing. On a contextually rich task of emotion recognition using multimodal videos, no subgroup differences were evident. Finally, empathic concern was rated as significantly lower by caregivers of right versus left SD cases. Overall, the extent of socioemotional disturbance was associated with the degree of behavioural changes in SD. Conclusion: Our results reveal considerable overlap in the extent to which socioemotional processes are disrupted in left and right-lateralised cases of SD. Notably, however, right SD cases show disproportionate deficits for recognition of facial emotions and the capacity for empathic concern, supporting a specialised role for the right anterior temporal lobes in mediating these cognitive functions.

  1. Excitation of transient lobe cell convection and auroral arc at the cusp poleward boundary during a transition of the interplanetary magnetic field from south to north

    Directory of Open Access Journals (Sweden)

    P. E. Sandholt

    2001-05-01

    Full Text Available We document the activation of transient polar arcs emanating from the cusp within a 15 min long intermediate phase during the transition from a standard two-cell convection pattern, representative of a strongly southward interplanetary magnetic field (IMF, to a "reverse" two-cell pattern, representative of strongly northward IMF conditions. During the 2–3 min lifetime of the arc, its base in the cusp, appearing as a bright spot, moved eastward toward noon by ~ 300 km. As the arc moved, it left in its "wake" enhanced cusp precipitation. The polar arc is a tracer of the activation of a lobe convection cell with clockwise vorticity, intruding into the previously established large-scale distorted two-cell pattern, due to an episode of localized lobe reconnection. The lobe cell gives rise to strong flow shear (converging electric field and an associated sheet of outflowing field-aligned current, which is manifested by the polar arc. The enhanced cusp precipitation represents, in our view, the ionospheric footprint of the lobe reconnection process.Key words. Magnetospheric physics (auroral phenomena; magnetopause, cusp, and boundary layers; plasma convection

  2. Atypical white matter microstructure in left-handed individuals.

    Science.gov (United States)

    McKay, Nicole S; Iwabuchi, Sarina J; Häberling, Isabelle S; Corballis, Michael C; Kirk, Ian J

    2017-05-01

    Information regarding anatomical connectivity in the human brain can be gathered using diffusion tensor imaging (DTI). Fractional anisotropy (FA) is the most commonly derived value, and reflects how strongly directional are the underlying tracts. Differences in FA are thus associated with differences in the underlying microstructure of the brain. The relationships between these differences in microstructure and functional differences in corresponding regions have also been examined. Previous studies have found an effect of handedness on functional lateralization in the brain and corresponding microstructural differences. Here, using tract-based spatial statistics to analyse DTI-derived FA values, we further investigated the structural white matter architecture in the brains of right- and left-handed males. We found significantly higher FA values for left-handed, relatively to right-handed, individuals, in all major lobes, and in the corpus callosum. In support of previous suggestions, we find that there is a difference in the microstructure of white matter in left- and right-handed males that could underpin reduced lateralization of function in left-handed individuals.

  3. New Learning of Music after Bilateral Medial Temporal Lobe Damage: Evidence from an Amnesic Patient

    Directory of Open Access Journals (Sweden)

    Jussi eValtonen

    2014-09-01

    Full Text Available Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly-identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ’s rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed, closely matched for factors contributing to a piece’s musical complexity. LSJ practiced playing two of the pieces, one in each of two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ’s complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

  4. Comparing CAT12 and VBM8 for Detecting Brain Morphological Abnormalities in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Farnaz Farokhian

    2017-08-01

    Full Text Available The identification of the brain morphological alterations that play important roles in neurodegenerative/neurological diseases will contribute to our understanding of the causes of these diseases. Various automated software programs are designed to provide an automatic framework to detect brain morphological changes in structural magnetic resonance imaging (MRI data. A voxel-based morphometry (VBM analysis can also be used for the detection of brain volumetric abnormalities. Here, we compared gray matter (GM and white matter (WM abnormality results obtained by a VBM analysis using the Computational Anatomy Toolbox (CAT12 via the current version of Statistical Parametric Mapping software (SPM12 with the results obtained by a VBM analysis using the VBM8 toolbox implemented in the older software SPM8, in adult temporal lobe epilepsy (TLE patients with (n = 51 and without (n = 57 hippocampus sclerosis (HS, compared to healthy adult controls (n = 28. The VBM analysis using CAT12 showed that compared to the healthy controls, significant GM and WM reductions were located in ipsilateral mesial temporal lobes in the TLE-HS patients, and slight GM amygdala swelling was present in the right TLE-no patients (n = 27. In contrast, the VBM analysis via the VBM8 toolbox showed significant GM and WM reductions only in the left TLE-HS patients (n = 25 compared to the healthy controls. Our findings thus demonstrate that compared to VBM8, a VBM analysis using CAT12 provides a more accurate volumetric analysis of the brain regions in TLE. Our results further indicate that a VBM analysis using CAT12 is more robust and accurate against volumetric alterations than the VBM8 toolbox.

  5. A Comparative Study of Feature Selection Methods for the Discriminative Analysis of Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Chunren Lai

    2017-12-01

    Full Text Available It is crucial to differentiate patients with temporal lobe epilepsy (TLE from the healthy population and determine abnormal brain regions in TLE. The cortical features and changes can reveal the unique anatomical patterns of brain regions from structural magnetic resonance (MR images. In this study, structural MR images from 41 patients with left TLE, 34 patients with right TLE, and 58 normal controls (NC were acquired, and four kinds of cortical measures, namely cortical thickness, cortical surface area, gray matter volume (GMV, and mean curvature, were explored for discriminative analysis. Three feature selection methods including the independent sample t-test filtering, the sparse-constrained dimensionality reduction model (SCDRM, and the support vector machine-recursive feature elimination (SVM-RFE were investigated to extract dominant features among the compared groups for classification using the support vector machine (SVM classifier. The results showed that the SVM-RFE achieved the highest performance (most classifications with more than 84% accuracy, followed by the SCDRM, and the t-test. Especially, the surface area and GMV exhibited prominent discriminative ability, and the performance of the SVM was improved significantly when the four cortical measures were combined. Additionally, the dominant regions with higher classification weights were mainly located in the temporal and the frontal lobe, including the entorhinal cortex, rostral middle frontal, parahippocampal cortex, superior frontal, insula, and cuneus. This study concluded that the cortical features provided effective information for the recognition of abnormal anatomical patterns and the proposed methods had the potential to improve the clinical diagnosis of TLE.

  6. New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient.

    Science.gov (United States)

    Valtonen, Jussi; Gregory, Emma; Landau, Barbara; McCloskey, Michael

    2014-01-01

    Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ's rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece's musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ's complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

  7. 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...

  8. Verbal memory decline from hippocampal depth electrodes in temporal lobe surgery for epilepsy.

    Science.gov (United States)

    Ljung, Hanna; Nordlund, Arto; Strandberg, Maria; Bengzon, Johan; Källén, Kristina

    2017-12-01

    To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language-dominant hemisphere. A long-term neuropsychological follow-up (mean 61.5 months, range 22-111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24). The groups were equal with respect to education, age at seizure onset, epilepsy duration, and prevalence of pharmacoresistant temporal lobe epilepsy (TLE; 75%) versus seizure freedom (25%). Retrospective neuropsychological data from preoperative surgical workup (T1) and prospective follow-up neuropsychological data (T2) were compared. A ≥1 SD intrapatient decline was considered as clinically relevant deterioration of verbal memory. Significant decline in verbal memory was seen in 56% of the patients in the study group compared to 21% in the reference group. At T1, there were no statistical between-group differences in memory performance. At T2, between-group comparison showed significantly greater verbal memory decline for the study group (Claeson Dahl Learning and Retention Test, Verbal Learning: p = 0.05; Rey Auditory Verbal Learning Test, Total Learning: p = 0.04; Claeson Dahl Learning and Retention Test, Verbal Retention: p = 0.04). An odds ratio (OR) of 7.1 (90% confidence interval [CI] 1.3-37.7) for verbal memory decline was seen if right temporal lobe resection (R TLR) had been performed between T1 and T2. The difference between groups remained unchanged when patients who had undergone R TLR were excluded from the analysis, with a remaining aggravated significant decline in verbal memory performance for the study group compared to the reference group. Our results suggest a risk of verbal memory deterioration after the use of depth electrodes along

  9. Theory of mind and the frontal lobes Teoria da mente e lobos frontais

    Directory of Open Access Journals (Sweden)

    Glauco C. Igliori

    2006-06-01

    Full Text Available BACKGROUND: Theory of mind (ToM is the ability to attribute mental states to other individuals. Its cerebral organization is not enough established, even though the literature suggests the relevant role of the frontal lobes. OBEJECTIVE: To evaluate frontal lobe patients and controls in ToM tests. METHOD:We studied 20 patients with lesions limited to the frontal lobes (as shown by CT or MRI, and 10 normal control subjects by means of ToM tests (recognizing himself in mirrors, false belief, first and second order ToM tasks, as well as tests of other cognitive functions (counter-proofs. RESULTS: Patients and controls performed similarly in ToM tests. There was significant difference between frontal subgroups (left, right, bifrontal in the double-bluff task (second order ToM (p=0.021, without relation to verbal fluency (p=0.302 or delayed recall ability (p=0.159. The only two patients with deficits in ToM tasks had impairment of social behavior. CONCLUSION: Frontal lesions do not necessarily implicate in ToM deficits, which may occur when such lesions are associated to disturbance of social behavior.CONTEXTO: Teoria da mente (TM é a capacidade de atribuir estados mentais aos outros. Sua organização cerebral não está suficientemente esclarecida, embora a literatura indique que os lobos frontais desempenham papel relevante. OBEJETIVO: Avaliar pacientes com lesões frontais e controles em testes de TM. MÉTODO: Foram estudados 20 pacientes com lesões restritas aos lobos frontais (conforme imagens de CT ou RM e 10 controles normais em testes de TM (reconhecimento da própria imagem no espelho, falsa crença, TM de 1ª ordem e TM de 2ª ordem, usando como contra-provas testes de outras funções cognitivas. RESULTADOS: Não houve diferença entre pacientes e controles nos testes de TM. Os subgrupos frontais (direito, esquerdo, bilateral diferiram significativamente no teste de "duplo blefe" (TM 2ª ordem (p=0,021, sem relação com a flu

  10. Short parietal lobe connections of the human and monkey brain

    DEFF Research Database (Denmark)

    Catani, Marco; Robertsson, Naianna; Beyh, Ahmad

    2017-01-01

    The parietal lobe has a unique place in the human brain. Anatomically, it is at the crossroad between the frontal, occipital, and temporal lobes, thus providing a middle ground for multimodal sensory integration. Functionally, it supports higher cognitive functions that are characteristic...... intralobar parietal tracts in twenty-one datasets acquired in vivo from healthy human subjects and eleven ex vivo datasets from five vervet and six macaque monkeys. Three regions of interest (postcentral gyrus, superior parietal lobule and inferior parietal lobule) were used to identify the tracts. Surface...... is a vertical pathway between the superior and inferior parietal lobules. This tract can be divided into an anterior (supramarginal gyrus) and a posterior (angular gyrus) component in both humans and monkey brains. The second prominent intraparietal tract connects the postcentral gyrus to both supramarginal...

  11. Amusia After Right Temporoparietal Lobe Infarction: A Case Report.

    Science.gov (United States)

    Yoo, Hyun-Joon; Moon, Hyun Im; Pyun, Sung-Bom

    2016-10-01

    Which brain regions participate in musical processing remains controversial. During singing and listening a familiar song, it is necessary to retrieve information from the long-term memory. However, the precise mechanism involved in musical processing is unclear. Amusia is impaired perception, understanding, or production of music not attributable to disease of the peripheral auditory pathways or motor system. We report a case of a 36-year-old right-handed man who lost the ability to discriminate or reproduce rhythms after a right temporoparietal lobe infarction. We diagnosed him as an amusic patient using the online version of Montreal Battery of Evaluation of Amusia (MBEA). This case report suggests that amusia could appear after right temporoparietal lobe infarction. Further research is needed to elucidate the dynamic musical processing mechanism and its associated neural structures.

  12. [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.

  13. Olfactory Information Processing in the Drosophila Antennal Lobe : Anything Goes?

    OpenAIRE

    Silbering, Ana F.; Okada, Ryuichi; Ito, Kei; Galizia, Cosmas Giovanni

    2008-01-01

    When an animal smells an odor, olfactory sensory neurons generate an activity pattern across olfactory glomeruli of the first sensory neuropil, the insect antennal lobe or the vertebrate olfactory bulb. Here, several networks of local neurons interact with sensory neurons and with output neurons-insect projection neurons, or vertebrate mitral/tufted cells. The extent and form of information processing taking place in these local networks has been subject of controversy. To investigate the ro...

  14. Childhood allergic bronchopulmonary aspergillosis presenting as a middle lobe syndrome

    OpenAIRE

    Shah, Ashok; Gera, Kamal; Panjabi, Chandramani

    2016-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is infrequently documented in children with asthma. Although collapse is not uncommon, middle lobe syndrome (MLS) as a presentation of ABPA is rather a rarity. A 9-year-old female child with asthma presented with increase in intensity of symptoms along with a right midzone patchy consolidation on a chest radiograph. In addition, an ill-defined opacity abutting the right cardiac border with loss of cardiac silhouette was noted. A right lateral vie...

  15. Somnambulism Due to Temporal Lobe Epilepsy - A Case Report

    Directory of Open Access Journals (Sweden)

    Rajesh S

    2004-01-01

    Full Text Available Somnambulism (sleep walking is a disorder of arousal that falls under the parasomnia group. It is more common in children than in adults. (1. The onset of sleep walking in adult life is most unusual and suggests the presence of secondary causes rather than a primary sleep disorder (1. We report a 30-year-old male who presented with repeated episodes of sleep waling possibly due to nocturnal temporal lobe epilepsy.

  16. Frontal Lobe Tuberculoma: A Clinical and Imaging Challenge

    OpenAIRE

    Alemayehu, Tinsae; Ergete, Wondwossen; Abebe, Workeabeba

    2017-01-01

    Background Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs. Conclusion Tuberculosis should be considered in children with a chr...

  17. The secondary lobe as anatomic landmark for different pulmonary diseases

    International Nuclear Information System (INIS)

    Spina, Juan C.; Spina, Juan C. h; Rolnik, Maria C.; Lema, Carlos; Venditi, Julio; Magarinos, Gabriel

    2002-01-01

    The objective of this paper is to present the spectrum of pathological findings in the pulmonary parenchyma, based on the knowledge of the secondary lobe and its components. The evaluation was made using high-resolution computed tomography (HRCT) and compared with the histopathological findings. By definition, the secondary lobe is the small portion of pulmonary tissue separated by septa of connective tissue and supplied by 2-5 or more terminal bronchioles according to their central or peripheral location. Different disorders may become evident as a consequence of : 1) Bronchiolar obstruction (transient or definitive); 2) Intra-alveolar or wall involvement; 3) Involvement of the support tissue; 4) Involvement of the vascular or lymphatic structures. The etiology may be idiopathic, infectious, due to inhalation, neoplastic, allergic, due to collagen diseases, secondary to drug administration and/or post-transplantation. The evaluation of the secondary lobe components, with fine section HRCT, is the dynamic method of choice for the characterisation of pulmonary diseases, and allows to perform earlier and more precise differential diagnoses, when correlated with the clinical findings. The addition of sections during expiration to the routine study is paramount to underscore perfusion disturbances, which may remain undiagnosed during deep inspiration. The goal of this study is to review some of these disorders in which HRCT may be very useful and to correlate our observations with the histopathological findings. (author)

  18. Explicit memory and implicit memory in occipital lobe stroke patients.

    Science.gov (United States)

    Gong, Liang; Wang, JiHua; Feng, Lei; Wang, MeiHong; Li, Xiu; Hu, JiaYun; Wang, Kai

    2015-03-01

    Occipital stroke patients mainly showed cortical blindness and unilateral vision loss; memory is generally reserved. Recent reports from neuroimaging show the occipital lobe may be involved in the processing of implicit memory (IM), especially the perception type of IM processing. In this study, we explored the explicit memory (EM) and IM damage in occipital lobe stroke patients. A total of 25 occipital strokes and 29 years of age, educational level equivalent healthy controls (HCs), evaluated by using immediate recall, delayed recall, recognition for EM tasks, picture identification, and category exemplar generation for IM tasks. There was no significant difference between occipital stroke patients and HCs in EM tasks and category exemplar generation task. In the picture identification task, occipital lobe stroke group score was poorer than HC group, the results were statistically significant, but in the pictures identify rate, occipital stroke patients and normal control group had no significant difference. The occipital stroke patients may have IM damage, primarily damage the perception type of IM priming effects, which was unrelated with their cortical blindness. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. A structural MRI study: gray matter changes in mesial temporal lobe epilepsy patients with different seizure types

    Directory of Open Access Journals (Sweden)

    Jun-hao XIAO

    2018-04-01

    Full Text Available Objective To observe gray matter volume changes and evaluate the relation between gray matter changes and duration of mesial temporal lobe epilepsy (mTLE patients with different seizure types. Methods A total of 40 patients with mTLE, including 20 with partial seizures (mTLE-PS group and 20 with secondarily generalized seizures (mTLE-sGS group, and 20 sex- and age-matched healthy volunteers (control group were recruited. T1-three-dimensional magnetization-prepared rapid gradient echo (T1-3D-MPRAGE was scanned for voxel.based morphometry (VBM. Bilateral frontal lobes and thalami were selected as regions of interest (ROIs to compare gray matter volume of brain regions among 3 groups. Spearman rank correlation analysis was used to evaluate the correlation between gray matter volume of brain regions and duration. Results There were significant differences in gray matter volumes in bilateral superior frontal gyri, right middle frontal gyrus, right medial frontal gyrus, right angular gyrus, right middle temproral gyrus, right hippocampus, bilateral thalami and bilateral cerebellar hemispheres among 3 groups (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral cerebellar hemispheres, right middle temproral gyrus, right hippocampus and right thalamus in mTLE-PS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, bilateral cerebellar hemispheres, right angular gyrus, right middle temporal gyrus and right hippocampus in mTLE-sGS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with mTLE-PS group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, right medial frontal gyrus and right gyrus rectus in mTLE-sGS group were significantly reduced (P < 0.01, for all; FWE correction. Gray matter volumes in left

  20. 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

  1. Rethinking cognition and behavior in the new classification for childhood epilepsy: Examples from frontal lobe and temporal lobe epilepsies.

    Science.gov (United States)

    Smith, Mary Lou

    2016-11-01

    The new approach to classification of the epilepsies emphasizes the role of dysfunction in networks in defining types of epilepsies. This paper reviews the structural and neuropsychological deficits in two types of childhood epilepsy: frontal lobe and temporal lobe epilepsy. The evidence for and against a pattern of specificity of deficits in executive function and memory associated with these two types of epilepsies is presented. The evidence varies with the methodologies used in the studies, but direct comparison of the two types of epilepsies does not suggest a clear-cut mapping of function onto structure. These findings are discussed in light of the concept of network dysfunction. The evidence supports the conceptualization of epilepsy as a network disease. Implications for future work in the neuropsychology of pediatric epilepsy are suggested. This article is part of a Special Issue entitled "The new approach to classification: Rethinking cognition and behavior in epilepsy". Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 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).

  3. Use of the Amplatzer ASD Occluder for Closing a Persistent Left Vertical Vein

    International Nuclear Information System (INIS)

    Zanchetta, Mario; Zennaro, Marco; Zecchel, Roberto; Mancuso, Daniela; Pedon, Luigi

    2009-01-01

    We report the case of a very large anomalous connection of the veins draining the upper lobe of the left lung to both the left-sided vertical vein and the left atrium, associated with mild rheumatic mitral valve stenosis, in which the atrial septum was intact and the remaining venous system, including the coronary sinus, was otherwise normal (a variant of Lutembacher's syndrome). In order to abolish the left-to-right shunting, a transcatheter approach to close this venous structure was successfully attempted using an Amplatzer ASD Occluder device. The technical aspects and the alternative options of performing a procedure with a device for a purpose outside the scope of its approved label are discussed.

  4. 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.

  5. Auras and clinical features in temporal lobe epilepsy: a new approach on the basis of voxel-based morphometry.

    Science.gov (United States)

    Santana, Maria Teresa Castilho Garcia; Jackowski, Andrea Parolin; da Silva, Henrique Hattori; Caboclo, Luis Otávio Sales Ferreira; Centeno, Ricardo Silva; Bressan, Rodrigo A; Carrete, Henrique; Yacubian, Elza Márcia Targas

    2010-05-01

    MRI investigations in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) have demonstrated structural abnormalities extending beyond ipsilateral hippocampus which may be studied through voxel-based morphometry (VBM). We investigated brain morphology related to clinical features in patients with refractory TLE with MTS using VBM. One hundred patients with unilateral TLE with MTS (59 left) and 30 controls were enrolled. VBM5 was employed to analyze (1) hemispheric damage, (2) influence of initial precipitating injury (IPI): 23 patients with febrile seizures and 19 with status epilepticus, and (3) types of auras classified as: mesial, including psychic auras (19 patients); anterior mesio-lateral, as autonomic symptoms, specially epigastric auras (27 patients) and neocortical, which included auditory, vertiginous, somatosensory and visual auras (16 patients). (1) Left TLE patients presented more widespread gray matter volume (GMV) reductions affecting ipsilateral hippocampus, temporal neocortex, insula and also left uncus, precentral gyrus, thalamus, parietal lobule, cuneus and bilateral cingulum. (2) Febrile seizures group presented ipsilateral GMV reductions in hippocampus, neocortical temporal, frontal and occipital cortices, insula and cingulum. Status epilepticus group presented more widespread GMV reductions involving temporal and extratemporal lobes. (3) Patients with mesial auras showed significant ipsilateral GMV reductions in hippocampus and amygdala, particularly right TLE group, who presented greater extension of GMV reduction in the entorhinal cortex. Significant reductions in hippocampus, amygdala and insula were seen in patients with anterior mesio-lateral auras. This study evaluated a large number of TLE-MTS patients showing structural damage extending beyond hippocampus, and different types of IPI associated with the extension of brain damage. Subtypes of auras are related to different clusters of areas of GMV reductions in

  6. [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.

  7. Visuo-spatial memory deficits following medial temporal lobe damage: A comparison of three patient groups.

    Science.gov (United States)

    Esfahani-Bayerl, Nazli; Finke, Carsten; Braun, Mischa; Düzel, Emrah; Heekeren, Hauke R; Holtkamp, Martin; Hasper, Dietrich; Storm, Christian; Ploner, Christoph J

    2016-01-29

    The contributions of the hippocampal formation and adjacent regions of the medial temporal lobe (MTL) to memory are still a matter of debate. It is currently unclear, to what extent discrepancies between previous human lesion studies may have been caused by the choice of distinct patient models of MTL dysfunction, as disorders affecting this region differ in selectivity, laterality and mechanisms of post-lesional compensation. Here, we investigated the performance of three distinct patient groups with lesions to the MTL with a battery of visuo-spatial short-term memory tasks. Thirty-one subjects with either unilateral damage to the MTL (postsurgical lesions following resection of a benign brain tumor, 6 right-sided lesions, 5 left) or bilateral damage (10 post-encephalitic lesions, 10 post-anoxic lesions) performed a series of tasks requiring short-term memory of colors, locations or color-location associations. We have shown previously that performance in the association task critically depends on hippocampal integrity. Patients with postsurgical damage of the MTL showed deficient performance in the association task, but performed normally in color and location tasks. Patients with left-sided lesions were almost as impaired as patients with right-sided lesions. Patients with bilateral post-encephalitic lesions showed comparable damage to MTL sub-regions and performed similarly to patients with postsurgical lesions in the association task. However, post-encephalitic patients showed additional impairments in the non-associative color and location tasks. A strikingly similar pattern of deficits was observed in post-anoxic patients. These results suggest a distinct cerebral organization of associative and non-associative short-term memory that was differentially affected in the three patient groups. Thus, while all patient groups may provide appropriate models of medial temporal lobe dysfunction in associative visuo-spatial short-term memory, additional deficits in

  8. Emotional stimuli-provoked seizures potentially misdiagnosed as psychogenic non-epileptic attacks: A case of temporal lobe epilepsy with amygdala enlargement

    Directory of Open Access Journals (Sweden)

    Hidetaka Tamune

    Full Text Available The association between emotional stimuli and temporal lobe epilepsy (TLE is largely unknown. Here, we report the case of a depressed, 50-year-old female complaining of episodes of a “spaced out” experience precipitated by emotional stimuli. Psychogenic non-epileptic attacks were suspected. However, video-EEG coupled with emotional stimuli-provoked procedures and MRI findings of amygdala enlargement, led to the diagnosis of left TLE. Accurate diagnosis and explanation improved her subjective depression and seizure frequency. This case demonstrated that emotional stimuli can provoke seizures in TLE and suggested the involvement of the enlarged amygdala and the modulation of emotion-related neural circuits. Keywords: Video-EEG, Psychogenic non-epileptic attacks, Temporal lobe epilepsy, Amygdala enlargement, Reflex seizure, Provoked seizure

  9. Temporal lobe and inferior frontal gyrus dysfunction in patients with schizophrenia during face-to-face conversation: a near-infrared spectroscopy study.

    Science.gov (United States)

    Takei, Yuichi; Suda, Masashi; Aoyama, Yoshiyuki; Yamaguchi, Miho; Sakurai, Noriko; Narita, Kosuke; Fukuda, Masato; Mikuni, Masahiko

    2013-11-01

    Schizophrenia (SC) is marked by poor social-role performance and social-skill deficits that are well reflected in daily conversation. Although the mechanism underlying these impairments has been investigated by functional neuroimaging, technical limitations have prevented the investigation of brain activation during conversation in typical clinical situations. To fill this research gap, this study investigated and compared frontal and temporal lobe activation in patients with SC during face-to-face conversation. Frontal and temporal lobe activation in 29 patients and 31 normal controls (NC) (n = 60) were measured during 180-s conversation periods by using near-infrared spectroscopy (NIRS). The grand average values of oxyhemoglobin concentration ([oxy-Hb]) changes during task performance were analyzed to determine their correlation with clinical variables and Positive and Negative Syndrome Scale (PANSS) subscores. Compared to NCs, patients with SC exhibited decreased performance in the conversation task and decreased activation in both the temporal lobes and the right inferior frontal gyrus (IFG) during task performance, as indicated by the grand average of [oxy-Hb] changes. The decreased activation in the left temporal lobe was negatively correlated with the PANSS disorganization and negative symptoms subscores and that in the right IFG was negatively correlated with illness duration, PANSS disorganization, and negative symptom subscores. These findings indicate that brain dysfunction in SC during conversation is related to functional deficits in both the temporal lobes and the right IFG and manifests primarily in the form of disorganized thinking and negative symptomatology. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Insular epilepsy: similarities to temporal lobe epilepsy case report Epilepsia insular: similaridades à epilepsia do lobo temporal - relato de caso

    Directory of Open Access Journals (Sweden)

    ARTHUR CUKIERT

    1998-03-01

    Full Text Available Insular epilepsy has been rarely reported and its clinical and el