The Relationship Between Duration of Postrotary Nystagmus and Driver Behavior: Learning Theory Module.

Science.gov (United States)

Geier, Suzanne Smith; Young, Barbara

It was hypothesized that behavior patterns, learned early in life and maintained by almost continuous reinforcement, are determined by basic physiology, which in this study is represented by the duration of postrotary nystagmus (involuntary eyeball movement following rotational stimulation). The Southern California Postrotary Nystagmus Test was…

Congenital nystagmus and negative electroretinography

Directory of Open Access Journals (Sweden)

Roussi M

2011-04-01

Full Text Available Mirella Roussi, Hélène Dalens, Jean Jacques Marcellier, Franck BacinDepartment of Ophthalmology, Clermont-Ferrand University, Clermont-Ferrand, FranceAbstract: Congenital nystagmus is a pathologic oculomotor state appearing at about three to four months of age. The precise diagnosis requires detailed clinical examination and electrophysiological findings. This case report presents two male patients with congenital nystagmus examined longitudinally from the age of six months until 17-18 years of age. Clinical and electrophysiological protocols were detailed. The first results showed electronegative electroretinography in the two cases and examination combined with electroretinographic findings helped us to make the diagnosis of Congenital Night Stationary Blindness (CSNB. This diagnosis was confirmed by genetic studies. CSNB is interesting to study because through electrophysiological findings, it enables a better understanding of the physiology of neural transmission in the outer part of the retina.Keywords: Congenital nystagmus, negative electroretinography, congenital night stationary blindness

Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating nystagmus.

Science.gov (United States)

Lopez-Escamez, Jose A; Molina, Maria I; Gamiz, Maria J

2006-01-01

The aim of this study was to describe the clinical features and video-oculographic findings in patients with anterior semicircular canal benign paroxysmal positional vertigo (BPPV). This is a prospective case series. The study was set at an outpatient clinic in a general hospital. Fourteen individuals with symptoms of BPPV and positional downbeating nystagmus (pDBN) were included in the study. The diagnosis was based on a history of brief episodes of vertigo and the presence of pDBN confirmed in the video-oculographic examination during Dix-Hallpike test (DH) or head-hanging maneuver. Patients were treated by particle repositioning maneuver and the effectiveness was evaluated at 7, 30, and 180 days posttreatment. The treatment was repeated up to 4 times if pDBN was persistent. The main outcome measure is the number of patients without pDBN at 30 and 180 days. Video-oculography showed a predominant pDBN in response to DH. Of the 14 patients, 7 had arterial hypertension, and 5 of 14 cases presented abnormalities on the caloric test. Horizontal spontaneous nystagmus was found in 3 of 14 individuals. Positional nystagmus at different positional test was observed in 5 of 14 individuals, suggesting the involvement of several canals. Of the 14 patients, 10 (71%) did not present vertigo, and the positional tests were negative at 30 days. However, 3 cases presented a positive DH with persistence of BPPV episodes and pDBN at 30 days, and another developed a contralateral posterior canal affectation. One of the patients maintained a persistent pDBN at 180 days despite the repeated maneuvers. Video-oculography demonstrates that anterior canal BPPV is characterized by a predominant downbeating nystagmus in response to DH. These individuals may show alterations in the vestibular caloric, and they can have multicanal affectation.

Horizontal nystagmus and multiple sclerosis using 3-Tesla magnetic resonance imaging.

Science.gov (United States)

Iyer, P M; Fagan, A J; Meaney, J F; Colgan, N C; Meredith, S D; Driscoll, D O; Curran, K M; Bradley, D; Redmond, J

2016-11-01

Nystagmus in patients with multiple sclerosis (MS) is generally attributed to brainstem disease. Lesions in other regions may result in nystagmus. The identification of these other sites is enhanced by using 3-Tesla magnetic resonance imaging (3TMRI) due to increased signal-to-noise ratio. We sought to evaluate the distribution of structural lesions and disruption of tracts in patients with horizontal nystagmus secondary to MS using 3TMRI. Twenty-four patients (20 women, 4 men; age range 26-55 years) with horizontal nystagmus secondary to MS underwent 3TMRI brain scans; and 18 patients had diffusion tensor imaging (DTI) for tractography. Nystagmus was bidirectional in 11, right-sided in 6 and left-sided in 7. We identified 194 lesions in 20 regions within the neural integrator circuit in 24 patients; 140 were within the cortex and 54 were within the brainstem. Only two patients had no lesions in the cortex, and 9 had no lesions in the brainstem. There was no relationship between side of lesion and direction of nystagmus. Thirteen of 18 (72 %) had tract disruption with fractional anisotropy (FA) values below 0.2. FA was significantly lower in bidirectional compared to unidirectional nystagmus (p = 0.006). In MS patients with horizontal nystagmus, lesions in all cortical eye fields and their descending connections were evident. Technical improvements in tractography may help identify the specific site(s) resulting in nystagmus in MS.

Magnetic Oculomotor Prosthetics for Acquired Nystagmus.

Science.gov (United States)

Nachev, Parashkev; Rose, Geoff E; Verity, David H; Manohar, Sanjay G; MacKenzie, Kelly; Adams, Gill; Theodorou, Maria; Pankhurst, Quentin A; Kennard, Christopher

2017-10-01

Acquired nystagmus, a highly symptomatic consequence of damage to the substrates of oculomotor control, often is resistant to pharmacotherapy. Although heterogeneous in its neural cause, its expression is unified at the effector-the eye muscles themselves-where physical damping of the oscillation offers an alternative approach. Because direct surgical fixation would immobilize the globe, action at a distance is required to damp the oscillation at the point of fixation, allowing unhindered gaze shifts at other times. Implementing this idea magnetically, herein we describe the successful implantation of a novel magnetic oculomotor prosthesis in a patient. Case report of a pilot, experimental intervention. A 49-year-old man with longstanding, medication-resistant, upbeat nystagmus resulting from a paraneoplastic syndrome caused by stage 2A, grade I, nodular sclerosing Hodgkin's lymphoma. We designed a 2-part, titanium-encased, rare-earth magnet oculomotor prosthesis, powered to damp nystagmus without interfering with the larger forces involved in saccades. Its damping effects were confirmed when applied externally. We proceeded to implant the device in the patient, comparing visual functions and high-resolution oculography before and after implantation and monitoring the patient for more than 4 years after surgery. We recorded Snellen visual acuity before and after intervention, as well as the amplitude, drift velocity, frequency, and intensity of the nystagmus in each eye. The patient reported a clinically significant improvement of 1 line of Snellen acuity (from 6/9 bilaterally to 6/6 on the left and 6/5-2 on the right), reflecting an objectively measured reduction in the amplitude, drift velocity, frequency, and intensity of the nystagmus. These improvements were maintained throughout a follow-up of 4 years and enabled him to return to paid employment. This work opens a new field of implantable therapeutic devices-oculomotor prosthetics-designed to modify eye

Staff and patient accounts of PRN medication administration and non-pharmacological interventions for anxiety.

Science.gov (United States)

Martin, Krystle; Ham, Elke; Hilton, N Zoe

2018-05-31

Most psychiatric inpatients will receive psychotropic PRN medication during their hospital stay for agitation, anxiety, and/or insomnia. While helpful in some cases, caution is warranted with regard to PRN use due to inherent risks of additional medication; therefore, experts advise that non-pharmacological interventions should be attempted first where indicated. However, research to date highlights that, in practice, non-pharmaceutical approaches are attempted in a minority of cases. While some information is known about the practice of PRN administration and the use of and barriers to implementing non-pharmacological interventions for treating acute psychiatric symptoms, full understanding of this practice is hampered by poor or altogether missing documentation of the process. This study used interviews with patients and staff from two psychiatric hospitals to collect first-person accounts of administering PRN medication for anxiety, thereby addressing the limitations of relying on documented notation found in previous research. Our results indicate that nurses are engaging in non-pharmacological interventions more often than had previously been captured in research. However, the types of strategies suggested are not typically evidence based and further, only happening approximately half the time. The barriers to providing such care are centred on two main beliefs about client choice and efficacy of these non-medical strategies. Implications for research and practice are discussed. © 2018 Australian College of Mental Health Nurses Inc.

Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

Science.gov (United States)

Martin, Krystle; Ham, Elke; Hilton, Zoe

2018-05-12

To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is

The impact of a good practice manual on professional practice associated with psychotropic PRN in acute mental health wards: an exploratory study.

Science.gov (United States)

Baker, J A; Lovell, K; Harris, N

2008-10-01

As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. The study used a pre-post exploratory design with two acute mental health wards in the NW of England. Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.

Nystagmus-based approach to vertebrobasilar stroke presenting as vertigo without initial neurologic signs.

Science.gov (United States)

Kim, Min-Beom; Boo, Sung Hyun; Ban, Jae Ho

2013-01-01

We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. Stroke occurred in the cerebellum (n=18, 78%), medulla (n=4, 17%), and pons (n=1, 4%). In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. Copyright © 2013 S. Karger AG, Basel.

Functional characterization of the origin of replication of pRN1 from Sulfolobus islandicus REN1H1.

Directory of Open Access Journals (Sweden)

Chijioke J Joshua

Full Text Available Plasmid pRN1 from Sulfolobus islandicus REN1H1 is believed to replicate by a rolling circle mechanism but its origin and mechanism of replication are not well understood. We sought to create minimal expression vectors based on pRN1 that would be useful for heterologous gene expression in S. acidocaldarius, and in the process improve our understanding of the mechanism of replication. We constructed and transformed shuttle vectors that harbored different contiguous stretches of DNA from pRN1 into S. acidocaldarius E4-39, a uracil auxotroph. A 232-bp region 3' of orf904 was found to be critical for pRN1 replication and is therefore proposed to be the putative origin of replication. This 232-bp region contains a 100-bp stem-loop structure believed to be the double-strand origin of replication. The loop of the 100-bp structure contains a GTG tri-nucleotide motif, a feature that was previously reported to be important for the primase activity of Orf904. This putative origin and the associated orf56 and orf904 were identified as the minimal replicon of pRN1 because transformants of plasmids lacking any of these three features were not recovered. Plasmids lacking orf904 and orf56 but harboring the putative origin were transformable when orf904 and orf56 were provided in-trans; a 75-bp region 5' of the orf904 start codon was found to be essential for this complementation. Detailed knowledge of the pRN1 origin of replication will broaden the application of the plasmid as a genetic tool for Sulfolobus species.

Finger extension weakness and downbeat nystagmus motor neuron disease syndrome: A novel motor neuron disorder?

Science.gov (United States)

Delva, Aline; Thakore, Nimish; Pioro, Erik P; Poesen, Koen; Saunders-Pullman, Rachel; Meijer, Inge A; Rucker, Janet C; Kissel, John T; Van Damme, Philip

2017-12-01

Disturbances of eye movements are infrequently encountered in motor neuron diseases (MNDs) or motor neuropathies, and there is no known syndrome that combines progressive muscle weakness with downbeat nystagmus. To describe the core clinical features of a syndrome of MND associated with downbeat nystagmus, clinical features were collected from 6 patients. All patients had slowly progressive muscle weakness and wasting in combination with downbeat nystagmus, which was clinically most obvious in downward and lateral gaze. Onset was in the second to fourth decade with finger extension weakness, progressing to other distal and sometimes more proximal muscles. Visual complaints were not always present. Electrodiagnostic testing showed signs of regional motor axonal loss in all patients. The etiology of this syndrome remains elusive. Because finger extension weakness and downbeat nystagmus are the discriminating clinical features of this MND, we propose the name FEWDON-MND syndrome. Muscle Nerve 56: 1164-1168, 2017. © 2017 The Authors Muscle & Nerve Published by Wiley Periodicals, Inc.

Adult Periodic Alternating Nystagmus Masked by Involuntary Head Movements

Directory of Open Access Journals (Sweden)

Diego Kaski

2018-05-01

Full Text Available Acquired periodic alternating nystagmus (PAN describes a horizontal jerk nystagmus that reverses its direction with a predictable cycle, and is thought to arise from lesions involving the brainstem and cerebellum. We report a 20-year-old patient with PAN who presented with an acute vertiginous episode and developed an involuntary head movement that initially masked the PAN. The involuntary head movements were abolished with a subtherapeutic dose of botulinum toxin to the neck muscles. We propose that the head movements initially developed as a compensatory movement to the nystagmus, to maintain visual fixation in the presence of the underlying nystagmus, and became an entrained involuntary behavior. This case highlights the importance of disambiguating psychogenic from organic pathology as this may have clinical therapeutic implications, in this case resolution of the most disabling symptom which was her head oscillations, leading to improved day-to-day function despite PAN.

The interpretation of static positional nystagmus in a balance clinic.

Science.gov (United States)

Jeffery, Hanna; Hopkins, Matthew; Anderson, Rebecca; Patel, Vignapti; Rogers, Jennifer

2017-12-01

To review the current criteria for the interpretation of positional nystagmus (PN). Videonystagmography data on PN was collected for 90 patients presenting for balance testing with a history of vertigo or imbalance (excluding those diagnosed with benign paroxysmal positional vertigo). These were compared to normative data from 90 asymptomatic subjects. A literature review was carried out regarding threshold criteria for clinically significant PN. These were evaluated using the data collected. Clinic group: 90 patients; 37 male, 53 female. Age range 15-82 years. Normative group: Ninety subjects; 31 male, 59 female. Age range 21-79 years. PN was seen in 75.6% of the clinic group and in 50% of the normative group. The prevalence of nystagmus of slow phase velocity (SPV) > 3°/s was significantly higher in the clinic group than the normative group. The maximum SPV recorded in each position was greater from the clinic group than the normative group. This study supports the use of normative thresholds for SPV for both horizontal and vertical PN. A normative threshold of >3°/s for horizontal and >7°/s for vertical nystagmus is proposed.

Brain lesions in congenital nystagmus as detected by computed tomography

International Nuclear Information System (INIS)

Lo, Chin-Ying

1982-01-01

Computed tomography (CT) was performed in a series of 60 cases with congenital nystagmus. The type of nystagmus was pendular in 20 and jerky in 40 cases. The age ranged from 3 months to 13 years. Abnormal CT findings of the central nervous system were detected in 31 cases (52%). There were 5 major CT findings: midline anomalies, cortical atrophy, ventricular dilatation, brain stem atrophy and low density area. The midline anomalies involved cavum septi pellucidi, cavum Vergae, cavum veli interpositi and partial agenesis of corpus callosum. The abnormal CT findings were more prominent in pendular type than in jerky type. The incidence of congenital nystagmus and positive CT findings were the same in the first and the second birth. There was a history of abnormalities during the prenatal or perinatal period in 28 out of the 60 cases (47%). This feature seemed to play a significant role in the occurrence of congenital nystagmus. The observed organic lesions in the central nervous system by CT would contribute to the elucidation of pathomechanism of congenital nystagmus. (author)

[Skull vibratory test in partial vestibular lesions--influence of the stimulus frequency on the nystagmus direction].

Science.gov (United States)

Dumas, G; Perrin, P; Morel, N; N'Guyen, D Q; Schmerber, S

2005-01-01

Results of the skull vibratory test (SVT) in partial unilateral vestibular peripheral lesions (PUVL) are different from the results in total vestibular lesions (TUVL). To reveal a correlation between the results of the analysis of the skull vibratory nystagmus (SVN) horizontal component and the side of the lesion; to correlate these results with the stimulus frequency. To find out a predictive correlation between the SVN horizontal and vertical components and the topography of a vestibular lesion. To appreciate the degree of vestibular deafferentation (extended to high frequencies) provoked by gentamicin labyrinthectomy and its efficiency in Meniere's disease. 53 patients with a SVN and a PUVL were included and compared with 10 TUVL and 10 normal subjects. Protocol included a HST (2 Hz), a SVT at 30, 60 and 100 Hz and a caloric test. Recordings were performed with a 2D and 3D VNG device. In PUVL, SVN at 30, 60 and 100 Hz was obtained in 80, 90 and 90% of cases respectively. SVN is correlated with the side of the lesion at 30, 60 and 100 Hz respectively in 65%, 63%, 80% of cases. SVN is not correlated with the side of the lesion in 20% of Meniere's disease, in 8% of vestibular neuritis and in 6% of vestibular schwannoma. In PUVL HSN is correlated with the side of the lesion in 69% of cases. The direction of the HSN and of the SVN was different in 23% when the nystagmus attended at the same time for both tests. In PUVL the direction of the SVN is different at 100 Hz and 30 Hz in 16% of cases when they are concomittant on the same patient. After Gentamicine labyrinthectomy, the coherence of the results in caloric test, HSN and SVN (areflexy and lesional nystagmus beating toward the safe side) was correlated with the efficiency of the therapy. A SVN vertical component was met in 10% of PUVL (essentially in anterior canal dehiscence and few cases of partial labyrinthitis). The horizontal SVN SPV is significantly slower in PUVL than in TUVL patients (p=0.0004). The SVT

Persistent positional nystagmus: a case of superior semicircular canal benign paroxysmal positional vertigo?

Science.gov (United States)

Heidenreich, Katherine D; Kerber, Kevin A; Carender, Wendy J; Basura, Gregory J; Telian, Steven A

2011-08-01

Involvement of the superior semicircular canal (SSC) in benign paroxysmal positional vertigo (BPPV) is rare. SSC BPPV is distinguished from the more common posterior semicircular canal (PSC) variant by the pattern of nystagmus triggered by the Dix-Hallpike position: down-beating torsional nystagmus in SSC BPPV versus up-beating torsional nystagmus in PSC BPPV. SSC BPPV may be readily treated at the bedside, which is a key component in excluding central causes of down-beating nystagmus. We present an unusual video case report believed to represent refractory SSC BPPV based on the pattern of nystagmus and the absence of any other central signs. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Spontaneous nystagmus in benign paroxysmal positional vertigo: is it a new sign?

Science.gov (United States)

Hajiabolhassan, Fahimeh; Tavanai, Elham

2013-01-01

Benign Paroxysmal Positional Vertigo (BPPV) is a condition that indicates a benign inner ear disorder. It is generally believed that BPPV is due to the dislodged otoconial particles from otolith organs and unusual collection of them within any of semicircular canals or even in all three semicircular canals. Although the typical features of nystagmus in BPPV have been well-studied, very few studies (just four articles) have highlighted the presence of spontaneous nystagmus in BPPV recently. During the past 10 years, 2850 patients have been examined at the audiology unit of our department, and 254 patients have received diagnoses of BPPV but recently 2 patients presented with BPPV and spontaneous nystagmus, a new symptom that has been never observed in our clinical records. We herein describe this rare symptom in 2 case of BPPV. A 50-year-old woman with BPPV who showed an 18 degree spontaneous nystagmus treated with Epley maneuver and a 53-year-old man with 3 degree spontaneous nystagmus.

Influence of head posture on the visual acuity of children with nystagmus

Directory of Open Access Journals (Sweden)

Ana Carla Ramos Vieira da Costa

2014-01-01

Full Text Available Purpose: Evaluate the relationship between the postural alignment of the head and possible interference in the view of children. Methods: We evaluated 11 children between 2 and 7 years of age of both sexes, with the visually impaired, who had nystagmus and head lock position. The test Lea Grating Acuity Test® was used to collect measurements of visual acuity. This applied on two occasions: with and without postural alignment of the head. For reliability of the postural alignment of the head, the slopes were measured by Fisiologic® software. Results: The children had a poorer performance after physiological postural alignment. This poor performance is possible due to loss of position lock nystagmus to gain postural alignment, said to be ideal. Postural compensations were observed, and sharply increased eyestrain. Conclusion: The pursuit of traditional postural alignment affect the visual response of children with visual impairments.

Infantile nystagmus and visual deprivation

DEFF Research Database (Denmark)

Fledelius, Hans C; Jensen, Hanne

2014-01-01

PURPOSE: To evaluate whether effects of early foveal motor instability due to infantile nystagmus might compare to those of experimental visual deprivation on refraction in a childhood series. METHODS: This was a retrospective analysis of data from the Danish Register for Blind and Weaksighted Ch...

Strabismus and Nystagmus Following Cataract Surgeries in Childhood

Directory of Open Access Journals (Sweden)

Ayşe Yeşim Oral

2012-03-01

Full Text Available Pur po se: To evaluate the incidence of strabismus in pediatric cataracts and the effects of strabismus and nystagmus accompanied by cataract on postoperative visual acuity. Ma te ri als and Met hod: Seventy-four eyes of 45 patients under 15 years old who had undergone cataract operation were included in this study. The mean postoperative follow-up period was 1.57±2.25 years (ranged between 3 months and 9 years. Twenty-nine of the patients (64% had bilateral and 16 of the patients (36% had unilateral cataract. Preoperative and postoperative visual acuities, as well as the presence of nystagmus and strabismus were recorded. Re sults: Seventeen of the patients (38% had strabismus: 9 of them (53% had esotropia (ET, and 8 of them had (47% exotropia (XT. Fourteen (19% of the total number of cases had nystagmus. The mean age was 5.8±4.4 years for the total group of patients, 4.6±3.0 years for patients with strabismus and 5.1±3.7 years for patients with nystagmus. Visual acuity measurements were not possible in 26 uncooperative patients. The visual acuity was 0.3 logMAR and over in 15 (31% and 1.0 logMAR and under in 12 (25% of the remaining of 48 eyes. Of a total of 28 eyes with strabismus, we were unable to measure visual acuity in 10 patients, and the visual acuities were 0.3 logMAR and over in 7 (39% and 1.0 logMAR and under in 5 (28% of the rest of the 18 patients. The mean visual acuity was significantly lower in the 8 of 14 patients with nystagmus whose visual acuity could be measured (1.25±0.45 logMAR than in both the patients without strabismus (0.44±0.59 logMAR and the patients with strabismus (0.66±0.56 logMAR (p=0.019 and p=0.015, respectively. Dis cus si on: Although strabismus is seen more often in childhood cataracts compared to general population, the presence of strabismus has no negative effect on visual acuity after cataract surgery, while nystagmus is the main factor limiting the visual outcome. (Turk J Ophthalmol 2012; 42

Low Vision Management For Infantile Nystagmus: A Case Study

OpenAIRE

Alexandra Troy, OD; Sara Appel, OD

2015-01-01

Background: Infantile nystagmus is a common cause of visual impairment. It can occur in isolation, but it is often found in association with other conditions, such as albinism. The condition results in varying levels of vision impairments ranging from mild to severe. Characteristics include early onset, bilateral involvement, pendular and jerk waveforms, the presence of a null point, and the lack of optokinetic nystagmus and oscillopsia (environment moving). This article provides a review of...

Monocular and binocular development in children with albinism, infantile nystagmus syndrome, and normal vision.

Science.gov (United States)

Huurneman, Bianca; Boonstra, F Nienke

2013-12-01

To compare interocular acuity differences, crowding ratios, and binocular summation ratios in 4- to 8-year-old children with albinism (n = 16), children with infantile nystagmus syndrome (n = 10), and children with normal vision (n = 72). Interocular acuity differences and binocular summation ratios were compared between groups. Crowding ratios were calculated by dividing the single Landolt C decimal acuity with the crowded Landolt C decimal acuity mono- and binocularly. A linear regression analysis was conducted to investigate the contribution of 5 predictors to the monocular and binocular crowding ratio: nystagmus amplitude, nystagmus frequency, strabismus, astigmatism, and anisometropia. Crowding ratios were higher under mono- and binocular viewing conditions for children with infantile nystagmus syndrome than for children with normal vision. Children with albinism showed higher crowding ratios in their poorer eye and under binocular viewing conditions than children with normal vision. Children with albinism and children with infantile nystagmus syndrome showed larger interocular acuity differences than children with normal vision (0.1 logMAR in our clinical groups and 0.0 logMAR in children with normal vision). Binocular summation ratios did not differ between groups. Strabismus and nystagmus amplitude predicted the crowding ratio in the poorer eye (p = 0.015 and p = 0.005, respectively). The crowding ratio in the better eye showed a marginally significant relation with nystagmus frequency and depth of anisometropia (p = 0.082 and p = 0.070, respectively). The binocular crowding ratio was not predicted by any of the variables. Children with albinism and children with infantile nystagmus syndrome show larger interocular acuity differences than children with normal vision. Strabismus and nystagmus amplitude are significant predictors of the crowding ratio in the poorer eye.

Effects of Sustained Otolith-Only Stimulation on Post-Rotational Nystagmus.

Science.gov (United States)

Shaikh, Aasef G; Solomon, David

2017-06-01

Constant velocity rotations in darkness evoke vestibulo-ocular reflex in form of pre- and post-rotational nystagmus under cerebellar supervision. Reorientation of the head with respect to gravity, stimulating otolith and semicircular canal, during post-rotational phase rapidly suppresses the post-rotational nystagmus. We asked if pure otolith stimulation without semicircular canal signal is sufficient for the suppression of post-rotational nystagmus. The experimental paradigm comprised of on-axis rotations in the horizontal plane when the subject was sitting upright, followed by a novel stimulus that combined off-axis centrifugation in the horizontal plane with amplitude matched, yet out-of-phase, on-axis horizontal rotation-double centrifugation. The resultant effect of double centrifugation was pure otolith stimulation that constantly changed direction, yet completely canceled out angular velocity (no horizontal semicircular canal stimulation). Double centrifugation without pre-existing on-axis rotations evoked mixture of horizontal and vertical eye movements, latter reflected the known uncertainty of the vestibular system to differentiate whether the sensory signal is related to low-frequency translations in horizontal plane or head tilts relative to the gravity. Double centrifugation during post-rotational phase suppressed the peak slow phase eye velocity of the post-rotational nystagmus, hence affecting the vestibular ocular reflex gain (eye velocity/head velocity) matrix. The decay time constant, however, was unchanged. Amount of suppression of the peak slow phase eye velocity of the post-rotational nystagmus during double centrifugation correlated with the peak vertical eye velocity evoked by the pure otolith stimuli in the absence of pre-existing on axis rotations. In post-rotational phase, the pure otolith signal affects vestibular ocular reflex gain matrix but does not affect the time constant.

Influence of spontaneous nystagmus with eyes closed on computerized vestibular exam of patients with chronic peripheral

Directory of Open Access Journals (Sweden)

Shin, Elizabeth

2010-06-01

Full Text Available Introduction: The spontaneous nystagmus with eyes closed (NEOF can modify the results obtained during some evidence of vestibular, leading to erroneous conclusions. Objective: To characterize the patients and the type of influence on the evidence of NEOF vectonystagmography digital. Method: Retrospective study based on survey charts of patients with the presence of NEOF vectonystagmography digital, in the Outpatient Equilibriometria UNIFESP-EPM, in the years 2000 to 2007. Comparisons were made between genders, ages, direction, angular velocity of NEOF, completion of entrance examination and its influence on the results of caloric testing. Results: We found 73.7% of the population was female, mean age of 55.08 years; NEOF prevalence of horizontal and angular velocity smaller than 7o/s in 86.7%. 59% had some kind of influence caused by the caloric test NEOF as inversion, hyporeflexia, hyperreflexia, nystagmus directional preponderance (NDP and labyrinthine preponderance (LP changed. The most prevalent findings were normal vestibular tests (EVN and bilateral irritative peripheral vestibular syndrome (BIPVS. 38.7% caloric ice and realized these cases it was possible to reach a conclusion in 79%. Conclusion: The NEOF most common was the horizontal type, with VACL less than 7o/s, influencing the majority of examinations and only the results of caloric testing the air, with reversal of post-caloric nystagmus, hyperreflexia and hyporeflexia, NDP and PL altered; the findings were more prevalent and BIPVS EVN, and the caloric test the influence of ice withdrew NEOF in most individuals, enabling to reach a final conclusion.

Effect of Gabapentin/Memantine on the Infantile Nystagmus Syndrome in the Zebrafish Model: Implications for the Therapy of Ocular Motor Diseases.

Science.gov (United States)

Bögli, Stefan Yu; Afthinos, Maresa; Huang, Melody Ying-Yu

2017-06-01

Infantile nystagmus syndrome (INS) is a disorder characterized by typical horizontal eye oscillations. Due to the uncertain etiology of INS, developing specific treatments remains difficult. Single reports demonstrated, on limited measures, alleviating effects of gabapentin and memantine. In the current study, we employed the zebrafish INS model belladonna (bel) to conduct an in-depth study of how gabapentin and memantine interventions alleviate INS signs, which may further restore visual conditions in affected subjects. Moreover, we described the influence of both medications on ocular motor functions in healthy zebrafish, evaluating possible iatrogenic effects. Ocular motor function and INS characteristics were assessed by eliciting optokinetic response, spontaneous nystagmus, and spontaneous saccades in light and in dark, in 5- to 6-day postfertilization bel larvae and heterozygous siblings. Single larvae were recorded before and after a 1-hour drug treatment (200 mM gabapentin/0.2 mM memantine). Both interventions significantly reduced nystagmus intensity (gabapentin: 59.98%, memantine: 39.59%). However, while the application of gabapentin affected all tested ocular motor functions, memantine specifically reduced nystagmus amplitude and intensity, and thus left controls completely unaffected. Finally, both drug treatments resulted in specific changes in nystagmus waveform and velocity. Our study provides deeper insight into gabapentin and memantine treatment effect in the zebrafish INS model. Moreover, this study should establish zebrafish as a pharmacologic animal model for treating nystagmus and ocular motor disease, serving as a basis for future large-scale drug screenings.

Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

Directory of Open Access Journals (Sweden)

Kosuke Matsuzono

2014-04-01

Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

Gravity-dependent nystagmus and inner-ear dysfunction suggest anterior and posterior inferior cerebellar artery infarct.

Science.gov (United States)

Shaikh, Aasef G; Miller, Benjamin R; Sundararajan, Sophia; Katirji, Bashar

2014-04-01

Cerebellar lesions may present with gravity-dependent nystagmus, where the direction and velocity of the drifts change with alterations in head position. Two patients had acute onset of hearing loss, vertigo, oscillopsia, nausea, and vomiting. Examination revealed gravity-dependent nystagmus, unilateral hypoactive vestibulo-ocular reflex (VOR), and hearing loss ipsilateral to the VOR hypofunction. Traditionally, the hypoactive VOR and hearing loss suggest inner-ear dysfunction. Vertigo, nausea, vomiting, and nystagmus may suggest peripheral or central vestibulopathy. The gravity-dependent modulation of nystagmus, however, localizes to the posterior cerebellar vermis. Magnetic resonance imaging in our patients revealed acute cerebellar infarct affecting posterior cerebellar vermis, in the vascular distribution of the posterior inferior cerebellar artery (PICA). This lesion explains the gravity-dependent nystagmus, nausea, and vomiting. Acute onset of unilateral hearing loss and VOR hypofunction could be the manifestation of inner-ear ischemic injury secondary to the anterior inferior cerebellar artery (AICA) compromise. In cases of combined AICA and PICA infarction, the symptoms of peripheral vestibulopathy might masquerade the central vestibular syndrome and harbor a cerebellar stroke. However, the gravity-dependent nystagmus allows prompt identification of acute cerebellar infarct. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Do nistagmo às provas calóricas com ar e com água From nystagmus to the air and water caloric tests

Directory of Open Access Journals (Sweden)

Anna Carolina Marques Perrella de Barros

2012-08-01

Full Text Available A prova calórica é uma importante ferramenta na avaliação da função labiríntica. OBJETIVO: Comparar o nistagmo pós-calórico da prova com ar a 50ºC e 24ºC com o da prova com água a 44ºC e 30ºC. Desenho científico: Estudo clínico cruzado randomizado. MATERIAL E MÉTODO: 40 indivíduos hígidos submetidos à avaliação da função vestibular incluindo a prova calórica com ar a 50ºC e 24ºC e com água a 44ºC e 30ºC. RESULTADOS: À comparação das provas com ar e com água, não houve diferença significante entre os valores da velocidade angular da componente lenta (VACL do nistagmo pós-calórico quanto à ordem de realização das estimulações, entre as orelhas e entre os valores de predomínio labiríntico e de preponderância direcional. Os valores da VACL foram maiores nas estimulações com água (p = 0,008; p The caloric test is an important tool for the assessment of labyrinthine function. OBJECTIVE: To compare the nystagmus response in the caloric tests with air at 50ºC and 24ºC and with water at 44ºC and 30ºC. Study Design: Randomized crossover clinical trial. MATERIALS AND METHODS: 40 healthy individuals were submitted to a neurotological evaluation, including caloric tests with air at 50ºC and 24ºC and water at 44ºC and 30ºC. RESULTS: Comparing the air and water caloric tests, there were no significant differences among the post-caloric nystagmus slow-phase velocity in relation to the stimulation order, between ears and between the values of unilateral weakness and directional preponderance. The slow-phase velocity values were higher with water (p = 0.008, p < 0.001, and cold stimulation produced stronger responses (p < 0.001. CONCLUSION: Comparing 50ºC and 24ºC air caloric test and 44ºC and 30ºC water caloric test, we observed similar slow-phase velocity values for both ears, higher responses in the cold temperature and in the test with water, and similar results of unilateral weakness or directional

[The exploration on optimization of two alternatives between roll test and Dix-Hallpike test in benign paroxysmal positional vertigo].

Science.gov (United States)

Ji, R; Chen, T S; Wang, W; Xu, K X; Li, S S; Wen, C; Liu, Q; Lin, P

2017-06-07

Objective: To analyze the objective characteristics of roll test and Dix-Hallpike test in benign paroxysmal positional vertigo(BPPV)patients, discussing the premier solution of positional test. Methods: A total of 230 patients with BPPV, whereas 170 posterior semicircular canal canalithiasis (PSC-Can) BPPV and 60 horizontal semicircular canal canalithiasis (HSC-Can) BPPV were involved respectively. The induced nystagmus in roll test and Dix-Hallpike test was recorded by video nystagmuo graph (VNG), and the direction, intensity and time characteristics of nystagmus were compared in various BPPV.SPSS19.0 software was used for statistical analysis. Results: Vertically upward nystagmus was induced by hanging in 170 PSC-Can Dix-Hallpike test, and the nystagmus reversed and turned weaker when the subjects came to sit. The intensity of nystagmus at turning to lesion side by hanging and sitting were (30.3±14.1)°/s and (12.6±7.5)°/s respectively, the difference was statistically significant ( t =20.153, P <0.05). However, no nystagmus was induced in PSC-Can roll test. Horizontal nystagmus in the same direction with turning was induced in 60 HSC-Can roll test. The intensity of nystagmus at turning to lesion side and normal side was (42.0±18.0)°/s and (20.3±8.7)°/s respectively, the difference was statistically significant ( t =12.731, P <0.05). Furthermore, horizontal nystagmus in the same direction with turning was induced in 57 HSC-Can Dix-Hallpike. The coherence was 95% with the results of roll test. Conclusions: Dix-Hallpike test can not only be used to diagnose PSC-Can, but also induce nystagmus in HSC-Can effectively. Whereas the roll test only show significance in diagnosing HSC-Can. To avoid uncomfortable stimulation to patients as much as possible, we suggest to use Dix-Hallpike test at first, and to judge whether using roll test based on the result of the horizontal nystagmus.

The effect of prolonged monocular occlusion on latent nystagmus in the treatment of amblyopia

NARCIS (Netherlands)

H.J. Simonsz (Huib)

1989-01-01

textabstractWe recorded eye movements in 5 patients with latent nystagmus (LN) before and after 2 days of occlusion of the better eye. The slow-phase speed of the nystagmus (SPS) was in general, before occlusion, lower when the better eye fixated but, after occlusion, lower when the worse eye

Tonic cervical influences on eye nystagmus following hemilabyrinthectomy: immediate and plastic effects.

Science.gov (United States)

Pettorossi, V E; Petrosini, L

1984-12-17

In intact guinea pigs a passive horizontal rotation of the body about the fixed head induces compensatory ocular movements (cervico-ocular reflex). When the static neck deviation is maintained, a significant ocular displacement is observed. In acutely hemilabyrinthectomized animals, static body deviation towards the lesion side tonically alters eye nystagmus. It affects slow phase eye velocity and quick phase amplitude and frequency causing the eye to reach a less eccentric orbital position. Apart from such immediate influences, a plastic effect on eye nystagmus abatement is induced. In the animals restrained with no body-on-head deviation, abatement of nystagmus is delayed with respect to the animals restrained with 35 degrees body deviation towards the lesion side. Thus the head position signal is not only a contributing factor for the correction of postural deficits but also influences the time course of the ocular balancing process following unilateral vestibular damage.

[A sporadic case of episodic ataxia with nystagmus (EA-2)].

Science.gov (United States)

Namekawa, M; Takiyama, Y; Ueno, N; Nishizawa, M

1998-05-01

A 39-year-old man with episodic ataxia with nystagmus (EA-2) was reported. He showed intermittent cerebellar dysfunction, i.e., ataxia, nystagmus, dysarthria and vertigo, since he was 10 years old. Although this attack lasted for several hours, he was normal with exception of interictal nystagmus. His parents and sister showed no episodic ataxia. We ruled out the diseases, which may cause episodic ataxia, such as multiple sclerosis, vascular disorders, metabolic disorders and congenital anomalies. He was released from the attack by treatment with acetazolamide. EA-2 has been associated with mutations in the alpha 1A-voltage dependent calcium channel gene (CACNL1A4), which is also affected in familial hemiplegic migraine (FMH) and spinocerebellar ataxia type 6 (SCA6). In EA-2, frame-shift mutation leading to premature stop and splice-site mutation leading to truncated, non-functional channel protein have been reported. However, our patient did not have the mutations in the CACNL1A4 gene that were previously reported. In addition, our patient did not have an expanded CAG allele in the CACNL1A4 gene which is responsible for SCA6. Further examination is required to address whether a new mutation exists in the CACNL1A4 gene in our patient.

Caloric stimulation with near infrared radiation does not induce paradoxical nystagmus.

Science.gov (United States)

Walther, L E; Asenov, D R; Di Martino, E

2011-04-01

Near infrared radiation can be used for warm stimulation in caloric irrigation of the equilibrium organ. Aim of this study was to determine whether near infrared radiation offers effective stimulation of the vestibular organ, whether it is well tolerated by the patients and especially whether it is a viable alternative to warm air stimulation in patients with defects of the tympanic membrane and radical mastoid cavities. Patients with perforations of the tympanic membrane (n = 15) and with radical mastoid cavities (n = 13) were tested both with near infrared radiation and warm dry air. A caloric-induced nystagmus could be seen equally effectively and rapidly in all patients. Contrary to stimulation with warm dry air, no paradoxical nystagmus was observed following caloric irrigation with a warm stimulus (near infrared radiation). Results of a questionnaire showed excellent patient acceptance of near infrared stimulation with no arousal effects or unpleasant feeling. In conclusion, near infrared radiation proved to be an alternative method of caloric irrigation to warm dry air in patients with tympanic membrane defects and radical mastoid cavities. Near infrared radiation is pleasant, quick, contact free, sterile and quiet. With this method an effective caloric warm stimulus is available. If near infrared radiation is used for caloric stimulus no evaporative heat loss occurs.

Polymorphisms within the prnD and pltC genes from pyrrolnitrin and pyoluteorin-producing Pseudomonas and Burkholderia spp

NARCIS (Netherlands)

Souza, J.T.; Raaijmakers, J.M.

2003-01-01

Pyrrolnitrin (PRN) and pyoluteorin (PLT) are broad-spectrum antibiotics produced by several strains of Pseudomonas and Burkholderia species. Both antibiotics play an important role in the suppression of multiple plant pathogenic fungi. Primers were developed from conserved sequences and amplified

Simultaneous and spontaneous reversal of positional nystagmus; an unusual peripheral sign of benign paroxysmal positional vertigo

Directory of Open Access Journals (Sweden)

Sertac Yetiser, MD

2017-06-01

Full Text Available Direction-changing positional nystagmus is generally thought to be of central origin. Reversal of initial positional nystagmus during maintaining the head position in patients with benign paroxysmal positional vertigo (BPPV is quite unusual and could be a sign of peripheral pathology. Vestibular reflex adaptation, simultaneous co-existence of canalolithiasis and cupulolithiasis in the same or both ears and changing in direction of debris movement have been proposed for the mechanism of this phenomenon. This can be a sign of simultaneous ampullopedal and ampulofugal flows during single head movement. This double-phase pattern of flow causing reversal of positional nystagmus could be related with the amount, location and dispersal of otolithic debris inside the membranous labyrinth. Four patients (3 lateral canal canalolithiasis and 1 posterior canal with reversing spontaneous nystagmus among 530 patients with BPPV have been identified in our clinic. They have been cured with standard re-positioning maneuvers. Endolymphatic reflux theory has been proposed as the underlying mechanism for unusual behavior of otolithic debris.

Influence of gravity on the spatial orientation of eye nystagmus induced by unilateral lesion of horizontal semicircular canal.

Science.gov (United States)

Pettorossi, V E; Ermanno, M; Pierangelo, E; Silvarosa, G

2000-03-01

The influence of gravity in the orientation and slow phase eye velocity of the ocular nystagmus following unilateral damage of the cupula in the ampulla of the horizontal semicircular canal (UHCD) was investigated. The nystagmus was analysed at different sagittal head positions using the x-y infrared eye monitor technique. The nystagmus was almost horizontal at 0 degrees head pitch angle and remained partially fixed in space when the head was pitched upward or downward. The reorientation gain of the slow and quick phases was high (about 0.75) within +/- 45 degrees of head pitch angle, but beyond this range, it decreased greatly. The gain value depended on the lesion extension to otolithic receptors. The absolute value of the slow phase eye velocity of UHCD nystagmus was also modified systematically by the head pitch, showing a reduction in the upward and an increase in the downward.

Investigating nystagmus in patients with traumatic brain injury: A ...

African Journals Online (AJOL)

Background. Traumatic brain injury (TBI) is a health and socioeconomic concern worldwide. In patients with TBI, post-traumatic balance problems are often the result of damage to the vestibular system. Nystagmus is common in these patients, and can provide insight into the damage that has resulted from the trauma.

Anticonvulsant-induced downbeat nystagmus in epilepsy

Directory of Open Access Journals (Sweden)

Dongyan Wu

2015-01-01

Full Text Available We report data from two patients who developed reversible downbeat nystagmus (DBN while using AEDs within the therapeutic range. All previous reported cases of epilepsy with drug-induced DBN related to toxic levels of AEDs were summarized, and DBN was found mostly occurring in those using a sodium channel blocking AED. We propose that in our cases, the DBN with therapeutic AED levels may be explained by additive effects of sodium channel blockers. Adverse drug effects should be considered as a cause of DBN in people with epilepsy treated with multiple AEDs.

[Necessity of repeated roll test in horizontal semicircular canalithasis positioned diagnosis].

Science.gov (United States)

Lu, H H; Zhao, Y; Chen, T S; Xu, K X; Wang, W; Liu, Q; Wen, C; Li, S S; Li, X J; Han, X; Lin, P

2016-04-07

To investigate the influence of repeated roll test in horizontal semicircular canalithasis(HSC-Can) positioned diagnosis, so as to investigate the cecessity of repeated roll test. The patients with a chief complaint of positional vertigo accepted two consecutive cycles roll test, the evoked nystagmus characteristics of each cycle recorded by video-nystagmuograph(VNG), whose direction, intensity, time and other parameters characteristics were analyzed in 51 HSC-Can. Horizontal nystagmus in the same direction with turning were induced in HSC-Can roll test. In 51 HSC-Can, roll test cycle 1 and cycle 2 induced nystagmus same strength side in 26 cases(51.0%), of which 19 cases with stronger nystagmus intensity in cycle 2, another 7 cases were weaker; the opposite strength side of the two loops induced nystagmus, and cycle 1 evoked nystagmus intensity were weaker than cycle 2, based on cycle 2 results determined HSC-Can affected side in 25 cases (49.0%). Lesion and normal side in cycle 1 induced nystagmus duration (x±s, the same below) were (13.4±11.5)s and (14.1±9.9)s, respectively intensity (18.1±22.4)°/s and (13.0±12.0)°/s; as in cycle 2 induced nystagmus duration was (20.7±10.2)s and (18.0±12.0)s, strength respectively(40.4±28.0)°/s and (15.6 ±11.2)°/s. Cycle 2 ipsilateral rotor position evoked nystagmus showed longer duration and stronger intensity than cycle 1. Between two cycle induced ipsilateral nystagmus duration, intensity differences were statistically significant (t values were -4.233 and -5.154, P=0.000). 51 HSC-Can patients, 44 patients selected repositioning maneuver, after 1-2 times of maneuver, 41 cases (93.2%) showed complete resolution of symptoms, all cases's symptoms were improved; other 7 patients selected medication only. The proposed suspicious HSC-Can patients should receive at least two cycles roll test, and mainly in the second cycle could determine the location of the responsible semicircular canals.

Novel Eye Movement Disorders in Whipple’s Disease—Staircase Horizontal Saccades, Gaze-Evoked Nystagmus, and Esotropia

Directory of Open Access Journals (Sweden)

Aasef G. Shaikh

2017-07-01

Full Text Available Whipple’s disease, a rare systemic infectious disorder, is complicated by the involvement of the central nervous system in about 5% of cases. Oscillations of the eyes and the jaw, called oculo-masticatory myorhythmia, are pathognomonic of the central nervous system involvement but are often absent. Typical manifestations of the central nervous system Whipple’s disease are cognitive impairment, parkinsonism mimicking progressive supranuclear palsy with vertical saccade slowing, and up-gaze range limitation. We describe a unique patient with the central nervous system Whipple’s disease who had typical features, including parkinsonism, cognitive impairment, and up-gaze limitation; but also had diplopia, esotropia with mild horizontal (abduction more than adduction limitation, and vertigo. The patient also had gaze-evoked nystagmus and staircase horizontal saccades. Latter were thought to be due to mal-programmed small saccades followed by a series of corrective saccades. The saccades were disconjugate due to the concurrent strabismus. Also, we noted disconjugacy in the slow phase of gaze-evoked nystagmus. The disconjugacy of the slow phase of gaze-evoked nystagmus was larger during monocular viewing condition. We propose that interaction of the strabismic drifts of the covered eyes and the nystagmus drift, putatively at the final common pathway might lead to such disconjugacy.

Three-dimensional analysis of post-caloric nystagmus caused by postural change.

Science.gov (United States)

Young, Y H; Chiang, C W; Wang, C P

2001-01-01

In order to record caloric nystagmus (CN) using three-dimensional videonystagmography (3D VNG) 14 subjects were placed in the supine position with the head tilted up 30 degrees relative to the earth's horizontal plane. After the primary-phase CN had terminated, the subjects were repositioned from a supine to a sitting position, with the head anteflexed 30 degrees for recording the post-caloric nystagmus (PCN). In addition, 8 of the original subjects were placed in the supine position but with the head turned 40 degrees to the left so that the irrigated (right) ear was oriented upwards. After the primary-phase CN had terminated, the subjects were rotated by 180 degrees so that the irrigated ear was oriented downwards to record PCN. The results indicated that both methods successfully provoked horizontal and vertical CN. For torsional CN, the irrigated ear up/down method produced a higher provocation rate (75%) than the supine/sitting method (50%), but the difference was not significant. Comparing the provocation rate of the PCN for the horizontal component revealed that the two methods do not differ significantly. However, when comparing the provocation rates of PCN for the vertical component, the irrigated ear up/down method showed a higher rate (82%) than the supine/sitting method (18%). Thus using 3D VNG coupled with postural change during caloric testing, the horizontal or vertical components of PCN can be successfully provoked.

Oncogenic activation of JAK3-STAT signaling confers clinical sensitivity to PRN371, a novel selective and potent JAK3 inhibitor, in natural killer/T-cell lymphoma.

Science.gov (United States)

Nairismägi, M -L; Gerritsen, M E; Li, Z M; Wijaya, G C; Chia, B K H; Laurensia, Y; Lim, J Q; Yeoh, K W; Yao, X S; Pang, W L; Bisconte, A; Hill, R J; Bradshaw, J M; Huang, D; Song, T L L; Ng, C C Y; Rajasegaran, V; Tang, T; Tang, Q Q; Xia, X J; Kang, T B; Teh, B T; Lim, S T; Ong, C K; Tan, J

2018-05-01

Aberrant activation of the JAK3-STAT signaling pathway is a characteristic feature of many hematological malignancies. In particular, hyperactivity of this cascade has been observed in natural killer/T-cell lymphoma (NKTL) cases. Although the first-in-class JAK3 inhibitor tofacitinib blocks JAK3 activity in NKTL both in vitro and in vivo, its clinical utilization in cancer therapy has been limited by the pan-JAK inhibition activity. To improve the therapeutic efficacy of JAK3 inhibition in NKTL, we have developed a highly selective and durable JAK3 inhibitor PRN371 that potently inhibits JAK3 activity over the other JAK family members JAK1, JAK2, and TYK2. PRN371 effectively suppresses NKTL cell proliferation and induces apoptosis through abrogation of the JAK3-STAT signaling. Moreover, the activity of PRN371 has a more durable inhibition on JAK3 compared to tofacitinib in vitro, leading to significant tumor growth inhibition in a NKTL xenograft model harboring JAK3 activating mutation. These findings provide a novel therapeutic approach for the treatment of NKTL.

The minimal ice water caloric test compared with established vestibular caloric test procedures.

Science.gov (United States)

Schmäl, Frank; Lübben, Björn; Weiberg, Kerstin; Stoll, Wolfgang

2005-01-01

Caloric testing of the vestibular labyrinth is usually performed by classical caloric test procedures (CCTP) using water warmed to 30 degrees C and 44 degrees C. Ice water irrigation (4 degrees C) is usually not performed, although it might be useful as a bedside test. To verify the validity of the Minimal Ice Water Caloric Test (MIWCT), comparative video-oculographic investigations were performed in 22 healthy subjects using ice water (0.5 ml, 1.0 ml, 2 ml), CCTP, and cold air (27 degrees C). Frequency, amplitude, slow phase velocity (SPV), the onset, and the duration of nystagmus were documented. After addition of three ice cubes, the temperature of conventional tap water (16 degrees C) fell within 13 min to 4 degrees C. In pessimum position the subjects demonstrated no nystagmus response. Compared to CCTP, MIWCT was associated with a significantly later onset of nystagmus and a significant prolongation of the nystagmus reaction. In contrast to air stimulation (27 degrees C), a significant Spearman's correlation was noted between MIWCT (1 and 2 ml) and established CCTP in respect of essential nystagmus parameters (frequency, amplitude and SPV). Furthermore, MIWCT (0.5 and 1 ml) showed a higher sensitivity and specificity with regard to the detection of canal paresis based on Jongkees' formula compared to stimulation with air 27 degrees C. Thus, MIWCT appears to be a suitable procedure for bedside investigation of vestibular function outside the vestibular laboratory, e.g. in a hospital ward, where bedridden patients with vertigo occasionally require vestibular testing.

Refractory Positional Vertigo With Apogeotropic Horizontal Nystagmus After Labyrinthitis: Surgical Treatment and Identification of Dysmorphic Ampullae.

Science.gov (United States)

Ahmed, Sameer; Heidenreich, Katherine D; McHugh, Jonathan B; Altschuler, Richard A; Carender, Wendy J; Telian, Steven A

2015-09-01

To describe the rationale, intraoperative details, and histopathologic findings discovered when treating an unusual case of apogeotropic horizontal canal positional vertigo with a transmastoid labyrinthectomy. A single case report. Therapeutic. Resolution of apogeotropic nystagmus and improvement of positional vertigo. The apogeotropic variant of horizontal canal positional vertigo can be a difficult entity to treat. This report describes a patient who developed profound sensorineural hearing loss and vertigo after an acute left labyrinthitis. Ten months later, she developed vertigo with apogeotropic positional nystagmus involving the left horizontal semicircular canal. Particle repositioning maneuvers and vestibular physical therapy were unsuccessful. In addition, she developed intermittent positional vertigo affecting the ipsilateral vertical semicircular canals. Given the persistence of her vertigo, multiple canal involvement, and patient preference for definitive treatment, a transmastoid labyrinthectomy was performed. Intraoperatively, the ampulla of the horizontal canal as well as that of the other canals was grossly abnormal as later confirmed on histology. After surgery, her apogeotropic nystagmus and vertigo resolved, and her balance ability gradually improved to a highly functional level. This case illustrates a unique form of positional vertigo that developed and persisted after acute labyrinthitis. Conservative measures were unsuccessful and a transmastoid labyrinthectomy documented dense inflammatory tissue involving all three ampullae. We postulate that the post-labyrinthitic inflammatory changes resulted in mass loading of the membranous ampullae, causing abnormal nystagmus patterns and positional vertigo, which resolved after the labyrinthectomy.

Protective levels of canine distemper virus antibody in an urban dog population using plaque reduction neutralization test

Directory of Open Access Journals (Sweden)

O.I. Oyedele

2004-11-01

Full Text Available Blood samples from 50 dogs were collected at three veterinary clinics in Ibadan and Abuja, Nigeria and the serum from each sample was evaluated serologically for neutralizing antibodies against canine distemper virus (CDV by the highly sensitive plaque reduction (PRN neutralization assay. Thirteen dogs had plaque reduction neutralization titres of 0-100, seven had titres of 100-1 000 while 30 had titres ranging from 1 000-6 000. The PRN titres of vaccinated dogs were found to be significantly higher than unvaccinated dogs. The widespread use of the highly reproducible PRN test for the evaluation of antibody response to CDV may be very important in the generation of international CDV positive serum standards that should help to improve pre-and post-vaccination testing of dogs worldwide.

Kocher-Debré-Sémélaigne syndrome and congenital nystagmus

OpenAIRE

Radhakrishnan, K.; Walia, B. N. S.; Venkateswarlu, K.; Mann, S. B. S.

1982-01-01

A 11-year-old boy with hypothyroidism developed generalized muscle hypertrophy and proximal muscular weakness. Electromyographic findings were suggestive of myopathy. He had had congenital nystagmus (CN) since early infancy. Although the association of childhood hypothyroidism and CN has been documented before, the triad of hypothyroidism, hypertrophic myopathy and CN exhibited by the patient is believed to be unique.

Diagnostic Role of Head-Bending and Lying-Down Tests in Lateral Canal Benign Paroxysmal Positional Vertigo.

Science.gov (United States)

Yetiser, Sertac; Ince, Dilay

2015-08-01

To compare the diagnostic value of the head-bending test (HBT), lying-down positioning test (LDPT) and patient's report to identify the affected canal in video-nystagmographically (VNG) confirmed patients with lateral canal benign paroxysmal positional vertigo (LC-BPPV). Case series with chart review. Head-bending, lying-down positioning and the head-roll maneuver (HRM) under VNG guidance. The data were collected in a referral community hospital. Seventy-eight patients (32 apogeotropic and 46 geotropic nystagmus) with LC-BPPV who had been recruited between 2009 and 2013 were enrolled in the study. Patients were tested with the HRM and then were asked about subjectively worse side. Later, they were subjected to HBT when sitting and the LDPT. The results were compared and studied with the 1-way ANOVA and chi-square tests. Statistical significance was set at p < 0.05. Affected side was identified by HRM in 75% of patients with apogeotropic nystagmus and 95.6% of patients with geotropic nystagmus. Approximately 65.6% of patients with apogeotropic and 52% of patients with geotropic nystagmus had nystagmus during LDPT. However, its comparability with HRM was low. However, treatment plan based on LDPT results alone provided relief of symptoms in additional 12.5% of patients with apogeotropic and in 2.2% of patients with geotropic nystagmus. Approximately 63% of patients with apogeotropic and 56% of patients with geotropic nystagmus were able to tell the worse side. Nystagmus comparable with HRM during HBT was low and not diagnostic. HRM has the greatest diagnostic value of positioning tests in LC-BPPV in this study. LDPT provides some contribution in the diagnosis of LC-BPPV but much less than HRM. Patients' subjective feeling of vertigo was also a useful test. However, HBT was not as sensitive as other measures in uncertain cases.

Effects of extraocular muscle surgery in children with monocular blindness and bilateral nystagmus.

Science.gov (United States)

Sturm, Veit; Hejcmanova, Marketa; Landau, Klara

2014-11-20

Monocular infantile blindness may be associated with bilateral horizontal nystagmus, a subtype of fusion maldevelopment nystagmus syndrome (FMNS). Patients often adopt a significant anomalous head posture (AHP) towards the fixing eye in order to dampen the nystagmus. This clinical entity has also been reported as unilateral Ciancia syndrome. The aim of the study was to ascertain the clinical features and surgical outcome of patients with FMNS with infantile unilateral visual loss. In this retrospective case series, nine consecutive patients with FMNS with infantile unilateral visual loss underwent strabismus surgery to correct an AHP and/or improve ocular alignment. Outcome measures included amount of AHP and deviation at last follow-up. Eye muscle surgery according to the principles of Kestenbaum resulted in a marked reduction or elimination of the AHP. On average, a reduction of AHP of 1.3°/mm was achieved by predominantly performing combined horizontal recess-resect surgery in the intact eye. In cases of existing esotropia (ET) this procedure also markedly reduced the angle of deviation. A dosage calculation of 3 prism diopters/mm was established. We advocate a tailored surgical approach in FMNS with infantile unilateral visual loss. In typical patients who adopt a significant AHP accompanied by a large ET, we suggest an initial combined recess-resect surgery in the intact eye. This procedure regularly led to a marked reduction of the head turn and ET. In patients without significant strabismus, a full Kestenbaum procedure was successful, while ET in a patient with a minor AHP was corrected by performing a bimedial recession.

Heterozygous KIDINS220/ARMS nonsense variants cause spastic paraplegia, intellectual disability, nystagmus, and obesity

NARCIS (Netherlands)

Josifova, Dragana J.; Monroe, Glen R.; Tessadori, Federico; de Graaff, Esther; van der Zwaag, Bert; Mehta, Sarju G.; Harakalova, Magdalena; Duran, Karen J.; Savelberg, Sanne M. C.; Nijman, Isaäc J.; Jungbluth, Heinz; Hoogenraad, Casper C.; Bakkers, Jeroen; Knoers, Nine V.; Firth, Helen V.; Beales, Philip L.; van Haaften, Gijs; van Haelst, Mieke M.

2016-01-01

We identified de novo nonsense variants in KIDINS220/ARMS in three unrelated patients with spastic paraplegia, intellectual disability, nystagmus, and obesity (SINO). KIDINS220 is an essential scaffold protein coordinating neurotrophin signal pathways in neurites and is spatially and temporally

Development and field test of psychophysical tests for DWI arrest

Science.gov (United States)

1981-03-01

Administration and scoring procedures were standardized for a sobriety test battery consisting of the walk-and-turn test, the one leg stand test, and horizontal gaze nystagmus. The effectiveness of the standardized battery was then evaluated in the l...

Monocular and binocular development in children with albinism, infantile nystagmus syndrome, and normal vision

NARCIS (Netherlands)

Huurneman, B.; Boonstra, F.N.

2013-01-01

Abstract Background/aims: To compare interocular acuity differences, crowding ratios, and binocular summation ratios in 4- to 8-year-old children with albinism (n = 16), children with infantile nystagmus syndrome (n = 10), and children with normal vision (n = 72). Methods: Interocular acuity

Downbeat nystagmus as a result of lamotrigine toxicity.

Science.gov (United States)

Alkawi, Ammar; Kattah, Jorge C; Wyman, Katie

2005-02-01

Downbeat nystagmus (DBN) has been reported with phenytoin and carbamazepine toxicity. DBN has not been described as a result of lamotrigine toxicity. Clinical records, neuroimaging and video recordings were obtained in two patients diagnosed with intractable epilepsy who developed oscillopsia and incoordination while being treated with lamotrigine. One patient had a videonystagmographic (VNG) study. Lamotrigine's half-life is extended when used with valproic acid; hence, the increased chance of neurotoxicity associated with DBN. In our cases, DBN and truncal ataxia occurred in conjunction with toxic lamotrigine serum levels. Anticonvulsant toxicity should be considered as a cause of DBN. Lamotrigine toxicity may be an unusual cause.

Investigating the relationship between foveal morphology and refractive error in a population with infantile nystagmus syndrome.

Science.gov (United States)

Healey, Natasha; McLoone, Eibhlin; Mahon, Gerald; Jackson, A Jonathan; Saunders, Kathryn J; McClelland, Julie F

2013-04-26

We explored associations between refractive error and foveal hypoplasia in infantile nystagmus syndrome (INS). We recruited 50 participants with INS (albinism n = 33, nonalbinism infantile nystagmus [NAIN] n = 17) aged 4 to 48 years. Cycloplegic refractive error and logMAR acuity were obtained. Spherical equivalent (SER), most ametropic meridian (MAM) refractive error, and better eye acuity (VA) were used for analyses. High resolution spectral-domain optical coherence tomography (SD-OCT) was used to obtain foveal scans, which were graded using the Foveal Hypoplasia Grading Scale. Associations between grades of severity of foveal hypoplasia, and refractive error and VA were explored. Participants with more severe foveal hypoplasia had significantly higher MAMs and SERs (Kruskal-Wallis H test P = 0.005 and P = 0.008, respectively). There were no statistically significant associations between foveal hypoplasia and cylindrical refractive error (Kruskal-Wallis H test P = 0.144). Analyses demonstrated significant differences between participants with albinism or NAIN in terms of SER and MAM (Mann-Whitney U test P = 0.001). There were no statistically significant differences between astigmatic errors between participants with albinism and NAIN. Controlling for the effects of albinism, results demonstrated no significant associations between SER, and MAM and foveal hypoplasia (partial correlation P > 0.05). Poorer visual acuity was associated statistically significantly with more severe foveal hypoplasia (Kruskal-Wallis H test P = 0.001) and with a diagnosis of albinism (Mann-Whitney U test P = 0.001). Increasing severity of foveal hypoplasia is associated with poorer VA, reflecting reduced cone density in INS. Individuals with INS also demonstrate a significant association between more severe foveal hypoplasia and increasing hyperopia. However, in the absence of albinism, there is no significant relation between refractive outcome and degree of foveal hypoplasia

Head position modulates optokinetic nystagmus.

Science.gov (United States)

Pettorossi, V E; Ferraresi, A; Botti, F M; Panichi, R; Barmack, N H

2011-08-01

Orientation and movement relies on both visual and vestibular information mapped in separate coordinate systems. Here, we examine how coordinate systems interact to guide eye movements of rabbits. We exposed rabbits to continuous horizontal optokinetic stimulation (HOKS) at 5°/s to evoke horizontal eye movements, while they were statically or dynamically roll-tilted about the longitudinal axis. During monocular or binocular HOKS, when the rabbit was roll-tilted 30° onto the side of the eye stimulated in the posterior → anterior (P → A) direction, slow phase eye velocity (SPEV) increased by 3.5-5°/s. When the rabbit was roll-tilted 30° onto the side of the eye stimulated in the A → P direction, SPEV decreased to ~2.5°/s. We also tested the effect of roll-tilt after prolonged optokinetic stimulation had induced a negative optokinetic afternystagmus (OKAN II). In this condition, the SPEV occurred in the dark, "open loop." Modulation of SPEV of OKAN II depended on the direction of the nystagmus and was consistent with that observed during "closed loop" HOKS. Dynamic roll-tilt influenced SPEV evoked by HOKS in a similar way. The amplitude and the phase of SPEV depended on the frequency of vestibular oscillation and on HOKS velocity. We conclude that the change in the linear acceleration of the gravity vector with respect to the head during roll-tilt modulates the gain of SPEV depending on its direction. This modulation improves gaze stability at different image retinal slip velocities caused by head roll-tilt during centric or eccentric head movement.

Estimulação calórica gelada com ar nas vestibulopatias periféricas crônicas com nistagmo espontâneo Ice air caloric test in chronic peripheral vestibular dysfunction with spontaneous nystagmus

Directory of Open Access Journals (Sweden)

Flavia Silveira dos Santos Cabral

2008-01-01

Full Text Available OBJETIVO: analisar o efeito da estimulação gelada com ar a 10ºC sobre o nistagmo pós-calórico em pacientes com vestibulopatias periféricas crônicas que apresentam nistagmo espontâneo com olhos fechados. MÉTODOS: 61 pacientes foram submetidos às estimulações com ar a 42, 18 e 10ºC. RESULTADOS: em 42 casos (69,8% foram encontrados valores anormais de preponderância direcional e/ou de predomínio labiríntico a 42 e 18ºC. A prova a 10ºC apresentou valores de assimetria dentro dos padrões de normalidade em 52,5% dos casos e valores anormais de assimetria em 16,4% (p=0,012, confirmou hiporreflexia unilateral em 11,5% e identificou anormalidades não evidenciadas a 42 e 18ºC em 8,2%. CONCLUSÃO: a estimulação gelada com ar a 10ºC possibilitou retirar a influência do nistagmo espontâneo de olhos fechados sobre o nistagmo pós-calórico em pacientes com vestibulopatias periféricas crônicas.PURPOSE: to analyze the effect of air caloric stimulation at 10ºC on the post-caloric responses in patients with chronic peripheral dysfunction who presented spontaneous nystagmus with the eyes closed. METHODS: 61 patients with spontaneous nystagmus with closed eyes were submitted to air caloric stimulation under the following temperatures: 42, 18 and 10ºC. RESULTS: in 42 patients (69.8%, abnormal values of directional preponderance and / or unilateral hypoexcitability were observed following the 42ºC and 18ºC stimulations. For the 10ºC stimulations an asymmetry within normal limits was seen in 52.5% of the patients, while abnormal values were seen in 16.4% (p=0.012. Unilateral hypoexcitability was confirmed in 11.5% of the cases. In 8.2% of the patients there were abnormal findings not evidenced under 42ºC and 18ºC stimulations. CONCLUSION: in patients with chronic peripheral labyrinthine disorders who show spontaneous nystagmus with closed eyes, the 10ºC caloric test makes it possible to remove the influence of the spontaneous

Monocular and binocular development in children with albinism, infantile nystagmus syndrome and normal vision

NARCIS (Netherlands)

Huurneman, B.; Boonstra, F.N.

2013-01-01

Background/aims: To compare interocular acuity differences, crowding ratios, and binocular summation ratios in 4- to 8-year-old children with albinism (n = 16), children with infantile nystagmus syndrome (n = 10), and children with normal vision (n = 72). Methods: Interocular acuity differences and

Seamless interaction with scrolling contents on eyewear computers using optokinetic nystagmus eye movements

DEFF Research Database (Denmark)

Jalaliniya, Shahram; Mardanbegi, Diako

2016-01-01

In this paper we investigate the utility of an eye-based interaction technique (EyeGrip) for seamless interaction with scrolling contents on eyewear computers. EyeGrip uses Optokinetic Nystagmus (OKN) eye movements to detect object of interest among a set of scrolling contents and automatically s...... a well-known input device. Moreover, the accuracy of the EyeGrip method for menu item selection was higher while in the Facebook study participants found keyboard more accurate.......In this paper we investigate the utility of an eye-based interaction technique (EyeGrip) for seamless interaction with scrolling contents on eyewear computers. EyeGrip uses Optokinetic Nystagmus (OKN) eye movements to detect object of interest among a set of scrolling contents and automatically...... stops scrolling for the user. We empirically evaluated the usability of EyeGrip in two different applications for eyewear computers: 1) a menu scroll viewer and 2) a Facebook newsfeed reader. The results of our study showed that the EyeGrip technique performs as good as keyboard which has long been...

Proprioceptive influence on the optokinetic nystagmus.

Science.gov (United States)

Botti, F; Anastasopoulos, D; Kostadima, V; Bambagioni, D; Pettorossi, V E

2001-01-01

The influence of neck and leg proprioceptive inputs on optokinetic-induced quick phases was studied in humans. Ten subjects received unidirectional horizontal optokinetic stimulation (10-20%/s) during sinusoidal neck, leg and combined neck + leg proprioceptive stimulation. The optokinetic reflex was measured by electro-oculography. Neck stimulation induced a shift in the nystagmus beating field in the opposite direction to body movement (gain 0.3 0.4, phase 140-180 degrees). The beating field shift resulted totally from the amplitude and frequency modulation of optokinetic quick phases, as slow phases were not affected. Leg proprioceptive stimulation induced a similar effect, but the phase of the response lagged by approximately 90 degrees compared with that of neck response. With combined neck + leg stimulation, the amplitude of the effect was a sum of the separate effects, but the phase coincided with that of the leg response. This suggests that neck and leg proprioceptive signals do not add linearly and that the leg signal determines the time of the response.

Anophthalmia, cleft lip/palate, absent vomer bone, nystagmus, and mental-motor retardation: a new syndrome or Fryns "anophthalmia-plus" syndrome?

Science.gov (United States)

Ozçelik, Derya; Sağlam, Ibrahim; SIlan, Fatma; Sezen, Gülbin; Unveren, Toygar

2008-05-01

We report that a 4-year-old boy presented with right unilateral complete cleft lip and palate, right anophthalmos, left congenital nystagmus, absence of the vomer bone, mental-motor retardation, and normal lymphocyte karyotype (46, XY). For reconstruction of the deformities, we performed cleft lip repair by Millard's rotation-advancement technique and planned cleft palate repair. This combination of cleft lip and palate, anophthalmos, congenital nystagmus, absent vomer bone, and mental-motor retardation has not, to our knowledge, previously been described. We suggest that this represents either another case of the rare Fryns "anophthalmia-plus" syndrome or a new syndrome.

A FRMD7 variant in a Japanese family causes congenital nystagmus.

Science.gov (United States)

Kohmoto, Tomohiro; Okamoto, Nana; Satomura, Shigeko; Naruto, Takuya; Komori, Takahide; Hashimoto, Toshiaki; Imoto, Issei

2015-01-01

Idiopathic congenital nystagmus (ICN) is a genetically heterogeneous eye movement disorder that causes a large proportion of childhood visual impairment. Here we describe a missense variant (p.L292P) within a mutation-rich region of FRMD7 detected in three affected male siblings in a Japanese family with X-linked ICN. Combining sequence analysis and results from structural and functional predictions, we report p.L292P as a variant potentially disrupting FRMD7 function associated with X-linked ICN.

Effects of pre- and postnatal litter size reduction on development and behavior of rat offspring.

Science.gov (United States)

Milković, K; Paunović, J; Joffe, J M

1976-07-01

Litter size was reduced to 2-5 rat pups either prenatally by unilateral maternal oviduct ligation (Group PRN) or postnatally by removing pups (Group PST). Normal size litters (8-10 pups) of sham ligated (SHM) and intact (CON) mothers served as controls. Weights at 30 days were increased by prenatal or postnatal reduction and reduced by prenatal stress (SHM); the sex difference in weight was most pronounced in PRN rats. At 75 days PRN rats were heaviest, with no differences between the other groups. Relative ovarian weights were reduced in PRN females and absolute testes weights increased in PST males. The PRN and SHM females had smaller relative adrenal weights than CON and PST females. Open-field activity was generally increased by prior avoidance conditioning and effects of treatments were found only in groups tested after avoidance-conditioning: PRN and SHM rats were more active than PST and CON rats, particularly on Days 1 (SHM) and 4 (SHM and PRN) of testing. Passive-avoidance behavior of PRN rats was also more susceptible to previous test experience: they emerged more slowly if they had prior open-field experience. The PST animals, in contrast, emerged more rapidly after prior test experience. Plasma corticosterone levels and shuttlebox conditioning and extinction were unaffected by treatments.

A dynamic model of the eye nystagmus response to high magnetic fields.

Science.gov (United States)

Glover, Paul M; Li, Yan; Antunes, Andre; Mian, Omar S; Day, Brian L

2014-02-07

It was recently shown that high magnetic fields evoke nystagmus in human subjects with functioning vestibular systems. The proposed mechanism involves interaction between ionic currents in the endolymph of the vestibular labyrinth and the static magnetic field. This results in a Lorentz force that causes endolymph flow to deflect the cupulae of the semi-circular canals to evoke a vestibular-ocular reflex (VOR). This should be analogous to stimulation by angular acceleration or caloric irrigation. We made measurements of nystagmus slow-phase velocities in healthy adults experiencing variable magnetic field profiles of up to 7 T while supine on a bed that could be moved smoothly into the bore of an MRI machine. The horizontal slow-phase velocity data were reliably modelled by a linear transfer function incorporating a low-pass term and a high-pass adaptation term. The adaptation time constant was estimated at 39.3 s from long exposure trials. When constrained to this value, the low-pass time constant was estimated at 13.6 ± 3.6 s (to 95% confidence) from both short and long exposure trials. This confidence interval overlaps with values obtained previously using angular acceleration and caloric stimulation. Hence it is compatible with endolymph flow causing a cupular deflection and therefore supports the hypothesis that the Lorentz force is a likely transduction mechanism of the magnetic field-evoked VOR.

A dynamic model of the eye nystagmus response to high magnetic fields

International Nuclear Information System (INIS)

Glover, Paul M; Li, Yan; Antunes, Andre; Mian, Omar S; Day, Brian L

2014-01-01

It was recently shown that high magnetic fields evoke nystagmus in human subjects with functioning vestibular systems. The proposed mechanism involves interaction between ionic currents in the endolymph of the vestibular labyrinth and the static magnetic field. This results in a Lorentz force that causes endolymph flow to deflect the cupulae of the semi-circular canals to evoke a vestibular–ocular reflex (VOR). This should be analogous to stimulation by angular acceleration or caloric irrigation. We made measurements of nystagmus slow-phase velocities in healthy adults experiencing variable magnetic field profiles of up to 7 T while supine on a bed that could be moved smoothly into the bore of an MRI machine. The horizontal slow-phase velocity data were reliably modelled by a linear transfer function incorporating a low-pass term and a high-pass adaptation term. The adaptation time constant was estimated at 39.3 s from long exposure trials. When constrained to this value, the low-pass time constant was estimated at 13.6 ± 3.6 s (to 95% confidence) from both short and long exposure trials. This confidence interval overlaps with values obtained previously using angular acceleration and caloric stimulation. Hence it is compatible with endolymph flow causing a cupular deflection and therefore supports the hypothesis that the Lorentz force is a likely transduction mechanism of the magnetic field-evoked VOR. (paper)

Patients with vestibular loss, tullio phenomenon, and pressure-induced nystagmus: vestibular atelectasis?

Science.gov (United States)

Wenzel, Angela; Ward, Bryan K; Schubert, Michael C; Kheradmand, Amir; Zee, David S; Mantokoudis, Georgios; Carey, John Patrick

2014-06-01

To propose an etiology for a syndrome of bilateral vestibular hypofunction and sound and/or pressure-evoked eye movements with normal hearing thresholds. Retrospective case series. Tertiary care referral center. Four patients with bilateral vestibular hypofunction, sound and/or pressure-evoked nystagmus and normal hearing thresholds were identified over a 3-year period. No evidence of other known vestibular disorders was identified. None of these patients presented with a history of exposure to toxins, radiation, aminoglycosides or chemotherapy; head trauma; or a family history of inherited vestibular loss. All patients underwent high-resolution CT scan of the temporal bones to evaluate for labyrinthine dehiscence. Additionally, all individuals underwent audiometric testing to ANSI standards, vestibular-evoked myogenic potentials (VEMP) testing using either click stimulus cervical VEMPs (cVEMPs), or tone burst ocular VEMPs (oVEMPs). Bithermal caloric stimulation was used to measure horizontal semicircular canal function, with either videonystagmography (VNG) or electronystagmography (ENG) to record eye movements. Individual responses of each of the 6 semicircular canals (SCC) to rapid head rotations were tested with the bedside head impulse test. We identified 4 patients with a combination of bilateral vestibular hypofunction and sound and/or pressure-induced eye movements, normal-hearing thresholds and no evidence for any other vestibular disorder. We suggest that this unique combination of symptoms should be considered as the clinical presentation of vestibular atelectasis, which has been previously described histologically as collapse of the endolymph-containing portions of the labyrinth.

The Dix-Hallpike test and the canalith repositioning maneuver.

Science.gov (United States)

Viirre, Erik; Purcell, Ian; Baloh, Robert W

2005-01-01

The Dix-Hallpike test and the canalith repositioning maneuver (CRM) are used to diagnose and treat benign positional vertigo (BPV). Dix-Hallpike is the standard procedure for diagnosis of BPV, but if the horizontal canal is not tested for BPV and the Dix-Hallpike is only carried out once, the condition may not be diagnosed and appropriately treated. We describe our method of testing for BPV and treating it with CRM. The Dix-Hallpike test involves rapidly moving the patient from a sitting position to "head hanging," where the patient's head is at least 10 degrees below horizontal. This is performed initially for the posterior semicircular canals. If these movements fail to elicit vertigo and nystagmus, tests of the horizontal semicircular canals are performed by laying the patient on each side. Importantly, if there is no vertigo or nystagmus elicited by testing the horizontal semi-circular canals, the posterior semicircular canals are tested again. It appears that being held in the head hanging positions and then left and right lateral positions will often allow the canaliths to collect such that the Dix-Hallpike test will become positive. Failure to repeat the tests of the posterior semicircular canals may result in a falsely negative test. Testing the horizontal canals and repeating the Dix-Hallpike test will reduce the likelihood of patients undergoing extra testing or other consequences of misdiagnosis. If, during any of this testing, a movement elicits vertigo or nystagmus, the appropriate CRM is then carried out.

Nystagmus responses in a group of normal humans during earth-horizontal axis rotation

Science.gov (United States)

Wall, Conrad, III; Furman, Joseph M. R.

1989-01-01

Horizontal eye movement responses to earth-horizontal yaw axis rotation were evaluated in 50 normal human subjects who were uniformly distributed in age (20-69 years) and each age group was then divided by gender. Subjects were rotated with eyes open in the dark, using clockwise and counter-clockwise 60 deg velocity trapezoids. The nystagmus slow component velocity is analyzed. It is shown that, despite large intersubject variability, parameters which describe earth-horizontal yaw axis responses are loosely interrelated, and some of them vary significantly with gender and age.

Comparison of indirect immunofluorescence test for measles antibodies with haemagglutination inhibition and plaque neutralization tests Comparação da reação de imunofluorescência indireta para o vírus do sarampo com as reações de inibição da hemaglutinação e neutralização por redução de placas

Directory of Open Access Journals (Sweden)

Vanda Akico Ueda Fick de Souza

1990-10-01

Full Text Available Indirect Immunofluorescence (IFA, Plaque Reduction Neutralization (PRN and Haemagglutination Inhibition (HI tests for measles antibodies were carried out in 197 sera obtained from umbilical cord and vaccinated children. The IFA was also applied to blood samples collected with filter paper. IFA results demonstrated that the test is relatively simple to perform, with good reproducibility for different antigen lots. Good correlation was obtained between IFA, PRN and HI antibody titers. Better correlation was demonstrated with IFA and PRN than with HI and PRN tests. Sensitivity of IFA in detecting antibody was less effective than PRN, however more effective than HI using rhesus monkey red blood cells. PRN antibody titers over 100 were detected by IFA but not by HI (9.7% with negative results. IFA may be of considerable practical use and able to substitute HI in Seroepidemiological surveys and to evaluate vaccine efficacy. It also can be simplified by employing filter paper collected samples.As reações de imunofluorescência indireta (RIF, neutralização por redução de placas (RNP e inibição da hemaglutinação (RIH para detecção de anticorpos para o vírus do sarampo foram aplicadas a 197 soros provenientes de cordão umbilical e de crianças vacinadas contra o sarampo. Avaliou-se ainda a aplicação da RIF em amostras colhidas em papel de filtro. A RIF apresentou-se como uma prova de execução relativamente simples, de boa reprodutibilidade com diferentes partidas de antígeno. Observou-se boa correlação entre os títulos de anticorpos obtidos por RIF, RNP e RIH. Com a RNP, a RIF apresentou maior correlação que a RIH. A sensibilidade da RIF na detecção de anticorpos contra o sarampo foi menor que RNP, porém superior à da RIH com hemácias de macaco rhesus. Anticorpos com títulos superiores a 100 pela RNP foram sistematicamente detectados pela RIF, mas não por RIH (9,7% de resultados negativos. A RIF pode ser de grande utilidade

[Clinical characteristics and surgical treatment of idiopathic congenital nystagmus in 224 patients].

Science.gov (United States)

Ding, J; Zhao, K X; Li, Y P; Ma, H Z; Chen, X; Guo, X; Zhu, L N; Li, N D; Zhang, W

2016-08-01

To study clinical characteristics and surgical treatment of idiopathic congenital nystagmus (ICN). A retrospective study was conducted in 224 patients with ICN in Tianjin eye hospital from July 2007 to February 2013. There were 224 patients, 158 (70.54%) males and 66 (29.5%) females, mean age was (11.6±8.4) years and (11.4±6.4) years separately. Horizontal nystgamus happened in 215 cases, 3 cases were vertical type and 6 cases were mixed. 214 cases were with no history of operation and 10 patients had ever underwent surgeries before. Furthermore, 151 patients combined with strabismus and refractive error, anterior segment or retinal disorders, which accounting for 67.4% of all the patients. 48 patients were associated myopia, 30 patients with hyperopia, 43 patients with strabismus. Among them, 153 cases of compensatory head position direction were horizontal with face turn, 43 cases (43/153, 28.1%) showed face turning to the left, 110 cases (110/153, 71.9%) showed face turning to the right. Surgeries were designed according to the compensatory head position and head retroversion angle. For 15 patients with double intermediate zones, the position which was often used with good visual function was chosen for operation design. As for the patients with nystagmus and strabismus, the transfer null zone to primary position for the dominant eye and strabismus surgery for the other eye was chosen. And for complicated patients with compensative head position, the dominant head posture were designed for surgery. ICN is dominated by male with variable clinical manifestations. Surgical choice for ICN depends on the direction of head position and if there is strabismus accompanying it.The aim of ocular muscle surgery is to transfer null zone to primary position. (Chin J Ophthalmol, 2016, 52: 574-578).

Review about hiperventilation test and Valsalva Maneuver

Directory of Open Access Journals (Sweden)

Eduardo Antonio MENA-DOMÍNGUEZ

2018-04-01

Full Text Available Introduction and objective: With this paper, we pretend to explain the characteristics and the field of application of two clinical explorations used in the patient with suspected vestibular pathology, the hyperventilation maneuver and the Valsalva maneuver. Methodology: Narrative review. Results: Through different neurophysiological mechanisms, hyperventilation can induce nystagmus in cases of vestibular asymmetry, both peripheral and central. The Valsalva maneuver may also trigger nystagmus and vertigo because of direct transmission of internal ear pressure in cases of perilymphatic fistula, anomalies of the cranio-cervical junction (Arnold-Chiari malformation, and other ossicles, oval window and saccule pathologies. Discussion and conclusions: Both the hyperventilation test and the Valsalva maneuver should be included in the battery of tests for patients with vestibular pathology to, depending on the results obtained, anatomically locate the site of the lesion and justify the use of imaging techniques.

32 CFR 636.16 - Detection, apprehension, and testing of intoxicated drivers.

Science.gov (United States)

2010-07-01

... drivers. In addition to the requirements in § 634.36 of this subchapter, the standard field sobriety test used by the Military Police may include the following tests: (a) Horizontal gaze nystagmus. (b) Walk and turn. (c) One leg stand. ...

32 CFR 634.36 - Detection, apprehension, and testing of intoxicated drivers.

Science.gov (United States)

2010-07-01

... enforcement personnel should use a standard field sobriety test (such as one-leg stand or walk and turn) horizontal gaze nystagmus tests as sanctioned by the National Highway Traffic and Safety Administration, and... vehicle is impaired, field sobriety tests should be conducted on the individual. The DD Form 1920 may be...

Perceptual Learning in Children With Infantile Nystagmus: Effects on Visual Performance.

Science.gov (United States)

Huurneman, Bianca; Boonstra, F Nienke; Goossens, Jeroen

2016-08-01

To evaluate whether computerized training with a crowded or uncrowded letter-discrimination task reduces visual impairment (VI) in 6- to 11-year-old children with infantile nystagmus (IN) who suffer from increased foveal crowding, reduced visual acuity, and reduced stereopsis. Thirty-six children with IN were included. Eighteen had idiopathic IN and 18 had oculocutaneous albinism. These children were divided in two training groups matched on age and diagnosis: a crowded training group (n = 18) and an uncrowded training group (n = 18). Training occurred two times per week during 5 weeks (3500 trials per training). Eleven age-matched children with normal vision were included to assess baseline differences in task performance and test-retest learning. Main outcome measures were task-specific performance, distance and near visual acuity (DVA and NVA), intensity and extent of (foveal) crowding at 5 m and 40 cm, and stereopsis. Training resulted in task-specific improvements. Both training groups also showed uncrowded and crowded DVA improvements (0.10 ± 0.02 and 0.11 ± 0.02 logMAR) and improved stereopsis (670 ± 249″). Crowded NVA improved only in the crowded training group (0.15 ± 0.02 logMAR), which was also the only group showing a reduction in near crowding intensity (0.08 ± 0.03 logMAR). Effects were not due to test-retest learning. Perceptual learning with or without distractors reduces the extent of crowding and improves visual acuity in children with IN. Training with distractors improves near vision more than training with single optotypes. Perceptual learning also transfers to DVA and NVA under uncrowded and crowded conditions and even stereopsis. Learning curves indicated that improvements may be larger after longer training.

Abnormally Small Neuromuscular Junctions in the Extraocular Muscles From Subjects With Idiopathic Nystagmus and Nystagmus Associated With Albinism.

Science.gov (United States)

McLoon, Linda K; Willoughby, Christy L; Anderson, Jill S; Bothun, Erick D; Stager, David; Felius, Joost; Lee, Helena; Gottlob, Irene

2016-04-01

Infantile nystagmus syndrome (INS) is often associated with abnormalities of axonal outgrowth and connectivity. To determine if this manifests in extraocular muscle innervation, specimens from children with idiopathic INS or INS and albinism were examined and compared to normal age-matched control extraocular muscles. Extraocular muscles removed during normal surgery on children with idiopathic INS or INS and albinism were immunostained for neuromuscular junctions, myofiber type, the immature form of the acetylcholine receptor, and brain-derived neurotrophic factor (BDNF) and compared to age-matched controls. Muscles from both the idiopathic INS and INS and albinism groups had neuromuscular junctions that were 35% to 71% smaller based on myofiber area and myofiber perimeter than found in age-matched controls, and this was seen on both fast and slow myosin heavy chain isoform-expressing myofibers (all P albinism showed a 7-fold increase in neuromuscular junction numbers on fast myofibers expressing the immature gamma subunit of the acetylcholine receptor. The extraocular muscles from both INS subgroups showed a significant increase in the number and size of slow myofibers compared to age-matched controls. Brain-derived neurotrophic factor was expressed in control muscle but was virtually absent in the INS muscles. These studies suggest that, relative to the final common pathway, INS is not the same between different patient etiologies. It should be possible to modulate these final common pathway abnormalities, via exogenous application of appropriate drugs, with the hope that this type of treatment may reduce the involuntary oscillatory movements in these children.

A girl without a chiasm : Electrophysiologic and MRI evidence for the absence of crossing optic nerve fibers in a girl with a congenital nystagmus

NARCIS (Netherlands)

Jansonius, NM; van der Vliet, TM; Cornelissen, FW; Pott, JWR; Kooijman, AC

An otherwise healthy 15-year-old girl with a congenital nystagmus was evaluated at our department using visual evoked potential recording and magnetic resonance imaging. She appears to have the unique isolated inborn absence of the optic chiasm, described only once before in two unrelated girls.

A previously unidentified deletion in G protein-coupled receptor 143 causing X-linked congenital nystagmus in a Chinese family

Directory of Open Access Journals (Sweden)

Jing Liu

2016-01-01

Full Text Available Background: Congenital nystagmus (CN is characterized by conjugated, spontaneous, and involuntary ocular oscillations. It is an inherited disease and the most common inheritance pattern is X-linked CN. In this study, our aim is to identify the disease-causing mutation in a large sixth-generation Chinese family with X-linked CN. Methods: It has been reported that mutations in four-point-one, ezrin, radixin, moesin domain-containing 7 gene (FRMD7 and G protein-coupled receptor 143 gene (GPR143 account for the majority patients of X-linked nystagmus. We collected 8 ml blood samples from members of a large sixth-generation pedigree with X-linked CN and 100 normal controls. FRMD7 and GPR143 were scanned by polymerase chain reaction (PCR-based DNA sequencing assays, and multiplex PCR assays were applied to detect deletions. Results: We identified a previously unreported deletion covering 7 exons in GPR143 in a Chinese family. The heterozygous deletion from exon 3 to exon 9 of GPR143 was detected in all affected males in the family, while it was not detected in other unaffected relatives or 100 normal controls. Conclusions: This is the first report of molecular characterization in GPR143 gene in the CN family. Our results expand the spectrum of GPR143 mutations causing CN and further confirm the role of GPR143 in the pathogenesis of CN.

Oculomotor neurocircuitry, a structural connectivity study of infantile nystagmus syndrome.

Directory of Open Access Journals (Sweden)

Nasser H Kashou

Full Text Available Infantile nystagmus syndrome (INS is one of the leading causes of significant vision loss in children and affects about 1 in 1000 to 6000 births. In the present study, we are the first to investigate the structural pathways of patients and controls using diffusion tensor imaging (DTI. Specifically, three female INS patients from the same family were scanned, two sisters and a mother. Six regions of interest (ROIs were created manually to analyze the number of tracks. Additionally, three ROI masks were analyzed using TBSS (Tract-Based Spatial Statistics. The number of fiber tracks was reduced in INS subjects, compared to normal subjects, by 15.9%, 13.9%, 9.2%, 18.6%, 5.3%, and 2.5% for the pons, cerebellum (right and left, brainstem, cerebrum, and thalamus. Furthermore, TBSS results indicated that the fractional anisotropy (FA values for the patients were lower in the superior ventral aspects of the pons of the brainstem than in those of the controls. We have identified some brain regions that may be actively involved in INS. These novel findings would be beneficial to the neuroimaging clinical and research community as they will give them new direction in further pursuing neurological studies related to oculomotor function and provide a rational approach to studying INS.

[Evaluation of the equilibrium system in patients with multiple sclerosis based on qualitative assessment with videonystagmography].

Science.gov (United States)

Kenig, Dagmara; Kantor, Ireneusz; Jurkiewicz, Dariusz

2005-09-01

Multiple sclerosis (SM) is the most frequent inflammatory-demyelinating disease of central nervous system. The character of SM disease provokes that its most frequent symptoms are vertigo, equilibrium disorders and ataxia. Objective method of vertigo estimation is evaluation of the nystagmus via videonystagmography registration (VNG). This examination allows to simultaneously assess the vertical and horizontal component of the nystagmus. It is considered that mainly the vertical nystagmus is characteristic to equilibrium system impairments of the central nervous system, caused also by SM. The study was carried out on 40 patients (28 women, 12 men) with SM diagnosed as a result of neurological examination. 7 patients (17.5%) suffered from sham - movement vertigo, while 33 patients (82.5%) suffered from instability of posture and walking deviation. The videonystagmography examination resulted in the following: deviation of the eye movement was recorded in 26 patients (65%) during either in saccadic test and in smooth pursuit test, optokinetic nystagmus recorded: dissymetric and variable amplitude result in 24 patients (60%), presence of vertical nystagmus component in 30 patients (75%), positional test: directional-changable nystagmus in 8 patients (20%), pendular nystagmus in 4 patients (10%), presence of vertical nystagmus component in 31 patients (77.5%), caloric test: impairments of one of the labyrinth recorded in 12 patients (30%). SM is still the diagnostic and therapeutic problem. During the mentioned tests we have found the quantitative and qualitative changes in VNG recordings. This may be helpful in SM diagnosis, mainly during its early stages.

Effect of 4-Horizontal Rectus Muscle Tenotomy on Visual Function and Eye Movement Records in Patients with Infantile Nystagmus Syndrome without Abnormal Head Posture and Strabismus: A Prospective Study

Directory of Open Access Journals (Sweden)

Ahmad Ameri

2013-10-01

Full Text Available Purpose: To evaluate the effect of tenotomy on visual function and eye movement records in patients with infantile nystagmus syndrome (INS without abnormal head posture (AHP and strabismusMethods: A prospective interventional case-series of patients with INS with no AHP or strabismus. Patients underwent 4-horizontal muscle tenotomy. Best corrected visual acuity (BCVA and eye movement recordings were compared pre and postoperatively.Results: Eight patients were recruited in this study with 3 to 15.5 months of follow-up. Patients showed significant improvement in their visual function. Overall nystagmus amplitude and velocity was decreased 30.7% and 19.8%, respectively. Improvements were more marked at right and left gazes. Conclusion: Tenotomy improves both visual function and eye movement records in INS with no strabismus and eccentric null point. The procedure has more effect on lateral gazes with worse waveforms, thus can broaden area with better visual function. We recommend this surgery in patients with INS but no associated AHP or strabismus.

Identification of three novel OA1 gene mutations identified in three families misdiagnosed with congenital nystagmus and carrier status determination by real-time quantitative PCR assay

Directory of Open Access Journals (Sweden)

Hamel Christian

2003-01-01

Full Text Available Abstract Background X-linked ocular albinism type 1 (OA1 is caused by mutations in OA1 gene, which encodes a membrane glycoprotein localised to melanosomes. OA1 mainly affects pigment production in the eye, resulting in optic changes associated with albinism including hypopigmentation of the retina, nystagmus, strabismus, foveal hypoplasia, abnormal crossing of the optic fibers and reduced visual acuity. Affected Caucasian males usually appear to have normal skin and hair pigment. Results We identified three previously undescribed mutations consisting of two intragenic deletions (one encompassing exon 6, the other encompassing exons 7–8, and a point mutation (310delG in exon 2. We report the development of a new method for diagnosis of heterozygous deletions in OA1 gene based on measurement of gene copy number using real-time quantitative PCR from genomic DNA. Conclusion The identification of OA1 mutations in families earlier reported as families with hereditary nystagmus indicate that ocular albinism type 1 is probably underdiagnosed. Our method of real-time quantitative PCR of OA1 exons with DMD exon as external standard performed on the LightCycler™ allows quick and accurate carrier-status assessment for at-risk females.

[Video-nystagmography and vibration test in the diagnosis of vestibular schwannoma. Review of 100 cases].

Science.gov (United States)

Négrevergne, M; Ribeiro, S; Moraes, C L; Maunsell, R; Morata, G Celis; Darrouzet, V

2003-01-01

To evaluate informations given by the combination of videonystagmography (VNG) including vibratory tests and auditory brainstem responses (ABR) in patients suffering vestibular schwannoma (VS) and try to find the most conclusive test(s). Combination of different functional tests is supposed to improve diagnosis and preoperative evaluation and precise indication for magnetic resonance imaging (MRI) facing audiological and vestibular symptoms. A prospective study of 100 patients with VS. All patients underwent a preoperative work-up including complete audiometry, auditory brainstem response (ABR) and videonystagmography (VNG). VNG protocol included caloric testing, rotatory tests, oculometry tests (saccade testing, optokinetic testing) and spontaneous and gaze-evoked nystagmus. From these six tests a score of positivity could be set, from 0 to 6. The vibratory test is non invasive and easy to realize. Were observed: 1/ a good sensitivity in vibratory test to elicit nystagmus in this context. 2/ a good correlation between subliminal rotatory chair tests and vibratory tests 3/ a better control of caloric testing using vibratory test. 4/ a good but deficient sensitivity of ABR alone with regard to VS (95%) 5/ an increase of sensitivity of VNG when coupling it with ABR and using as a criterion the score of positivity: no patient had all tests negative. The vibratory test is a non-invasive, fast examination with an easy execution. It reinforces VNG-ABR association screening power to diagnose VS. It constitutes, combined to caloric testing a good tool to diagnose and evaluate unilateral vestibular weakness.

[Positioning diagnosis of benign positional paroxysmal vertigo by VNG].

Science.gov (United States)

Wang, Na; Chen, Taisheng; Lin, Peng; Song, Wei; Dong, Hong

2009-07-01

To analyze the value of positioning diagnosis of VNG (Videonystagmograph) in patients with benign paroxysmal positional vertigo (BPPV). One hundred and twenty-six patients with BPPV were enrolled in this retrospective study. Their positional nystagmus recorded by VNG in Dix-Hallpike and roll tests were analyzed to summarize the characteristics of nystagmus on nystagmography of various BPPV. Of 126 patients with BPPV diagnosed in our center, the posterior semicircular canals (PSC) were involved in 98 patients (77.8%), whereas the horizontal semicircular canal (HSC) and anterior semicircular canal (ASC) were involved in 17 (13.5%) and 5 (3.9%), respectively. Six patients (4.8%) confirmed combined-BPPV had HSC-BPPV and ipsilateral PSC-BPPV. Twenty-eight patients with PSC-BPPV had reversal phase on nystagmography. The nystagmus of patients with P/ASC-canalithiasis showed upward/downward on the vertical phase of nystagmography and orientated the opposite side on horizontal phase in the head hanging position, and the nystagmus reversed when returned to sit. Nystagmus on horizontal phase could be provoked when the head turned to both sides of the roll tests in patients with HSC-BPPV. If the nystagmus and the head-turning shared the same direction, then HSC-canalithiasis was confirmed, and the direction of the head-turning which provoked the stronger nystagmus indicates the lesion side. If the nystagmus and the head-turning had the opposite direction, then HSC-cupulolithiasis was confirmed, and the direction of the head-turning which provoked the weaker nystagmus indicates the lesion side. Positional nystagmus can be recorded objectively using VNG, According to which positioning the semicircular canal involved would be easier and more accurate. The recording conserved also could be helpful for clinical diagnosis and repositioning of BPPV.

Auction based spectrum management of cognitive radio networks

DEFF Research Database (Denmark)

Chang, H. B.; Chen, K.-C.; Prasad, Ramjee

2009-01-01

(PS-MSs), and we therefore construct a cognitive radio network (CRN) consisting of a PRN with multiple CR-MSs. We propose a spectrum management policy framework such that CR-MSs can compete in utilization of the PRN spectrum bands available to opportunistic transmission of CR-MSs by Vickrey auction...... to the PRN, the overall spectrum utilization, the profit of the service provider, the spectrum access opportunity of the CR-MSs are increased to achieve cowin situation for every party in cognitive radio networks.......Cognitive radio (CR) technology is considered as an effective solution to enhance overall spectrum efficiency, especially primary radio network (PRN) typically having relatively low spectrum utilization. However, to realize CR concept, it is essential to provide enough incentives to PRN and extra...

Enzyme-linked immunosorbent assay (ELISA for measles antibody: a comparison with haemagglutination inhibition, immunofluorescence and plaque neutralization tests Reação imunoenzimática (ELISA para detecção de anticorpos para o vírus do sarampo: comparação com reações de inibição da hema-glutinação, imunofluorescência indireta e neutralização de placas

Directory of Open Access Journals (Sweden)

Vanda Akico Ueda Fick de Souza

1991-02-01

Full Text Available An enzyme-linked immunosorbent assay (ELISA for measles antibodies was compared with Plaque Neutralization (PRN, Haemagglutination inhibition (HI and Fluorescent antibody (IFA tests in 181 sera from vaccinated children and umbilical cord. Of 179 positive samples by the sensitive PRN, only two, with titers of 8, were negative by ELISA (copositivity of 98.9%. IFA and HI presented, respectively, copo-sitivities of 93.3% and 82.7%. The ELISA presented a high sensitivity as well as a good reproducibility and represents an alternative for the time consuming PRN for detection of low measles antibodies.A reação imunoenzimática (ELISA para determinação de anticorpos para o vírus do sarampo foi comparada com a reação de neutralização de placas (RNP, inibição da hemaglutinação (RIH e imunofluorescência indireta (RIF. Das 179 amostras positivas pela RNP, somente 2, com títulos iguais a 8, se apresentaram negativas por ELISA (copositividade de 98.9%. A RIF e RIH apresentaram, respectivamente, copositividade de 93.3 e 82.7%. ELISA apresentou sensibilidade equivalente à complexa RNP, boa reprodutibilidade e representa uma alternativa para a detecção de baixos títulos de anticorpos contra o sarampo.

Ultrasound-guided continuous interscalene block: the influence of local anesthetic background delivery method on postoperative analgesia after shoulder surgery: a randomized trial.

Science.gov (United States)

Hamdani, Mehdi; Chassot, Olivier; Fournier, Roxane

2014-01-01

Automated bolus delivery has recently been shown to reduce local anesthetic consumption and improve analgesia, compared with continuous infusion, in continuous sciatic and epidural block. However, there are few data on the influence of local anesthetic delivery method on local anesthetic consumption following interscalene blockade. This randomized, double-blind trial was designed to determine whether hourly automated perineural boluses (4 mL) of local anesthesia delivered with patient-controlled pro re nata (PRN, on demand) boluses would result in a reduction in total local anesthesia consumption during continuous interscalene blockade after shoulder surgery compared with continuous perineural infusion (4 mL/h) plus patient-controlled PRN boluses. One hundred one patients undergoing major shoulder surgery under general anesthesia with ultrasound-guided continuous interscalene block were randomly assigned to receive 0.2% ropivacaine via interscalene end-hole catheter either by continuous infusion 4 mL/h (n = 50) or as automated bolus 4 mL/h (n = 51). Both delivery methods were combined with 5 mL PRN boluses of 0.2% ropivacaine with a lockout time of 30 minutes. Postoperative number of PRN boluses, 24- and 48-hour local anesthetic consumption, pain scores, rescue analgesia (morphine), and adverse events were recorded. There were no significant differences in either the number of PRN ropivacaine boluses or total 48 hour local anesthetic consumption between the groups (18.5 [11-25.2] PRN boluses in the continuous infusion group vs 17 [8.5-29] PRN boluses in the automated bolus group). Postoperative pain was similar in both groups; on day 2, the median average pain score was 4 (2-6) in the continuous infusion group versus 3 (2-5) in the automated bolus group (P = 0.54). Nor were any statistically significant intergroup differences observed with respect to morphine rescue, incidence of adverse events, or patient satisfaction. In continuous interscalene blockade under

The importance of Bordetella pertussis strains which do not produce virulence factors in the epidemiology of pertussis

Directory of Open Access Journals (Sweden)

Maciej Polak

2017-05-01

Full Text Available Bordetella pertussis strains, which have lost the ability to produce antigens, such as pertactin - Prn, pertussis toxin - Ptx, filamentous haemagglutinin - FHA, fimbriae type 2 and 3 - Fim 2 and 3, tracheal colonization factor - TcfA, have recently been isolated in countries with a high vaccination coverage. The emergence of such isolates might have resulted from B. pertussis natural evolution course or adaptive mechanisms, allowing increased circulation of the pathogen in vaccinated populations. So far, the majority of described mutants were deficient in the Prn production. Prn deficient isolates were found in countries which use acellular pertussis vaccines (aP in routine immunization programmes. The increase of frequency of Prn¯ strains isolation was correlated with the period of routine vaccination with aP vaccines. In most countries, the spread of these isolates has resulted from independent mutations rather than from the expansion of a single clone. Prn¯ isolates were collected from patients showing typical clinical symptoms of pertussis found for Prn+ strains. Results of in vitro and in vivo studies have shown that Prn¯, Ptx¯ and FHA¯ isolates retain cytotoxic properties, and besides Ptx¯ isolates, were lethal in intranasally infected mice. Further explanation of the impact of antigen deficiencies on virulence and transmission of B. pertussis in the context of the continuous increase of pertussis incidence is necessary to develop a new, optimized strategy of pertussis prevention.

Quantifying the combined effects of pronase and benzalkonium chloride in removing late-stage Listeria monocytogenes-Escherichia coli dual-species biofilms.

Science.gov (United States)

Rodríguez-López, Pedro; Puga, Carmen H; Orgaz, Belén; Cabo, Marta L

2017-09-01

This work presents the assessment of the effectivity of a pronase (PRN)-benzalkonium chloride (BAC) sequential treatment in removing Listeria monocytogenes-Escherichia coli dual-species biofilms grown on stainless steel (SS) using fluorescence microscopy and plate count assays. The effects of PRN-BAC on the occupied area (OA) by undamaged cells in 168 h dual-species samples were determined using a first-order factorial design. Empirical equations significantly (r 2 = 0.927) described a negative individual effect of BAC and a negative interactive effect of PRN-BAC achieving OA reductions up to 46%. After treatment, high numbers of remaining attached and released viable and cultivable E. coli cells were detected in PRN-BAC combinations when low BAC concentrations were used. Therefore, at appropriate BAC doses, in addition to biofilm removal, sequential application of PRN and BAC represents an appealing strategy for pathogen control on SS surfaces while hindering the dispersion of live cells into the environment.

A Prediction Model to Help with the Assessment of Adenopathy in Lung Cancer: HAL.

Science.gov (United States)

O'Connell, Oisin J; Almeida, Francisco A; Simoff, Michael J; Yarmus, Lonny; Lazarus, Ray; Young, Benjamin; Chen, Yu; Semaan, Roy; Saettele, Timothy M; Cicenia, Joseph; Bedi, Harmeet; Kliment, Corrine; Li, Liang; Sethi, Sonali; Diaz-Mendoza, Javier; Feller-Kopman, David; Song, Juhee; Gildea, Thomas; Lee, Hans; Grosu, Horiana B; Machuzak, Michael; Rodriguez-Vial, Macarena; Eapen, George A; Jimenez, Carlos A; Casal, Roberto F; Ost, David E

2017-06-15

Estimating the probability of finding N2 or N3 (prN2/3) malignant nodal disease on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with non-small cell lung cancer (NSCLC) can facilitate the selection of subsequent management strategies. To develop a clinical prediction model for estimating the prN2/3. We used the AQuIRE (American College of Chest Physicians Quality Improvement Registry, Evaluation, and Education) registry to identify patients with NSCLC with clinical radiographic stage T1-3, N0-3, M0 disease that had EBUS-TBNA for staging. The dependent variable was the presence of N2 or N3 disease (vs. N0 or N1) as assessed by EBUS-TBNA. Univariate followed by multivariable logistic regression analysis was used to develop a parsimonious clinical prediction model to estimate prN2/3. External validation was performed using data from three other hospitals. The model derivation cohort (n = 633) had a 25% prevalence of malignant N2 or N3 disease. Younger age, central location, adenocarcinoma histology, and higher positron emission tomography-computed tomography N stage were associated with a higher prN2/3. Area under the receiver operating characteristic curve was 0.85 (95% confidence interval, 0.82-0.89), model fit was acceptable (Hosmer-Lemeshow, P = 0.62; Brier score, 0.125). We externally validated the model in 722 patients. Area under the receiver operating characteristic curve was 0.88 (95% confidence interval, 0.85-0.90). Calibration using the general calibration model method resulted in acceptable goodness of fit (Hosmer-Lemeshow test, P = 0.54; Brier score, 0.132). Our prediction rule can be used to estimate prN2/3 in patients with NSCLC. The model has the potential to facilitate clinical decision making in the staging of NSCLC.

Tolerance development in Listeria monocytogenes-Escherichia coli dual-species biofilms after sublethal exposures to pronase-benzalkonium chloride combined treatments.

Science.gov (United States)

Rodríguez-López, Pedro; Cabo, Marta López

2017-10-01

This study was designed to assess the effects that sublethal exposures to pronase (PRN) and benzalkonium chloride (BAC) combined treatments have on Listeria monocytogenes-Escherichia coli dual-species biofilms grown on stainless steel in terms of tolerance development (TD) to these compounds. Additionally, fluorescence microscopy was used to observe the changes of the biofilm structure. PRN-BAC exposure was carried out using three different approaches and TD was evaluated treating biofilms with a final 100 μg/ml PRN followed by 50 μg/ml BAC combined treatment. Results showed that exposure to PRN-BAC significantly decreased the number of adhered L. monocytogenes (P reduction values were generally lower in L. monocytogenes compared to E. coli. Additionally, microscopy images showed an altered morphology produced by sublethal PRN-BAC in exposed L. monocytogenes-E. coli dual-species biofilms compared to control samples. Results also demonstrated that L. monocytogenes-E. coli dual-species biofilms are able to develop tolerance to PRN-BAC combined treatments depending on way they have been previously exposed. Moreover, they suggest that the generation of bacterial tolerance should be included as a parameter for sanitation procedures design. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Value of visual nystagmography in diagnosis of the patients with vertebrobasilar transient ischemic vertigo].

Science.gov (United States)

Guo, Ying; Zhou, Huifang

2007-07-01

To study the changes of visual nystagmography(VNG) in patients with vertebrobasilar transient ischemic vertigo(VBTIV), explore their clinical value in diagnosis of the patients with VBTIV. Thirty-eight patients who complained vertigo and imbalance with VBTIV were selected as experimental group for testing of visual nystagmography (VNG). Twenty normal persons were chosen as control group. The result was analyzed. In the experimental group, there was one case that had spontaneous nystagmus and 29 cases (76.3%) with positional nystagmus. The positional nystagmus intension in those patients was (4.08+/-3.18) degrees/s, which was much higher as compared with the control group( P VNG be used as important diagnostic test for patients with VBTIV and might be helpful for the location diagnosis of VBTIV.

Comparative efficacy of tadalafil once daily in men with erectile dysfunction who demonstrated previous partial responses to as-needed sildenafil, tadalafil, or vardenafil.

Science.gov (United States)

Kim, Edward; Seftel, Allen; Goldfischer, Evan; Baygani, Simin; Burns, Patrick

2015-02-01

Phosphodiesterase type-5 inhibitors (PDE5Is) are first-line therapies for erectile dysfunction (ED). Sildenafil (SIL) and vardenafil (VAR) are approved for as-needed (PRN) dosing; tadalafil (TAD) is approved for both PRN and once-a-day (OaD) dosing for ED. Recent evidence suggests that TAD-OaD may be effective as therapy in men with an incomplete response to PRN-PDE5I therapy. This study evaluated whether TAD-OaD provides similar efficacy in men with ED who had previously demonstrated a partial response to PRN-PDE5I therapy. In this randomized, double-blind, placebo-controlled trial, men with a ≥3 month ED history received SIL 100 mg, TAD 20 mg, or VAR 20 mg during a 4 week open-label lead-in period. Those with International Index of Erectile Function - Erectile Function (IIEF-EF) domain scores TAD 2.5 mg up-titrated to 5 mg, TAD 5 mg, or placebo (PBO) OaD for 12 weeks. MAIN OUTCOME MEASURES obtained from patients treated with TAD-OaD were compared to PBO-treated patients. Additionally, results of treatment with TAD-OaD were compared to results obtained from 4 week PRN-PDE5I therapy to determine whether OaD and PRN regimens provided comparable efficacy. NCT01130532. International Index of Erectile Function (IIEF) domain scores; Sexual Encounter Profile (SEP) questions 2-5. Endpoint data was obtained from 590 men (391 TAD; 199 PBO). RESULTS for all IIEF and SEP measures were significantly better for TAD-OaD (p TAD 2.5 mg and TAD 5 mg OaD therapy were safe and generally well tolerated. Tadalafil once daily is a viable alternative to as-needed PDE5I therapy in men with ED. Key limitations include the lack of a PRN PDE5I study group during the double-blind period, and that many more patients took tadalafil than sildenafil or vardenafil during the PRN period.

Cost-effectiveness of ranibizumab versus aflibercept in the treatment of visual impairment due to diabetic macular edema: a UK healthcare perspective

Directory of Open Access Journals (Sweden)

Régnier SA

2015-05-01

Full Text Available Stephane A Régnier,1 William Malcolm,2 Jennifer Haig,3 Weiguang Xue41Novartis Pharma AG, Basel, Switzerland; 2Novartis Pharmaceuticals UK Ltd, Frimley Business Park, UK; 3Optum, Burlington, ON, Canada; 4Optum, Uxbridge, UKBackground: Ranibizumab and aflibercept are alternative anti-vascular endothelial growth factor agents approved for the treatment of visual impairment (VI due to diabetic macular edema (DME.Objective: To estimate, from a UK healthcare perspective, the cost-effectiveness of ranibizumab 0.5 mg pro re nata (PRN and ranibizumab 0.5 mg treat and extend (T&E compared with aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8 in the treatment of VI due to DME.Methods: A Markov model previously reviewed by the National Institute for Health and Care Excellence was used to simulate the long-term outcomes and costs of treating DME. Health states were defined by increments of ten letters in best-corrected visual acuity (BCVA, with a 3-month cycle length. Patients could gain (or lose a maximum of two health states between cycles. A 3-year treatment time frame and a lifetime horizon were used. Future costs and health outcomes were discounted at 3.5% per annum. Patient baseline characteristics and the efficacy of ranibizumab PRN were derived using data from the RESTORE study. The relative efficacies of ranibizumab PRN, ranibizumab T&E, and aflibercept were assessed with a network meta-analysis. Different utilities were assigned based on BCVA and whether the treated eye was the better- or the worse-seeing eye. Sensitivity analyses tested the robustness of the model.Results: Lifetime costs per patient of treating DME were £20,019 for ranibizumab PRN, £22,930 for ranibizumab T&E, and £25,859 for aflibercept 2q8. Ranibizumab was dominant over aflibercept, with an incremental gain of 0.05 quality-adjusted life-years (QALYs and cost savings of £5,841 (PRN and £2,930 (T&E compared with aflibercept. Ranibizumab PRN and

Changes in vestibular evoked myogenic potentials after Meniere attacks.

Science.gov (United States)

Kuo, Shih-Wei; Yang, Ting-Hua; Young, Yi-Ho

2005-09-01

The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks.

A light weight secure image encryption scheme based on chaos & DNA computing

Directory of Open Access Journals (Sweden)

Bhaskar Mondal

2017-10-01

Full Text Available This paper proposed a new light weight secure cryptographic scheme for secure image communication. In this scheme the plain image is permuted first using a sequence of pseudo random number (PRN and encrypted by DeoxyriboNucleic Acid (DNA computation. Two PRN sequences are generated by a Pseudo Random Number Generator (PRNG based on cross coupled chaotic logistic map using two sets of keys. The first PRN sequence is used for permuting the plain image whereas the second PRN sequence is used for generating random DNA sequence. The number of rounds of permutation and encryption may be variable to increase security. The scheme is proposed for gray label images but the scheme may be extended for color images and text data. Simulation results exhibit that the proposed scheme can defy any kind of attack.

Barriers and facilitators to ED physician use of the test and treatment for BPPV.

Science.gov (United States)

Kerber, Kevin A; Forman, Jane; Damschroder, Laura; Telian, Steven A; Fagerlin, Angela; Johnson, Patricia; Brown, Devin L; An, Lawrence C; Morgenstern, Lewis B; Meurer, William J

2017-06-01

The test and treatment for benign paroxysmal positional vertigo (BPPV) are evidence-based practices supported by clinical guideline statements. Yet these practices are underutilized in the emergency department (ED) and interventions to promote their use are needed. To inform the development of an intervention, we interviewed ED physicians to explore barriers and facilitators to the current use of the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). We conducted semi-structured in-person interviews with ED physicians who were recruited at annual ED society meetings in the United States. We analyzed data thematically using qualitative content analysis methods. Based on 50 interviews with ED physicians, barriers that contributed to infrequent use of DHT/CRM that emerged were (1) prior negative experiences or forgetting how to perform them and (2) reliance on the history of present illness to identify BPPV, or using the DHT but misattributing patterns of nystagmus. Based on participants' responses, the principal facilitator of DHT/CRM use was prior positive experiences using these, even if infrequent. When asked which clinical supports would facilitate more frequent use of DHT/CRM, participants agreed supports needed to be brief, readily accessible, and easy to use, and to include well-annotated video examples. Interventions to promote the use of the DHT/CRM in the ED need to overcome prior negative experiences with the DHT/CRM, overreliance on the history of present illness, and the underuse and misattribution of patterns of nystagmus. Future resources need to be sensitive to provider preferences for succinct information and video examples.

Divided visual attention: A comparison of patients with multiple sclerosis and controls, assessed with an optokinetic nystagmus suppression task.

Science.gov (United States)

Williams, Isla M; Schofield, Peter; Khade, Neha; Abel, Larry A

2016-12-01

Multiple sclerosis (MS) frequently causes impairment of cognitive function. We compared patients with MS with controls on divided visual attention tasks. The MS patients' and controls' stare optokinetic nystagmus (OKN) was recorded in response to a 24°/s full field stimulus. Suppression of the OKN response, judged by the gain, was measured during tasks dividing visual attention between the fixation target and a second stimulus, central or peripheral, static or dynamic. All participants completed the Audio Recorded Cognitive Screen. MS patients had lower gain on the baseline stare OKN. OKN suppression in divided attention tasks was the same in MS patients as in controls but in both groups was better maintained in static than in dynamic tasks. In only dynamic tasks, older age was associated with less effective OKN suppression. MS patients had lower scores on a timed attention task and on memory. There was no significant correlation between attention or memory and eye movement parameters. Attention, a complex multifaceted construct, has different neural combinations for each task. Despite impairments on some measures of attention, MS patients completed the divided visual attention tasks normally. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Assessment of betahistine dihydrochloride effectiveness in the treatment of vertigo of a different aetiology based on videonystagmography test results].

Science.gov (United States)

Kantor, Ireneusz; Jurkiewicz, Dariusz

2006-03-01

Comprehensive medical history and videonystagmography (VNG) testing play very important role in balance assessment especially when dealing with balance disorders occurring occasionally. VNG in many clinical situations is performed as an initial test before complete otoneurological examination is carried out. Betahistine dihydrochloride (betahistine) a synthetic histamine analogue is one of many drugs used in the treatment of balance disorders of central or peripheral etiology. The aim of our work was to analyze, using the VNG test, effectiveness of betahistine treatment and to compare it with the control group treated with different drugs. 42 patients suffering from vertigo were evaluated before and after the treatment with betahistine. Treatment results were compared with the results of 20 vertigo sufferers treated during the same period of time with different drugs. In effort to standardize asked questions, interviews with patients were completed with specially structured questionnaire. In 54% of patients, decreased intensity and severity of vegetative symptoms was observed after the treatment with betahistine, in 45.2% of patients (30% of the control group) decreased frequency of attacks was noted. In 69.1% of patients treated with betahistine and in 50% of the control group improved results of the VNG test were noted. In 9.5% of patients (4 patients) treated with betahistine and in 20% of patients from the control group, the VNG test results were worse. Quantitative and qualitative features of the VNG test were best improved in parts of the test showing features of its central origin. In 50% of patients improvement of the symmetry in Optokinetic testing, decrease or stop of vertical component of positional nystagmus was noted. In 38.1% of patients decrease of directional predominance of nystagmus in Caloric Testing was noted. None of all examined patients exhibited features of worsening of VNG test results and no new symptoms were noted. Radiological

Emotional reaction evaluation provoked by the vestibular caloric test through physiological variables monitoring.

Science.gov (United States)

Barona-de-Guzmán, Rafael; Krstulovic-Roa, Claudio; Donderis-Malea, Elena; Barona-Lleó, Luz

2018-03-08

The emotional evaluation of the causes of vertigo is made using the clinical records and several subjective questionnaires. The aim of the present study is to evaluate the emotional response objectively, in normal subjects, during an induced vertigo crisis. A caloric vestibular test with cold water was performed on 30 healthy subjects. The following physiological parameters were monitored during the 60seconds prior to and the 60seconds after the stimulation: Skin Conductivity, Peripheral Pulse Volume, Body Temperature, Muscle Contraction, Heart Rate, and Respiratory Rate. The maximum angular speed of the nystagmus slow phase at each stimulation was assessed. Skin conductance presented a statistically significant increase during the vertigo crisis in relation to the prior period while the peripheral pulse volume presented a statistically significant decrease. There was no relationship between the slow phase of the provoked nystagmus angular speed and skin conductance and peripheral pulse volume changes. The decrease in peripheral pulse volume was significantly higher in the second vertigo crisis. Skin conductance and peripheral pulse volume changed significantly during a vertigo crisis. There was no relation between the provoked vertiginous crisis intensity and the changes produced in those variables. The stress generated by the caloric stimulation is higher in the second crisis, when the subject has experience of the vertigo caused by the stimulation. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical and ocular motor analysis of the infantile nystagmus syndrome in the first 6 months of life.

Science.gov (United States)

Hertle, R W; Maldanado, V K; Maybodi, M; Yang, D

2002-06-01

The infantile nystagmus syndrome (INS) usually begins in infancy and may or may not be associated with visual sensory system abnormalities. Little is known about its specific waveforms in the first 6 months of life or their relation to the developing visual system. This study identifies the clinical and ocular motility characteristics of the INS and establishes the range of waveforms present in the first 6 months of life. 27 infants with involuntary ocular oscillations typical of INS are included in this analysis. They were evaluated both clinically and with motility recordings. Eye movement analysis was performed off line from computer analysis of digitised data. Variables analysed included age, sex, vision, ocular abnormalities, head position, and null zone, neutral zone characteristics, symmetry, conjugacy, waveforms, frequencies, and foveation times. Ages ranged from 3 to 6.5 months (average 4.9 months). 15 patients (56%) had abnormal vision for age, nine (33%) had strabismus, five (19%) had an anomalous head posture, 13 (48%) had oculographic null and neutral positions, nine (33%) had binocular asymmetry, and only two showed consistent dysconjugacy. Average binocular frequency was 3.3 Hz, monocular frequency 6.6 Hz. Average foveation periods were longer and more "jerk" wave forms were observed in those patients with normal vision. Common clinical characteristics and eye movement waveforms of INS begin in the first few months of infancy and waveform analysis at this time may help with both diagnosis and visual status.

Preoperative vestibular assessment protocol of cochlear implant surgery: an analytical descriptive study.

Science.gov (United States)

Bittar, Roseli Saraiva Moreira; Sato, Eduardo Setsuo; Ribeiro, Douglas Jósimo Silva; Tsuji, Robinson Koji

Cochlear implants are undeniably an effective method for the recovery of hearing function in patients with hearing loss. To describe the preoperative vestibular assessment protocol in subjects who will be submitted to cochlear implants. Our institutional protocol provides the vestibular diagnosis through six simple tests: Romberg and Fukuda tests, assessment for spontaneous nystagmus, Head Impulse Test, evaluation for Head Shaking Nystagmus and caloric test. 21 patients were evaluated with a mean age of 42.75±14.38 years. Only 28% of the sample had all normal test results. The presence of asymmetric vestibular information was documented through the caloric test in 32% of the sample and spontaneous nystagmus was an important clue for the diagnosis. Bilateral vestibular areflexia was present in four subjects, unilateral arreflexia in three and bilateral hyporeflexia in two. The Head Impulse Test was a significant indicator for the diagnosis of areflexia in the tested ear (p=0.0001). The sensitized Romberg test using a foam pad was able to diagnose severe vestibular function impairment (p=0.003). The six clinical tests were able to identify the presence or absence of vestibular function and function asymmetry between the ears of the same individual. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Emergency department documentation templates: variability in template selection and association with physical examination and test ordering in dizziness presentations

Directory of Open Access Journals (Sweden)

Meurer William J

2011-03-01

Full Text Available Abstract Background Clinical documentation systems, such as templates, have been associated with process utilization. The T-System emergency department (ED templates are widely used but lacking are analyses of the templates association with processes. This system is also unique because of the many different template options available, and thus the selection of the template may also be important. We aimed to describe the selection of templates in ED dizziness presentations and to investigate the association between items on templates and process utilization. Methods Dizziness visits were captured from a population-based study of EDs that use documentation templates. Two relevant process outcomes were assessed: head computerized tomography (CT scan and nystagmus examination. Multivariable logistic regression was used to estimate the probability of each outcome for patients who did or did not receive a relevant-item template. Propensity scores were also used to adjust for selection effects. Results The final cohort was 1,485 visits. Thirty-one different templates were used. Use of a template with a head CT item was associated with an increase in the adjusted probability of head CT utilization from 12.2% (95% CI, 8.9%-16.6% to 29.3% (95% CI, 26.0%-32.9%. The adjusted probability of documentation of a nystagmus assessment increased from 12.0% (95%CI, 8.8%-16.2% when a nystagmus-item template was not used to 95.0% (95% CI, 92.8%-96.6% when a nystagmus-item template was used. The associations remained significant after propensity score adjustments. Conclusions Providers use many different templates in dizziness presentations. Important differences exist in the various templates and the template that is used likely impacts process utilization, even though selection may be arbitrary. The optimal design and selection of templates may offer a feasible and effective opportunity to improve care delivery.

Effect of the stringency of conditions on caloric test results in healthy subjects.

Science.gov (United States)

Krstulovic, Claudio; Tulsidas Mahtani, Bharti; Atrache Al Attrache, Nabil; Pérez-Garrigues, Herminio

The caloric test is widely used to assess vestibular function, but the conditions in which it is performed can vary. Caloric nystagmus obtained in 57 healthy subjects were compared: 24 subjects studied in ideal conditions and 33 subjects in non-ideal conditions. A statistically significant decrease in the slow phase velocity of the 4 irrigations performed on the subjects in non-ideal conditions was observed. This must be considered, especially in subjects with suspected bilateral involvement. Stringent conditions reduce the risk of misdiagnosis with bilateral deficit. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Detección de Anticuerpos IgG Específicos para Sarampión mediante la Técnica de Inmunofluorescencia Indirecta

Directory of Open Access Journals (Sweden)

Mónica Nieto Z

2000-01-01

Full Text Available La técnica de ínmunofluorescencia indirecta para detectar anticuerpos IgG específicos a sarampión (IFI-IgG fue evaluada con la prueba de neutralización por reducción de placas (PRN con 128 muestras de suero de personas con edades entre 0 y 15 años, 64 con antecedente de vacunación y 64 sin éste antecedente. El IFI-IgG alcanzó una sensibilidad de 80,4% y una especificidad de 100,0%, mostrando ser una prueba sencilla, reproducible, y tener correlación con PRN, aunque menos sensible que ésta última, especialmente cuando la PRN estimó títulos bajos de anticuerpos. Se concluye que la técnica IFI-IgG puede ser usada como método de rutina para la confirmación de sarampión en muestras de fase aguda y convalesciente de la enfermedad (sueros pareados, así como para estudios de prevalencia de anticuerpos en la comunidad, aunque no reemplazaría a la PRN.

Resistance to changing practice from pro re nata prescriptions to patient group directions in acute mental health settings.

Science.gov (United States)

Price, O; Baker, J A

2013-09-01

Poor practice associated with pro re nata (PRN) prescriptions in mental health is known to be common and can increase the risk of serious and potentially fatal side effects. A contributing factor to poor practice is the lack of a clear chain of accountability between the decision to prescribe and administer PRN prescriptions. To address this problem, a patient group direction (PGD) for acute behavioural disturbance (lorazepam 0.5-2 mg) and staff training materials were developed. The intention was to replace PRN prescriptions with the PGD in two mental health trusts. One of the potential benefits of this would be the removal of the contribution of PRN to high and combined dose antipsychotic prescriptions. This proposal, however, was met with significant resistance in both trusts and did not replace PRN as a result. A series of interviews and focus groups were conducted with 16 RMNs working in the two trusts, to explore the reasons why the PGD was met with resistance. Senior nurses perceived resistance to be associated with anxieties over increased responsibility for decision making. Junior nurses reported concerns regarding the medicalization of the nursing role, the paperwork associated with the PGD and the training approach used. Future efforts to implement PGDs in mental health settings must carefully consider the methods for engaging effectively with participating organizations, in terms of managing change and completing the necessary groundwork for successful implementation. © 2012 John Wiley & Sons Ltd.

Vestibular Function Impairment in Alzheimer's Disease.

Science.gov (United States)

Nakamagoe, Kiyotaka; Fujimiya, Suguru; Koganezawa, Tadachika; Kadono, Kotarou; Shimizu, Kotone; Fujizuka, Natsu; Takiguchi, Shino; Ueno, Tomoyuki; Monzen, Tatsuya; Tamaoka, Akira

2015-01-01

Falls and fractures due to impaired balance in patients with Alzheimer's disease (AD) have an adverse effect on the clinical course of the disease. To evaluate balance impairment in AD from the viewpoint of vestibular functional impairment. The subjects were 12 patients with AD, 12 dementia-free elderly adults, and 12 younger adults. Vestibular function was assessed using a stepping test, caloric nystagmus, and a visual suppression (VS) test. The stepping test was abnormal in 9 of the 12 patients in the AD group. An abnormal stepping test was not associated with self-reported dizziness or tendency to fall. Significant VS abnormalities were present in the AD group. The suppression rate of VS was lower in AD patients with either a tendency to fall or constructional apraxia than in AD patients without either. The velocity of the rapid phase of caloric nystagmus before the VS test was similar in the AD group and the elderly control group. Significant abnormalities of both caloric nystagmus and VS were not present in either the elderly or the younger control groups. AD could involve impairments in the vestibular control of balance. The VS test is useful for assessing the tendency to fall in AD. Impairment of VS in AD might arise from cerebral vestibular cortex impairment rather than comorbid peripheral vestibular disorders.

Evidence of central and peripheral vestibular pathology in blast-related traumatic brain injury.

Science.gov (United States)

Scherer, Matthew R; Burrows, Holly; Pinto, Robin; Littlefield, Philip; French, Louis M; Tarbett, Aaron K; Schubert, Michael C

2011-06-01

To prospectively assay the vestibular and oculomotor systems of blast-exposed service members with traumatic brain injury (TBI). Prospective, nonblinded, nonrandomized descriptive study. Tertiary care facility (Department of Defense Medical Center). Twenty-four service members recovering from blast-related TBI sustained in Iraq or Afghanistan. Focused history and physical, videonystagmography (VNG), rotational chair, cervical vestibular-evoked myogenic potentials, computerized dynamic posturography, and self-report measures. Vestibular testing confirms a greater incidence of vestibular and oculomotor dysfunction in symptomatic (vestibular-like dizziness) personnel with blast-related TBI relative to asymptomatic group members. VNG in the symptomatic group revealed abnormal nystagmus or oculomotor findings in 6 of 12 subjects tested. Similarly, rotational chair testing in this group revealed evidence of both peripheral (4/12) and central (2/12) vestibular pathology. By contrast, the asymptomatic group revealed less vestibular impairment with 1 of 10 rotational chair abnormalities. The asymptomatic group was further characterized by fewer aberrant nystagmus findings (4/12 abnormal VNGs). Computerized dynamic posturography testing revealed no significant differences between groups. Self-report measures demonstrated differences between groups. Vestibular function testing confirms a greater incidence of peripheral vestibular hypofunction in dizzy service members with blast-related TBI relative to those who are asymptomatic. Additionally, oculomotor abnormalities and/or nystagmus consistent with central involvement were present in 10 of the 24 study participants tested. The precise cause of these findings remains unknown.

Alexander's law revisited.

Science.gov (United States)

Jacobson, Gary P; McCaslin, Devin L; Kaylie, David M

2008-09-01

It is a common occurrence in the balance function laboratory to evaluate patients in the post-acute period following unilateral vestibular system impairment. It is important to be able to differentiate spontaneous nystagmus (SN) emanating from peripheral vestibular system impairments from asymmetric gaze-evoked nystagmus (GEN) that originates from central ocular motility impairment. To describe the three elements of Alexander's Law (AL) that have been used to define SN from unilateral peripheral impairment. Additionally, a fourth element is described (i.e., augmentation of spontaneous nystagmus from unilateral peripheral vestibular system impairment) that differentiates nystagmus of peripheral vestibular system origin from nystagmus that originates from a central eye movement disorder. Case reports. Case data were obtained from two patients both showing a nystagmus that followed AL. None Videonystagmography (VNG), rotational, vestibular evoked myogenic potential (VEMP), and neuro-imaging studies were presented for each patient. The nystagmus in Case 1 occurred as a result of a unilateral, peripheral, vestibular system impairment. The nystagmus was direction-fixed and intensified in the vision-denied condition. The nystagmus in Case 2, by appearance identical to that in Case 1, was an asymmetric gaze-evoked nystagmus originating from a space-occupying lesion in the cerebello-pontine angle. Unlike Case 1, the nystagmus did not augment in the vision-denied condition. Although nystagmus following AL usually occurs in acute peripheral vestibular system impairment, it can occur in cases of central eye movement impairment. The key element is whether the SN that follows AL is attenuated or augmented in the vision-denied condition. The SN from a unilateral peripheral vestibular system impairment should augment in the vision denied condition. An asymmetric GEN will either not augment, decrease in magnitude, or disappear entirely, in the vision-denied condition.

Comprehensive visual impairment evaluation for cerebral palsy children

Directory of Open Access Journals (Sweden)

Ping Wang

2015-01-01

Full Text Available AIM: To evaluate the visual impairment in cerebral palsy children with series objective indicators, and conclude their clinical features of visual function.METHODS: Objective tests including following pursuing test, optokinetic nystagmus(OKNdrum test, refractive error examination, fundus examination, ocular deviation examination, pattern visual evoked potential(P-VEPtests and brain magnetic resonance imaging(MRIwere carried out in 43 cerebral palsy children(86 eyeswith ocular visual dysfunction; The visual impairment data of the cerebral palsy children were collected, and the clinical features and possible mechanism were analyzed.RESULTS: 1. Of the 43 cerebral palsy children(86 eyeswith the visual impairment presented diversified, 25(50 eyes, 58.1%of refractive error, 24(48 eyes, 55.8%of strabismus, 12(24 eyes, 27.9%with nystagmus, 19(38 eyes, 44.2%of optical nerve atrophy or hyperplasia, 35(70 eyes, 81.4%of VEP abnormality. Among children with spastic cerebral palsy, the incidence of visual impairment was statistically significant difference compared with other groups(PP>0.05, no nystagmus in patients with severe occipital cortex damage.CONCLUSION: Cerebral palsy children were usually with visual impairment, and presented with special clinical features; Comprehensive objective visual tests are accurate and reliable for evaluation of the visual function in cerebral palsy children.

PRN 88-2: Clustering of Quaternary Ammonium Compounds

Science.gov (United States)

This Notice announces that EPA has clustered the Quaternary Ammonium Compounds into four groups for the purpose of testing chemicals to build a database that will support continued registration of the entire family of quaternary ammonium compounds

[The changes in vestibular function in patients with diabetes mellitus and its clinical significance].

Science.gov (United States)

Li, Juan; Zhang, Tianyu; Shen, Jianzhong; Gong, Jingrong; Wang, Hongli; Zhang, Jimin; Pang, Yufeng

2008-01-01

To study the changes of vestibular function in patients with diabetes mellitus and its clinical significance. Electronystagmography (ENG) was used to examine 76 patients with diabetes mellitus and 60 healthy adults subjects. After clinical detection of vestibular function including spontaneous nystagmus, positional test, head shaking nystagmus, neck torsion test, caloric test, and sensory organization tests which consist of gaze, saccade and smooth pursuit test, the results of these two groups were recorded for qualitative and quantitative statistical analysis. The rate of vestibular dysfunction in patients with diabetes mellitus were 68.4%. and that of the controls were 8.3%. There was significant difference between these two groups (chi2 = 15.472, P Vertigo or dizziness occurred in patients with diabetes mellitus might be related to vestibular dysfunction. ENG test could be used as one of the objective clinical examinations in patients with diabetes mellitus.

Switching from pro re nata to treat-and-extend regimen improves visual acuity in patients with neovascular age-related macular degeneration.

Science.gov (United States)

Kvannli, Line; Krohn, Jørgen

2017-11-01

To evaluate the visual outcome after transitioning from a pro re nata (PRN) intravitreal injection regimen to a treat-and-extend (TAE) regimen for patients with neovascular age-related macular degeneration (AMD). A retrospective review of patients who were switched from a PRN regimen with intravitreal injections of bevacizumab, ranibizumab or aflibercept to a TAE regimen. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and type of medication used at baseline, at the time of changing treatment regimen and at the end of the study were analysed. Twenty-one eyes of 21 patients met the inclusion criteria. Prior to the switch, the patients received a mean of 13.8 injections (median, 10; range, 3-39 injections) with the PRN regimen for 44 months (range, 3-100 months), which improved the visual acuity in five patients (24%). After a mean of 6.1 injections (median, 5; range, 3-14 injections) with the TAE regimen over 8 months (range, 2-16 months), the visual acuity improved in 12 patients (57%). The improvement in visual acuity during treatment with the TAE regimen was statistically significant (p = 0.005). The proportion of patients with a visual acuity of 0.2 or better was significantly higher after treatment with the TAE regimen than after treatment with the PRN regimen (p = 0.048). No significant differences in CRT were found between the two treatment regimens. Even after prolonged treatment and a high number of intravitreal injections, switching AMD patients from a PRN regimen to a strict TAE regimen significantly improves visual acuity. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

[Normative values of kinetic tests in VNG assessment].

Science.gov (United States)

Zamysłowska-Szmytke, Ewa; Sliwińska-Kowalska, Mariola

2011-01-01

Balance assessment plays an important role in occupational medicine. The diagnosis of patients with balance disturbances is based on a number of laboratory tests, including rotational chair tests, one of the most important. The normative value of kinetic tests greatly depends on movement parameters and laboratory equipment, which vary between diagnostic centers. The aim of the presented paper was to establish normatives for our laboratory and testing methodology in a group of healthy persons. The balance examination included 45 healthy persons (21 women and 24 men) aged 20-63 years (mean 38.5 +/- 14.9). The study population underwent very thorough neuro-otological examination, static posturography and VNG tests. The caloric test result was a crucial criterion for inclusion to the group of healthy persons. Rotational tests included: one "burst" test analyzing vestibulo-ocular reflex (VOR) with and without optokinetic stimulation visual vestibular optokinetic reflex (VVOR) and cervico-ocular reflex (COR); three impulse tests and sinusoidal harmonic rotation tests of 0.04, 0.08, 0.1, 0.16, 0.32, and 0.64 Hz. The mean values were: VVOR, 0.9 +/- 0.1; VOR, 0.5 +/- 0.1; and COR, 0.2 +/- 0.1. The mean value of rotational and post-rotational nystagmus induced by sudden chair stop (impulse stimulus) was 9 +/- 7 s, the gain values were 0.4 for sinusoidal tests, in the stimulation range of 0.1-0.32 and 0.5 for 0.64 Hz stimulation. There was no significant linear relationship between age and test parameters except for the test using sinusoidal-decreasing stimulation. These normative values form the base for a closer incorporation of rotational tests in occupational medicine procedures.

Clinical statistics of patients with dizziness consulting the emergency outpatient clinic

International Nuclear Information System (INIS)

Ogawa, Yasuo; Hagiwara, Akira; Kitajima, Naoharu; Inagaki, Taro; Shimizu, Masaaki; Furuse, Hiroko; Konomi, Ujimoto; Yukawa, Kumiko; Suzuki, Mamoru

2007-01-01

Between May 2004 and April 2006, 468 emergency patients with vertigo or dizziness consulted the otorhinolarygological emergency room of Tokyo Medical University. Patients with vertigo or dizziness comprised about 9% of the whole otorhinolaryngological emergency patients. The number of female patients was larger than that of male patients. About half of the patients were brought to our hospital by ambulance. Nystagmus was observed in 219 patients (46.8%). Incidence of nystagmus was highest on positional nystagmus test. Brain CT was obtained in 185 patients (39.5%), but there were no abnormal findings in any patients. The most frequent diagnosis was inner ear disorder (22%), followed by Meniere's disease (7%), vestibular neuritis (6%), Benign paroxysmal positional vertigo (BPPV) (6%). Cerebral infarction was observed in 1.9%. Eighty-four patients were admitted. Major diseases requiring admission were vestibular neuritis and inner ear disorder. In patients with cerebral infarction, brain CT was normal. These patients were all elderly males over 60 years old. Their nystagmus in the emergency room did not suggest central disorder, or they did not have other neurological findings. Neurological signs and symptoms appeared thereafter. In the emergency room, establishing a diagnosis by limited examination is difficult. Careful examination is necessary, since vertigo or dizzy patient with a central disorder can show sudden change. (author)

Nystagmus

Science.gov (United States)

... with Myopia Aug 31, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, 2017 Combating ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

A reevaluation of the vestibulo-ocular reflex: new ideas of its purpose, properties, neural substrate, and disorders

Science.gov (United States)

Leigh, R. J.; Brandt, T.

1993-01-01

Conventional views of the vestibulo-ocular reflex (VOR) have emphasized testing with caloric stimuli and by passively rotating patients at low frequencies in a chair. The properties of the VOR tested under these conditions differ from the performance of this reflex during the natural function for which it evolved--locomotion. Only the VOR (and not visually mediated eye movements) can cope with the high-frequency angular and linear perturbations of the head that occur during locomotion; this is achieved by generating eye movements at short latency (disorders that disrupt the VOR cause not just only nystagmus, but also instability of posture (eg, increased fore-aft sway in patients with downbeat nystagmus) and disturbance of spatial orientation (eg, tilt of the subjective visual vertical in Wallenberg's syndrome).

[Immunogenicity and protective efficacy of pertactin recombinants against Bordetella bronchiseptica challenge].

Science.gov (United States)

Zhao, Zhanqin; Wang, Chen; Xue, Yun; Ding, Ke; Zhang, Chunjie; Cheng, Xiangchao; Li, Yinju; Liu, Yichen; Wu, Tingcai

2010-09-01

In this study we showed the immunogenicity and protective efficacy of five pertactin recombinants against Bordetella bronchiseptica (Bb) challenge. The complete coding sequence (2040 bp) of the prn gene (PRN) and its fragments,5'-terminal 1173 bp fragment (PN),3'-terminal 867 bp fragment (PC), two copies of region I (654 bp; PR I) in PN, and 2 copies of region II (678 bp; PR II) in PC, were separately cloned into the prokaryotic expression vector pGEX-KG, and expressed in the Eschierichia coli BL21 (DE3) using induction by isopropyl-beta-D-thiogalactopyranoside. The recombinant proteins were named GST-PRN, GST-PN, GST-PC, GST-2PR I and GST-2PR II. All five recombinant proteins showed immunological reactivity in the Western-blot analysis. Mice, immunized subcutaneously with two doses of the purified proteins mixed with an equal volume of Freund's adjuvant,produced robust PRN-specific IgG antibody levels. When challenged, 6 of 9 mice in GST-2PR I group and all 9 mice in the other groups survived intranasal challenge with three times the 50% lethal dose (LD50) of virulent Bb HH0809. After challenge with 10 LD50 7/9,3/9,6/9,1/10 and 6/10 of the mice survived. Furthermore, complete protection against intraperitoneal (i.p.) challenge with 10 LD50 of HH0809 was observed in mice that were injected i.p. with 0.5 ml rabbit anti-GST-PRN, GST-PN,GST-PC or GST-2PR II serum. Only 1 of 10 mice survived in the group of mice that received anti-GST-2PR I, and no survivors were noted in the group of mice that received PRN-absorbed rabbit antiserum (0/5). In this study,we showed that all of five pertactin recombinants had differential immunogenicity and protective efficacy against Bb challenge. Mice immunized with GST-PC had better survival against fatal Bb challenge than did those immunized with GST-PN. In addition, GST-2PR II and GST-2PR I provided the similar results These data may have implications for the development of safe and efficacious subunit vaccines for the prevention of

Can emergency physicians accurately and reliably assess acute vertigo in the emergency department?

Science.gov (United States)

Vanni, Simone; Nazerian, Peiman; Casati, Carlotta; Moroni, Federico; Risso, Michele; Ottaviani, Maddalena; Pecci, Rudi; Pepe, Giuseppe; Vannucchi, Paolo; Grifoni, Stefano

2015-04-01

To validate a clinical diagnostic tool, used by emergency physicians (EPs), to diagnose the central cause of patients presenting with vertigo, and to determine interrater reliability of this tool. A convenience sample of adult patients presenting to a single academic ED with isolated vertigo (i.e. vertigo without other neurological deficits) was prospectively evaluated with STANDING (SponTAneousNystagmus, Direction, head Impulse test, standiNG) by five trained EPs. The first step focused on the presence of spontaneous nystagmus, the second on the direction of nystagmus, the third on head impulse test and the fourth on gait. The local standard practice, senior audiologist evaluation corroborated by neuroimaging when deemed appropriate, was considered the reference standard. Sensitivity and specificity of STANDING were calculated. On the first 30 patients, inter-observer agreement among EPs was also assessed. Five EPs with limited experience in nystagmus assessment volunteered to participate in the present study enrolling 98 patients. Their average evaluation time was 9.9 ± 2.8 min (range 6-17). Central acute vertigo was suspected in 16 (16.3%) patients. There were 13 true positives, three false positives, 81 true negatives and one false negative, with a high sensitivity (92.9%, 95% CI 70-100%) and specificity (96.4%, 95% CI 93-38%) for central acute vertigo according to senior audiologist evaluation. The Cohen's kappas of the first, second, third and fourth steps of the STANDING were 0.86, 0.93, 0.73 and 0.78, respectively. The whole test showed a good inter-observer agreement (k = 0.76, 95% CI 0.45-1). In the hands of EPs, STANDING showed a good inter-observer agreement and accuracy validated against the local standard of care. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

El liberalismo conservador y la ideología del Proceso de Reorganización Nacional

Directory of Open Access Journals (Sweden)

Sergio Morresi

2010-06-01

Full Text Available This article aims to show that the political ideas of the selfnamed "National Reorganization Process -Proceso de Reorganización Nacional [PRN]" -were structured within the ideological frame offered by conservative-liberalism. Through the study of some of the ideologicalpromoters of the PRN, it is argued that conservative-liberalism served as merger of the different types of argentinian rights and laid the foundations for the neoliberal ideas that were impelled afer the dictatorship period

Curriculum and instructional methods for drug information, literature evaluation, and biostatistics: survey of US pharmacy schools.

Science.gov (United States)

Phillips, Jennifer A; Gabay, Michael P; Ficzere, Cathy; Ward, Kristina E

2012-06-01

The drug information curriculum in US colleges of pharmacy continues to evolve. The American College of Clinical Pharmacy (ACCP) Drug Information Practice and Research Network (DI PRN) published an opinion paper with specific recommendations regarding drug information education in 2009. Adoption of these recommendations has not been evaluated. To assess which recommendations made in the ACCP DI PRN opinion paper are included in US pharmacy school curricula and characterize faculty qualifications, educational methods, and recent changes in drug information education. An electronic survey was designed using the ACCP DI PRN opinion paper and the Accreditation Council for Pharmacy Education standards and guidelines for accreditation of PharmD programs in the US. Survey questions addressed curricular content within the following categories: drug information, literature evaluation, and biostatistics. A letter including the online survey link was sent via email to the dean of each US college/school of pharmacy (N = 128). Recipients were instructed to forward the email to the individual at their institution who was the most knowledgeable about the content and methodology used for didactic drug information education. Sixty-four responses were included in the final analysis. Of the 19 ACCP DI PRN minimum core concepts, 9 (47%) were included in curricula of all responding institutions; 14 of 19 (74%) were included in curricula for all but 1 institution. In contrast, 5 of 16 concepts (31%) were not formally taught by a number of institutions. Many respondents noted an increased focus on evidence-based medicine, medication safety, and informatics. Although a survey of drug information curricula documented substantial inclusion of the essential concepts presented in the ACCP DI PRN opinion paper, room for improvement remains in drug information curricula in US colleges of pharmacy.

PRN 2007-2: Guidance on Small-Scale Field Testing and Low-level Presence in Food of Plant-Incorporated Protectants (PIPs)

Science.gov (United States)

This notice clarifies how EPA ensures the safety of residues of PIPs possibly present in food or feed and when a tolerance or tolerance exemption would be required for field tests for biotechnology-derived food and feed crop plants containing PIPs.

Nitrogenated compounds' biofiltration under alternative bacterium fixation substrates Biofiltración de compuestos nitrogenados bajo medios de fijación bacteriana alternativos

Directory of Open Access Journals (Sweden)

Carlos Carroza

2012-09-01

Full Text Available This study compares the behavior of nitrification (NH4+, NO2- and NO3-, and performance, in terms of the surface TAN conversion rate (STR, volumetric TAN conversion rate (VTR and removal percentage of TAN (PTR among three fixation media of nitrifying bacteria (two alternatives (S1, S2 and one commercial (Co. The experiment was performed in two tests of 42 days each. Three isolated biofiltration systems were built for the experience, to which were added media colonized by bacteria as a "seed" to start the process of nitrification. Ammonium chloride (NH4Cl was attached as source of ammonium in reconditioned freshwater, also gradually adding inorganic carbon (HCO3- to maintain moderate water hardness. The average results for both tests indicate that the substrates S1 and S2 show a statistically similar behavior to the substrate Co (P > 0.05 during the first 33 days (until steady state. For the second test in terms of performance, STR values were 0.40, 0.39, 0.39 g TAN m-2 d-1 recorded for S2 and Co respectively; in terms of PRN, values were 92(3 9־/ and 93% for S1, S2 and Co, respectively. Regarding VTR, values of 72.31, 114.94, and 39.02 g TAN m-3 d-1 were recorded for S2 and Co respectively. Statistical analysis provided that for STR and PRN, no significant differences, were found. But for VTR, statistically significant differences between means were evaluated, registering for the S2 media the highest value of VTR.Se compara el comportamiento del proceso de nitrificación (NH4+, NO2- y NO3-, y el rendimiento, en términos de la tasa superficial de conversión de NAT, tasa volumétrica de conversión de NAT y porcentaje de remoción de NAT (PRN entre tres medios de fijación de bacterias nitrificantes, dos alternativos (S1, S2 y uno comercial (Co. La experiencia se realizó en dos pruebas de 42 días cada una. Se construyeron tres sistemas aislados para la experiencia, a los cuales se adicionaron medios colonizados por bacterias a modo de

Effect Of Prolonged Monocular Occlusion On Latent Nystagms

NARCIS (Netherlands)

H.J. Simonsz (Huib); G. Kommerell (Guntram)

1992-01-01

textabstractThe authors recorded nystagmus during seeing with one eye in eight patients with latent nystagmus (LN) before and after two or three days of prolonged occlusion of the better eye (POBE). Before POBE, the slow-phase speed of the nystagmus (SPS) was usually higher when the better eye was

Magnetic Vestibular Stimulation in Subjects with Unilateral Labyrinthine Disorders

Directory of Open Access Journals (Sweden)

Bryan Kevin Ward

2014-03-01

Full Text Available We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magnetohydrodynamic (MHD Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS in individuals with unilateral loss of labyrinthine function is unknown and may provide insight into mechanism of MVS. These individuals should experience MVS, but with differences consistent with their residual labyrinthine function. We recorded eye movements in the static magnetic field of a 7T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP. Eye movements were recorded using infrared videooculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology.

El silencio bajo la última Dictadura Militar en la Argentina

Directory of Open Access Journals (Sweden)

Mercedes María Barros

2009-12-01

Full Text Available This paper explores the issue of silence under the last military dictatorship in Argentina (1976-1983. Silence spread rapidly in Argentine society during the first years of the so called National Reorganization Process (PRN and it became crucial for the maintenance of the illegal regime, This silence was actually assured not only by the action of the military government, but also by the clear identification of the political and social forces with the aims and values of the Proceso. However, this prevailing silence and the resulting failure of the existing discourses to articulate the effects of the dirty war resulted in a temporal suspension of meaning within the reality of the PRN. Silence became then the instance that would finally put into question the apparently smooth functioning of the PRN and would force the emergence and constitution of a new social movement and a new language of human rights in the country.

Implementation of Trauma-Informed Care and Brief Solution-Focused Therapy: A Quality Improvement Project Aimed at Increasing Engagement on an Inpatient Psychiatric Unit.

Science.gov (United States)

Aremu, Babatunde; Hill, Pamela D; McNeal, Joanne M; Petersen, Mary A; Swanberg, Debbie; Delaney, Kathleen R

2018-03-14

Addressing tense and escalating situations with noncoercive measures is an important element of inpatient psychiatric treatment. Although restraint rates are frequently monitored, the use of pro re nata (PRN) intramuscular (IM) injections to address agitation is also an important indicator. In 2015, at the current study site, a significant increase was noted in PRN IM medication use despite unit leadership's efforts to build a culture of trauma-informed care (TIC). The purpose of the current quality improvement project was to educate staff on methods to incorporate TIC into daily practice and the use of brief solution-focused therapy techniques in escalating situations. Measurement of attitudes toward patient aggression and engagement with patients followed two waves of staff education. Upon completion of the project, a decrease in PRN IM medications, improvement in staff attitudes toward patient aggression, and improved sense of staff competency in handling tense situations were noted. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.]. Copyright 2018, SLACK Incorporated.

Changes of ampulla pressure in the semicircular canal of pigeons by caloric stimulation

Science.gov (United States)

Wada, Yoshiro; Suzuki, Hiroyuki; Watanabe, Satoru

Still now several hypotheses about the mechanisms of the caloric nystagmus have been in conclusive. In this study we confirmed the convection effect and the volume change effect of the endolymph in horizontal semicircular canal following the caloric stimulation using pigeons ( Columba livia). Although the direction of the caloric nystagmus depended on the head position and the stimulus site of calorization, the caloric nystagmus disappeared after plugging of horizontal semicircular canal. On the other hand, the ampulla pressure increased by cold calorization and decreased by hot calorization and these pressure changes had no relation to the head position. These results show that the main role of the mechanisms of the caloric nystagmus under 1G is the convection effect but the volume change effect may act on the caloric nystagmus not only under 1G but also under microgravity.

Vestibular Dysfunction in Preschool Children with a History of Otitis Media.

Science.gov (United States)

Denning, Jennifer; Mayberry, Wanda

1987-01-01

Thirty-five preschoolers, assigned to otitis media (OM) or no OM groups, were administered the Southern California Postrotary Nystagmus Test and the Miller Assessment for Preschoolers (MAP). Children with a history of OM had significantly decreased scores on the Stepping and Vertical Writing MAP tests, indicating vestibulospinal dysfunction. (SK)

Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing.

Science.gov (United States)

La Frenais, Francesca L; Bedder, Rachel; Vickerstaff, Victoria; Stone, Patrick; Sampson, Elizabeth L

2018-02-01

To explore global changes in the prescription of analgesic drugs over time in the international long-term care (LTC) population. Systematic review. We included original research articles in English, published and unpublished, that included number of participants, country and year(s) of data collection, and prescription of analgesics (analgesics not otherwise specified, opioids, acetaminophen; scheduled only, or scheduled plus as needed (PRN)). LTC residents. We searched PubMed, EMBASE, CINAHL, International Pharmaceutical Abstracts, PsycINFO, Cochrane, Web of Science, Google Scholar, using keywords for LTC facilities and analgesic medication; hand-searched references of eligible papers; correspondence. Studies were quality rated using an adapted Newcastle-Ottawa scale. Pearson correlation coefficients were generated between percentage of residents prescribed an analgesic and year of data collection. If available, we investigated changes in acetaminophen and opioid prescriptions. Forty studies met inclusion criteria. A moderate correlation (0.59) suggested that scheduled prescription rates for analgesics have increased over time. Similar findings were reflected in scheduled prescriptions for acetaminophen and opioids. No increase was seen when analyzing scheduled plus PRN analgesics. Use of opioids (scheduled plus PRN) appears to have increased over time. Worldwide, use of opioids and acetaminophen has increased in LTC residents. Research is needed to explore whether this reflects appropriate pain management for LTC residents and if PRN medication is used effectively. © 2017 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

2017 AMcard prn.pmd

Indian Academy of Sciences (India)

Administrator

2017-11-03

Nov 3, 2017 ... Chairperson: M M Sarin, Physical Research laboratory, Ahmedabad. 1200–1220 Shailesh Nayak, Ministry of Earth Sciences, New Delhi. Towards the understanding of triggered earthquakes. 1225–1245 Gobinda Majumder, Tata Institute of Fundamental Research, Mumbai. A journey to the discovery of ...

Vertigo and electronystagmography in uni- and bilateral Meniere's disease

NARCIS (Netherlands)

Mateijsen, DJM; Hengel, PWJ; Kingma, H; Oreel, MA; Wit, HP; Albers, FWJ

2001-01-01

In this study we performed standardized measurements of spontaneous nystagmus (SN), caloric tests and velocity step tests on a well-defined group of 92 Meniere patients as part of a diagnostic protocol. The aim of the study was to look for results that could contribute to the diagnosis, but more

Pyrrolnitrin and Hydrogen Cyanide Production by Pseudomonas chlororaphis Strain PA23 Exhibits Nematicidal and Repellent Activity against Caenorhabditis elegans.

Directory of Open Access Journals (Sweden)

Munmun Nandi

Full Text Available Pseudomonas chlororaphis strain PA23 is a biocontrol agent able to suppress growth of the fungal pathogen Sclerotinia sclerotiorum. This bacterium produces an arsenal of exometabolites including pyrrolnitrin (PRN, phenazine (PHZ, hydrogen cyanide (HCN, and degradative enzymes. Production of these compounds is controlled at both the transcriptional and posttranscriptional levels by the Gac-Rsm system, RpoS, PsrA, and the Phz quorum-sensing system. Beyond pathogen-suppression, the success of a biocontrol agent is dependent upon its ability to establish itself in the environment where predation by bacterivorous organisms, including nematodes, may threaten persistence. The focus of this study was to investigate whether PA23 is able to resist grazing by Caenorhabditis elegans and to define the role played by exoproducts in the bacterial-nematode interaction. We discovered that both PRN and HCN contribute to fast- and slow-killing of C. elegans. HCN is well-established as having lethal effects on C. elegans; however, PRN has not been reported to be nematicidal. Exposure of L4 stage nematodes to purified PRN reduced nematode viability in a dose-dependent fashion and led to reduced hatching of eggs laid by gravid adults. Because bacterial metabolites can act as chemoattractants or repellents, we analyzed whether PA23 exhibited attractant or repulsive properties towards C. elegans. Both PRN and HCN were found to be potent repellents. Next we investigated whether the presence of C. elegans would elicit changes in PA23 gene activity. Co-culturing the two organisms increased expression of a number of genes associated with biocontrol, including phzA, hcnA, phzR, phzI, rpoS and gacS. Exoproduct analysis showed that PHZ and autoinducer signals were upregulated, consistent with the gene expression profiles. Collectively, these findings indicate that PA23 is able to sense the presence of C. elegans and it is able to both repel and kill the nematodes, which

[Effect of 24-hour sleep deprivation on the oculomotor reactions of human operator].

Science.gov (United States)

Bukhtiiarov, I V; Chistov, S D

2011-01-01

The article presents the results of oculomotor reaction investigations during 24-hour sleep deprivation of 10 normal male subjects aged 25 to 30 yrs. Video nistagmograph VNG System VO-25 was used for binocular registration of eye movements. The proposed video procedures for assessment of the functional ability of human operator are a balancing test, investigation of saccadic and smooth tracking eye movements. The balancing test is designed to determine the nystagmic activity, the saccade test, latency, peak velocity and precision of saccades, and the smooth tracking test, standard errors in tracking velocity and displacement In addition to video oculography, velocity of a simple sensorimotor reaction was measured and the self-rating scale of well-being, alertness and mood (SAN) was employed. The balancing test showed balancing nystagmus; occurrence of this nystagmus grew high with desynchronosis. Saccades registered during sleep deprivation pointed to a considerable decline of velocity, less noticeable extension of latency and degradation of precision. Sleep deprivation reduced values of the mean coefficient of gain and increased the standard error in velocity and displacement of smooth eye tracking.

[Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology].

Science.gov (United States)

Armato, E; Ferri, E; García Purrinos, F

2001-10-01

From February 1998 to July 1999, 569 patients affected by vestibular disorders--following a whiplash injury and/or a cranial trauma--were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

Utility of quick oculomotor tests for screening the vestibular system in the subacute and chronic populations.

Science.gov (United States)

Cohen, Helen S; Stitz, Jasmine; Sangi-Haghpeykar, Haleh; Williams, Susan P; Mulavara, Ajitkumar P; Peters, Brian T; Bloomberg, Jacob J

2018-04-01

The goal of this study was to determine the sensitivity and specificity of some widely used, easily administered clinical tests. Simple tests of oculomotor function have become widely used for clinical screening of patients suspected of having vestibular disorders despite a paucity of evidence showing good statistical support for their use in this highly variable population. Healthy controls with no history of otologic or neurologic disorders (n = 291) were compared to patients with known vestibular disorders (n = 62). All subjects performed passive and active head shaking, un-instrumented head impulse tests (HT), and video head impulse tests (vHIT) recorded with infrared video-oculography. For both passive and active head shaking, using presence/absence of vertigo and of nystagmus, sensitivity was low (<0.40). Sensitivity of presence/absence of saccades on HT was even lower (<0.15). On vHIT, gains were all approximately = 1.0, so sensitivity was very low (approximately 0.15-0.35). Sensitivity and specificity for presence/absence of saccades were moderately poor (less than 0.70). None of these tests are adequate for screening patients in the out-patient clinic for vestibular disorders or for screening people in epidemiologic studies to determine the prevalence of vestibular disorders.

Introduction to electronystagmography for END technologists.

Science.gov (United States)

Markley, Brian A

2007-09-01

Electronystagmography (ENG) is a procedure used to evaluate patients with vertigo. Electrodes applied around the patient's eyes use the corneoretinal potential to record eye movements in response to numerous test maneuvers. Some of the portions of the ENG measure a patient's ability to track moving stimuli. Others monitor for the presence of nystagmus. Lastly, the lateral semicircular canals of the ear can be stimulated with warm and cool water or with air producing nystagmus. A comparison of the responses to stimulations of the left and right ears can demonstrate the relative sensitivities of the peripheral vestibular systems. Videonystamography (VNG) is similar to ENG in the data obtained. VNG uses infrared cameras to monitor eye position.

Comparison of Effects and Side Effects of Two Naloxone-Based Regimens in Treatment of Methadone Overdose

Directory of Open Access Journals (Sweden)

Arash Yazdanbakhsh

2015-11-01

Full Text Available Background: Acute opioid overdose is a common cause of admission in emergency department. In spite of the fact that naloxone is the main therapy for decades, there are controversies about the proper way of its use. This study aimed to compare two most recommended administration modes for naloxone. Methods: In this single-blind clinical trial, 80 patients with methadone overdose syndrome were randomly divided into two equal groups. The patients in infusion group received a constant infusion of naloxone preparation; while in the patients in PRN group, naloxone was administered only if needed clinically. Severity of withdrawal syndrome was evaluated after 30 min, 3 h, and 12 h of the treatments in both groups. Results: Eighty patients completed the study (10 women and 70 men. Both groups were similar in terms of mean age, sex ratio, and the severity of intoxication. The severity of withdrawal symptom was significantly lower in the PRN group (P<0.001. Conclusion: Naloxone administration as PRN mode lowers the rate and severity of withdrawal syndrome. It is recommended as the preferred mode of naloxone administration.

Cortical modulation of the nucleus of the optic tract in the rabbit.

Science.gov (United States)

Pettorossi, V E; Troiani, D

1983-09-01

We analyzed in rabbits the relationships between the temporooccipital nystagmogenic cortex (NGC)--the region sited at the border between cortical areas 17, 21, and 22--and the nucleus of the optic tract (NOT). Two experimental approaches were used: (a) eye movement analysis before and after electrolytic lesion of the NOT region provided an indication of the importance of the NOT for the interaction between the ocular nystagmus elicited by natural optokinetic stimulation (OKN) and the nystagmus evoked by electrical stimulation of the nystagmogenic area; (b) NOT direction-selective and velocity-sensitive units were tested with single shock or repetitive electrical stimulation of the nystagmogenic region. Single-shock stimulation evoked single or multiple spikes in 50% of NOT units analyzed and repetitive stimuli induced prolonged facilitation and inhibitory rebounds in 70% of the units tested. Comparison of orthodromic activation latencies of the NOT cells (3.2 and 6.1 ms) after cortical stimulation and of antidromic activation latencies of cortical nystagmogenic units (2.6 ms) after NOT shocks, suggested monosynaptic as well as polysynaptic connections between the temporooccipital cortex and the NOT. The existence of such cortical-NOT linkage indicates that the NOT is intercalated between the cortex and the oculomotor centers and represents the most probable site of interaction of the cortical nystagmus pathway with the optokinetic reflex arc.

Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway.

Science.gov (United States)

Fog, Amura Francesca; Kvalvaag, Gunnar; Engedal, Knut; Straand, Jørund

2017-12-01

We describe the drug-related problems (DRPs) identified during medication reviews (MRs) and the changes in drug utilization after MRs at nursing homes in Oslo, Norway. We explored predictors for the observed changes. Observational before-after study. Forty-one nursing homes. MRs performed by multidisciplinary teams during November 2011 to February 2014. In all, 2465 long-term care patients. DRPs identified by explicit criteria (STOPP/START and NORGEP) and drug-drug interaction database; interventions to resolve DRPs; drug use changes after MR. A total of 6158 DRPs were identified, an average of 2.6 DRPs/patient, 2.0 for regular and 0.6 for pro re nata (prn) drugs. Of these patients, 17.3% had no DRPs. The remaining 82.7% of the patients had on average 3.0 DRPs/patient. Use of unnecessary drugs (43.5%), excess dosing (12.5%) and lack of monitoring of the drug use (11%) were the most frequent DRPs. Opioids and psychotropic drugs were involved in 34.4% of all DRPs. The mean number of drugs decreased after the MR from 6.8 to 6.3 for regular drugs and from 3.0 to 2.6 for prn drugs. Patients with DRPs experienced a decrease of 1.1 drugs after MR (0.5 for regular and 0.6 for prn drugs). The reduction was most pronounced for the regular use of antipsychotics, antidepressants, hypnotics/sedatives, diuretics, antithrombotic agents, antacid drugs; and for prn use of anxiolytics, opioids, hypnotics/sedatives, metoclopramide and NSAIDs. The medication review resulted in less drug use, especially opioids and psychotropic drugs.

Analysis of risk factors influencing the outcome of the Epley maneuver.

Science.gov (United States)

Domínguez-Durán, E; Domènech-Vadillo, E; Álvarez-Morujo de Sande, M G; González-Aguado, R; Guerra-Jiménez, G; Ramos-Macías, Á; Morales-Angulo, C; Martín-Mateos, A J; Figuerola-Massana, E; Galera-Ruiz, H

2017-10-01

Benign paroxysmal positional vertigo (BPPV) is the most frequent type of vertigo. The treatment of canalithiasis of the posterior semicircular canal consists in performing a particle-repositioning maneuver, such as the Epley maneuver (EM). However, the EM is not effective in all cases. The objective of this study is to identify risk factors, which predict the EM failure, among the clinical variables recorded in anamnesis and patient examination. This is an observational prospective multicentric study. All patients presenting with BPPV were recruited and applied the EM and appointed for a follow-up visit 7 days later. The following variables were recorded: sex, age, arterial hypertension, diabetes, hyperlipidemia, smoking habit, alcohol consumption, migraine, osteoporosis, diseases of the inner ear, previous ipsilateral BPPV, previous traumatic brain injury, previous sudden head deceleration, time of evolution, sulpiride or betahistine treatment, experienced symptoms, outcome of the Halmagyi maneuver, laterality, cephalic hyperextension of the neck, intensity of nystagmus, intensity of vertigo, duration of nystagmus, occurrence of orthotropic nystagmus, symptoms immediately after the EM, postural restrictions, and symptoms 7 days after the EM. Significant differences in the rate of loss of nystagmus were found for six variables: hyperlipidemia, previous ipsilateral BPPV, intensity of nystagmus, duration of nystagmus, post-maneuver sweating, and subjective status. The most useful significant variables in the clinical practice to predict the success of the EM are previous BPPV and intensity of nystagmus. In the other significant variables, no physiopathological hypothesis can be formulated or differences between groups are too small.

[The significance of directional preponderance in the evaluation of vestibular function in patients with vertigo].

Science.gov (United States)

Wang, J; Zhou, Y J; Yu, J; Gu, J

2017-03-07

Objective: To analyze the relationship between directional preponderance (DP), spontaneous nystagmus(SN) and vestibular disorders, and to investigate the significance of DP in directing peripheral vestibular function in patients with vertigo. Methods: This was a retrospective analysis of 394 cases diagnosed with peripheral vestibular disease accompanied by vertigo from March 2012 to June 2014 in the Outpatient Department of the Eye & ENT Hospital of Fudan University. Results of static and dynamic posture equilibrium tests, SN, unilateral weakness(UW), and DP in videonystagmography(VNG) were analyzed and compared. Results: The mean interval time between the last vertigo attack and examination in patients with SN or DP in caloric test were 4.4 d and 7.3 d respectively, and those without SN or DP were 18.3 d and 17.5 d respectively. The patients were divided into two groups according to DP results of caloric test. DP-normal group had 203 cases and DP-abnormal group had 191 cases. Spontaneous nystagmus was presented in 44 cases in the DP-normal group (21.67%) and four in the DP-abnormal group (2.09%). A significant difference was found between the two groups (χ 2 =35.27, P =0.000). Deficiency of vestibular function was noted in 165 cases in the DP-normal group (81.28%) and 123 (64.40%) in the DP-abnormal group in static and dynamic posture equilibrium tests. The difference between the two groups was statistically significant (χ 2 =14.26, P =0.000). Conclusion: Compared with DP-normal patients, DP-abnormal patients are more likely to have spontaneous nystagmus and balance disorders due to vestibular dysfunction.

Vestibular neuritis: three-dimensional videonystagmography and vestibular evoked myogenic potential results.

Science.gov (United States)

Chen, C W; Young, Y H; Wu, C H

2000-10-01

Eight patients diagnosed with vestibular neuritis received the newly developed three-dimensional videonystagmography (3D VNG) and vestibular evoked myogenic potential (VEMP) examination in order to localize the lesion site. Two (25%) of the 8 patients exhibited spontaneous nystagmus with 3 components, indicating that both the horizontal semicircular canal (HSCC) and anterior semicircular canal (ASCC) were affected. The remaining 6 patients (75%) displayed only horizontal nystagmus, meaning that only the HSCC was involved. Seven (88%) of the 8 patients had bilateral normal VEMPs, revealing sparing of the posterior semicircular canal (PSCC). In a comparative study, another seven patients with vestibular neuritis 1 year post-treatment also received the caloric test, 3D VNG and VEMP examination. Only one patient exhibited spontaneous nystagmus. An absent caloric response of the lesioned side persisted in 5 (71%) of the 7 patients. However, all patients showed normal VEMPs bilaterally. 3D VNG and VEMP examination indicates that vestibular neuritis mainly affects the superior division of the vestibular nerve, which innervates the HSCC and ASCC. Meanwhile, the function of the PSCC and saccule, innervated by the inferior vestibular nerve, is preserved.

Experiences of mental health professionals and patients in the use of pro re nata medication in acute adult mental healthcare settings: a systematic review.

Science.gov (United States)

Morkunas, Bernadette; Porritt, Kylie; Stephenson, Matthew

2016-10-01

The use of pro re nata (PRN) medication, a medication that is given when needed, as opposed to medication that is given at a regular time, is surrounded by claims of misuse and poor accountability within the mental health setting. Gaining insight into and understanding of the experiences of health professionals' and patients' use of PRN medication will assist in contributing to improving education and safety around this common intervention. To analyze and synthesize the best available evidence on the perspectives of patients and mental health professionals (MHPs) with their experiences of PRN medication in mental health settings. Participants considered for inclusion in this review include MHPs working in, and adult patients admitted to, an acute adult mental healthcare setting. This review will consider studies that investigated the experience of MHPs' and patients' use of PRN medication in acute adult mental healthcare settings. The current review will consider studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. The context of the review is acute adult mental healthcare settings with no restriction on geographical location. The search strategy aims to find both published and unpublished studies. The databases searched include CINAHL, PubMed, Scopus, PsycINFO and Embase. A gray literature search included ProQuest Dissertations and Theses, Mednar and Google Scholar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The standardized data extraction tool from the JBI-QARI was used to extract data from the papers. Qualitative research findings were pooled using the JBI-QARI. This involved the aggregation of findings to generate a

The Vestibular Effects of Repeated Low-Level Blasts.

Science.gov (United States)

Littlefield, Philip D; Pinto, Robin L; Burrows, Holly L; Brungart, Douglas S

2016-01-01

The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. They also received shorter assessments immediately following blast exposure in order to identify acute findings. The main outcome measures were the Neurobehavioral Symptom Inventory, vestibular Visual Analog Scale (VAS) of subjective vestibular function, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), rotary chair (including the unilateral centrifugation test), computerized dynamic posturography, and computerized dynamic visual acuity. A total of 11 breachers and 4 engineers were followed for up to 17 months. No acute effects or longitudinal deteriorations were identified, but there were some interesting baseline group differences. Upbeat positional nystagmus was common, and correlated (p<0.005) with a history of mild traumatic brain injury (mTBI). Several instructors had abnormally short low-frequency phase leads on rotary chair testing. This study evaluated breaching instructors over a longer test period than any other study, and the results suggest that this population appears to be safe from a vestibular standpoint at the current exposure levels. Upbeat positional nystagmus correlated with a history of mTBI in this population, and this has not been described elsewhere. The data trends also suggest that this nystagmus could be an acute blast effect. However, the reasons for the abnormally short phase leads seen in rotary chair testing are unclear at this time. Further investigation seems warranted.

acadAR2011 prn.pmd

Indian Academy of Sciences (India)

Administrator

journals for the calendar year 2010 are given in Tables ..... Though it was originally called 'anti-hydrogen ...... supplied with ready made formulae and asked to ..... Plasmodium falciparum. 6. ..... ideal vaccines; endophytic fungi in various plants;.

Graphical User Interface and Microprocessor Control Enhancement of a Pseudorandom Code Generator

National Research Council Canada - National Science Library

Kos, John

1999-01-01

.... This thesis addresses the issue of providing automated computer control to previously built, manually controlled hardware incorporating the Stanford Telecom STEL-1032 Pseudo-Random Number (PRN) Coder...

Effect of visual art on patient anxiety and agitation in a mental health facility and implications for the business case.

Science.gov (United States)

Nanda, U; Eisen, S; Zadeh, R S; Owen, D

2011-06-01

There is a growing body of evidence on the impact of the environment on health and well-being. This study focuses on the impact of visual artworks on the well-being of psychiatric patients in a multi-purpose lounge of an acute care psychiatric unit. Well-being was measured by the rate of pro re nata (PRN) medication issued by nurses in response to visible signs of patient anxiety and agitation. Nurses were interviewed to get qualitative feedback on the patient response. Findings revealed that the ratio of PRN/patient census was significantly lower on the days when a realistic nature photograph was displayed, compared to the control condition (no art) and abstract art. Nurses reported that some patients displayed agitated behaviour in response to the abstract image. This study makes a case for the impact of visual art on mental well-being. The research findings were also translated into the time and money invested on PRN incidents, and annual cost savings of almost $US30,000 a year was projected. This research makes a case that simple environmental interventions like visual art can save the hospital costs of medication, and staff and pharmacy time, by providing a visual distraction that can alleviate anxiety and agitation in patients. © 2010 Blackwell Publishing.

Crowded visual search in children with normal vision and children with visual impairment

NARCIS (Netherlands)

Huurneman, Bianca; Cox, Ralf F. A.; Vlaskamp, Björn N. S.; Boonstra, F. Nienke

This study investigates the influence of oculomotor control, crowding, and attentional factors on visual search in children with normal vision ([NV], n = 11), children with visual impairment without nystagmus ([VI-nys], n = 11), and children with VI with accompanying nystagmus ([VI+nys], n = 26).

Presbyequilibrium in the oldest old, a combination of vestibular, oculomotor and postural deficits.

Science.gov (United States)

Tuunainen, Eeva; Poe, Dennis; Jäntti, Pirkko; Varpa, Kirsi; Rasku, Jyrki; Toppila, Esko; Pyykkö, Ilmari

2011-01-01

Dizziness, impaired balance and fear of falling are common complaints in the elderly. We evaluated the association of vestibular symptoms with vestibular findings in the elderly by posturography and video-oculography (VOG). We studied 38 oldest old subjects (≥ 85 yrs, mean age 89) living in a residential home. Vestibular symptoms were taken with a structured questionnaire, the Mini Mental State Examination (MMSE) was scored and any falls were recorded over a period of 12 months. Posturography was measured with a force platform and eye movements were measured by video-oculography. In the majority of the elderly, vestibular abnormalities were found, such as reduced vestibulo-ocular reflex gain 6/38, spontaneous nystagmus 5/38, gaze deviation nystagmus 5/38, head shaking nystagmus 9/38, pathologic head thrust test 10/38, and positional nystagmus 17/38. Posturography demonstrated two major findings: the body support area was limited and the use of vision for postural control was reduced. In principal component analysis of the vertigo, four major factors described elements of failure in the vestibular and other systems important to maintenance of balance: episodic vertigo, postural instability, multisystem failure (frail) and presyncopal imbalance. These four factors were associated in different degrees to vestibular abnormalities and falls. During the follow-up period, in 19 elderly (19/38), one or more falls were recorded. Progressive loss of balance in the aged, or "presbyequilibrium," is a complex and incompletely understood process involving vestibular, oculomotor, visual acuity, proprioception, motor, organ system and metabolic weaknesses and disorders. These factors provide a potential basis for streamlining diagnostic evaluations and aiding in planning for effective therapy. In oldest old, these problems are magnified, increasing the need for additional expertise in their care, which may be met by training specialized healthcare staff.

Preventable visual impairment in children 
with nonprofound intellectual disability.

Science.gov (United States)

Aslan, Lokman; Aslankurt, Murat; Aksoy, Adnan; Altun, Hatice

2013-01-01

To assess the preventable visual impairment in children with nonprofound intellectual disability (ID). 
 A total of 215 children with IDs (90 Down syndrome [DS], 125 nonprofound ID) and 116 age- and sex-matched healthy subjects were enrolled in this study. All participants underwent ophthalmologic examinations including cycloplegic refraction measurements, ocular movement evaluation, screening for strabismus (Hirschberg, Krimsky, or prism cover test), slit-lamp biomicroscopy, funduscopy, and intraocular pressure measurements. All data were recorded for statistical analysis.
 Ocular findings in decreasing prevalence were as follows: refractive errors 55 (61.1%), strabismus 30 (33.2%), cataract 7 (7.8%), and nystagmus 7 (7.8%) in children with DS; refractive errors 57 (45.6%), strabismus 19 (15.2%), cataract 7 (6.4%), nystagmus 5 (4%), and glaucoma 1 (0.8%) in children with other ID; and refractive errors 13 (11.2%) and strabismus 4 (3.5%) in controls. Cataracts, glaucoma, and nystagmus were not observed in the control group. The most common ophthalmic findings in children with DS compared with other ID and controls were with hyperopia (pvisual impairments, refractive errors, strabismus, and cataracts. The prevalence of strabismus and refractive errors was more frequent in children with DS. The importance of further health screenings including ophthalmic examinations should be utilized to implement appropriate care management and improve quality of life.

ANALYTICAL STUDY OF ESSENTIAL INFANTILE ESOTROPIA AND ITS MANAGEMENT

Directory of Open Access Journals (Sweden)

Kandasamy Sivakumar

2017-06-01

Full Text Available BACKGROUND Essential Infantile Esotropia (EIE is the most common type of strabismus. About 0.1% of the newborn are found to have esotropia. 1 Though present since birth, it becomes manifest and remains constant around six months of age. The features are large angle constant strabismus, defective Binocular Single Vision (BSV, cross fixation, DVD and latent nystagmus. Most of the patients have mild-to-moderate hyperopia; the amount of deviation is unrelated to the amount and type of refractive error. MATERIALS AND METHODS Fifty cases with EIE were included in this prospective study. A thorough ophthalmic and orthoptic evaluation was done in all the patients. For patients more than three years of age, the angle of deviation was measured with prism bar cover test, and for patients less than three years of age, angle of deviation was measured with Hirschberg’s test. Associated features like cross fixation, abduction limitation, Dissociated Vertical Deviation (DVD, nystagmus, amblyopia and Inferior Oblique Overaction (IOOA were documented. Occlusion therapy was given to amblyopic patients prior to surgery. All these patients underwent surgery and were followed up for a period of six months. RESULTS The prevalence of EIE in our centre was 0.33%. Of the fifty patients, 28 were males and 22 were female patients. 39 patients (78% had deviation of 30-50 Prism Dioptres (PD. Incidence of DVD, inferior oblique overaction and nystagmus was found to be lower when compared to western population. Amblyopia should be diagnosed early and treated adequately before surgery. Standard surgical option is bimedial recession. Monocular recession-resection surgery in one eye can be opted for in cases of irreversible amblyopia. Three or four muscle surgery can be done if deviation is very large. If marked inferior oblique overaction is present, the same should be weakened in addition to the horizontal muscle surgery. CONCLUSION EIE is the most common type of strabismus

Pro re nata prescribing in a population receiving palliative care: a prospective consecutive case note review.

Science.gov (United States)

Russell, Bethany J; Rowett, Debra; Currow, David C

2014-09-01

To document pro re nata (PRN) prescribing practices and to identify patterns with respect to clinical characteristics and the medications prescribed. Prospective consecutive case note review. Two interrelated consultative hospice and palliative care services in regional Victoria, Australia. Terminally ill inpatients and community-based individuals (N = 203) at the time of referral to a hospice or palliative care service. Number of medications that the referring physician prescribed on a PRN basis and on a regular basis for symptom control; comorbid disease, performance status, comorbidity burden, disease phase, and survival. Mean number of PRN medications prescribed was 3.0, with significantly higher rates in the last week of life (rate ratio (RR) = 1.30, 95% confidence interval (CI) = 1.07-1.59) and during the terminal phase of disease (RR = 1.36, 95% CI = 1.09-1.68). One-quarter of prescriptions were for medications that met the Beers consensus criteria for potentially inappropriate medication use in elderly persons. These descriptive baseline data are new. A mean of three different medications allows responsiveness to a variety of fluctuating symptoms, but there was a large range within the sample, indicating that some individuals and their caregivers have a high burden of administration-related decision-making. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Assessment of senses of hearing and balance in chronic suppurative otitis media

Directory of Open Access Journals (Sweden)

Babić Borivoj

2008-01-01

Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.

Selective otolith dysfunctions objectively verified.

Science.gov (United States)

Manzari, Leonardo; MacDougall, Hamish G; Burgess, Ann M; Curthoys, Ian S

2014-01-01

Vertigo and vigorous horizontal spontaneous nystagmus in a presenting patient is usually taken to indicate unilaterally reduced horizontal canal function. However here we report results which question that presumption. In three such patients with an acute vestibular syndrome, complete testing of all peripheral vestibular sense organs using new tests of canal and otolith function (vHIT and VEMPs) showed that semicircular canal function was normal, but that there were unilateral otolithic deficits which probably caused their acute syndrome.

17oct AM posters prn.pmd

Indian Academy of Sciences (India)

Administrator

2017-11-05

Nov 5, 2017 ... Session 2E: Public Lecture. Chairperson: Ram Ramaswamy, Jawaharlal Nehru University, New Delhi. 1800–1900 Sanjoy Hazarika, Commonwealth Human Rights ... 0950–1010 Subhro Bhattacharjee, International Centre for ...

16nov Sadhana broch prn.cdr

Indian Academy of Sciences (India)

2 Springer. For more information, please contact the Editorial office: ... alternative technologies, etc. The journal ... that are relevant to more than one professional group, either ... Sādhanā brings out special issues on theme-based topics or in.

Preservation of vestibular function after scala vestibuli cochlear implantation.

Science.gov (United States)

Suzuki, Mitsuya; Goto, Takio; Kashio, Akinori; Yasui, Takuya; Sakamoto, Takashi; Ito, Ken; Yamasoba, Tatsuya

2011-10-01

A 58-year-old man, in whom the cochlear implant (CI) had been inserted into the left ear, had right middle-ear cancer. The CI was removed immediately before receiving subtotal removal of right temporal bone. Four months later, the CI was again inserted in his left cochlea. Because of obliterated scala tympani, the 22 active electrodes of the CI were placed into the scala vestibuli. After the surgery, the patient complained that he experienced rotary vertigo and "jumbling of vertical direction" of objects on walking. Using rotation test, we evaluated vestibular function of remaining left ear. Numerous horizontal nystagmus beats were induced during earth-vertical axis rotation, whereas vertical downbeat nystagmus was scarcely induced during off-vertical axis rotation. The horizontal vestibulo-ocular reflex (VOR) was almost normally induced by sinusoidal stimulation at 0.8Hz. These data suggest that the scala vestibuli insertion of CI would be not so invasive against the lateral semicircular canal. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Familial Case of Pelizaeus-Merzbacher Disorder Detected by Oligoarray Comparative Genomic Hybridization: Genotype-to-Phenotype Diagnosis

Directory of Open Access Journals (Sweden)

Kimia Najafi

2017-01-01

Full Text Available Introduction. Pelizaeus-Merzbacher disease (PMD is an X-linked recessive hypomyelinating leukodystrophy characterized by nystagmus, spastic quadriplegia, ataxia, and developmental delay. It is caused by mutation in the PLP1 gene. Case Description. We report a 9-year-old boy referred for oligoarray comparative genomic hybridization (OA-CGH because of intellectual delay, seizures, microcephaly, nystagmus, and spastic paraplegia. Similar clinical findings were reported in his older brother and maternal uncle. Both parents had normal phenotypes. OA-CGH was performed and a 436 Kb duplication was detected and the diagnosis of PMD was made. The mother was carrier of this 436 Kb duplication. Conclusion. Clinical presentation has been accepted as being the mainstay of diagnosis for most conditions. However, recent developments in genetic diagnosis have shown that, in many congenital and sporadic disorders lacking specific phenotypic manifestations, a genotype-to-phenotype approach can be conclusive. In this case, a diagnosis was reached by universal genomic testing, namely, whole genomic array.

Acute Cerebellar Ataxia Induced by Nivolumab

OpenAIRE

Kawamura, Reina; Nagata, Eiichiro; Mukai, Masako; Ohnuki, Yoichi; Matsuzaki, Tomohiko; Ohiwa, Kana; Nakagawa, Tomoki; Kohno, Mitsutomo; Masuda, Ryota; Iwazaki, Masayuki; Takizawa, Shunya

2017-01-01

A 54-year-old woman with adenocarcinoma of the lung and lymph node metastasis experienced nystagmus and cerebellar ataxia 2 weeks after initiating nivolumab therapy. An evaluation for several autoimmune-related antibodies and paraneoplastic syndrome yielded negative results. We eventually diagnosed the patient with nivolumab-induced acute cerebellar ataxia, after excluding other potential conditions. Her ataxic gait and nystagmus resolved shortly after intravenous steroid pulse therapy follow...

Analysis, modeling, and simulation (AMS) testbed development and evaluation to support dynamic mobility applications (DMA) and active transportation and demand management (ATDM) programs — evaluation report for ATDM program. [supporting datasets - Pasadena Testbed

Science.gov (United States)

2017-07-26

This zip file contains POSTDATA.ATT (.ATT); Print to File (.PRN); Portable Document Format (.PDF); and document (.DOCX) files of data to support FHWA-JPO-16-385, Analysis, modeling, and simulation (AMS) testbed development and evaluation to support d...

Download this PDF file

African Journals Online (AJOL)

Mr Olusoji

Symptomatic and improve lung maturity, pethidine/pentazocine supportive care was the modality of management. injection PRN because of severe pain, sitz bath with Judicious analgesics and anxiolytics wererequired chlohexidine solution and Chymoral, an antitypsin because of pain and anxiety. Mechanical drainage.

Bordetella pertussis pertactin knock-out strains reveal immunomodulatory properties of this virulence factor.

NARCIS (Netherlands)

Hovingh, Elise Sofie; Mariman, Rob; Solans, Luis; Hijdra, Daniëlle; Hamstra, Hendrik-Jan; Jongerius, Ilse; van Gent, Marjolein; Mooi, Frits; Locht, Camille; Pinelli, Elena

2018-01-01

Whooping cough, caused by Bordetella pertussis, has resurged and presents a global health burden worldwide. B. pertussis strains unable to produce the acellular pertussis vaccine component pertactin (Prn), have been emerging and in some countries represent up to 95% of recent clinical isolates.

Applied clinical and pathogenetic aspects of interdisciplinary cooperation in the diagnosis and treatment of concussion of brain

Directory of Open Access Journals (Sweden)

V. N. Hertsev

2017-05-01

Full Text Available The article discusses the issues of pathogenesis and diagnostics of different variants of dizziness, as one of the main symptoms of traumatic brain injury. Along with traumatic brain injury raises concussion of the labyrinth benign paroxysmal positional vertigo and others described a range of diagnostic assessment techniques and differential diagnosis of post-traumatic nystagmus, as well as the adequacy of the practical application of a number of vestibulometric studies, caloric tests, tests, medical maneuvers, and their effectiveness from a position of evidence-based medicine.

Unprecedented Proline-Based Heterogeneous Organocatalyst for Selective Production of Vanillin

Directory of Open Access Journals (Sweden)

Farveh Saberi

2018-04-01

Full Text Available An organocatalytic system based on an unprecedented proline analogue and iron oxide magnetic nanoparticles (Prn/Fe2O3@SiO2 was designed and employed in vanillin production from isoeugenol and vanillyl alcohol. Full characterization of the obtained catalyst revealed the successful functionalization of the nanoparticle surface with the organic moieties. The activity of the magnetic bifunctional material was compared with its proton-unexchanged counterpart. Interestingly, the oxidation of isoeugenol resulted in being highly dependent on the acidic functionalities of the organocatalyst. Nonetheless, the catalytic performance of the proton-unexchanged catalyst suggested that the acidic and basic sites of the Prn/Fe2O3@SiO2 exhibited a synergic effect, giving rise to higher conversion and selectivity. The presence of bifunctional groups in the proline analogue, together with the magnetic properties of the iron oxide nanoparticles, could lead to high efficiency, versatility, recoverability, and reusability.

Pleomorphic xanthoastrocytoma within the medulla oblongata of a young dog.

Science.gov (United States)

Hostnik, E T; Kube, S A; Jortner, B; Hager, D; Garman, R H

2015-01-01

A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetraparesis, and vomiting. The patient presented ambulatory, tetraparetic, and ataxic with a head tilt to the left and a disconjugate nystagmus (rotary nystagmus with fast phase to the right in right eye and vertical nystagmus in left eye). There were absent postural reactions in the left pelvic and left thoracic limbs and decreased right-sided postural reactions. Magnetic resonance imaging demonstrated an intra-axial mass within the left midcaudal medulla oblongata. On gross dissection, there was a left-sided neoplasm in the medulla oblongata with surrounding hemorrhage. The histologic findings indicated that the mass was a pleomorphic xanthoastrocytoma. This tumor, an uncommon variant of an astrocytoma most often seen in children and young adult humans, has yet to be described in dogs. © The Author(s) 2014.

Screening of TYR, OCA2, GPR143, and MC1R in patients with congenital nystagmus, macular hypoplasia, and fundus hypopigmentation indicating albinism

Science.gov (United States)

Preising, Markus N.; Gonser, Miriam; Lorenz, Birgit

2011-01-01

Background A broad spectrum of pigmentation of the skin and hair is found among patients diagnosed with ocular albinism (OA) and oculocutaneous albinism (OCA). Even though complexion is variable, three ocular features, i.e., hypopigmentation of the fundus, hypoplasia of the macula, and nystagmus, are classical pathological findings in these patients. We screened 172 index patients with a clinical diagnosis of OA or OCA based on the classical findings, to evaluate the frequency of sequence variants in tyrosinase (TYR), P-gene, P-protein (OCA2), and the G-protein-coupled receptor 143 gene, OA1 (GPR143). In addition, we investigated the association of sequence variants in the melanocortin receptor 1 gene (MC1R) and OCA2. Methods Pigmentation of the hair, skin, iris, and fundus were included in the evaluation of OCA and OA. Male OA patients showing X-linked inheritance were screened for GPR143. Females showing OA without family history were regarded as representing autosomal recessive OA (OA3). Direct sequencing was applied to PCR products showing aberrant single-strand conformation polymorphism–banding patterns. Results Fifty-seven male index patients were screened for OA. We identified 16 potentially pathogenic sequence variations in GPR143 (10 novel) in 22 males. In TYR, we identified 23 (7 novel), and in OCA2 28 (11 novel) possibly pathogenic variants. Variants on both alleles were identified in TYR or OCA2 in 29/79 OCA patients and 14/71 OA patients. Sequence changes in TYR were identified almost exclusively in OCA patients, while sequence changes in OCA2 occurred in OCA and OA patients. MC1R sequencing was performed in 47 patients carrying mutations in OCA2 and revealed MC1R mutations in 42 of them. Conclusions TYR gene mutations have a more severe effect on pigmentation than mutations in OCA2 and the GPR143 gene. Nevertheless, mutations in these genes affect the development of visual function either directly or by interaction with other genes like MC1R, which

Calibration of Correlation Radiometers Using Pseudo-Random Noise Signals

Directory of Open Access Journals (Sweden)

Sebastián Pantoja

2009-08-01

Full Text Available The calibration of correlation radiometers, and particularly aperture synthesis interferometric radiometers, is a critical issue to ensure their performance. Current calibration techniques are based on the measurement of the cross-correlation of receivers’ outputs when injecting noise from a common noise source requiring a very stable distribution network. For large interferometric radiometers this centralized noise injection approach is very complex from the point of view of mass, volume and phase/amplitude equalization. Distributed noise injection techniques have been proposed as a feasible alternative, but are unable to correct for the so-called “baseline errors” associated with the particular pair of receivers forming the baseline. In this work it is proposed the use of centralized Pseudo-Random Noise (PRN signals to calibrate correlation radiometers. PRNs are sequences of symbols with a long repetition period that have a flat spectrum over a bandwidth which is determined by the symbol rate. Since their spectrum resembles that of thermal noise, they can be used to calibrate correlation radiometers. At the same time, since these sequences are deterministic, new calibration schemes can be envisaged, such as the correlation of each receiver’s output with a baseband local replica of the PRN sequence, as well as new distribution schemes of calibration signals. This work analyzes the general requirements and performance of using PRN sequences for the calibration of microwave correlation radiometers, and particularizes the study to a potential implementation in a large aperture synthesis radiometer using an optical distribution network.

How is agitation and restlessness managed in the last 24 h of life in patients whose care is supported by the Liverpool care pathway for the dying patient?

Science.gov (United States)

Gambles, M; McGlinchey, T; Latten, R; Dickman, A; Lowe, D; Ellershaw, J E

2011-12-01

Guidance regarding the patient centred management of agitation and restlessness reinforces the importance of considering underlying causes, non-pharmacological approaches to treatment and judicious use of medications titrated to patient need. In contrast, recent reports in the literature suggest that the practice of continuous deep sedation until death is prevalent in the UK. To use data from the National Care of the Dying Audit-Hospitals (NCDAH) to explore the administration of medication for management of agitation and restlessness in the last 24 h of life. Hospitals submitted data from up to 30 consecutive adult patients whose care in the final hours/days of life was supported by the Liverpool Care Pathway for the Dying Patient (LCP). Data on the total dose received in the last 24 h of life PRN and the last dose prescribed for administration via continuous subcutaneous infusion (CSCI) for agitation and restlessness were submitted. 155 hospitals provided data from 3893 patients. Median total doses in the last 24 h for midazolam, haloperidol and levomepromazine, respectively, were: PRN only, 2.5, 1.5 and 6.25 mg; CSCI only, 10, 3 and 6.25 mg; PRN+CSCI, 15, 3 and 12.5 mg. Only 51% of patients received medication to alleviate agitation and restlessness in the last 24 h of life. Median doses were low in comparison to doses recommended for continuous deep sedation, suggesting that there is no 'blanket' policy for continuous deep sedation at the end of life for patients whose care is supported by the LCP.

Records of Lead and Other Heavy Metal Inputs to Sediments of the Ala Wai Canal, Oahu, HI

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Four cores are given: G8, G8B, M21, and M3. For each core, a printable table file (.PRN) and a spreadsheet (.WK3) are provided. The file names reflect the sediment...

Ophthalmologic correlates of disease severity in children and adolescents with Wolfram syndrome.

Science.gov (United States)

Hoekel, James; Chisholm, Smith Ann; Al-Lozi, Amal; Hershey, Tamara; Tychsen, Lawrence

2014-10-01

To describe an ophthalmic phenotype in children at relatively early stages of Wolfram syndrome. Quantitative ophthalmic testing of visual acuity, color vision, automated visual field sensitivity, optic nerve pallor and cupping, and retinal nerve fiber layer (RNFL) thickness assessed by optical coherence tomography (OCT) was performed in 18 subjects 5-25 years of age. Subjects were also examined for presence or absence of afferent pupillary defects, cataracts, nystagmus, and strabismus. Subnormal visual acuity was detected in 89% of subjects, color vision deficits in 94%, visual field defects in 100%, optic disk pallor in 94%, abnormally large optic nerve cup:disk ratio in 33%, thinned RNFL in 100%, afferent pupillary defects in 61%, cataracts in 22%, nystagmus in 39%, and strabismus in 39% of subjects. RNFL thinning (P Wolfram United Rating Scale. Children and adolescents with Wolfram syndrome have multiple ophthalmic markers that correlate with overall disease severity. RNFL thickness measured by OCT may be the most reliable early marker. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Patofysiologiske mekanismer bag øjensymptomer ved primaere tumorer i corpus pineale

DEFF Research Database (Denmark)

Illum, N O; Møller, M; Garde, E

1993-01-01

Primary tumors of the pineal body can produce dyscoordinative movements of the eye, pupillary dilatation, paralysis of adduction during convergence and nystagmus. Obstruction of the aqueduct can cause hydrocephalus, increased intracranial pressure and papilledema. Diabetes insipidus may be a pres......Primary tumors of the pineal body can produce dyscoordinative movements of the eye, pupillary dilatation, paralysis of adduction during convergence and nystagmus. Obstruction of the aqueduct can cause hydrocephalus, increased intracranial pressure and papilledema. Diabetes insipidus may...

On the vertigo due to static magnetic fields.

Science.gov (United States)

Mian, Omar S; Li, Yan; Antunes, Andre; Glover, Paul M; Day, Brian L

2013-01-01

Vertigo is sometimes experienced in and around MRI scanners. Mechanisms involving stimulation of the vestibular system by movement in magnetic fields or magnetic field spatial gradients have been proposed. However, it was recently shown that vestibular-dependent ocular nystagmus is evoked when stationary in homogenous static magnetic fields. The proposed mechanism involves Lorentz forces acting on endolymph to deflect semicircular canal (SCC) cupulae. To investigate whether vertigo arises from a similar mechanism we recorded qualitative and quantitative aspects of vertigo and 2D eye movements from supine healthy adults (n = 25) deprived of vision while pushed into the 7T static field of an MRI scanner. Exposures were variable and included up to 135s stationary at 7T. Nystagmus was mainly horizontal, persisted during long-exposures with partial decline, and reversed upon withdrawal. The dominant vertiginous perception with the head facing up was rotation in the horizontal plane (85% incidence) with a consistent direction across participants. With the head turned 90 degrees in yaw the perception did not transform into equivalent vertical plane rotation, indicating a context-dependency of the perception. During long exposures, illusory rotation lasted on average 50 s, including 42 s whilst stationary at 7T. Upon withdrawal, perception re-emerged and reversed, lasting on average 30 s. Onset fields for nystagmus and perception were significantly correlated (p<.05). Although perception did not persist as long as nystagmus, this is a known feature of continuous SSC stimulation. These observations, and others in the paper, are compatible with magnetic-field evoked-vertigo and nystagmus sharing a common mechanism. With this interpretation, response decay and reversal upon withdrawal from the field, are due to adaptation to continuous vestibular input. Although the study does not entirely exclude the possibility of mechanisms involving transient vestibular stimulation

Quantitative detection and diversity of the pyrrolnitrin biosynthetic locus in soil under different treatments

NARCIS (Netherlands)

Garbeva, P; Voesenek, K; van Elsas, JD

The prevalence of antibiotic production loci in soil is a key issue of current research aimed to unravel the mechanisms underlying the suppressiveness of soil to plant pathogens. Pyrrolnitrin (PRN) is a key antibiotic involved in the suppression of a range of phytopathogenic fungi. Therefore, field

Quanitative detection and diversity of the pyrrolnitrin biosynthetic locus in soil under different treatments.

NARCIS (Netherlands)

Garbeva, P.; Voesenek, K.; Elsas, van J.D.

2004-01-01

The prevalence of antibiotic production loci in soil is a key issue of current research aimed to unravel the mechanisms underlying the suppressiveness of soil to plant pathogens. Pyrrolnitrin (PRN) is a key antibiotic involved in the suppression of a range of phytopathogenic fungi. Therefore, field

[Vertigo and dizziness in the emergency room].

Science.gov (United States)

Zwergal, A; Möhwald, K; Dieterich, M

2017-06-01

Vertigo and dizziness are among the most common chief complaints in the emergency department. Etiologies can be categorized into three subgroups: neurootological (vestibular), medical (especially cardiovascular, metabolic), and psychiatric disorders. The diagnostic approach in the emergency department is based on a systematic analysis of case history (type, time course of symptoms, modulating factors, associated symptoms), clinical examination of the vestibular, ocular motor, and cerebellar systems (head impulse test, nystagmus, skew deviation, positioning maneuver, test of gait and stance), as well as a basal monitoring (vital signs, 12-lead ECG, blood tests). For differentiation of peripheral and central etiologies in acute vestibular syndrome, the HINTS exam (head impulse test, nystagmus, test of skew) and examination of smooth pursuit and saccades should be applied. Nonselective use of neuroimaging is not indicated due to a low diagnostic yield. Cranial imaging should be done in the following constellations: (1) detection of focal neurological or central ocular motor and vestibular signs on clinical exam, (2) acute abasia with only minor ocular motor signs, (3) presence of various cardiovascular risk factors, (4) headache of unknown quality as an accompanying symptom. Besides the symptomatic therapy of vertigo and dizziness with antiemetics or analgesics, further diagnostic differentiation is urgent to guide proper treatment. Examples are the acute therapy in cerebral ischemia, the execution of positioning maneuvers in benign paroxysmal positional vertigo, the use of corticosteroids in acute unilateral vestibulopathy, as well as the readjustment of metabolic homeostasis in medical disorders.

The effect of geomagnetic storm on GPS derived total electron content (TEC) at Varanasi, India

International Nuclear Information System (INIS)

Kumar, Sanjay; Singh, A K

2010-01-01

In this paper we studied the effect of geomagnetic storm on Global Positioning System (GPS) derived total electron content (TEC) at low latitude Varanasi (Geomagnetic lat 14 0 , 55' N, geomagnetic long 154 0 E) during the period of May 2007 to April 2008. During this period 2 storms were found, which were occurred on 20 November 2007 and 9 March 2008. In this study vertical total electron content (VTEC) of single Pseudorandom Noise (PRN) and average of VTEC of same PRN before 10 days of storm, which is called background TEC, were used to see the effect of these storms on the variation of TEC. From this study this is found that during the storm of March 2008 the TEC increases in main phase of storm while in the case of November 2007 storm, TEC decreases during the main phase of storm but increases in the recovery phase (next day) of storm.

PRN 2011-1: Residential Exposure Joint Venture

Science.gov (United States)

This PR Notice is to advise registrants of an industry-wide joint venture, titled the Residential Exposure Joint Venture (REJV), which has developed a national survey regarding residential consumer use/usage data for pesticides.

Frequency, Levels and Predictors of Potential Drug-Drug ...

African Journals Online (AJOL)

HP

administration to carry out this study in hospital. The following information items were collected: patient's age, gender, date of admission, date of discharge, diagnosis and detail of medication therapy provided in the hospital. All regular and. PRN (pro-re-nata, means as required) medications were included, however, topical.

Functional impact of treatment with ranibizumab under a reactive strategy in patients with neovascular age-related macular degeneration.

Science.gov (United States)

Gallego-Pinazo, R; Dolz-Marco, R; Andreu-Fenoll, M; Farrés, J; Monclús, L

2017-03-01

To analyse the functional recovery using a pro re nata (PRN) dosing strategy with intravitreal injections of ranibizumab for patients with neovascular age-related macular degeneration (AMD). An observational, retrospective, single-centre study, was conducted on patients with neovascular AMD managed with a PRN strategy with ranibizumab, and were followed-up for a minimum of 18 months. Sociodemographic and clinical data were collected from medical records. The percentage of visual acuity (VA) recovered after losing 5 or more letters was calculated taking into account the previous visit, as well as considering the best VA recorded prior to the retreament. The analysis included 128 patients. The mean (SD) follow-up period was 18.9 (2.3) months. The mean (SD) elapsed days between onset of symptoms and diagnosis, and between prescription and administration of treatment was 50.2 (57.4) and 10.9 (16.0), respectively. Only 108 patients were prescribed ranibizumab after losing 5 or more letters of VA. The mean (SD) VA recovery compared to the previous VA was 70.3% (114.4). On the other hand, the mean (SD) VA recovery when considering the best VA registered before the retreatment was 43.5% (112.9), with 59.4% of re-treatments having a VA recovery below 75%, and with 11.7% not presenting any VA recovery. A PRN dosing strategy with intravitreal ranibizumab for neovascular AMD may not be efficient in preserving and/or recovering VA in the long-term, due to a cumulative irreversible VA loss. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Influence of maternal vaccination against diphtheria, tetanus, and pertussis on the avidity of infant antibody responses to a pertussis containing vaccine in Belgium.

Science.gov (United States)

Caboré, Raïssa Nadège; Maertens, Kirsten; Dobly, Alexandre; Leuridan, Elke; Van Damme, Pierre; Huygen, Kris

2017-10-03

Maternal antibodies induced by vaccination during pregnancy cross the placental barrier and can close the susceptibility gap to pertussis in young infants up to the start of primary immunization. As not only the quantity but also the quality of circulating antibodies is important for protection, we assessed whether maternal immunization affects the avidity of infant vaccine-induced IgG antibodies, in the frame of a prospective clinical trial on pregnancy vaccination in Belgium. Infants born from Tdap (Boostrix®) vaccinated (N = 55) and unvaccinated (N = 26) mothers were immunized with a hexavalent pertussis containing vaccine (Infanrix Hexa®) at 8, 12 and 16 weeks, followed by a fourth dose at 15 months of age. Right before and one month after this fourth vaccine dose, the avidity of IgG antibodies against diphtheria toxin (DT), tetanus toxin (TT), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (Prn) was determined using 1.5 M ammonium thiocyanate as dissociating agent. In both groups, antibody avidity was moderate for TT, PT, FHA and Prn and low for DT after priming. After a fourth dose, antibody avidity increased significantly to high avidity for TT and PT, whereas it remained moderate for FHA and Prn and low for DT. The avidity correlated positively with antibody level in both study groups, yet not significantly for PT. When comparing both study groups, only PT-specific antibodies showed significantly lower avidity in infants born from vaccinated than from unvaccinated mothers after the fourth vaccine dose. The clinical significance of lower avidity of vaccine induced infant antibodies after maternal vaccination, if any, needs further investigation.

Clinical characteristics of children with severe visual impairment but favorable retinal structural outcomes from the Early Treatment for Retinopathy of Prematurity (ETROP) study.

Science.gov (United States)

Siatkowski, R Michael; Good, William V; Summers, C Gail; Quinn, Graham E; Tung, Betty

2013-04-01

To describe visual function and associated characteristics at the 6-year examination in children enrolled in the Early Treatment for Retinopathy of Prematurity Study who had unfavorable visual outcomes despite favorable structural outcomes in one or both eyes. The clinical examination records of children completing the 6-year follow-up examination were retrospectively reviewed. Eligible subjects were those with visual acuity of ≤20/200 in each eye (where recordable) and a normal fundus or straightening of the temporal retinal vessels with or without macular ectopia in at least one eye. Data regarding visual function, retinal structure, presence of nystagmus, optic atrophy, optic disk cupping, seizures/shunts, and Functional Independence Measure for Children (ie, WeeFIM: pediatric functional independence measure) developmental test scores were reviewed. Of 342 participants who completed the 6-year examination, 39 (11%) met inclusion criteria. Of these, 29 (74%) had normal retinal structure, 18 (46%) had optic atrophy, and 3 (8%) had increased cupping of the optic disk in at least one eye. Latent and/or manifest nystagmus occurred in 30 children (77%). The presence of nystagmus was not related to the presence of optic atrophy. Of the 39 children, 28 (72%) had a below-normal WeeFIM score. In 25 participants (7%) completing the 6-year examination, cortical visual impairment was considered the primary cause of visual loss. The remainder likely had components of both anterior and posterior visual pathway disease. Clinical synthesis of ocular anatomy and visual and neurologic function is required to determine the etiology of poor vision in these children. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing impairment.

Science.gov (United States)

Niewiadomski, Piotr; Bielińska, Marzena; Pietkiewicz, Piotr; Olszewski, Jurek

2017-10-30

The aim of the study was to evaluate the neck torsion test in objective examinations of patients with vertigo and/or hearing loss. The study was conducted in 100 patients, including 54 women and 46 men aged 17-79 years, who were divided into two groups: I - 50 patients, including 30 women and 20 men aged 17-79 years (mean age 49.92 years) with dizziness and/or hearing impairments, and confirmed asymmetry of intracranial vessels, II - 50 patients - the control group, including 24 women and 26 men aged 20-71 years without dizziness and/or hearing disorders and without disturbance in the construction of intracranial vessels. For each patient, the following tests were carried out: subjective, objective otorhinolaryngological, Doppler ultrasound specifying the diameter of vertebral and carotid arteries and the velocity of blood flow in these vessels, audiological diagnostics, including the examination of latency of waves I, III, V of the auditory evoked potentials of the brain stem, otoneurological diagnostics with used the neck torsion test. It appears from the analysis of the material presented that the application of the neck torsion test in the Doppler ultrasound results in the fact that the difference in the mean systolic velocity of blood flow in vertebral artery is higher on the side opposite to the turning of the neck, and the increase in the average diastolic blood flow velocity in the vertebral artery on the side of the test being performed and its reduction on the opposite side in the study group, when compared to the control group. The value of the wave I, II, V latency in the ABR test during the neck torsion test is extended more in the study group than in the controls, on the side of the performed test. The performed neck torsion test in the VNG test increases the occurrence of both, square waves and nystagmus (much higher in the study group than in the controls). The application of the neck torsion test in the Doppler ultrasound, ABR and VNG test in

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing-impairment.

Science.gov (United States)

Niewiadomski, Piotr; Bielińska, Marzena; Pietkiewicz, Piotr; Olszewski, Jurek

2017-06-30

The aim of the study was to evaluate the neck torsion test in objective examinations of patients with vertigo and/or hearing loss. The study was conducted in 100 patients, including 54 women and 46 men aged 17-79 years, who were divided into two groups: I - 50 patients, including 30 women and 20 men aged 17-79 years (mean age 49.92 years) with dizziness and/or hearing impairments, and confirmed asymmetry of intracranial vessels, II - 50 patients - control group, including 24 women and 26 men aged 20-71 years without dizziness and/or hearing disorders and without disturbance in the construction of intracranial vessels. For each patient, the following tests were carried out: subjective, objective otorhinolaryngological, Doppler ultrasound specifying diameter of vertebral and carotid arteries and the velocity of blood flow in these vessels, audiological diagnostics, including the examination of latency of waves I, III, V of the auditory evoked potentials of the brain stem, otoneurological diagnostics with used the neck torsion test. It appears from the analysis of the material presented that the application of the neck torsion test in the Doppler ultrasound results in the fact that the difference in the mean systolic velocity of blood flow in vertebral artery is higher on the side opposite to the turning of the neck, and the increase in the average diastolic blood flow velocity in the vertebral artery on the side of the test being performed and its reduction on the opposite side in the study group, when compared to the control group. The value of the wave I, II, V latency in the ABR test during the neck torsion test is extended more in the study group than in the controls, on the side of the performed test. The performed neck torsion test in the VNG test increases the occurrence of both, square waves and nystagmus (much higher in the study group than in the controls). Conclussion. The application of the neck torsion test in the Doppler ultrasound, ABR and VNG test in

Chloral hydrate enteral infusion for sedation in ventilated children: the CHOSEN pilot study.

Science.gov (United States)

Joffe, Ari R; Hogan, Jessica; Sheppard, Cathy; Tawfik, Gerda; Duff, Jonathan P; Garcia Guerra, Gonzalo

2017-11-26

We aimed to test a novel method of delivery of chloral hydrate (CH) sedation in ventilated critically ill young children. Children PRISM) category, using Fisher's exact test and the t test. The primary outcome was feasibility, defined as the use of an enteral CH continuous infusion without discontinuation attributable to a pre-specified potential harm. There were 21 patients enrolled, at age 11.4 (12.1) months, with bronchiolitis in 10 (48%), a mean Pediatric Logistic Organ Dysfunction (PELOD) score of 6.2 (5.2), and having received enteral CH continuous infusion for 4.5 (2.2) days. Infusion of CH was feasible in 20/21 (95%; 95% CI 76-99%) patients, with one (5%) adverse event of duodenal ulcer perforation on day 3 in a patient with croup receiving regular ibuprofen and dexamethasone. The CH infusion dose (mg/kg/h) on day 2 (n = 20) was 8.9 (IQR 5.9, 9), and on day 4 (n = 11) was 8.8 (IQR 7, 9). Days to titration of adequate sedation (defined as ≤ 3 PRN doses/shift) was 1 (IQR 0.5, 2.5), and hours to awakening for extubation was 5 (IQR 2, 9). Cases (versus controls) had less positive fluid balance at 48 h (-2 (45) vs. 26 (46) ml/kg, p = 0.051), and a decrease in number of PRN sedation doses from 12 h pre to 12 hours post starting CH (4.7 (3.3) to 2.6 (2.8), p = 0.009 versus 2.9 (3.9) to 3.4 (5), p = 0.74). There were no statistically significant differences between cases and controls in inotrope scores, signs or treatment of withdrawal, or PICU days. Delivering CH by continuous enteral infusion is feasible, effective, and may be associated with less positive fluid balance. Whether there is a risk of duodenal perforation requires further study.

A case of dentato-rubro-pallido-luysian atrophy

International Nuclear Information System (INIS)

Usui, Sadanari; Komiya, Tadatoshi

1988-01-01

A clinical case of dentato-rubro-pallido-luysian atrophy (DRPLA) was reported. We established several aspects on the basis of MRI findings and a neuro-otological study. A 47-year-old woman had gait disturbance, involuntary movements, speech disturbance, and memory disturbance at the age of 42. She was admitted to the hospital because of worsening of the gait disturbance. Neurological examinations showed choreo-athetosis of the face, neck and upper extremities, mental disturbance, and scanning speech. However, she had neither ocular disturbance nor epilepsy or myoclonus. On the MRI-CT, an atrophy of midbrain and pontine tegmentum was observed. The neuro-otological study showed gaze nystagmus at the horizontal gaze, rebound nystagmus, hypometria of the saccade, saccadic pursuit, reduction of the optokinetic nystagmus, and increase in caloric nystagmus by means of visual input. A severe atrophy of the brainstem tegmentum and a mild atrophy of the cerebellar hemisphere and cerebral cortex are regarded as neuro-radiological features of DRPLA. Moreover, tegmental atrophy is related to ocular disturbance as a clinical feature. Various neuro-otological findings reveal many systems of ocular movements, i.e., a smooth pursuit system, a saccade system, and a vestibulo-ocular reflex system, involving flocculus. DRPLA can be clinically diagnosed by means of clinical features, MRI findings, and neuro-otological findings. A variety of neuro-otological abnormalities may indicate a progression of the ocular disturbance and a variety of lesions. (author)

Carbon Dioxide Induced Alkene Extrusion from Bis(pentamethylcyclopentadienyl)titanium(III) Alkyls

NARCIS (Netherlands)

Luinstra, Gerrit A.; Teuben, Jan H.

1987-01-01

Reaction of titanium(III) alkyls, (η5-C5Me5)2TiR (R = Et or Prn), in toluene solution with CO2 proceeds at room temperature with formation of the titanium formate (η5-C5Me5)2TiO2CH, and the corresponding alkene (ethene or propene).

Eye Movement Abnormalities in Multiple Sclerosis: Pathogenesis, Modeling, and Treatment

Directory of Open Access Journals (Sweden)

Alessandro Serra

2018-02-01

Full Text Available Multiple sclerosis (MS commonly causes eye movement abnormalities that may have a significant impact on patients’ disability. Inflammatory demyelinating lesions, especially occurring in the posterior fossa, result in a wide range of disorders, spanning from acquired pendular nystagmus (APN to internuclear ophthalmoplegia (INO, among the most common. As the control of eye movements is well understood in terms of anatomical substrate and underlying physiological network, studying ocular motor abnormalities in MS provides a unique opportunity to gain insights into mechanisms of disease. Quantitative measurement and modeling of eye movement disorders, such as INO, may lead to a better understanding of common symptoms encountered in MS, such as Uhthoff’s phenomenon and fatigue. In turn, the pathophysiology of a range of eye movement abnormalities, such as APN, has been clarified based on correlation of experimental model with lesion localization by neuroimaging in MS. Eye movement disorders have the potential of being utilized as structural and functional biomarkers of early cognitive deficit, and possibly help in assessing disease status and progression, and to serve as platform and functional outcome to test novel therapeutic agents for MS. Knowledge of neuropharmacology applied to eye movement dysfunction has guided testing and use of a number of pharmacological agents to treat some eye movement disorders found in MS, such as APN and other forms of central nystagmus.

On the vertigo due to static magnetic fields.

Directory of Open Access Journals (Sweden)

Omar S Mian

Full Text Available Vertigo is sometimes experienced in and around MRI scanners. Mechanisms involving stimulation of the vestibular system by movement in magnetic fields or magnetic field spatial gradients have been proposed. However, it was recently shown that vestibular-dependent ocular nystagmus is evoked when stationary in homogenous static magnetic fields. The proposed mechanism involves Lorentz forces acting on endolymph to deflect semicircular canal (SCC cupulae. To investigate whether vertigo arises from a similar mechanism we recorded qualitative and quantitative aspects of vertigo and 2D eye movements from supine healthy adults (n = 25 deprived of vision while pushed into the 7T static field of an MRI scanner. Exposures were variable and included up to 135s stationary at 7T. Nystagmus was mainly horizontal, persisted during long-exposures with partial decline, and reversed upon withdrawal. The dominant vertiginous perception with the head facing up was rotation in the horizontal plane (85% incidence with a consistent direction across participants. With the head turned 90 degrees in yaw the perception did not transform into equivalent vertical plane rotation, indicating a context-dependency of the perception. During long exposures, illusory rotation lasted on average 50 s, including 42 s whilst stationary at 7T. Upon withdrawal, perception re-emerged and reversed, lasting on average 30 s. Onset fields for nystagmus and perception were significantly correlated (p<.05. Although perception did not persist as long as nystagmus, this is a known feature of continuous SSC stimulation. These observations, and others in the paper, are compatible with magnetic-field evoked-vertigo and nystagmus sharing a common mechanism. With this interpretation, response decay and reversal upon withdrawal from the field, are due to adaptation to continuous vestibular input. Although the study does not entirely exclude the possibility of mechanisms involving transient

Update on strabismus and amblyopia.

Science.gov (United States)

Campos, E C

1995-01-01

This review analyzes progress in the field of infantile strabismus and amblyopia. Only works which are of clinical interest have been reviewed. A brief survey is provided also of subjects matter of international debate, as surgery for accommodative esotropia, the prism adaptation test and the use of sectors for amblyopia treatment. Mention is made of new developments in the field which are not yet applicable to clinical practice. Finally, progress in the approach towards ocular nystagmus is considered as well.

Hearing Recovey in Patients Suffering Sudden Deafness

Directory of Open Access Journals (Sweden)

Parviz Eslami

1992-04-01

Full Text Available The study included 80 patients treated for sudden deafness over the last 5-7 years. Case history, laboratory findings, pure-tone audiogram and electronystagmography (ENG findings were noted. If any abnormalities had been recorded in ENG studies, the studies were redone. ORL status was redefined and audiograms were obtained in all patients. When becoming ill, the 80 patients had not differed from the normal population in common cardiovascular risk factors. None of them had had signs of viral infection (paired serum samples had been taken at 2-week intervals; routine examinations had been done for common viral antigens. As many as 31 of the 80 patients with acute hearing loss had had abnormalities such as spontaneous nystagmus (PN, hypoexcitability (HE and directional preponderance (DP in the bithermal caloric tests (+44 degrees C, + 30 degrees C of their ENG studies. Twenty of the 31 patients still had abnormal ENG studies after 5-7 years. Only 1 subject had positional nystagmus, and none had subjective vertigo. Patients with an abnormal ENG study showed a poor recovery of the speech reception threshold, whereas those with a normal ENG study showed slightly significant (p less than 0.05 recovery.

PACE - The first placebo controlled trial of paracetamol for acute low back pain: design of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Day Richard O

2010-07-01

Full Text Available Abstract Background Clinical practice guidelines recommend that the initial treatment of acute low back pain (LBP should consist of advice to stay active and regular simple analgesics such as paracetamol 4 g daily. Despite this recommendation in all international LBP guidelines there are no placebo controlled trials assessing the efficacy of paracetamol for LBP at any dose or dose regimen. This study aims to determine whether 4 g of paracetamol daily (in divided doses results in a more rapid recovery from acute LBP than placebo. A secondary aim is to determine if ingesting paracetamol in a time-contingent manner is more effective than paracetamol taken when required (PRN for recovery from acute LBP. Methods/Design The study is a randomised double dummy placebo controlled trial. 1650 care seeking people with significant acute LBP will be recruited. All participants will receive advice to stay active and will be randomised to 1 of 3 treatment groups: time-contingent paracetamol dose regimen (plus placebo PRN paracetamol, PRN paracetamol (plus placebo time-contingent paracetamol or a double placebo study arm. The primary outcome will be time (days to recovery from pain recorded in a daily pain diary. Other outcomes will be pain intensity, disability, function, global perceived effect and sleep quality, captured at baseline and at weeks 1, 2, 4 and 12 by an assessor blind to treatment allocation. An economic analysis will be conducted to determine the cost-effectiveness of treatment from the health sector and societal perspectives. Discussion The successful completion of the trial will provide the first high quality evidence on the effectiveness of the use of paracetamol, a guideline endorsed treatment for acute LBP. Trail registration ACTRN12609000966291.

Reliability of reference distances used in photogrammetry.

Science.gov (United States)

Aksu, Muge; Kaya, Demet; Kocadereli, Ilken

2010-07-01

To determine the reliability of the reference distances used for photogrammetric assessment. The sample consisted of 100 subjects with mean ages of 22.97 +/- 2.98 years. Five lateral and four frontal parameters were measured directly on the subjects' faces. For photogrammetric assessment, two reference distances for the profile view and three reference distances for the frontal view were established. Standardized photographs were taken and all the parameters that had been measured directly on the face were measured on the photographs. The reliability of the reference distances was checked by comparing direct and indirect values of the parameters obtained from the subjects' faces and photographs. Repeated measure analysis of variance (ANOVA) and Bland-Altman analyses were used for statistical assessment. For profile measurements, the indirect values measured were statistically different from the direct values except for Sn-Sto in male subjects and Prn-Sn and Sn-Sto in female subjects. The indirect values of Prn-Sn and Sn-Sto were reliable in both sexes. The poorest results were obtained in the indirect values of the N-Sn parameter for female subjects and the Sn-Me parameter for male subjects according to the Sa-Sba reference distance. For frontal measurements, the indirect values were statistically different from the direct values in both sexes except for one in male subjects. The indirect values measured were not statistically different from the direct values for Go-Go. The indirect values of Ch-Ch were reliable in male subjects. The poorest results were obtained according to the P-P reference distance. For profile assessment, the T-Ex reference distance was reliable for Prn-Sn and Sn-Sto in both sexes. For frontal assessment, Ex-Ex and En-En reference distances were reliable for Ch-Ch in male subjects.

Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema.

Directory of Open Access Journals (Sweden)

Yuki Mori

Full Text Available To investigate whether baseline optical coherence tomography (OCT parameters can predict the treatment frequency of intravitreal ranibizumab (IVR injections during the first year in patients with diabetic macular edema (DME treated with pro re nata (PRN IVR injections.We retrospectively reviewed 68 eyes of 63 patients with center-involved DME who received IVR injections for 12 months or longer according to three monthly IVR injections followed by the PRN dosing. We measured the mean retinal thicknesses in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid and evaluated the qualitative and quantitative parameters on OCT sectional images. We investigated the relationship between these OCT parameters at baseline and the number of IVR injections during the 12-month follow-up.Three loading doses were administered to 10 eyes; four to seven annualized IVR injections were administered to 34 eyes. The number of eyes that received IVR injections decreased gradually until month 6 and was almost constant from months 7 to 11. No relationships were seen between the treatment frequency and baseline systemic factors and the ophthalmic examination findings. Univariate analyses showed that the number of IVR injections during the first year was associated with the mean retinal thickness in the individual subfields and the transverse length of the disrupted external limiting membrane (ELM and ellipsoid zone of the photoreceptors. Multivariate analysis showed a significant association with the thickness in the inferior subfield alone. The treatment frequency during the 12-month follow-up was not correlated with improved visual acuity but was associated with the decrease in the central subfield thickness and disrupted ELM.The retinal thickness in the inferior subfield predicts the treatment frequency during the first year in eyes with DME treated with PRN IVR injections.

Pressure dependence of crystal field splitting in Pr pnictides and chalcogenides

International Nuclear Information System (INIS)

Schirber, J.E.; Weaver, H.T.; Ginley, D.S.

1978-01-01

We have measured the pressure dependence of the Pr nuclear magnetic resonance shift in PrN, PrP, PrSb, PrAs, PrS and PrSe. The shifts in all the pnictides increase while in the chalcogenides the shifts decrease with pressure. The rare earth frequency shift is inversely proportional to the crystal field splitting in the context of the point charge model (PCM) so a decrease would be expected for all of these materials at a rate of 5/3 the volume compressibility. Our values for the pnictides tend to be considerably larger than the PCM value as well as the wrong sign. The chalcogenide values are much nearer in magnitude and are of the right sign for the PCM. Contrary to the report of Guertin et al. we see no anomaly in the pressure dependence of the susceptibility of PrS. The fact that PrN which is reported to be non-metallic also shows the wrong sign for the PCM presents difficulties for various conduction electron explanations for this unexpected behavior of the pnictides

Downbeat down south.

Science.gov (United States)

Chen, Ying; Morgan, Michael L; Palau, Angelina Espino Barros; Mudd, Janice A; Lee, Andrew G; Barton, Jason J S

2015-01-01

A 59-year-old woman with late-onset diabetes mellitus presented with a 4-week history of oscillopsia and vertigo. Physical examination revealed downbeating nystagmus in the primary position that worsened on right gaze and left gaze. Magnetic resonance imaging of the brain and orbits showed enhancement and signal abnormality in the right temporal lobe without evidence of a cervicomedullary junction lesion. Serum anti-glutamic acid decarboxylase 65 (GAD65) antibody titer was markedly elevated. Given these findings, her vertigo and downbeat nystagmus were likely secondary to elevated anti-GAD antibodies. Copyright © 2015 Elsevier Inc. All rights reserved.

Insights into horizontal canal benign paroxysmal positional vertigo from a human case report.

Science.gov (United States)

Aron, Margaret; Bance, Manohar

2013-12-01

For horizontal canal benign paroxysmal positional vertigo, determination of the pathologic side is difficult and based on many physiological assumptions. This article reports findings on a patient who had one dysfunctional inner ear and who presented with horizontal canal benign paroxysmal positional vertigo, giving us a relatively pure model for observing nystagmus arising in a subject in whom the affected side is known a priori. It is an interesting human model corroborating theories of nystagmus generation in this pathology and also serves to validate Ewald's second law in a living human subject. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

[Serial change of perilymphatic potassium ion concentration in the scala tympani after introducing KCl-solution into the guinea pigs' tympanic cavity].

Science.gov (United States)

Ikeno, K

1990-09-01

Characteristic nystagmus similar to the Meniere's attack could be observed after introducing KCl solution into the tympanic cavity of guinea pigs. To confirm the fact that this nystagmus was provoked by the high perilymphatic potassium ion concentration, the K+ activity of perilymph was recorded serially through the K+ specific microelectrode inserted into the scala tympani. The rapid increment of K+ activity reached maximum at 120 minutes after introducing KCl solution, and then it decreased gradually to a half of the maximum activity. However, such change of perilymphatic potassium ion concentration was not observed by introducing sucrose solution as control.

PRN 94-2: Recycling Empty Aerosol Pesticide Containers

Science.gov (United States)

This notice offers registrants use of an optional label statement permitting recycling as an alternative to instructions to dispose of aerosol pesticide containers. Registrants may add a label reference to recycling the empty aerosol pesticide container.

N-Acetyl-L-Leucine Accelerates Vestibular Compensation after Unilateral Labyrinthectomy by Action in the Cerebellum and Thalamus

Science.gov (United States)

Xiong, Guoming; Potschka, Heidrun; Jahn, Klaus; Bartenstein, Peter; Brandt, Thomas; Dutia, Mayank; Dieterich, Marianne; Strupp, Michael; la Fougère, Christian; Zwergal, Andreas

2015-01-01

An acute unilateral vestibular lesion leads to a vestibular tone imbalance with nystagmus, head roll tilt and postural imbalance. These deficits gradually decrease over days to weeks due to central vestibular compensation (VC). This study investigated the effects of i.v. N-acetyl-DL-leucine, N-acetyl-L-leucine and N-acetyl-D-leucine on VC using behavioural testing and serial [18F]-Fluoro-desoxyglucose ([18F]-FDG)-μPET in a rat model of unilateral chemical labyrinthectomy (UL). Vestibular behavioural testing included measurements of nystagmus, head roll tilt and postural imbalance as well as sequential whole-brain [18F]-FDG-μPET was done before and on days 1,3,7 and 15 after UL. A significant reduction of postural imbalance scores was identified on day 7 in the N-acetyl-DL-leucine (p metabolism (rCGM) by means of μPET revealed that only N-acetyl-L-leucine but not N-acetyl-D-leucine caused a significant increase of rCGM in the vestibulocerebellum and a decrease in the posterolateral thalamus and subthalamic region on days 3 and 7. A similar pattern was found when comparing the effect of N-acetyl-L-leucine on rCGM in an UL-group and a sham UL-group without vestibular damage. In conclusion, N-acetyl-L-leucine improves compensation of postural symptoms after UL in a dose-dependent and specific manner, most likely by activating the vestibulocerebellum and deactivating the posterolateral thalamus. PMID:25803613

Existence and multiplicity of weak solutions for a class of degenerate nonlinear elliptic equations

Directory of Open Access Journals (Sweden)

Mihai Mihăilescu

2006-02-01

Full Text Available The goal of this paper is to study the existence and the multiplicity of non-trivial weak solutions for some degenerate nonlinear elliptic equations on the whole space RN. The solutions will be obtained in a subspace of the Sobolev space W1/p(RN. The proofs rely essentially on the Mountain Pass theorem and on Ekeland's Variational principle.

Things That Go Boom!: Noise and Toxic Exposures Associated with Weapon Systems

Science.gov (United States)

2010-06-17

Munitions Pyrotechnics Tracers Spot ing Charges Oxidizers Delay Elements Propellatl s Fuses De· onators Pr~n1ers Constituent of Concern BariL ...r11 chromate Potassium perchlorate lead oxide BariL m chromate P a tass ~L m perch I o r,ate l e ad chromate An1n1onil tll perch lara e P a

Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough

Directory of Open Access Journals (Sweden)

Angela Jinsook Oh

2018-06-01

Full Text Available Purpose: Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Observations: A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1–2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500–3000 mg per day. Conclusions and importance: We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition. Keywords: Keyhole aqueduct syndrome, Midbrain cleft, Mesencephalic cleft, Syrinx, Syringobulbia, Down-beating nystagmus, Cerebrospinal fluid

Longitudinal ophthalmic findings in a child with Helsmoortel-Van der Aa Syndrome

Directory of Open Access Journals (Sweden)

Michael J. Gale

2018-06-01

Full Text Available Purpose: We present the first detailed ophthalmic description of a child with Helsmoortel-Van der Aa Syndrome (HVDAS, including longitudinal follow-up and analysis. Observations: After extensive workup, a young child with poor visual behavior, hypotonic cerebral palsy, intellectual disability, and global developmental delay was found to have a heterozygous de novo mutation in the ADNP gene and diagnosed with HVDAS. Ophthalmic findings were remarkable for progressive nystagmus, macular pigment mottling, mild foveal hypoplasia with abnormal macular laminations, persistent rod dysfunction with electronegative waveform, and progressive cone degeneration. Conclusions and importance: Patients with HVDAS are known to have abnormal visual behavior due to refractive or cortical impairment. However, we present the first description, to our knowledge, of an association with retinal mal-development and degeneration. Thus, patients with HVDAS should be referred for ophthalmic genetics evaluation, and HVDAS should be on the differential diagnosis for young children with global developmental delay who present with nystagmus, rod and cone dysfunction with electronegative waveform, and relative lack of severe structural degeneration on optical coherence tomography. Keywords: Helsmoortel-Van der Aa Syndrome, HVDAS, Activity-dependent neuroprotective protein, ADNP, Nystagmus, Retinal degeneration, Electronegative waveform, Optical coherence tomography

Acute Cerebellar Ataxia Induced by Nivolumab

Science.gov (United States)

Kawamura, Reina; Nagata, Eiichiro; Mukai, Masako; Ohnuki, Yoichi; Matsuzaki, Tomohiko; Ohiwa, Kana; Nakagawa, Tomoki; Kohno, Mitsutomo; Masuda, Ryota; Iwazaki, Masayuki; Takizawa, Shunya

2017-01-01

A 54-year-old woman with adenocarcinoma of the lung and lymph node metastasis experienced nystagmus and cerebellar ataxia 2 weeks after initiating nivolumab therapy. An evaluation for several autoimmune-related antibodies and paraneoplastic syndrome yielded negative results. We eventually diagnosed the patient with nivolumab-induced acute cerebellar ataxia, after excluding other potential conditions. Her ataxic gait and nystagmus resolved shortly after intravenous steroid pulse therapy followed by the administration of decreasing doses of oral steroids. Nivolumab, an immune checkpoint inhibitor, is known to induce various neurological adverse events. However, this is the first report of acute cerebellar ataxia associated with nivolumab treatment. PMID:29249765

Vestibular System Evaluation: Results on Analysis of Vestibulony stagmography (VNG

Directory of Open Access Journals (Sweden)

Mitra Janghorban

2015-04-01

Full Text Available Objective: Falls are one of the major problems in the elderly and are considered one of the “Geriatric Giants”. Recurrent falls an important cause of morbidity and mortality in this segment of the population and is a marker of poor physical and cognitive status. The aim of the present study is to compare the VNG (Videonystagmography test results in adults with and without falls history. Materials & Methods: 60 adults ( 30 with one or more falls history and 30 without any falls history above 65 year old performed the VNG subtests included saccade, gaze, smooth pursuit, positional nystagmus, spontaneous nystagmus and caloric at rehabilitation faculty of Tehran University of Medical Sciences. Results: According to the data 74% of the faller group showed abnormal performance in the caloric subtest and more than 60% had abnormal results in the saccade, gaze and smooth pursuit subtests too. The members who suffered from central vestibular disorders had worse function than the others who suffered from peripheral vestibular ones. Conclusion: The non- faller group had better performance than the faller group in all of the subtests which indicates better vestibular system status in this group. According to the results, VNG performance can help guide the clinicians in the development of a safe exercise program.

Surface detection performance evaluation of pseudo-random noise continuous wave laser radar

Science.gov (United States)

Mitev, Valentin; Matthey, Renaud; Pereira do Carmo, Joao

2017-11-01

A number of space missions (including in the ESA Exploration Programme) foreseen a use of laser radar sensor (or lidar) for determination of range between spacecrafts or between spacecraft and ground surface (altimetry). Such sensors need to be compact, robust and power efficient, at the same time with high detection performance. These requirements can be achieved with a Pseudo-Random Noise continuous wave lidar (PRN cw lidar). Previous studies have pointed to the advantages of this lidar with respect to space missions, but they also identified its limitations in high optical background. The progress of the lasers and the detectors in the near IR spectral range requires a re-evaluation of the PRN cw lidar potential. Here we address the performances of this lidar for surface detection (altimetry) in planetary missions. The evaluation is based on the following system configuration: (i) A cw fiber amplifier as lidar transmitter. The seeding laser exhibits a single-frequency spectral line, with subsequent amplitude modulation. The fiber amplifier allows high output power level, keeping the spectral characteristics and the modulation of the seeding light input. (ii) An avalanche photodiode in photon counting detection; (iii) Measurement scenarios representative for Earth, Mercury and Mars.

The evaluation of the neck torsion test in subjective examinations of patients with vertigo and/or hearing loss.

Science.gov (United States)

Niewiadomski, Piotr; Zielińska-Bliźniewskaw, Hanna; Miloński, Jarosław; Pietkiewicz, Piotr; Olszewski, Jurek

2015-01-01

The aim of this work was to evaluate the diagnostic value of the neck torsion test in VNG, Doppler ultrasonography and brainstem auditory evoked potentials in patients with vertigo and/or hearing loss due to intracranial vascular malformations. The study covered 47 patients, 30 female and 17 male (mean age, 55.5 years; range, 19-74 years) with vertigo and/or hearing disorders and the asymmetry of vertebral arteries. Each patient underwent a subjective examination, an otolaryngological examination, otoneurological diagnostics, VNG with gaze tracking in the straight ahead position and in the 600 left and right neck torsion, the neck torsion test, audiological diagnostics including I-, III- and V-wave latency of the brainstem evoked potentials in the straight ahead position and the right ear stimulation in the 600 right neck torsion and the left ear stimulation in the neck torsion to the left, Doppler ultrasonography with measuring the diameter of vertebral arteries and the velocity of the blood flow in these vessels with the use of the neck torsion test. In own study, in VNG, the positive neck torsion test was observed in 76.5% of the study patients, while square waves in both directions were found in 46.5% and in one direction in 10.6%. Cervical nystagmus was noticed in 19.1% of these patients. In the auditory evoked potentials test, the differences in I-, III- and V-wave latency time were not statistically significant, either at rest or in the neck torsion. In the Doppler ultrasound examination, the asymmetry of vertebral arteries were present (below 25%) in 7 women (14.9%) and 4 men (8.5%), whereas large asymmetries (above 25%) were observed in 23 women (48.9%) and 13 (27.7%) men (range, 25% - 215%) and was statistically insignificant. The resting blood flow velocity in vertebral arteries of large asymmetries, both in systole and diastole heart phases, was significantly higher in the artery with larger asymmetry. The neck torsion test can be diagnostically useful

Safety and immunogenicity of a combined Tetanus, Diphtheria, recombinant acellular Pertussis vaccine (TdaP) in healthy Thai adults.

Science.gov (United States)

Sirivichayakul, Chukiat; Chanthavanich, Pornthep; Limkittikul, Kriengsak; Siegrist, Claire-Anne; Wijagkanalan, Wassana; Chinwangso, Pailinrut; Petre, Jean; Hong Thai, Pham; Chauhan, Mukesh; Viviani, Simonetta

2017-01-02

An acellular Pertussis (aP) vaccine containing recombinant genetically detoxified Pertussis Toxin (PTgen), Filamentous Hemagglutinin (FHA) and Pertactin (PRN) has been developed by BioNet-Asia (BioNet). We present here the results of the first clinical study of this recombinant aP vaccine formulated alone or in combination with tetanus and diphtheria toxoids (TdaP). A phase I/II, observer-blind, randomized controlled trial was conducted at Mahidol University in Bangkok, Thailand in healthy adult volunteers aged 18-35 y. The eligible volunteers were randomized to receive one dose of either BioNet's aP or Tetanus toxoid-reduced Diphtheria toxoid-acellular Pertussis (TdaP) vaccine, or the Tdap Adacel® vaccine in a 1:1:1 ratio. Safety follow-up was performed for one month. Immunogenicity was assessed at baseline, at 7 and 28 d after vaccination. Anti-PT, anti-FHA, anti-PRN, anti-tetanus and anti-diphtheria IgG antibodies were assessed by ELISA. Anti-PT neutralizing antibodies were assessed also by CHO cell assay. A total of 60 subjects (20 per each vaccine group) were enrolled and included in the safety analysis. Safety laboratory parameters, incidence of local and systemic post-immunization reactions during 7 d after vaccination and incidence of adverse events during one month after vaccination were similar in the 3 vaccine groups. One month after vaccination, seroresponse rates of anti-PT, anti-FHA and anti-PRN IgG antibodies exceeded 78% in all vaccine groups. The anti-PT IgG, anti-FHA IgG, and anti-PT neutralizing antibody geometric mean titers (GMTs) were significantly higher following immunization with BioNet's aP and BioNet's TdaP than Adacel® (Pdiphtheria GMTs at one month after immunization were comparable in all vaccine groups. All subjects had seroprotective titers of anti-tetanus and anti-diphtheria antibodies at baseline. In this first clinical study, PTgen-based BioNet's aP and TdaP vaccines showed a similar tolerability and safety profile to Adacel

Stereotactic radiosurgery for trigeminal pain secondary to recurrent malignant skull base tumors.

Science.gov (United States)

Phan, Jack; Pollard, Courtney; Brown, Paul D; Guha-Thakurta, Nandita; Garden, Adam S; Rosenthal, David I; Fuller, Clifton D; Frank, Steven J; Gunn, G Brandon; Morrison, William H; Ho, Jennifer C; Li, Jing; Ghia, Amol J; Yang, James N; Luo, Dershan; Wang, He C; Su, Shirley Y; Raza, Shaan M; Gidley, Paul W; Hanna, Ehab Y; DeMonte, Franco

2018-04-27

OBJECTIVE The objective of this study was to assess outcomes after Gamma Knife radiosurgery (GKRS) re-irradiation for palliation of patients with trigeminal pain secondary to recurrent malignant skull base tumors. METHODS From 2009 to 2016, 26 patients who had previously undergone radiation treatment to the head and neck received GKRS for palliation of trigeminal neuropathic pain secondary to recurrence of malignant skull base tumors. Twenty-two patients received single-fraction GKRS to a median dose of 17 Gy (range 15-20 Gy) prescribed to the 50% isodose line (range 43%-55%). Four patients received fractionated Gamma Knife Extend therapy to a median dose of 24 Gy in 3 fractions (range 21-27 Gy) prescribed to the 50% isodose line (range 45%-50%). Those with at least a 3-month follow-up were assessed for symptom palliation. Self-reported pain was evaluated by the numeric rating scale (NRS) and MD Anderson Symptom Inventory-Head and Neck (MDASI-HN) pain score. Frequency of as-needed (PRN) analgesic use and opioid requirement were also assessed. Baseline opioid dose was reported as a fentanyl-equivalent dose (FED) and PRN for breakthrough pain use as oral morphine-equivalent dose (OMED). The chi-square and Student t-tests were used to determine differences before and after GKRS. RESULTS Seven patients (29%) were excluded due to local disease progression. Two experienced progression at the first follow-up, and 5 had local recurrence from disease outside the GKRS volume. Nineteen patients were assessed for symptom palliation with a median follow-up duration of 10.4 months (range 3.0-34.4 months). At 3 months after GKRS, the NRS scores (n = 19) decreased from 4.65 ± 3.45 to 1.47 ± 2.11 (p control.

Protocols for Visually Guided Navigation Assessment of Efficacy of Retina-Directed Cell or Gene Therapy in Canines

Directory of Open Access Journals (Sweden)

Jean Bennett

2017-04-01

Full Text Available There has been marked progress in recent years in developing gene delivery approaches for the treatment of inherited blinding diseases. Many of the proof-of-concept studies have utilized rodent models of retinal degeneration. In those models, tests of visual function include a modified water maze swim test, optokinetic nystagmus, and light-dark activity assays. Test paradigms used in rodents can be difficult to replicate in large animals due to their size and awareness of non-visual aspects of the test system. Two types of visual behavior assays have been utilized in canines: an obstacle avoidance course and a forced choice Y maze. Given the progress in developing cell and gene therapies in large animals, such tests will become more and more valuable. This study provides guidelines for carrying out such tests and assesses the challenges and benefits associated with each test.

Tullio phenomenon in superior semicircular canal dehiscence syndrome.

Science.gov (United States)

Basura, Gregory J; Cronin, Scott J; Heidenreich, Katherine D

2014-03-18

Tullio phenomenon refers to eye movements induced by sound.(1) This unusual examination finding may be seen in superior semicircular canal dehiscence (SSCD) syndrome.(2) This disorder is due to absent bone over the superior semicircular canal (figure). Patients complain of dizziness triggered by loud sound, aural fullness, autophony, and pulsatile tinnitus. When Tullio phenomenon exists in SSCD syndrome, the patient develops a mixed vertical-torsional nystagmus in which the slow phase rotates up and away from the affected ear (video on the Neurology® Web site at Neurology.org). This pattern of nystagmus aligns in the plane of the dehiscent semicircular canal and is due to excitation of its afferent nerves.

The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

Directory of Open Access Journals (Sweden)

Sergio Carmona

2016-08-01

Full Text Available The head impulse, nystagmus type, test of skew (HINTS protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS. The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests and negative MRI, and the rest with Stroke: 32 in the PICA territory (positive HINTS findings, positive MRI and 10 in the AICA territory (variable findings and grade 3 Ataxia, positive MRI. Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture.When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38, 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.

Comparative analysis of pharmacological treatments with N-acetyl-DL-leucine (Tanganil) and its two isomers (N-acetyl-L-leucine and N-acetyl-D-leucine) on vestibular compensation: Behavioral investigation in the cat.

Science.gov (United States)

Tighilet, Brahim; Leonard, Jacques; Bernard-Demanze, Laurence; Lacour, Michel

2015-12-15

Head roll tilt, postural imbalance and spontaneous nystagmus are the main static vestibular deficits observed after an acute unilateral vestibular loss (UVL). In the UVL cat model, these deficits are fully compensated over 6 weeks as the result of central vestibular compensation. N-Acetyl-dl-leucine is a drug prescribed in clinical practice for the symptomatic treatment of acute UVL patients. The present study investigated the effects of N-acetyl-dl-leucine on the behavioral recovery after unilateral vestibular neurectomy (UVN) in the cat, and compared the effects of each of its two isomers N-acetyl-L-leucine and N-acetyl-D-leucine. Efficacy of these three drug treatments has been evaluated with respect to a placebo group (UVN+saline water) on the global sensorimotor activity (observation grids), the posture control (support surface measurement), the locomotor balance (maximum performance at the rotating beam test), and the spontaneous vestibular nystagmus (recorded in the light). Whatever the parameters tested, the behavioral recovery was strongly and significantly accelerated under pharmacological treatments with N-acetyl-dl-leucine and N-acetyl-L-leucine. In contrast, the N-acetyl-D-leucine isomer had no effect at all on the behavioral recovery, and animals of this group showed the same recovery profile as those receiving a placebo. It is concluded that the N-acetyl-L-leucine isomer is the active part of the racemate component since it induces a significant acceleration of the vestibular compensation process similar (and even better) to that observed under treatment with the racemate component only. Copyright © 2015 Elsevier B.V. All rights reserved.

Disease: H00169 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H00169 Ocular albinism; Ocular albinism, type I (OA1); Waardenburg syndrome, type ...ia, nystagmus, translucent irides, strabismus, hypermetropic refractive errors. Waardenburg syndrome type II

Determination of Precise Satellite Orbital Position Using Multi-Band GNSS Signals

Science.gov (United States)

2017-10-16

occultation and overhead ray paths provide some improvement in the inversion , especially at high altitudes. Insofar as the analysis of the VELOX...Shows an example of cycle slip detection and correction for PRN 17 on 2016-02-26/27. The algorithm performs multiple iterations of simultaneous ...sharp inversion layers. The IGRA detected PBLHs are more affected by the nearby terrain and are generally higher/larger compared to the PBLHs from

PRN 73-4: Residual Insecticides in Food Handling Establishments

Science.gov (United States)

This notice provides a copy of a Federal Register notice published July 6, 1973, regarding certain insecticides used in food-handling establishments. It establishes certain definitions and requirements related to approval for crack and crevice treatment.

Pesquisa do nistagmo/vertigem de posição e avaliação eletronistagmográfica em um grupo de indivíduos portadores de diabetes Mellitus tipo I Search of the nystagmus/ positional vertigo and electronystagmographic evaluation in a group of diabetics Mellitus type I

Directory of Open Access Journals (Sweden)

Lílian P. Scherer

2002-05-01

search the nystagmus/ positional vertigo and electronystagmographic evaluation, and to identify possible alterations. Study design: Prospective clinical. Material and method: 12 Diabetics Type I, insulin dependents, between 12 and 27 years old, and members of Associação Riograndense de Apoio aos Diabéticos (ARAD. To observe the vestibular reactions, we did a specific interview, otoscopy, tympanometric, search of the Nystagmus/ Positional Vertigo and Electronystagmographic Evaluation in the selected sample. Results: We verified Periferic Irritable Vestibular Syndrome in 75% of the altered results. 62,5% in this group didn't present otoneurologyc symptom. Conclusions: We note that the effect of Diabetes Type I in the vestibular function may be taken into consideration like any other usual complications, since the same may occur in asymptomatic patients, and also because with the early etiologic diagnostic it is possible to help in the prevention of this disease's complications.

Differential diagnosis of vertigo and dizziness in the emergency department.

Science.gov (United States)

Ozono, Yoshiyuki; Kitahara, Tadashi; Fukushima, Munehisa; Michiba, Takahiro; Imai, Ryusuke; Tomiyama, Youichirou; Nishiike, Suetaka; Inohara, Hidenori; Morita, Hisaki

2014-02-01

To establish a system of differential diagnosis for vertigo/dizziness at the Emergency Department (ED), careful history-taking of complications and examinations of nystagmus should be helpful and therefore prepared by ED staff. Vertigo/dizziness could come from various kinds of organs for equilibrium, sometimes resulting in an emergency due to the central origin. In the present study, we checked patients' background data at the ED in advance of a definitive diagnosis at the Department of Otolaryngology and examined the significance of the correlation between the data and the diagnosis. We studied a series of 120 patients with vertigo/dizziness, who visited the Departments of Emergency and Otolaryngology between April 2011 and March 2012. At the ED, we first checked patients' backgrounds and carried out neurologic and neuro-otologic examinations. At the Department of Otolaryngology, we finally diagnosed all the patients according to the criteria and classified the origins of vertigo/dizziness into central and non-central diseases. The ratio of patients with disease of central origin was 12.5% and that for non-central origin was 87.5%. The risk factors for cerebrovascular disease such as hypertension, heart disease, and diabetes were also the risk factors for central vertigo/dizziness by the chi-squared test. To predict a central origin for vertigo/dizziness, only gaze nystagmus was the significant factor by multivariate regression analysis.

Effects of static orientation upon human optokinetic afternystagmus

Science.gov (United States)

Wall, C. 3rd; Merfeld, D. M.; Zupan, L.

1999-01-01

"Normal" human subjects were placed in a series of 5 static orientations with respect to gravity and were asked to view an optokinetic display moving at a constant angular velocity. The axis of rotation coincided with the subject's rostro-caudal axis and produced horizontal optokinetic nystagmus and afternystagmus. Wall (1) previously reported that these optokinetic afternystagmus responses were not well characterized by parametric fits to slow component velocity. The response for nose-up, however, was larger than for nose-down. This suggested that the horizontal eye movements measured during optokinetic stimulation might include an induced linear VOR component as presented in the body of this paper. To investigate this hypothesis, another analysis of these data has been made using cumulative slow component eye position. Some subjects' responses had reversals in afternystagmus direction. These reversals were "filled in" by a zero slow component velocity. This method of analysis gives a much more consistent result across subjects and shows that, on average, responses from the nose-down horizontal (prone) orientation are greatly reduced (p the responses to post-rotatory nystagmus after earth horizontal axis rotation. Ten of 11 subjects had larger responses in their supine than their prone orientation. Application of horizontal axis optokinetic afternystagmus for clinical otolith function testing, and implications for altered gravity experiments are discussed.

Caffeine increases the velocity of rapid eye movements in unfatigued humans.

Science.gov (United States)

Connell, Charlotte J W; Thompson, Benjamin; Turuwhenua, Jason; Hess, Robert F; Gant, Nicholas

2017-08-01

Caffeine is a widely used dietary stimulant that can reverse the effects of fatigue on cognitive, motor and oculomotor function. However, few studies have examined the effect of caffeine on the oculomotor system when homeostasis has not been disrupted by physical fatigue. This study examined the influence of a moderate dose of caffeine on oculomotor control and visual perception in participants who were not fatigued. Within a placebo-controlled crossover design, 13 healthy adults ingested caffeine (5 mg·kg -1 body mass) and were tested over 3 h. Eye movements, including saccades, smooth pursuit and optokinetic nystagmus, were measured using infrared oculography. Caffeine was associated with higher peak saccade velocities (472 ± 60° s -1 ) compared to placebo (455 ± 62° s -1 ). Quick phases of optokinetic nystagmus were also significantly faster with caffeine, whereas pursuit eye movements were unchanged. Non-oculomotor perceptual tasks (global motion and global orientation processing) were unaffected by caffeine. These results show that oculomotor control is modulated by a moderate dose of caffeine in unfatigued humans. These effects are detectable in the kinematics of rapid eye movements, whereas pursuit eye movements and visual perception are unaffected. Oculomotor functions may be sensitive to changes in central catecholamines mediated via caffeine's action as an adenosine antagonist, even when participants are not fatigued.

The ARMOUR Study: Anti-VEGF in Neovascular AMD--Our Understanding in a Real-World Indian Setting.

Science.gov (United States)

Jain, Nimesh; Yadav, Naresh Kumar; Jayadev, Chaitra; Srinivasan, Priya; Mohan, Ashwin; Shetty, Bhujang K

2017-01-01

The aim of our study was to share our experience with anti-vascular endothelial growth factor (anti-VEGF) injections in the treatment of neovascular age-related macular degeneration (nAMD) in a real-world setting. A retrospective, observational study. Patients of Indian origin with nAMD receiving anti-VEGF with a minimum follow-up of 12 months were enrolled in this study. In group 1, patients were treated on a pro re nata (PRN) basis; in group 2, patients received a loading dose (3 injecti Results: Overall, we observed that 77.31% (92/119 eyes) of patients either maintained or had improved visual acuity at 12 months' follow-up. Similar visual outcome was observed in both groups. The average number of injections given in group 1 was 4.98 and in group 2 was 3.7. CDVA at 12 months was significantly correlated with type of drug molecule, CSFT at 3 and 12 months, baseline visual acuity, and CDVA at 3 months. PRN treatment with significantly fewer injections achieved similar anatomical and functional outcomes when compared with the loading dose group. The results of this study need to be validated with a larger study group and a longer follow-up. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

Proteomic Analysis of a Global Regulator GacS Sensor Kinase in the Rhizobacterium, Pseudomonas chlororaphis O6

Directory of Open Access Journals (Sweden)

Chul Hong Kim

2014-06-01

Full Text Available The GacS/GacA system in the root colonizer Pseudomonas chlororaphis O6 is a key regulator of many traits relevant to the biocontrol function of this bacterium. Proteomic analysis revealed 12 proteins were down-regulated in a gacS mutant of P. chlororaphis O6. These GacS-regulated proteins functioned in combating oxidative stress, cell signaling, biosynthesis of secondary metabolism, and secretion. The extent of regulation was shown by real-time RT-PCR to vary between the genes. Mutants of P. chlororaphis O6 were generated in two GacS-regulated genes, trpE, encoding a protein involved in tryptophan synthesis, and prnA, required for conversion of tryptophan to the antimicrobial compound, pyrrolitrin. Failure of the trpE mutant to induce systemic resistance in tobacco against a foliar pathogen causing soft rot, Pectobacterium carotovorum SCCI, correlated with reduced colonization of root surfaces implying an inadequate supply of tryptophan to support growth. Although colonization was not affected by mutation in the prnA gene, induction of systemic resistance was reduced, suggesting that pyrrolnitrin was an activator of plant resistance as well as an antifungal agent. Study of mutants in the other GacS-regulated proteins will indicate further the features required for biocontrol-activity in this rhizobacterium.

Joubert Syndrome: Imaging Features and Illustration of a Case

International Nuclear Information System (INIS)

Arora, Richa

2014-01-01

Joubert Syndrome (JS) is a rare autosomal recessive disorder characterised clinically by neonatal breathing dysregulation, developmental delay, intellectual disability, hypotonia, ataxia, nystagmus. We present another case of this uncommon syndrome in a 12 years old patient presenting with classical complaints of developmental delay, intellectual impairment, weakness in both lower limbs, ataxia and abnormal facies and diagnosed on Computed Tomography. Joubert Syndrome should be ruled out in all patients presenting with hypotonia, ataxia, nystagmus, breathing abnormalities and developmental delay. Its neuroimaging hallmarks include molar tooth sign and batwing shaped fourth ventricle. As JS is associated with multiorgan involvement, these patients should enter a diagnostic protocol to assess systemic abnormalities. Extreme caution should be taken while administering drugs in these patients as they are prone to respiratory depression

The Methods of Implementation of the Three-dimensional Pseudorandom Number Generator DOZEN for Heterogeneous CPU/GPU /FPGA High-performance Systems

Directory of Open Access Journals (Sweden)

Nikolay Petrovich Vasilyev

2015-03-01

Full Text Available The paper describes the scope of information security protocols based on PRN G in industrial systems. A method for implementing three-dimensional pseudorandom number generator D O Z E N in hybrid systems is provided. The description and results of studies parallel CUDA-version of the algorithm for use in hybrid data centers and high-performance FPGA-version for use in hardware solutions in controlled facilities of SCADA-systems are given.

A Pilot Study to Assess the Vestibular Apparatus Function with Videonystagmography During Chronic Otitis Media with Effusion.

Science.gov (United States)

Saliba, Issam; Dagher, Chady; El-Zir, Elie; Yammine, Fady G

2015-01-01

To assess the effect of chronic middle ear effusion (CMEE) on balance and equilibrium. Prospective study controlling two groups of children. The active arm consisted of children having a unilateral or bilateral CMEE that persisted for at least 3 months. The control group consisted of children presenting with normal middle ear. Children and parents in both groups were questioned about any symptom of vertigo, dizziness, disequilibrium or child's tendency to fall. ENT exam included an assessment with pneumatic and microscopic otoscopy, evaluation of the vestibular system with the Romberg test, the Fukuda test, the head-shaking test and the Starwalk test. The study group consisted of 15 children (mean = 6.5 years, SD = 2; 10 females and 5 males). The control group consisted also of 15 children (mean = 7.2 years, SD = 1.8; 8 females and 7 males). The duration of MEE was between 3 and 12 months (mean = 8 months). Three children (20%) in the study group had a history of vertigo, imbalance, disequilibrium and/or tendency to fall. None of the children in the control group had such a history (p = 0.22); Five children in the study group had abnormal head-shaking test, Fukuda and/or Starwalk tests (33.33%). Two children in the control group had such a finding (13.33%) (p = 0.39). Romberg test was normal in all children in both groups. In the study group, one child showed positional and spontaneous nystagmus on VNG testing. Another one showed positional nystagmus. Hence, 2 children had abnormal findings on VNG (13.33%). In the control group, VNG was normal in all children (p = 0.46). Tympanometry showed a type B curve in 26 ears, a type C curve in 3 ears and type A in one ear. In the control group all patients presented a type A curve. This paper describes the first study using VNG in a population of children with CMEE. The presence of balance disturbances associated or not with hearing loss is of paramount importance to the clinician as to the indications of myringotomy with a

Pediatric Oculomotor Findings during Monocular Videonystagmography: A Developmental Study.

Science.gov (United States)

Doettl, Steven M; Plyler, Patrick N; McCaslin, Devin L; Schay, Nancy L

2015-09-01

The differential diagnosis of a dizzy patient >4 yrs old is often aided by videonystagmography (VNG) testing to provide a global assessment of peripheral and central vestibular function. Although the value of a VNG evaluation is well-established, it remains unclear if the VNG test battery is as applicable to the pediatric population as it is for adults. Oculomotor testing specifically, as opposed to spontaneous, positional, and caloric testing, is dependent upon neurologic function. Thus, age and corresponding neuromaturation may have a significant effect on oculomotor findings. The purpose of this investigation was to describe the effect of age on various tests of oculomotor function during a monocular VNG examination. Specifically, this study systematically characterized the impact of age on saccade tracking, smooth pursuit tracking, and optokinetic (OPK) nystagmus. The present study used a prospective, repeated measures design. A total of 62 healthy participants were evaluated. Group 1 consisted of 29 4- to 6-yr-olds. Group 2 consisted of 33 21- to 44-yr-olds. Each participant completed a standard VNG oculomotor test battery including saccades, smooth pursuit, and OPK testing in randomized order using a commercially available system. The response metrics saccade latency, accuracy, and speed, smooth pursuit gain, OPK nystagmus gain, speed and asymmetry ratios were collected and analyzed. Significant differences were noted between groups for saccade latency, smooth pursuit gain, and OPK asymmetry ratios. Saccade latency was significantly longer for the pediatric participants compared to the adult participants. Smooth pursuit gain was significantly less for the pediatric participants compared to the adult participants. The pediatric participants also demonstrated increased OPK asymmetry ratios compared to the adult participants. Significant differences were noted between the pediatric and adult participants for saccade latency, smooth pursuit gain, and OPK

A field study of the accuracy and reliability of a biometric iris recognition system.

Science.gov (United States)

Latman, Neal S; Herb, Emily

2013-06-01

The iris of the eye appears to satisfy the criteria for a good anatomical characteristic for use in a biometric system. The purpose of this study was to evaluate a biometric iris recognition system: Mobile-Eyes™. The enrollment, verification, and identification applications were evaluated in a field study for accuracy and reliability using both irises of 277 subjects. Independent variables included a wide range of subject demographics, ambient light, and ambient temperature. A sub-set of 35 subjects had alcohol-induced nystagmus. There were 2710 identification and verification attempts, which resulted in 1,501,340 and 5540 iris comparisons respectively. In this study, the system successfully enrolled all subjects on the first attempt. All 277 subjects were successfully verified and identified on the first day of enrollment. None of the current or prior eye conditions prevented enrollment, verification, or identification. All 35 subjects with alcohol-induced nystagmus were successfully verified and identified. There were no false verifications or false identifications. Two conditions were identified that potentially could circumvent the use of iris recognitions systems in general. The Mobile-Eyes™ iris recognition system exhibited accurate and reliable enrollment, verification, and identification applications in this study. It may have special applications in subjects with nystagmus. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Altered whole-brain connectivity in albinism.

Science.gov (United States)

Welton, Thomas; Ather, Sarim; Proudlock, Frank A; Gottlob, Irene; Dineen, Robert A

2017-02-01

Albinism is a group of congenital disorders of the melanin synthesis pathway. Multiple ocular, white matter and cortical abnormalities occur in albinism, including a greater decussation of nerve fibres at the optic chiasm, foveal hypoplasia and nystagmus. Despite this, visual perception is largely preserved. It was proposed that this may be attributable to reorganisation among cerebral networks, including an increased interhemispheric connectivity of the primary visual areas. A graph-theoretic model was applied to explore brain connectivity networks derived from resting-state functional and diffusion-tensor magnetic resonance imaging data in 23 people with albinism and 20 controls. They tested for group differences in connectivity between primary visual areas and in summary network organisation descriptors. Main findings were supplemented with analyses of control regions, brain volumes and white matter microstructure. Significant functional interhemispheric hyperconnectivity of the primary visual areas in the albinism group were found (P = 0.012). Tests of interhemispheric connectivity based on the diffusion-tensor data showed no significant group difference (P = 0.713). Second, it was found that a range of functional whole-brain network metrics were abnormal in people with albinism, including the clustering coefficient (P = 0.005), although this may have been driven partly by overall differences in connectivity, rather than reorganisation. Based on the results, it was suggested that changes occur in albinism at the whole-brain level, and not just within the visual processing pathways. It was proposed that their findings may reflect compensatory adaptations to increased chiasmic decussation, foveal hypoplasia and nystagmus. Hum Brain Mapp 38:740-752, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Eye Movement Disorders

Science.gov (United States)

... work properly. There are many kinds of eye movement disorders. Two common ones are Strabismus - a disorder ... in "crossed eyes" or "walleye." Nystagmus - fast, uncontrollable movements of the eyes, sometimes called "dancing eyes" Some ...

Svimmelhed, der er relateret til øjensygdomme

DEFF Research Database (Denmark)

Lund-Andersen, Henrik

2013-01-01

Dizziness stands for vertigo (rotatory and nautic) and dysbalance/unstability. Vertigo originates from the vestibular central nervous system; no eye disease, but nystagmus is often present. Dysbalance/unstability: normal ophthalmological findings exclude ophthalmological pathogenesis...

Abnormal Eye Movements in Creutzfeldt-Jakob Disease

Science.gov (United States)

Grant, Michael P.; Cohen, Mark; Petersen, Robert B.; Halmagyi, G. Michael; McDougall, Alan; Tusa, Ronald J.; Leigh, R. John

1993-01-01

We report 3 patients with autopsy-proven Creutzfeldt-Jakob disease who, early in their course, developed abnormal eye movements that included periodic alternating nystagmus and slow vertical saccades. These findings suggested involvement of the cerebellar nodulus and uvula, and the brainstem reticular formation, respectively. Cerebellar ataxia was also an early manifestation and, in one patient, a frontal lobe brain biopsy was normal at a time when ocular motor and cerebellar signs were conspicuous. As the disease progressed, all saccades and quick phases of nystagmus were lost, but periodic alternating gaze deviation persisted. At autopsy, 2 of the 3 patients had pronounced involvement of the cerebellum, especially of the midline structures. Creutzfeldt-Jakob disease should be considered in patients with subacute progressive neurological disease when cognitive changes are overshadowed by ocular motor findings or ataxia.

Visually induced eye movements in Wallenberg's syndrome

International Nuclear Information System (INIS)

Kanayama, R.; Nakamura, T.; Ohki, M.; Kimura, Y.; Koike, Y.; Kato, I.

1991-01-01

Eighteen patients with Wallenberg's syndrome were investigated concerning visually induced eye movements. All results were analysed quantitatively using a computer. In 16 out of 18 patients, OKN slow-phase velocities were impaired, in the remaining 2 patients they were normal. All patients showed reduced visual suppression of caloric nystagmus during the slow-phase of nystagmus toward the lesion side, except 3 patients who showed normal visual suppression in both directions. CT scan failed to detect either the brainstem or the cerebellar lesions in any cases, but MRI performed on the most recent cases demonstrated the infractions clearly. These findings suggest that infractions are localized in the medulla in the patients of group A, but extend to the cerebellum as well as to the medulla in patients of group B. (au)

Visually induced eye movements in Wallenberg's syndrome

Energy Technology Data Exchange (ETDEWEB)

Kanayama, R.; Nakamura, T.; Ohki, M.; Kimura, Y.; Koike, Y. (Dept. of Otolaryngology, Yamagata Univ. School of Medicine (Japan)); Kato, I. (Dept. of Otolaryngology, St. Marianna Univ. School of Medicine, Kawasaki (Japan))

1991-01-01

Eighteen patients with Wallenberg's syndrome were investigated concerning visually induced eye movements. All results were analysed quantitatively using a computer. In 16 out of 18 patients, OKN slow-phase velocities were impaired, in the remaining 2 patients they were normal. All patients showed reduced visual suppression of caloric nystagmus during the slow-phase of nystagmus toward the lesion side, except 3 patients who showed normal visual suppression in both directions. CT scan failed to detect either the brainstem or the cerebellar lesions in any cases, but MRI performed on the most recent cases demonstrated the infractions clearly. These findings suggest that infractions are localized in the medulla in the patients of group A, but extend to the cerebellum as well as to the medulla in patients of group B. (au).

Vestibular Dysfunction in Wernicke’s Encephalopathy: Predominant Impairment of the Horizontal Semicircular Canals

Directory of Open Access Journals (Sweden)

Seung-Han Lee

2018-03-01

Full Text Available BackgroundWernicke’s encephalopathy (WE, a metabolic disorder due to thiamine deficiency, manifests with various neurological symptoms and signs. It has been known as a cause of vestibular dysfunction. Preliminary reports have proposed predominant involvement of the horizontal semicircular canals (HSCs.ObjectiveTo better characterize the pattern of vestibular impairment in patients with WE using quantitative video head-impulse testing and to review the literature regarding this topic.MethodFrom January 2014 to December 2016, we retrospectively enrolled five cases of WE that received quantitative video-head-impulse testing (vHIT. We retrieved the clinical features from the medical records and reviewed quantitative head-impulse testing (qHIT and caloric irrigation. Based on the gain and the number of corrective saccades, the function (normal vs. impaired of each semicircular canal was rated. In addition, we conducted a MEDLINE and EMBASE search to identify other published cases of WE that had received qHIT. Neuro-otologic and neuro-ophthalmologic findings and vestibular testing results were extracted.ResultsA total of 17 patients (own series = 5; published cases = 12 aged 54.6 ± 11 years were included. Key neurologic findings were ataxia of stance and gait (13/13, 100%, spontaneous nystagmus (7/14, 50%, gaze-evoked nystagmus (GEN (17/17, 100%, positive bedside head-impulse testing for the horizontal canals (16/17, 94%, and memory impairment and mental changes (6/11, 54.5%. Regarding vestibular testing, qHIT (either video based or search-coil based documented selective bilateral horizontal canal dysfunction with normal or minimal vertical canal impairment (14/14, 100%. On caloric irrigation, bilateral horizontal canal paresis was noted in most cases (10/11, 91%.ConclusionIn WE, signs of both peripheral and central vestibular dysfunction (i.e., GEN, ataxia of stance and gait, abnormal head-impulse testing were common. Selective or

Genetics Home Reference: spastic paraplegia type 7

Science.gov (United States)

... in the arms; speech difficulties (dysarthria); difficulty swallowing (dysphagia); involuntary movements of the eyes (nystagmus); mild hearing ... AH, Warner TT. A clinical, genetic and biochemical study of SPG7 mutations in hereditary spastic paraplegia. Brain. ...

Genotyping and prenatal diagnosis of a large spinocerebellar ataxia ...

Indian Academy of Sciences (India)

2011-08-19

Aug 19, 2011 ... range of eye movements with horizontal nystagmus, dysdi- adochokinesia, and ... individuals; open symbols indicate normal individuals; grey sym- bols indicate .... prenatal diagnosis of a fetus at risk of MJD. In conclusion, we ...

MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 3

DEFF Research Database (Denmark)

Jarius, Sven; Kleiter, Ingo; Ruprecht, Klemens

2016-01-01

identified. All were negative for AQP4-IgG. Symptoms included respiratory insufficiency, intractable nausea and vomiting (INV), dysarthria, dysphagia, impaired cough reflex, oculomotor nerve palsy and diplopia, nystagmus, internuclear ophthalmoplegia (INO), facial nerve paresis, trigeminal hypesthesia...

On the Evolution of Specificity in Members of the Yeast Amino Acid Transporter Family as Parts of Specific Metabolic Pathways

Directory of Open Access Journals (Sweden)

Christos Gournas

2018-05-01

Full Text Available In the recent years, molecular modeling and substrate docking, coupled with biochemical and genetic analyses have identified the substrate-binding residues of several amino acid transporters of the yeast amino acid transporter (YAT family. These consist of (a residues conserved across YATs that interact with the invariable part of amino acid substrates and (b variable residues that interact with the side chain of the amino acid substrate and thus define specificity. Secondary structure sequence alignments showed that the positions of these residues are conserved across YATs and could thus be used to predict the specificity of YATs. Here, we discuss the potential of combining molecular modeling and structural alignments with intra-species phylogenetic comparisons of transporters, in order to predict the function of uncharacterized members of the family. We additionally define some orphan branches which include transporters with potentially novel, and to be characterized specificities. In addition, we discuss the particular case of the highly specific l-proline transporter, PrnB, of Aspergillus nidulans, whose gene is part of a cluster of genes required for the utilization of proline as a carbon and/or nitrogen source. This clustering correlates with transcriptional regulation of these genes, potentially leading to the efficient coordination of the uptake of externally provided l-Pro via PrnB and its enzymatic degradation in the cell.

Molecular epidemiology of Bordetella pertussis in Cambodia determined by direct genotyping of clinical specimens.

Science.gov (United States)

Moriuchi, Takumi; Vichit, Ork; Vutthikol, Yong; Hossain, Md Shafiqul; Samnang, Chham; Toda, Kohei; Grabovac, Varja; Hiramatsu, Yukihiro; Otsuka, Nao; Shibayama, Keigo; Kamachi, Kazunari

2017-09-01

This study sought to determine the genotypes of circulating Bordetella pertussis, the causative agent of pertussis, in Cambodia by direct molecular typing of clinical specimens. DNA extracts from nasopharyngeal swabs obtained from 82 pertussis patients in 2008-2016 were analyzed by multilocus variable-number tandem repeat analysis (MLVA). B. pertussis virulence-associated allelic genes (ptxA, prn, and fim3) and the pertussis toxin promoter ptxP were also investigated by DNA sequence-based typing. Forty-four DNA extracts (54%) yielded a complete MLVA profile, and these were sorted into 8 MLVA types (MT18, MT26, MT27, MT29, MT43, MT72, MT95, and MT200). MT27 and MT29, which are common in developed countries, were the predominant strain types (total 73%). The predominant profile of virulence-associated allelic genes was the combination of ptxP3/ptxA1/prn2/fim3A (48%). MT27 strains were detected during the entire study period, whereas MT29 strains were only found in 2014-2016. The B. pertussis population in Cambodia, where a whole-cell pertussis vaccine (WCV) has been continuously used, resembled those observed previously in developed countries where acellular pertussis vaccines are used. Circulating B. pertussis strains in Cambodia were distinct from those in other countries using WCVs. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Impact of age and vaccination history on long-term serological responses after symptomatic B. pertussis infection, a high dimensional data analysis

Science.gov (United States)

van Twillert, Inonge; Bonačić Marinović, Axel A.; Kuipers, Betsy; van Gaans-van den Brink, Jacqueline A. M.; Sanders, Elisabeth A. M.; van Els, Cécile A. C. M.

2017-01-01

Capturing the complexity and waning patterns of co-occurring immunoglobulin (Ig) responses after clinical B. pertussis infection may help understand how the human host gradually loses protection against whooping cough. We applied bi-exponential modelling to characterise and compare B. pertussis specific serological dynamics in a comprehensive database of IgG, IgG subclass and IgA responses to Ptx, FHA, Prn, Fim2/3 and OMV antigens of (ex-) symptomatic pertussis cases across all age groups. The decay model revealed that antigen type and age group were major factors determining differences in levels and kinetics of Ig (sub) classes. IgG-Ptx waned fastest in all age groups, while IgA to Ptx, FHA, Prn and Fim2/3 decreased fast in the younger but remained high in older (ex-) cases, indicating an age-effect. While IgG1 was the main IgG subclass in response to most antigens, IgG2 and IgG3 dominated the anti-OMV response. Moreover, vaccination history plays an important role in post-infection Ig responses, demonstrated by low responsiveness to Fim2/3 in unvaccinated elderly and by elevated IgG4 responses to multiple antigens only in children primed with acellular pertussis vaccine (aP). This work highlights the complexity of the immune response to this re-emerging pathogen and factors determining its Ig quantity and quality. PMID:28091579

Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

Directory of Open Access Journals (Sweden)

Soo Jung Lee

2014-06-01

Full Text Available AIM: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS: The medical records of 122 patients, aged 1.5mo to 9y, who had undergone cataract extraction with primary intraocular lens implantation between January 1993 and August 2011 were reviewed. Fourteen patients (17 eyes with strabismus before cataract surgery were excluded. Patients were divided into those with congenital bilateral cataracts (64 patients, 128 eyes and those with unilateral cataracts (44 patients, 44 eyes. The associations between the development of strabismus and age at cataract surgery, pre- and post-cataract extraction corrected distance visual acuity (CDVA, interocular CDVA difference, nystagmus, surgical method, and secondary cataract were evaluated.RESULTS: Factors significantly associated with the development of strabismus included age at cataract surgery (≤1y, preoperative mean CDVA ≤20/100, presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference ＞20/70 in the unilateral group. Postoperative CDVA ≤20/100 and preservation of posterior capsule, and presence of secondary cataract were significant factors in both groups.CONCLUSION: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus, especially when they underwent surgery at age ≤1y, and they have nystagmus, large postoperative interocular CDVA difference, poor preoperative and postoperative CDVA, preservation of the posterior capsule, or secondary cataract.

Acute comparison of clovoxamine and mianserin, alone and in combination with ethanol, on human psychomotor performance.

Science.gov (United States)

Strömberg, C; Mattila, M J

1987-05-01

Objective and subjective effects on human performance of clovoxamine and mianserin were measured in 12 student volunteers who participated in 12 test sessions and received single doses of clovoxamine 50 mg, 100 mg and 150 mg, mianserin 20 mg, and placebo in a double-blind and cross-over manner. Each test drug was given twice, both in combination with alcohol 0.8 g/kg and with a non-alcoholic drink. The tests included tracking, body balance, flicker fusion, horizontal nystagmus, digit symbol substitution, recall memory, and subjective assessments on visual analogue scales. Mianserin and alcohol impaired objective performance in most tests, and their combination showed at least an additive effect. Alcohol counteracted rather than increased mianserin-induced subjective sedation. Clovoxamine neither differed significantly from placebo nor increased alcohol effects. On the contrary, clovoxamine 150 mg reduced significantly alcohol-induced body sway. No evidence of pharmacokinetic interactions were found between the study drugs and alcohol.

Hermansky-Pudlak syndrome

Directory of Open Access Journals (Sweden)

Preena A

2017-04-01

Full Text Available Hermansky-Pudlak syndrome is a rare autosomal recessive multisystem disease, with oculocutneous albinism, pulmonary fibrosis and bleeding diathesis. Here we report a case of Hermansky-Pudlak syndrome who presented with dyspnea, oculocutaneous albinism and nystagmus.

Experimental technique of neutron reflection

International Nuclear Information System (INIS)

Chen Bo; Huang Chaoqiang; Li Xinxi

2006-12-01

It is presented that the classifications, structures and components of neutron reflectometer (NR), as well s functions and parameters of each components, detailed characters of NR facility 'PRN-2M'. Based on the practical experiments, the basic experimental techniques, the measurement and the related experimental settings are described, including the choice of experimental conditions, adjustments of polarized neutron beam line, basic experimental technique and approach of measurement. The above can be an instruction for NR experiments and a reference for NR construction. (authors)

Genetics Home Reference: X-linked infantile nystagmus

Science.gov (United States)

... 12 [updated 2011 Sep 29]. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews® [Internet]. Seattle (WA): ...

PRN 99-1: Import of Unregistered Pesticides Intended for Export

Science.gov (United States)

This PR notice clarifies EPA's interpretation of the scope of the FIFRA Section 17 (a)(1) for import of unregistered pesticides, devices or pesticide active ingredients when the importation is solely for the purpose of formulation or packaging for export.

PRN 2001-1: First Aid Statements on Pesticide Product Labels

Science.gov (United States)

This PR notice is intended to provide guidance for what the Agency believes is the most updated appropriate first aid language for pesticide product labels to ensure that they continue to adequately protect the public.

An Expanded Multi-Organ Disease Phenotype Associated with Mutations in YARS

DEFF Research Database (Denmark)

Tracewska-Siemiątkowska, Anna; Haer-Wigman, Lonneke; Bosch, Danielle G M

2017-01-01

Whole exome sequence analysis was performed in a Swedish mother-father-affected proband trio with a phenotype characterized by progressive retinal degeneration with congenital nystagmus, profound congenital hearing impairment, primary amenorrhea, agenesis of the corpus callosum, and liver disease...

An expanded multi-organ disease phenotype associated with mutations in YARS

NARCIS (Netherlands)

Tracewska-Siemiątkowska, Anna; Haer-Wigman, Lonneke; Bosch, Danielle G.M.; Nickerson, Deborah; Bamshad, Michael J.; Möller, J. C.; Kjellström, U.; Andréasson, S.; Van De Vorst, Maartje; Rendtorff, Nanna Dahl; Möller, Claes; Kjellström, Ulrika; Andréasson, Sten; Cremers, Frans P. M.; Tranebjærg, Lisbeth

2017-01-01

Whole exome sequence analysis was performed in a Swedish mother–father-affected proband trio with a phenotype characterized by progressive retinal degeneration with congenital nystagmus, profound congenital hearing impairment, primary amenorrhea, agenesis of the corpus callosum, and liver disease. A

Durability and Kinetics of Maternal Pertussis Antibodies in Infants of Mothers Immunized with Tdap During Pregnancy

Science.gov (United States)

Healy, C Mary; Rench, Marcia; Swaim, Laurie; Timmins, Audra; Vyas, Anuja; Ng, Nancy; Paulos, Simon; Park, So Hee; Jeyachandran, Amilia; Rajam, Gorisankar; Schiffer, Jarad; Baker, Carol J

2017-01-01

Abstract Background Infant protection against severe pertussis requires sufficient maternal pertussis antibodies until infant immunization begins. The kinetics of maternally-derived Tdap-induced antibodies in infants is poorly understood. Methods 34 healthy mother-infant pairs were followed prospectively from maternal Tdap immunization to infant age 6 weeks. Blood was collected from women pre-Tdap, 4 weeks post Tdap and at delivery, and from infants at birth, and age 3 and 6 weeks. IgG to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by luminex assay (IU/mL). Geometric mean concentrations (GMCs) with 95% confidence intervals (C.I.) for pertussis-specific IgG and half-life of IgG to PT were calculated. Results Mean maternal age was 31.1 years (range 22.7–39.7); 47% were white, 32% Hispanic and 21% Black. Tdap was administered at a mean gestation of 30.7 weeks (28–32.7). Infants had a mean gestation of 39.1 weeks (36–41.1) and birthweight of 3379g (2580–4584). GMCs (95%C.I.) for maternal pertussis-specific IgG increased significantly 4 weeks post-Tdap (4-fold higher in 59%, 41%, 29% and 44% for PT, FHA, FIM and PRN, respectively) and waned before delivery. Placental transfer was 135% for PT, 141% for FHA, 131% for FIM and 136% for PRN. Maternal antibodies in infants decayed quickly, but at age 6 weeks GMC of infant PT-specific IgG was 21.1IU/mL (14.7–30.2) and 91% had PT ≥ 10 IU/mL. Estimated half-life of PT-specific IgG in infants was 30.9 days. Time PT (IU/mL) FHA (IU/mL) FIM (IU/mL) PRN (IU/mL) Pre-Tdap 9.85 (6.71–14.45) 32.81 (21.79–49.42) 131.55 (81.98–211.15) 55.67 (35.75–86.68) Post-Tdap 46.8 (34.4–63.68) 116.82 (88.9–153.5) 440.35 (327.57–591.97) 233.02 (179.14–303.04) Maternal Delivery 40.78 (29.4–56.53) 104.81 (78.27–140.35) 384.5 (287.41–514.28) 204.41 (155.42–268.84) Infant Cord 55.12 (38.65–78.6) 147.81 (113.47–192.49) 505.36 (366.44–696.95) 278

Effects of rectilinear acceleration, caloric and optokinetic stimulation of human subjects in the Spacelab D-1 mission

Science.gov (United States)

Wetzig, J.; von Baumgarten, R.

A set of vestibular experiments was performed during the course of the German Spacelab D-1 mission from 30 October to 6 November 1985 by a consortium of experimenters from various european countries. Similar to the Spacelab SL-1 mission all of the scientific crew members were theoretically and practically trained for the experiments. Baseline measurements for all tests were collected 113, 86, 44, 30 and 18 days prior to the mission and compared with data taken inflight, on the landing day and the consecutive 7 to 14 days. The hardware comprised mainly a motordriven accelerating platform, the SPACE SLED, and the vestibular helmet, a multi-purpose instrument in support of a variety of vestibular experiments including air-calorisation of the ears, optokinetic stimulation pattern presentation and optical and nystagmographic recording of eye movements. Measurements of the threshold for the perception of detection of whole body movement did not reveal any dramatic changes in the 2 measured axes inflight when compared to preflight values. Early postflight values show a significantly elevated threshold for all axes in 3 out of 4 subjects. The caloric nystagmus, already found during the SL-1 mission, was confirmed on all three tested subjects during the D-1 mission. It's amplitude and in some instances it's direction were influenced by horizontal acceleration on the SLED. The amplitude of optokinetic nystagmus increased when subjects were allowed to free-float over that seen when subjects were fixed. Stimulation of the neck receptors by roll movements of the body against the fixated head resulted in illusory object motion to the contralateral side. Torsional movements of the eyes during such neck receptor stimulation was present inflight and postflight, while it had not been observed preflight. Most results point to a reduction of otolithic effects in favour of visual and proprioceptive influences for spatial orientation.

Reversible cerebellar dysfunction associated with ciguatera fish poisoning.

Science.gov (United States)

Oh, Sun-Young; Kim, Do-Hyung; Seo, Man-Wook; Shin, Byoung-Soo

2012-10-01

Ciguatera-fish poisoning (or ciguatera) is a common but underdiagnosed food-borne illness related to fish consumption that is characterized by nausea, vomiting and neurologic symptoms such as tingling in the fingers or toes. We describe the case of a young man who suffered from diarrhea and abdominal pain after eating raw fish and who also developed severe ataxia with spontaneous downbeat and perverted head-shaking nystagmus. The patient experienced visual fixation suppression failure during the bithermal caloric test and bilateral smooth-pursuit impairment. Oculomotor findings suggested dysfunction of the vestibulocerebellum, especially the flocculus. These findings suggest that both the peripheral and the central nervous systems can be involved in ciguatera. Copyright © 2012 Elsevier Inc. All rights reserved.

Optokinetic and vestibular stimulation determines the spatial orientation of negative optokinetic afternystagmus in the rabbit.

Science.gov (United States)

Pettorossi, V E; Errico, P; Ferraresi, A; Barmack, N H

1999-02-15

Prolonged binocular optokinetic stimulation (OKS) in the rabbit induces a high-velocity negative optokinetic afternystagmus (OKAN II) that persists for several hours. We have taken advantage of this uniform nystagmus to study how changes in static head orientation in the pitch plane might influence the orientation of the nystagmus. After horizontal OKS, the rotation axis of the OKAN II remained almost constant in space as it was kept aligned with the gravity vector when the head was pitched by as much as 80 degrees up and 35 degrees down. Moreover, during reorientation, slow-phase eye velocity decreased according to the head pitch angle. Thereafter, we analyzed the space orientation of OKAN II after optokinetic stimulation during which the head and/or the OKS were pitched upward and downward. The rotation axis of OKAN II did not remain aligned with an earth vertical axis nor a head vertical axis, but it tended to be aligned with that of the OKS respace. The slow-phase eye velocity of OKAN II was also affected by the head pitch angle during OKS, because maximal OKAN II velocity occurred at the same head pitch angle as that during optokinetic stimulation. We suggest that OKAN II is coded in gravity-centered rather than in head-centered coordinates, but that this coordinate system may be influenced by optokinetic and vestibular stimulation. Moreover, the velocity attenuation of OKAN II seems to depend on the mismatch between the space-centered nystagmus rotation axis orientation and that of the "remembered" head-centered optokinetic pathway activated by OKS.

Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

Science.gov (United States)

Oh, Angela Jinsook; Lanzman, Bryan Alexander; Liao, Yaping Joyce

2018-06-01

Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills.

Science.gov (United States)

Chai, Peter R; Carreiro, Stephanie; Innes, Brendan J; Chapman, Brittany; Schreiber, Kristin L; Edwards, Robert R; Carrico, Adam W; Boyer, Edward W

2017-12-01

Opioid analgesics are commonly prescribed on an as-needed (PRN) basis for acute painful conditions. Uncertainty of how patients actually take PRN opioids, coupled with a desire to completely cover pain, leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids. This opioid surplus becomes a source for diversion and nonmedical opioid use. Understanding patterns of actual opioid ingestion after acute painful conditions can help clinicians counsel patients on safe opioid use, and allow timely recognition and intervention when escalating opioid self-dosing occurs, to prevent tolerance and addiction. We used a novel oxycodone digital pill system (ingestible biosensor within a standard gelatin capsule combined with 5-mg oxycodone) that when ingested, is activated by the chloride ion gradient in the stomach thereby emitting a radiofrequency signal captured by a wearable reader. The reader relays ingestion data to a cloud-based server that displays ingestion events to the study team. We deployed the oxycodone digital pill among opioid-naive individuals discharged from the emergency department with acute fracture pain. Participants were trained on digital pill operation and discharged with twenty-one 5-mg oxycodone digital pills. They were instructed to take digital pills PRN for pain on discharge. We conducted a brief interview 7 days after study enrollment, at which point participants returned the digital pill system. We identified oxycodone ingestion events in real time by data from the digital pill system and performed pill counts at the return visit to validate digital pill reporting of medication ingestion. In this study, 26 individuals were approached; 16 enrolled with 15 completing the study. Participants ingested a median of 6 (3-9.5) oxycodone digital pills over the course of 7 days, with 82% of the oxycodone dose ingested in the first 3 days. In individuals who required operative repair, 86% (N = 6) continued to ingest

Fistules perilymphatiques post-traumatiques | Khamassi | Journal ...

African Journals Online (AJOL)

84.6%) and tinnitus in 4 cases (30.8%). Flow of liquid from the ear was reported by 2 patients (15.4%). Clinical examination showed spontaneous nystagmus beating to the contralateral side of the trauma in one patient, and a positive sign of the ...

Demographic analysis of benign paroxysmal positional vertigo as a ...

African Journals Online (AJOL)

The data were collected in Anadolu Medical Center. Distribution of gender, age and affected side were reviewed. Associated problems were noted. Patients were analyzed according to the canal involvement, age, duration of symptoms, duration of nystagmus and recurrence. Mean values and standard deviations were ...

Distributed optimization of a multisubchannel Ad Hoc cognitive radio network

KAUST Repository

Leith, Alex

2012-05-01

In this paper, we study the distributed-duality-based optimization of a multisubchannel ad hoc cognitive radio network (CRN) that coexists with a multicell primary radio network (PRN). For radio resource allocation in multiuser orthogonal frequency-division multiplexing (MU-OFDM) systems, the orthogonal-access-based exclusive subchannel assignment (ESA) technique has been a popular method, but it is suboptimal in ad hoc networks, because nonorthogonal access between multiple secondary-user links by using shared subchannel assignment (SSA) can bring a higher weighted sum rate. We utilize the Lagrangian dual composition tool and design low-complexity near-optimal SSA resource allocation methods, assuming practical discrete-rate modulation and that the CRN-to-PRN interference constraint has to strictly be satisfied. However, available SSA methods for CRNs are either suboptimal or involve high complexity and suffer from slow convergence. To address this problem, we design fast-convergence SSA duality schemes and introduce several novel methods to increase the speed of convergence and to satisfy various system constraints with low complexity. For practical implementation in ad hoc CRNs, we design distributed-duality schemes that involve only a small number of CRN local information exchanges for dual update. The effects of many system parameters are presented through simulation results, which show that the near-optimal SSA duality scheme can perform significantly better than the suboptimal ESA duality and SSA-iterative waterfilling schemes and that the performance loss of the distributed schemes is small, compared with their centralized counterparts. © 2012 IEEE.

The reactivation time in the treatment of AMD: a forgotten key parameter?

Science.gov (United States)

Real, J P; Luna, J D; Palma, S D

2018-06-01

Summarize and compare the available evidence on the reactivation times in patients with age-related macular degeneration treated with Ranibizumab (RNB). Systematic review of studies that reported the reactivation time of patients (direct method) or the number of injections received in a certain period of follow-up (indirect method). Only 18 of 89 selected studies reported the average reactivation time of patients in a manifest form, without the need of any calculation. The average calculated, weighted reactivation time was 101.8 days with the direct method and 99.8 days in the indirect method (84 studies included). With both methods, it was found that the average reactivation time of the RCTs was between 2 and 3 weeks less than the average time identified in the observational studies. These differences are also reflected in the clinical results, there being a correlation between the number of doses received and the change in BCVA. The analysis of 11 comparative studies showed a difference in reactivation times between patients treated with RNB or Bevacizumab (BVZ). There are few direct studies of reactivation time, but calculation from the PRN dose number turns out to be a good approximation for retrospective study of the variable. The use of the PRN, with criteria not based on optical coherence tomography scans, delays the application of doses between 2 or 3 weeks, and patients suffer loss of clinical benefits. RNB enables patients to receive less injections than BVZ throughout treatment.

La derecha en la Universidad : la investigación en ciencias sociales

OpenAIRE

Rodríguez, Laura Graciela

2017-01-01

En esta ponencia nos proponemos analizar el desarrollo de las ciencias sociales durante la última dictadura o Proceso de Reorganización Nacional (PRN), a través del estudio de la revista Sociológica. Revista Argentina de Ciencias Sociales, editada con subsidios del CONICET, cuyo primer número salió en 1978 y el último en 1984. Estaba dirigida por el sociólogo Roberto José Brie, quien fue miembro de las comisiones asesoras del CONICET, integrante del Directorio en 1981 y director de un Institu...

Long-range correlations in PbPb collisions at 158 a *GeV

CERN Document Server

Alt, C; Baatar, B; Barna, D; Bartke, J; Betev, L; Bialkowska, H; Blume, C; Boimska, B; Botje, M; Bracinik, J; Bramm, R; Brun, R; Buncic, P; Cerny, V; Christakoglou, P; Chvala, O; Cramer, J G; Csato, P; Darmenov, N; Dimitrov, A; Dinkelaker, P; Eckardt, V; Farantatos, G; Flierl, D; Fodor, Z; Foka, P; Freund, P; Friese, V; Gal, J; Gazdzicki, M; Georgopoulos, G; Gladysz, E; Grebieszkow, K; Hegyi, S; Hohne, C; Kadija, K; Karev, A; Kliemant, M; Kniege, S; Kolesnikov, V I; Kollegger, T; Kornas, E; Korus, R; Kowalski, M; Kraus, I; Kreps, M; van Leeuwen, M; Levai, P; Litov, L; Lungwitz, B; Makariev, M; Malakhov, A I; Mateev, M; Mayes, B W; Melkumov, G L; Meurer, C; Mischke, A; Mitrovski, M; Molnar, J; Mrowczynski, S; Palla, G; Panagiotou, A D; Panayotov, D; Petridis, A; Pikna, M; Pinsky, L; Puhlhofer, F; Renfordt, R; Richard, A; Roland, C; Roland, G; Rybczynski, M; Rybicki, A; Sandoval, A; Schmitz, N; Seyboth, P; Sikler, F; Sitar, B; Skrzypczak, E; Stefanek, G; Stock, R; Strobele, H; Susa, T; Szentpetery, I; Sziklai, J; Trubnikov, V; Varga, D; Vassiliou, M; Veres, G l; Vesztergombi, G; Vranie, D; Wetzler, A; Wlodarczyk, Z; Yoo, l K; Zaranek, J; Zimanyi, J; Feofilov, G; Kolevatov, R; Kondratiev, V; Naumenko, P; Vechernin, V

2005-01-01

We present the 1st results of the event-by-event study of long-range correlations between event mean Pt and charged particle multiplicity using NA49 experimental data in two separated rapidity intervals in 158 A *Ge V Pb Pb collisions at the CERN SPS. Noticeable long range correlations are found. The most striking feature is the negative Prn correlation observed for the central PbPb collisions. Results are compared to the predictions of the HIJING event generator and of the String Fusion Model favoring a string fusion hypothesis.

Nuevo algoritmo molecular para la clasificación del glioblastoma: correlato con los perfiles de expresión génica

OpenAIRE

Carrato Moñino, Cristina

2017-01-01

En los últimos años, y gracias al empleo de plataformas de análisis masivo de datos, se ha descrito la existencia de varios subtipos transcriptómicos de glioblastoma (GB) que definen subgrupos de pacientes con diferente supervivencia y respuesta a la terapia. Entre los distintos modelos de clasificación publicados, uno de los más referenciados es el de Verhaak y col, que divide los GB en los subtipos proneural (PRN), neural (NEU), clásico (CLS) y mesenquimal (MES). Además de diferencias en la...

Multilinear integral operators and mean oscillation

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

Suppose that ψ is convex, ψ(0) = 0, ψ(2t) ≤ Cψ(t). Let S be the same as in Definition 2 such that S is bounded from L r(Rn) to Ls(Rn) for any 1 < r < n/δ and 1/s = 1/r − δ/n. Then SA is bounded from L p(Rn) to Lψ(Rn) if DαA ∈ BMOϕ(Rn) for all α with. |α| = m. Remark. (i) If ϕ(t) ≡ 1 and ψ(t) = tp for 1 < p < ∞, then T A and SA.

Malignant Melanoma in an Albino | Efem | Sudan Journal of Medical ...

African Journals Online (AJOL)

Oculocutaneous albinism is a rare autosomal recessive disorder characterised by generalised depigmentation, photophobia, decreased visual acuity, and nystagmus. Malignant melanoma is rare in patients with albinism. We report a case of a large advanced fumigating tumour on the right forearm of a male Nigerian albino ...

Early-delayed radiation rhombencephalopathy

International Nuclear Information System (INIS)

Nightingale, S.; Dawes, P.J.D.K.; Cartlidge, N.E.F.; Newcastle upon Tyne Univ.

1982-01-01

A 37-year-old woman developed an early-delayed rhombencephalopathy 7 weeks after completing a course of radiotherapy to a glomus jugulare tumour. The clinical features, comprising nystagmus, skew strabismus, unilateral facial weakness, dysarthria and ataxia, are compared with four previously reported patients with this syndrome. (author)

Relation of Infant Vision to Early Cognitive and Language Status.

Science.gov (United States)

Duckman, Robert; Tulloch, Deborah

Relationships between infant visual skills and the development of object permanence and expressive language skills were examined with 31 infants in three groups: visually typical, visually atypical, and Down Syndrome. Measures used to evaluate visual status were: forced preferential looking, optokinetic nystagmus, and behavioral. Object permanence…

Case report

African Journals Online (AJOL)

abp

2014-05-01

May 1, 2014 ... A 80 year- old Moroccan female, followed for arteriel hypertension treated by calcium antagonists, who consulted in our hospital complaining from vertigo, vomiting and nystagmus.The clinical examination found cerebellar syndrome and inguinal lymphadenopathy in the right measuring 25 mm. The brain ...

Hereditary spastic paraplegia caused by the PLP1 'rumpshaker mutation'

DEFF Research Database (Denmark)

Svenstrup, Kirsten; Giraud, Geneviève; Boespflug-Tanguy, Odile

2010-01-01

with the 'rumpshaker mutation.' PATIENTS: A family with HSP caused by the 'rumpshaker mutation.' RESULTS: The patients showed nystagmus during infancy and had early onset of HSP. They had normal cognition, and cerebral MRI showed relatively unspecific white matter abnormalities on T2 sequences without clear...

Correlation of anatomy and function in medulla oblongata infarction.

Science.gov (United States)

Eggers, C; Fink, G R; Möller-Hartmann, W; Nowak, D A

2009-02-01

A presentation of all aspects of the dorsolateral medulla oblongata syndrome is clinically very rare to find. In most cases patients present with fragmentary symptoms, e.g. ipsilateral axial lateropulsion, nystagmus, dysarthria, dysphagia or hemiataxia. However, the clinical presentation and lesion anatomy at the level of the medulla oblongata is still unsatisfactory. The aim of this study was to correlate the functional deficit with structural MRI-data. We included thirteen patients (eight male, five female, mean age 65.5) with medulla oblongata infarction with clinically predominant ipsilateral axial lateropulsion and correlated clinical with structural deficits. Magnetic resonance imaging lesion mapping demonstrated ipsilateral axial lateropulsion to result from lesions of the spinocerebellar tract, the inferior cerebellar peduncle or the inferior vestibular nucleus. Nystagmus was associated with lesions of the inferior vestibular nucleus, dissociated sensory loss with the spinothalamic tract and hemiataxia with the spinocerebellar tract. Correlating dysfunction and lesion anatomy is a promising approach to enhance our knowledge on medulla oblongata topography.

Homozygous variegate porphyria presenting with developmental and language delay in childhood.

Science.gov (United States)

Pinder, V A E; Holden, S T; Deshpande, C; Siddiqui, A; Mellerio, J E; Wraige, E; Powell, A M

2013-10-01

Variegate porphyria is an autosomal dominant disorder that usually presents with photosensitivity and acute neurological crises in adulthood. It is caused by heterozygous mutations in the protoporphyrinogen oxidase gene (PPOX). A rarer variant, homozygous variegate porphyria (HVP), presents in childhood with recurrent skin blisters and scarring. More variable features of HVP are short stature, brachydactyly, nystagmus, epilepsy, developmental delay and mental retardation. We describe a child who presented with nystagmus, developmental delay and ataxia, combined with a photosensitive eruption. Analysis of porphyrins in plasma, urine and stool supported a clinical diagnosis of HVP. DNA from the patient showed that he is compound heterozygous for two novel missense mutations in the PPOX coding region: c.169G>C (p.Gly57Arg) and c.1259C>G (Pro420Arg). Interestingly, cranial magnetic resonance imaging showed an absence of myelin, a feature not previously reported in HVP, which expands the differential diagnosis of childhood hypomyelinating leucoencephalopathies. © 2013 British Association of Dermatologists.

Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

Directory of Open Access Journals (Sweden)

Eliana Teixeira Maranhão

2015-06-01

Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

[Epidural anaesthesia: Simulated intravascular test dose with S(+) ketamine, lidocaine and adrenaline. A prospective, randomized, double blind and placebo controlled study].

Science.gov (United States)

Higueras, R; Errando, C L; Soriano-Bru, J L

2015-02-01

The use of a test dose in epidural anaesthesia is a safety recommendation. However specificity and sensitivity of the drugs used with this indication have been not conclusive. The main objective of this study was to compare the effectiveness and the adverse effects of a simulated intravascular test dose of adrenaline, lidocaine and S(+)-ketamine. A prospective, randomized, double blinded, placebo controlled study was designed. ASA I patients scheduled for elective surgery were included. These were randomized to the following study groups: S(+)-ketamine 0.5 mg.kg-1 (S+K group), 5% lidocaine 1.5 mg.kg-1 (L5% group), adrenaline 15μg (ADR group), and physiological saline 3 ml (SF group; control group). An evaluation was made during the first 15 minutes after the study drug was administered. Variables including heart rate (HR) systolic and diastolic blood pressure (sBP and dBP), mean arterial pressure (MAP), and SpO2 were recorded at 0 min (baseline) and at 2, 5, 8, 10 and 15 minutes after drug injection. An increase of at least 20 beats per minute (bpm) in relation to the baseline measurement was considered a positive result, as was an increase sBP >15 mmHg. The clinical effects described as related to iv injection of the study drugs recorded were: sedation-hypnosis, dizziness, nystagmus, metallic taste perception, perioral or facial paresthesias, tinnitus, as well as any other effect the patients mentioned. Sensitivity and specificity were calculated as was the percent increase in the parameters in order to see if these were clinically useful. A total of 80 patients, 20 per group, were included. The sBP, dBP, and MAP were significantly raised at the 2, 5, 8 and 10 minutes measurements in the S(+)K group compared to the rest of the groups (Padrenaline at the scheduled doses showed low sensitivity and specificity as a simulated iv epidural test dose. S(+)-ketamine could be a feasible marker after accidental iv injection during epidural anaesthesia or analgesia

A severe connatal form of Pelizaeus Merzbacher disease in a Czech boy caused by a novel mutation (725C>A, Ala242Glu) at the 'jimpy(msd) codon' in the PLP gene.

Science.gov (United States)

Seeman, Pavel; Paderova, Katerina; Benes, Vladimir; Sistermans, Erik A

2002-02-01

Pelizaeus Merzbacher disease (PMD) is an X-linked recessive disorder of the central nervous system myelination caused by mutations involving the proteolipid protein gene (PLP). Early nystagmus and developmental delay, progressive pyramidal, cerebellar and dystonic signs as well as white matter changes in brain MRI are typical for PMD. The PLP gene can be affected by two major types of mutations. A duplication of the whole PLP gene is the most common mutation and results usually in the milder classical phenotype, whereas point mutations in PLP gene often result in the rarer and more severe connatal form of PMD. The PLP protein is a higly conserved across species and is identical in human, mouse and rat. We describe a 13-year-old Czech boy with an early and severe developmental delay. His maternal uncle died at the age of one year and was also early and severely psychomotoricly retarded. The patient was the first child of healthy unrelated parents born after an uneventful pregnancy and delivery in 1988. Hyperbilirubinemia and bronchopneumonia and early stridor complicated his neonatal period. Diffuse hypotonia, nystagmus, psychomotor retardation, visual and hearing impairment have been observed in the patient since the age of 6 weeks. White matter abnormalities, cortical and periventricular atrophy were detected by MRI at the age of 6 and 11 years, respectively. Despite these signs and results an accurate clinical diagnosis was unclear until the age of 11 years. Last neurological examination in 1999 showed no nystagmus anymore, but extremely dystrophic limbs, truncal deformation, due to severe scoliosis, tetraplegia with hyperreflexia in C5C7 and areflexia L2S2 and positive pyramidal signs. The boy had no visual or speech contact. DNA tests followed the clinical suspicion for PMD. At first, duplication of PLP gene was excluded by quantitative comparative PCR. Direct sequencing of PLP gene detected a novel mutation in exon 6, a missense mutation 725C-->A (Ala242Glu

Estudo genético da precocidade sexual de novilhas em um rebanho Nelore Genetic studies of sexual precocity of heifers in a Nellore herd

Directory of Open Access Journals (Sweden)

Josineudson Augusto II de Vasconcelos Silva

2005-10-01

Full Text Available Objetivou-se, com este trabalho, estimar a herdabilidade (h² para prenhez de novilhas e sua correlação genética (rg com idade ao primeiro parto (IPP, em animais da raça Nelore. A prenhez de novilhas foi definida de três formas: prenhez aos 16 meses (Pr16 - para as novilhas que pariram com menos de 31 meses, atribuiu-se 1 (sucesso e, para aquelas que pariram após 30,99 meses ou que não pariram, atribuiu-se 0 (fracasso; prenhez aos 24 meses (Pr24 - para as novilhas que pariram até 46 meses (incluindo as Pr16, foi atribuído 1 e, para aquelas que não pariram 0; e prenhez da novilha (PrN - atribuiu-se classificação 2 para as que pariram com menos de 31 meses, 1 para as que pariram entre 31 e 46 meses e 0 para as que não pariram. Os arquivos, analisados pelo Método R e Inferência Bayesiana, continham registros de 30.802 novilhas desmamadas. As análises forneceram médias de estimativas de h² de 0,52, 0,12 e 0,16 para Pr16, Pr24 e PrN, respectivamente, pelo Método R. O valor médio obtido por Inferência Bayesiana foi de 0,45 para Pr16. A rg estimada entre Pr16 e IPP foi -0,32. Os resultados indicam que, para selecionar para precocidade sexual, é necessário expor todas as fêmeas em idades jovens e que a mensuração da taxa de prenhez por meio da Pr16 é pertinente, uma vez que esta característica apresenta variabilidade genética alta e deve responder eficientemente à seleção com possibilidades de rápido ganho genético. A análise indicou também que Pr16 e IPP são determinadas em grande parte por genes diferentes.The objectives of this research were to estimate heritability (h2 of heifer pregnancy and its genetic correlation (rg with age at first calving (AFC in a Nellore herd. Heifer pregnancy evaluated as three different definitions: pregnancy at 16 months (Pr16 - heifers calving before 31 months received 1 (success and those calving after 30.99 months or that failed received 0 (failure; pregnancy at 24 months (Pr24

Diverse prevalence of large deletions within the OA1 gene in ocular albinism type 1 patients from Europe and North America

NARCIS (Netherlands)

Bassi, M. T.; Bergen, A. A.; Bitoun, P.; Charles, S. J.; Clementi, M.; Gosselin, R.; Hurst, J.; Lewis, R. A.; Lorenz, B.; Meitinger, T.; Messiaen, L.; Ramesar, R. S.; Ballabio, A.; Schiaffino, M. V.

2001-01-01

Ocular albinism type 1 (OA1) is an X-linked disorder mainly characterized by congenital nystagmus and photodysphoria, moderate to severe reduction of visual acuity, hypopigmentation of the retina, and the presence of macromelanosomes in the skin and eyes. We have previously isolated the gene for OA1

PRN 98-1: Self-Certification of Product Chemistry Data with Attachments

Science.gov (United States)

The Office of Pesticide Programs has established a self-certification program for certain product chemistry data of manufacturing-use products and end-use products produced by a non-integrated formulation system.

PRN 2002-X Draft: False or Misleading Pesticide Product Brand Name

Science.gov (United States)

This notice provides guidance to registrants and distributors on pesticide product brand names that may be false or misleading, either by themselves or in association with particular company names or trademarks. It is a draft.

Phenytoin intoxication with no symptoms correlated with serum drug ...

African Journals Online (AJOL)

In high-dose intake of phenytoin, which is used frequently to treatepilepsy, nystagmus, diplopia, nausea-vomiting, lethargy, confusion, seizure, and coma can be observed. In recent studies on phenytoin intoxication, in which seizure and coma were observed in drug levels greater than 50 ug/mL. The serum phenytoin level ...

Therapeutic effect of dexamethasone implant in retinal vein occlusions resistant to anti-VEGF therapy

Directory of Open Access Journals (Sweden)

Wallsh J

2016-05-01

Full Text Available Josh Wallsh, Behnam Sharareh, Ron GallemoreRetina Macula Institute, Torrance, CA, USAPurpose: To test the efficacy of the intravitreal dexamethasone (DEX implant in patients with retinal vein occlusions (RVOs who have failed multiple anti-vascular endothelial growth factor (anti-VEGF treatments.Methods: A randomized exploratory study of ten patients with branch RVO or central RVO who received at least two previous anti-VEGF treatments and had persistent or unresponsive cystoid macular edema. Treatment with the DEX implant was either every 4 months or pro re nata (PRN depending on their group assignment for 1 year. Multifocal electroretinography and microperimetry were the primary end points, with high-resolution optical coherence tomography and best-corrected visual acuity as the secondary end points.Results: All patients in both the every 4 month and PRN cohorts who completed the study received the three maximal injections of DEX; therefore, the data from both cohorts were combined and reported as a case series. On average, the multifocal electroretinography amplitude increased significantly from 5.11±0.66 to 24.19±5.30 nV/deg2 at 12 months (P<0.005, mean macular sensitivity increased from 7.67±2.10 to 8.01±1.98 dB at 4 months (P=0.32, best-corrected visual acuity increased significantly from 51.0±5.1 to 55.4±5.1 early treatment of diabetic retinopathy study letters at 2 months (P<0.05, and central retinal thickness decreased from 427.6±39.5 to 367.1±37.8 µm at 4 months (P<0.05. Intraocular pressure increased significantly in one patient, with that patient requiring an additional glaucoma medication for management. Additionally, cataract progression increased significantly (P<0.05 in this patient population and partially limited analysis of other end points.Conclusion: DEX should be considered as a treatment option in patients with RVOs who have failed anti-VEGF therapy, as the results of this study demonstrated an improvement in

Emerging treatments for premature ejaculation: focus on dapoxetine

Directory of Open Access Journals (Sweden)

Wayne JG Hellstrom

2008-12-01

Full Text Available Wayne JG HellstromChief, Section of Andrology, Department of Urology, Tulane University School of Medicine, New Orleans, LA, USAAbstract: Premature ejaculation (PE is a common problem in men worldwide. It has a significant impact on affected men and their partners in terms of self-esteem, dissatisfaction with their sexual relationships, personal distress, and interpersonal difficulty. Psychological therapies may achieve short-term improvements, but there are limited data on the long-term success of these methods. Oral therapy with long-acting selective serotonin reuptake inhibitors (SSRIs improves intravaginal ejaculatory latency time (IELT, but these agents are designed to be administered daily and may be associated with unwanted sexual side effects and withdrawal symptoms upon abrupt discontinuation. Dapoxetine is a short-acting SSRI that can be taken as needed (prn by men with PE. It has been studied in five separate multicenter, randomized, double-blind, placebo-controlled trials involving more than 6000 men with PE. In four studies that evaluated IELT as an endpoint (N = 4843, dapoxetine 30 and 60 mg prn achieved statistically significant increases in IELT versus placebo. Dapoxetine also showed statistically significant improvements in perceived control over ejaculation, PE-related personal distress, and other patient-reported outcomes in all five trials. Dapoxetine treatment is generally well-tolerated, with low incidences of discontinuation syndrome, sexual dysfunction, and treatment-emergent mood symptoms. The most common adverse events with dapoxetine included nausea, diarrhea, headache, dizziness, and somnolence.Keywords: dapoxetine, discontinuation syndrome, premature ejaculation, selective serotonin reuptake inhibitor

A lateral cephalometric study of the hard- and soft tissue profile around the face in the mixed dentition

International Nuclear Information System (INIS)

Lee, Sang Rae; Ahn, Hyung Kyu

1978-01-01

A study was made investigate a relationship existing in the dentoskeletal framework and the soft tissue profile around the face, and compared the sexual differences between boys and girls having the normal occlusion in the mixed dentition. The lateral cephalograms were composed of 67 boys aged 10.3 years and 68 girls aged 10.4 years, respectively. By means of the lateral cephalograms, both the hard-and soft tissue structures were simultaneously analyzed, measured and evaluated by introducing the several reference items: S-N plane, palatal plane, mandibular plane, N-A line and A-P line for the dentoskeletal structures and N'-P' line for the soft tissue, and the 21 measuring points for the both structures. The significant findings were as follows: 1. In general the boys showed the larger nasal component dimension than did the girls, but the length and height of nose(N'-Prn and NA-Prn) showed the significant sexual difference among those when evaluated statistically. 2. The lip-thickness was found to be minimal in the region of nasion, greater in the region of pogonion, and much greater in the region of point A in the both sexes, but the only thickness over point A(A-A') showed the significant sexual difference statistically. 3. The upper and lower lip position were found to be located anteriorly to the esthetic line in the both sexes, but upper lip position showed the significant sexual difference when evaluated statistically. 4. The regions of nose and upper lip had a tendency not to be following the underlying skeletal profile.

A Belgian Serosurveillance/Seroprevalence Study of Diphtheria, Tetanus and Pertussis Using a Luminex xMAP Technology-Based Pentaplex

Directory of Open Access Journals (Sweden)

Raissa Nadège Caboré

2016-05-01

Full Text Available Serosurveillance and seroprevalence studies are an essential tool to monitor vaccine-preventable diseases. We have developed a magnetic bead-based pentaplex immunoassay (MIA for the simultaneous detection of IgG antibodies against diphtheria toxin (DT, tetanus toxin (TT, pertussis toxin (PT, filamentous hemagglutinin (FHA and pertactin (Prn. The in-house pentaplex MIA showed a good correlation with commercial ELISAs with correlation coefficients between 0.89 for PT and 0.98 for TT. Intra- and inter-assay variability was <10%. A total of 670 anonymized serum samples collected in 2012 in Belgian adults (ages 20–29.9 years were analyzed. Geometric mean concentrations (GMC were 0.2 (0.13–0.29 IU/mL for DT, 0.63 (0.45–0.82 IU/mL for TT, 3.9 (2.6–5.8 IU/mL for PT, 16.3 (11.7–22.7 IU/mL for FHA and 15.4 (10.1–23.6 IU/mL for Prn. Antibody concentrations were below the protective level of 0.1 IU/mL in 26.4% of the sera for DT and in 8.6% of the sera for TT. Anti-PT IgG concentrations indicative of recent pertussis infection (>125 IU/mL were detected in 1.2% of the subjects. High anti-PT antibodies were not correlated with high antibodies against any of the four other vaccine antigens. This pentaplex MIA will be used for a new large-scale Belgian serosurveillance/seroprevalence study of diphtheria, tetanus and pertussis.

Neutral and acidic oligosaccharides supplementation does not increase the vaccine antibody response in preterm infants in a randomized clinical trial.

Directory of Open Access Journals (Sweden)

Jolice P van den Berg

Full Text Available BACKGROUND: In preterm infants, a decreased immunological response and lower serological effectiveness are observed after immunizations due to ineffectiveness of both humoral and cellular immune mechanisms. OBJECTIVE: To determine the effect of 80% neutral oligosaccharides [small-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides (scGOS/lcFOS] in combination with 20% pectin-derived acidic oligosaccharides (pAOS on antibody concentrations after DTaP-IPV-Hib immunization in preterm infants. DESIGN: In this randomized clinical trial, preterm infants with gestational age <32 weeks and/or birth weight <1500 g received enteral supplementation with scGOS/lcFOS/pAOS or placebo (maltodextrin between days 3 and 30 of life. Blood samples were collected at 5 and 12 months of age. RESULTS: In total, 113 infants were included. Baseline and nutritional characteristics were not different in both groups. Geometric mean titers were not different after prebiotic supplementation at 5 months, Ptx (37/44 EU/ml, FHA (78/96 EU/ml, Prn (78/80 EU/ml, Diphtheria (0.40/0.57 IU/ml, Tetanus (0.74/0.99 IU/ml and Hib (0.35/0.63 µg/ml, and at 12 months Ptx (55/66 EU/ml, FHA (122/119 EU/ml, Prn (116/106 Eu/ml, Diphtheria (0.88/1.11 IU/ml, Tetanus (1.64/1.79 IU/ml and Hib (2.91/2.55 µg/ml. CONCLUSIONS: Enteral supplementation of neutral (scGOS/lcFOS and acidic oligosaccharides (pAOS does not improve the immunization response in preterm infants. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN16211826 ISRCTN16211826.

Large Genomic Deletions in CACNA1A Cause Episodic Ataxia Type 2

Directory of Open Access Journals (Sweden)

Jijun eWan

2011-09-01

Full Text Available Episodic ataxia (EA syndromes are heritable diseases characterized by dramatic episodes of imbalance and incoordination. Episodic ataxia type 2 (EA2, the most common and the best characterized subtype, is caused by mostly nonsense, splice site, small indel and sometimes missense mutations in CACNA1A. Direct sequencing of CACNA1A fails to identify mutations in some patients with EA2-like features, possibly due to incomplete interrogation of CACNA1A or defects in other EA genes not yet defined. Previous reports described genomic deletions between 4-40kb in EA2. In 47 subjects with EA (26 with EA2-like features who tested negative for mutations in the known EA genes, we used Multiplex Ligation-dependent Probe Amplification (MLPA to analyze CACNA1A for exonic copy number variations. Breakpoints were further defined by long-range PCR. We identified distinct multi-exonic deletions in three probands with classic EA2-like features: episodes of prolonged vertigo and ataxia triggered by stress and fatigue, interictal nystagmus, with onset during infancy or early childhood. The breakpoints in all three probands are located in Alu sequences, indicating errors in homologous recombination of Alu sequences as the underlying mechanism. The smallest deletion spanned exons 39 and 40, while the largest deletion spanned 200kb, missing all but the first three exons. One deletion involving exons 39 through 47 arose spontaneously. The search for mutations in CACNA1A appears most fruitful in EA patients with interictal nystagmus and onset early in life. The finding of large heterozygous deletions suggests haploinsufficiency as a possible pathomechanism of EA2.

Parkinsonism secondary to neurosyphilis

African Journals Online (AJOL)

1983-04-23

Apr 23, 1983 ... ing and limited facial expression, His gait was slow, shuffling and hesitant. He had bilateral primary optic atrophy and his pupils were small (3 mm), irregular and failed to respond to light, but accommodation was intact (Argyll Robertson pupils), There was a mild bilateral coarse horizontal nystagmus and ...

Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian

African Journals Online (AJOL)

Yeshigeta Gelaw

2014-06-16

Jun 16, 2014 ... Supranuclear ocular motor disorders can be caused by brain- stem, cerebellar or ... in the left eye and ataxic abducting nystagmus in the right eye on right gaze ... The gender (female sex) of the patient is also another supportive risk ... precede, occur concurrently with, or follow the development of bilateral ...

Variation in postoperative non-steroidal anti-inflammatory analgesic use after colorectal surgery

DEFF Research Database (Denmark)

Pommergaard, Hans-Christian; Klein, Mads; Burcharth, Jakob

2014-01-01

, receiving a pre-defined dosage as a minimum and receiving NSAIDs as p.r.n. medication, and the type of NSAID were significantly different both between department and within departments. The median dose of ibuprofen and diclofenac were 1200 mg (400-2,400 mg) and 100 mg (50-200 mg), respectively. CONCLUSIONS...... for the use of the two NSAIDs diclofenac and ibuprofen were recorded. The data from six colorectal departments in eastern Denmark were compared. RESULTS: Of the 2,754 patients analyzed overall, 40.6% received NSAIDs as part of their analgesic treatment. The percentage of the patients receiving NSAIDs...

Desclasificando las huellas presentes de un pasado violento : La producción documental de la UNLP desde la organización del Estado terrorista (1976-1983) hasta la normalización de la universidad (1986)

OpenAIRE

Casareto, Laura Mariana

2017-01-01

De las interrupciones de la vida democrática que sufrió nuestro país, la última dictadura marcó a fuego la vida de las universidades, el autodenominado Proceso de Reorganización Nacional (PRN). En el ámbito universitario, unos días después del golpe de 1976, se dictó la ley 21.276 que puso a las Casas de Altos Estudios bajo la órbita del Poder Ejecutivo Nacional, el cual designó a interventores militares en dichas instituciones. En la universidad platense, el Teniente de Fragata Eduardo Sacco...

Eye and vision defects in under-five-year-old children in Oman: A public health intervention study

Directory of Open Access Journals (Sweden)

Rajiv Khandekar

2010-01-01

Result : Among 1,520 examined children, three children had absent eyeball bilaterally and three had unilaterally absent eyeball. Strabismus and nystagmus were detected in 44 (2.9% and 18 (1.2% children respectively. ′Hiding Heidi′ test was normal in 530/537 (87% of children. Distant vision reading was ≥0.32 in 386/448 (86.2% eyes. Preferential looking test suggested that half of the children had defective vision (>2cpcm. Screening at ′1-2 year′ and ′3-4 years′ age group could significantly predict eye problems ( P≤0.001. Conclusion : Eye and vision screening of under-five kids helped in detection of eye problems in early stages. Instead of universal screening, high risk population or children of ′3 to 4′ years for vision and ′1 to 2′ years for ocular abnormalities is proposed The existing health services could not detect some children with eye problems and they were identified during such screening.

Clinical Management of a Patient with Chronic Recurrent Vertigo Following a Mild Traumatic Brain Injury

Directory of Open Access Journals (Sweden)

Eric G. Johnson

2009-01-01

Full Text Available Vertigo, was provoked and right torsional up-beat nystagmus was observed in a 47-year-old patient when she was placed into the right Hallpike-Dix test position using infrared goggle technology. The clinical diagnosis was benign paroxysmal positional vertigo (BPPV, specifically right posterior canalithiasis, resulting from a mild traumatic brain injury (TBI suffered approximately six-months earlier. Previous medical consultations did not include vestibular system examination, and Meclizine was prescribed to suppress her chief complaint of vertigo. Ultimately, the patient was successfully managed by performing two canalith repositioning maneuvers during a single clinical session. The patient reported 100% resolution of symptoms upon reexamination the following day, and the Hallpike-Dix test was negative. Continued symptom resolution was subjectively reported 10 days postintervention via telephone consultation. This case report supports previous publications concerning the presence of BPPV following TBI and the need for inclusion of vestibular system examination during medical consultation.

Health-related quality of life, visual function and treatment satisfaction following intravitreal dexamethasone implant for diabetic macular edema

Directory of Open Access Journals (Sweden)

Ramu J

2017-03-01

Full Text Available Jayashree Ramu,1 Irini Chatziralli,1 Yit Yang,2 Geeta Menon,3 Clare Bailey,4 Michael Eckstein,5 Phil Hykin,1 Sobha Sivaprasad1 On behalf of the OZDRY Study Group 1NIHR Moorfields Biomedical Research Centre, London, 2The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, 3Frimley Health NHS Foundation Trust, Surrey, 4Bristol Eye Hospital, Bristol, 5Brighton and Sussex University Hospital, Brighton, UK Purpose: The aim of this study was to explore and describe quantitatively patient-reported outcome measures (PROMs, ie, health-related quality of life (QoL, visual function and treatment satisfaction, in patients with diabetic macular edema (DME receiving two different regimens of Ozurdex (intravitreal dexamethasone implant. Methods: In this multicenter, prospective study, 100 patients with center-involving refractory DME were randomized 1:1 to either five monthly fixed dosing or optical coherence tomography (OCT-guided pro re nata (PRN regimen of dexamethasone intravitreal implant therapy. The primary outcome was the difference between arms in change in PROMs and health-related QoL from baseline to 12 months, as measured by the Retinopathy-Dependent Quality of Life (RetDQoL questionnaire, Visual Function Questionnaire-25 (VFQ-25 and Retinopathy Treatment Satisfaction Questionnaire (RetTSQ. Results: There was no statistically significant difference in the RetDQoL score and VFQ-25 score at month 12 compared to those at baseline, whereas the total mean RetTSQ score increased significantly at the exit visit. The two treatment arms did not differ significantly regarding the change in PROMs and health-related QoL questionnaires. Logistic regression analysis showed that visual acuity (VA of ≥55 letters, central foveal thickness <300 µm and macular volume <9.2 mm3 at the exit visit (month 12 predicted a higher change in RetTSQ. Conclusion: This study showed that there is a statistically significant improvement in treatment satisfaction, as

[A new syllable text for evaluating near vision].

Science.gov (United States)

Kolling, G H; Höltzcke, P

1995-02-01

When visual acuity for distance is tested correct recognition of (as an example) 6 of 10 Landolt-rings is required. On the other hand, it is very difficult to define visual acuity exactly with reading cards, the result will also depend on the patient's reading ability. The new near vision test consists of 10 syllables with two letters being calibrated according to DIN 58,220 (part 2 A1-correlation of optotypes) by Rassow et al. [11]. The patient is required to recognize 6 syllables out of 10 correctly. To test crowding phenomena the syllables are connected by a letterlike symbol. In 18 patients suffering from squint amblyopia and in 18 patients suffering from anisometropic amblyopia visual acuity with Oculus reading cards and with the new near vision test was identical. The crowding syllables test yielded a visual acuity comparable to that determined with the C test according to Haase/Hohmann [6]. The new near vision test makes it possible to examine visual acuity for reading with syllables as exactly as for single optotypes using Landolt-rings. In both cases, 6 of 10 answers have to be correct. Additionally, reading time for one syllable can be restricted to one second when patients with nystagmus are being tested.

Oculomotor deficits in aryl hydrocarbon receptor null mouse.

Directory of Open Access Journals (Sweden)

Aline Chevallier

Full Text Available The Aryl hydrocarbon Receptor or AhR, a ligand-activated transcription factor, is known to mediate the toxic and carcinogenic effects of various environmental pollutants such as 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD. Recent studies in Caenorhabditis elegans and Drosophila melanogaster show that the orthologs of the AhR are expressed exclusively in certain types of neurons and are implicated in the development and the homeostasis of the central nervous system. While physiological roles of the AhR were demonstrated in the mammalian heart, liver and gametogenesis, its ontogenic expression and putative neural functions remain elusive. Here, we report that the constitutive absence of the AhR in adult mice (AhR-/- leads to abnormal eye movements in the form of a spontaneous pendular horizontal nystagmus. To determine if the nystagmus is of vestibular, visual, or cerebellar origin, gaze stabilizing reflexes, namely vestibulo-ocular and optokinetic reflexes (VOR and OKR, were investigated. The OKR is less effective in the AhR-/- mice suggesting a deficit in the visuo-motor circuitry, while the VOR is mildly affected. Furthermore, the AhR is expressed in the retinal ganglion cells during the development, however electroretinograms revealed no impairment of retinal cell function. The structure of the cerebellum of the AhR-/- mice is normal which is compatible with the preserved VOR adaptation, a plastic process dependent on cerebellar integrity. Finally, intoxication with TCDD of control adults did not lead to any abnormality of the oculomotor control. These results demonstrate that the absence of the AhR leads to acquired central nervous system deficits in the adults. Given the many common features between both AhR mouse and human infantile nystagmus syndromes, the AhR-/- mice might give insights into the developmental mechanisms which lead to congenital eye disorders.

Audio-vestibular signs and symptoms in Chiari malformation type i. Case series and literature review.

Science.gov (United States)

Guerra Jiménez, Gloria; Mazón Gutiérrez, Ángel; Marco de Lucas, Enrique; Valle San Román, Natalia; Martín Laez, Rubén; Morales Angulo, Carmelo

2015-01-01

Chiari malformation is an alteration of the base of the skull with herniation through the foramen magnum of the brain stem and cerebellum. Although the most common presentation is occipital headache, the association of audio-vestibular symptoms is not rare. The aim of our study was to describe audio-vestibular signs and symptoms in Chiari malformation type i (CM-I). We performed a retrospective observational study of patients referred to our unit during the last 5 years. We also carried out a literature review of audio-vestibular signs and symptoms in this disease. There were 9 patients (2 males and 7 females), with an average age of 42.8 years. Five patients presented a Ménière-like syndrome; 2 cases, a recurrent vertigo with peripheral features; one patient showed a sudden hearing loss; and one case suffered a sensorineural hearing loss with early childhood onset. The most common audio-vestibular symptom indicated in the literature in patients with CM-I is unsteadiness (49%), followed by dizziness (18%), nystagmus (15%) and hearing loss (15%). Nystagmus is frequently horizontal (74%) or down-beating (18%). Other audio-vestibular signs and symptoms are tinnitus (11%), aural fullness (10%) and hyperacusis (1%). Occipital headache that increases with Valsalva manoeuvres and hand paresthesias are very suggestive symptoms. The appearance of audio-vestibular manifestations in CM-I makes it common to refer these patients to neurotologists. Unsteadiness, vertiginous syndromes and sensorineural hearing loss are frequent. Nystagmus, especially horizontal and down-beating, is not rare. It is important for neurotologists to familiarise themselves with CM-I symptoms to be able to consider it in differential diagnosis. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

[How to manage vertigo in adult?

Science.gov (United States)

Vuong Chaney, Hella; Rohmer, Dominique; Charpiot, Anne

2017-11-01

The interrogation and the clinical examination are critical in the research of vertigo etiology. In the context of vertigo, the vital emergencies are of neurological and vascular origins. It is therefore necessary to be able to identify them quickly and simply. Vertigo is a symptom to relieve and the cause is to be diagnosed. Careful questioning combined with neurological examination, nystagmus study, Halmagyi test and skew deviation search are more reliable than imaging in the first 48hours to detect a stroke. There are 12% false negatives in cerebral MRI and 74% false negative in cerebral CT-scan in the first 48hours of an ischemic stroke. Labyrinth emergencies are infectious labyrinthitis, perilymphatic fistula and aeroembolism of the vestibule. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Anti-Yo Mediated Paraneoplastic Cerebellar Degeneration Associated with Pseudobulbar Affect in a Patient with Breast Cancer

Directory of Open Access Journals (Sweden)

Allison N. Martin

2017-01-01

Full Text Available Paraneoplastic cerebellar degeneration (PCD is a rare anti-Yo mediated paraneoplastic syndromes rarely that is infrequently associated with breast cancer. We present a case of a 52-year-old female presenting with diplopia, gait instability, dysarthria, dysphagia, nystagmus, and, most notably, new onset paroxysmal episodes of uncontrollable crying concerning for pseudobulbar affect (PBA. Serologic testing showed anti-Yo antibodies. The patient was found to have stage IIIA breast cancer as the inciting cause of the paraneoplastic syndrome. The patient was treated with neoadjuvant chemotherapy, modified radical mastectomy, adjuvant Herceptin, and pertuzumab. She was given IVIG for paraneoplastic syndrome, antidepressants, and dextromethorphan-quinidine (Nuedexta, the first FDA-approved therapy for PBA. With multimodality therapy, she demonstrated significant improvement in neurologic and mood symptoms associated with PCD and PBA.

Pattern visual evoked potentials in malingering.

Science.gov (United States)

Nakamura, A; Akio, T; Matsuda, E; Wakami, Y

2001-03-01

We previously developed a new method for estimating objective visual acuity by means of pattern visual evoked potentials (PVEP). In this study, this method was applied to the diagnosis of malingering. Six patients ranging in age from 40 to 54 years (mean 47 years) with suspected malingering were evaluated by means of the visual evoked potential test, optokinetic nystagmus (OKN) inhibition test, and the visual field test. In the PVEP study, the stimulus consisted of black and white checkerboards (39', 26', 15', and 9') with a visual angle of 8 degrees, contrast level of 15%, and a frequency of 0.7 Hz. One hundred PVEP responses were averaged per session. Routine ophthalmic examinations were normal in all patients. Five patients had a tubularly constricted visual field, and the remaining patient had a normal visual field. The objective visual acuities of the six patients estimated from PVEP were better than their subjective visual acuities estimated with Landolt rings. Among a variety of psychophysical and electrophysiologic ancillary tests, we consider our PVEP method a useful method for objectively determining visual acuity in a patient with signs of ocular malingering.

The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study

Directory of Open Access Journals (Sweden)

Lynna Chen

2016-11-01

Full Text Available Abstract Background Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. Methods A cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs and 95% confidence intervals (CIs for the association between benzodiazepine use and sleep quality. Covariates included pain, dementia severity, depression, insomnia and other sedative use. Results Of the 383 residents (mean age 87.5 years, 77.5% female, 96(25.1% used a benzodiazepine on a regular basis. Residents who used long-acting benzodiazepines on a regular basis had higher night-time sleep quality than non-users (AOR = 4.00, 95%CI 1.06 – 15.15. Residents who used short-acting benzodiazepines on a PRN only basis had longer daytime napping times than non-users (AOR = 1.77, 95%CI 1.01 – 3.08. No benzodiazepine category was associated with day-time drowsiness. Conclusions The association between benzodiazepine use and sleep quality is dependent on the half-life and prescribing pattern of the benzodiazepine. Short-acting PRN benzodiazepines were associated with lower night time sleep quality and longer day-time napping compared to long-acting regular benzodiazepines. Longitudinal studies are needed to determine whether these findings reflect channeling of short-acting agents to residents at higher risk of sleep disorders.

Relationship Between Visual Acuity and Retinal Thickness During Anti-Vascular Endothelial Growth Factor Therapy for Retinal Diseases.

Science.gov (United States)

Ou, William C; Brown, David M; Payne, John F; Wykoff, Charles C

2017-08-01

To investigate the relationship between best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in eyes receiving ranibizumab for 3 common retinal diseases. Retrospective analysis of clinical trial data. Early Treatment Diabetic Retinopathy Study BCVA and spectral-domain optical coherence tomography-measured CRT of 387 eyes of 345 patients enrolled in 6 prospective clinical trials for management of neovascular age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) were evaluated by Pearson correlation and linear regression. At baseline, there was a small correlation between BCVA and CRT in pooled AMD trial data (r = -0.24). A medium correlation was identified in pooled DME trial data (r = -0.42). No correlation was found in pooled RVO trial data. At month 12, no correlation was found between changes from baseline in BCVA and CRT in pooled AMD trial data. Medium correlations were identified in both pooled DME (r = -0.45) and pooled RVO (r = -0.35) trial data at month 12. Changes in BCVA and CRT associated with edema recurrence upon transition from monthly to pro re nata (PRN) dosing were correlated in AMD (r = -0.27) and RVO (r = -0.72) trials, but not in DME trial data. DME demonstrated a convincing relationship between BCVA and CRT. Correlations appear to be more complex in AMD and RVO. At the inflection point between monthly and PRN dosing, when recurrence of edema is anticipated in many patients, CRT appears strongly correlated with loss of BCVA in RVO. Copyright © 2017 Elsevier Inc. All rights reserved.

The Evaluation of Undergraduate Nursing Students' Knowledge of Post-op Pain Management after Participation in Simulation.

Science.gov (United States)

Evans, Cecile B; Mixon, Diana K

2015-12-01

The purpose of this paper was to assess undergraduate nursing students' pain knowledge after participation in a simulation scenario. The Knowledge and Attitudes of Survey Regarding Pain (KASRP) was used to assess pain knowledge. In addition, reflective questions related to the simulation were examined. Student preferences for education method and reactions to the simulation (SIM) were described. Undergraduate nursing students' knowledge of pain management is reported as inadequate. An emerging pedagogy used to educate undergraduate nurses in a safe, controlled environment is simulation. Literature reports of simulation to educate students' about pain management are limited. As part of the undergraduate nursing student clinical coursework, a post-operative pain management simulation, the SIM was developed. Students were required to assess pain levels and then manage the pain for a late adolescent male whose mother's fear of addiction was a barrier to pain management. The students completed an anonymous written survey that included selected questions from the KASRP and an evaluation of the SIM experience. The students' mean KASRP percent correct was 70.4% ± 8.6%. Students scored the best on items specific to pain assessment and worst on items specific to opiate equivalents and decisions on PRN orders. The students' overall KASRP score post simulation was slightly better than previous studies of nursing students. These results suggest that educators should consider simulations to educate about pain assessment and patient/family education. Future pain simulations should include more opportunities for students to choose appropriate pain medications when provided PRN orders. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Effectiveness of vestibular exercise in acute vertigo

International Nuclear Information System (INIS)

Hashim, N.D.; Abdullah, A.; Ami, M.; Rahman, R.A.

2015-01-01

To evaluate effectiveness of vestibular exercises in acute vertigo. 45 patients with acute vertigo were divided into 2 groups; 23 in study group (SG) and 22 in control group (CG). All patients were given tablet betahistine 24 mg twice daily as basic medical treatment and tablet Stemetil 5mg as a rescue. Those in SG also received vestibular exercise. Assessment was done using validated questionnaires, neuro-otology tests and individual diaries. Results : Intragroup comparison of intensity of symptoms showed a significant improvement from baseline, 3-month and 6-month visit with p<0.001. While intergroup comparison showed reduction of scores in both groups and which was greater in SG at 6 months visit. An improvement of neuro-otology tests was seen in all five tests whereby the Romber test, Unterberger-Fukuda test and spontaneous nystagmus test showed earlier improvement in SG at 3-month visit than CG. The SG also recovered faster and used lesser medication. 30.4% patients in SG were asymptomatic as early as first to third week after intervention. The number of rescue medications required in each group lessened towards the end of study. By week 7, 56.3% of SG and 43.8% of CG needed no rescue medication. (author)

Common Vestibular Disorders

Directory of Open Access Journals (Sweden)

Dimitrios G. Balatsouras

2017-01-01

Full Text Available The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD and vestibular neuritis (VN, are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the development of appropriate therapeutic maneuvers resulted in its effective treatment. However, involvement of the horizontal or the anterior canal has been found in a significant rate and the recognition and treatment of these variants completed the clinical picture of the disease. MD is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Presence of endolymphatic hydrops on postmortem examination is its pathologic correlate. MD continues to be a diagnostic and therapeutic challenge. Patients with the disease range from minimally symptomatic, highly functional individuals to severely affected, disabled patients. Current management strategies are designed to control the acute and recurrent vestibulopathy but offer minimal remedy for the progressive cochlear dysfunction. VN is the most common cause of acute spontaneous vertigo, attributed to acute unilateral loss of vestibular function. Key signs and symptoms are an acute onset of spinning vertigo, postural imbalance and nausea as well as a horizontal rotatory nystagmus beating towards the non-affected side, a pathological headimpulse test and no evidence for central vestibular or ocular motor dysfunction. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea

The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

Directory of Open Access Journals (Sweden)

N. Saki

2011-04-01

Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

Evidence for the horizontal transfer of an integrase gene from a fusellovirus to a pRN-like plasmid within a single strain of Sulfolobus and the implications for plasmid survival

DEFF Research Database (Denmark)

Peng, Xu

2008-01-01

of the integrase gene occurs in the viral attachment site (attP), which corresponds to the anticodon region of the targeted tRNA gene in the host chromosome. This point mutation confers on pXZ1 the ability to integrate into the tRNA(Glu)[CUC] gene, which differs from the integration site of SSV4, t......RNA(Glu)[UUC]. SSV4 and pXZ1 were also shown experimentally to integrate into separate sites on the host chromosome. This is believed to be the first report of a pRN plasmid sharing its natural host with a fusellovirus and carrying a highly similar integrase gene....

Simultaneous canine distemper encephalitis and canine parvovirus infection with distemper-associated cardiac necrosis in a pup Infecção simultânea por vírus da cinomose e da parvovirose associada à necrose cardíaca em um canino

OpenAIRE

Selwyn Arlington Headley; Taís Berelli Saito

2003-01-01

Simultaneous infection of canine distemper virus and canine parvovirus associated with distemper myocardial degeneration and necrosis is described in a pup. The dog demonstrated myoclonus, nystagmus, enamel hypoplasia, abdominal pustules, and bilateral corneal ulceration clinically. Demyelinating encephalitis, myocardial degeneration and necrosis with mineralization, and necrosis, hemorrhage and fusion of intestinal villi were observed. The lesions observed in this dog are characteristic of a...

Simultaneous canine distemper encephalitis and canine parvovirus infection with distemper-associated cardiac necrosis in a pup

OpenAIRE

Headley,Selwyn Arlington; Saito,Taís Berelli

2003-01-01

Simultaneous infection of canine distemper virus and canine parvovirus associated with distemper myocardial degeneration and necrosis is described in a pup. The dog demonstrated myoclonus, nystagmus, enamel hypoplasia, abdominal pustules, and bilateral corneal ulceration clinically. Demyelinating encephalitis, myocardial degeneration and necrosis with mineralization, and necrosis, hemorrhage and fusion of intestinal villi were observed. The lesions observed in this dog are characteristic of a...

Risk of Central Nervous System Decompression Sickness in Air Diving to No-Stop Limits

Science.gov (United States)

2009-01-01

190 9 1 10 1. Weak, faint, vertigo 2. Heavy legs, abnormal gait 3. Vertigo and cardiorespiratory symptoms 4. Bilateral numbness and paresthesia ...original report," were included. 6. Pain in both feet, paresthesia 7. Hearing deficit, anisocoria, nystagmus, confusion, emotionally labile, abnormal...tandem gait 8. Scintillating scotoma, abnormal left foot dorsiflexion 9. Weakness, general left side paresthesia , numbness, abnormal gait 10. See

Bedside examination for vestibular screening in occupational medicine

Directory of Open Access Journals (Sweden)

Ewa Zamysłowska-Szmytke

2015-04-01

Full Text Available Objectives: The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG oculomotor tests (central group and 43 subjects with normal VNG. Material and Methods: Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT, Dynamic Visual Acuity (DVA and gaze nystagmus assessment. Results: Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73% had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. Conclusions: The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes.

Investigating nystagmus in patients with traumatic brain injury: A ...

African Journals Online (AJOL)

and make automatic postural adjustments to maintain posture and stability in ... read or watch television, drive a car and read road signs), a sense of falling over .... and low-technology types of assessments) were included and are important for ...

[Study of cerebellar infarction with isolated vertigo].

Science.gov (United States)

Utsumi, Ai; Enomoto, Hiroyuki; Yamamoto, Kaoru; Kimura, Yu; Koizuka, Izumi; Tsukuda, Mamoru

2010-07-01

Isolated vertigo is generally attributed to labyrinthine disease, but may also signal otherwise asymptomatic cerebellar infarction. Of 309 subjects admitted between April 2004 and March 2009 for the single symptom of acute vertigo initially thought to be labyrinthine, four were found to have cerebellar infarction of the posterior inferior cerebellar artery area (PICA). All were over 60 years old and had risk factors including hypertension, diabetes mellitus, arrhythmia, and/or hyperlipidemia. Two had trunk ataxia, with magnetic resonance imaging (MRI) showing infarction within a few days. The other two could walk without apparent trunk ataxia, however, it took 4 to 7 days to find the infarction, mainly through neurological, neurootological, and MRI findings. Neurologically, astasia, dysbasia or trunk ataxia were important signs. Neurootologically, nystagmus and electronystagmographic testing involving eye tracking, saccade, and optokinetic patttens were useful.

Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

Directory of Open Access Journals (Sweden)

Muhammed Dagkiran

2015-12-01

Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

Short‐term efficacy of Epley's manoeuvre: a double‐blind randomised trial

Science.gov (United States)

von Brevern, M; Seelig, T; Radtke, A; Tiel‐Wilck, K; Neuhauser, H; Lempert, T

2006-01-01

Background Benign paroxysmal positional vertigo of the posterior canal (PC‐BPPV) is a common vestibular disorder and can be easily treated with Epley's manoeuvre. Thus far, the short‐term efficacy of Epley's manoeuvre for treatment of PC‐BPPV is unknown. Objectives To evaluate the efficacy of Epley's manoeuvre for treatment of PC‐BPPV 24 h after applying the manoeuvre. Methods The short‐term efficacy of Epley's manoeuvre was compared with a sham procedure in 66 patients with PC‐BPPV by using a double‐blind randomised study design. Results 24 h after treatment, 28 of 35 (80%) patients in the Epley's manoeuvre group had neither vertigo nor nystagmus on positional testing compared with 3 of 31 (10%) patients in the sham group (p<0.001). Conclusion Epley's manoeuvre is shown to resolve PC‐BPPV both effectively and rapidly. PMID:16549410

Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem

Directory of Open Access Journals (Sweden)

Majid Malaki

2012-01-01

Full Text Available An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome.

Dynamic changes in the inner ear function and vestibular neural pathway related to the progression of labyrinthine infarction in patient with an anterior inferior cerebellar artery infarction.

Science.gov (United States)

Kim, Duk Rim; Lee, Hyo-Jeong; Kim, Hyung-Jong; Hong, Sung Kwang

2011-12-01

To describe changes in the inner ear function and the vestibular neural pathway according to the progression of a labyrinthine infarction in a patient with an anterior inferior cerebellar artery (AICA) infarction. A 58-year-old woman with hypertension who presented with isolated inner ear symptoms similar to those of endolymphatic hydrops but finally progressed to an AICA infarction. Serial neurotologic testing according to progression to an AICA infarction and antiplatelet therapy. Radiologic findings and neurotologic parameters, including pure tone audiogram thresholds, spontaneous nystagmus, summating potentials/action potentials on electrocochleography, interaural amplitude difference on the vestibular-evoked myogenic potential test, canal paresis and fixation index on the bithermal caloric test, and gain on oculomotor tests. Our patient initially presented with sudden hearing loss and was diagnosed with an acute AICA infarction on a follow up MRI. Dynamic change in neurotologic testing was observed during disease progression. The vertigo and motion intolerance improved gradually after antiplatelet therapy. Changes in the clinical profile, which were documented during a transition from isolated labyrinthine ischemia to an AICA infarction, suggest that sensitivity to an ischemic injury is variable in different components of the labyrinthine organs in addition to providing a new insight into the response of vestibular neural pathway to ischemic injury.

Reduced thalamic and pontine connectivity in Kleine-Levin syndrome

Directory of Open Access Journals (Sweden)

Maria eEngström

2014-04-01

Full Text Available The Kleine-Levin syndrome is a rare sleep disorder, characterized by exceptionally long sleep episodes. The neuropathology of the syndrome is unknown and treatment is often inadequate. The aim of the study was to improve understanding of the underlying neuropathology, related to cerebral networks, in Kleine-Levin syndrome during sleep episodes. One patient with Kleine-Levin syndrome and congenital nystagmus, was investigated by resting state functional Magnetic Resonance Imaging during both asymptomatic and hypersomnic periods. Fourteen healthy subjects were also investigated as control samples. Functional connectivity was assessed from seed regions of interest in the thalamus and the dorsal pons. Thalamic connectivity was normal in the asymptomatic patient whereas the connectivity between the brain stem, including dorsal pons, and the thalamus was diminished during hypersomnia. These results suggest that the patient’s nystagmus and hypersomnia might have their pathological origin in adjacent dorsal pontine regions. This finding provides additional knowledge of the cerebral networks involved in the neuropathology of this disabling disorder. Furthermore, these findings regarding a rare syndrome have broad implications and results could be of interest to researchers and clinicians in the whole field of sleep medicine.

Surgical treatment of vertigo in cochlear implantees by electrode resealing.

Science.gov (United States)

Karimi, Dania; Mittmann, Philipp; Ernst, Arneborg; Todt, Ingo

2017-10-01

Our present findings demonstrate that resealing to cover the electrode is an effective method to treat vertigo after CI. An insufficient cochleostomy sealing can be regarded as a cause of postoperatively newly occuring vertigo after CI. A transtympanic revision is a promising treatment option in cases of post-operative dizziness. Intoduction: A well-known and frequently reported complication after cochlear implantation is the appearance of postoperative vertigo symptoms. The aim of the present study was to observe if the postoperatively new occurrence of vertigo can be treated by resealing of the round window patch after cochlear implantation. A retrospective analysis revealed that 10 patients underwent revision surgery transtympanally. Vertigo was assessed preoperatively and directly postoperatively and after 6 month after revision surgery by using the Dizziness Handycap Inventory (DHI). The most common symptom was rotating vertigo. A spontanous nystagmus was seen in four cases. No nystagmus was found after the revision surgery. In three cases, the onset of dizziness was associated with an event (sneezing, otitis media, climbing a mountain). A preoperative CT showed insuspectible results in seven patients but revealed pathologies two patients. Vertigo was improved significantly in six patients, and three of them were symptom-free.

Crowded visual search in children with normal vision and children with visual impairment.

Science.gov (United States)

Huurneman, Bianca; Cox, Ralf F A; Vlaskamp, Björn N S; Boonstra, F Nienke

2014-03-01

This study investigates the influence of oculomotor control, crowding, and attentional factors on visual search in children with normal vision ([NV], n=11), children with visual impairment without nystagmus ([VI-nys], n=11), and children with VI with accompanying nystagmus ([VI+nys], n=26). Exclusion criteria for children with VI were: multiple impairments and visual acuity poorer than 20/400 or better than 20/50. Three search conditions were presented: a row with homogeneous distractors, a matrix with homogeneous distractors, and a matrix with heterogeneous distractors. Element spacing was manipulated in 5 steps from 2 to 32 minutes of arc. Symbols were sized 2 times the threshold acuity to guarantee visibility for the VI groups. During simple row and matrix search with homogeneous distractors children in the VI+nys group were less accurate than children with NV at smaller spacings. Group differences were even more pronounced during matrix search with heterogeneous distractors. Search times were longer in children with VI compared to children with NV. The more extended impairments during serial search reveal greater dependence on oculomotor control during serial compared to parallel search. Copyright © 2014 Elsevier B.V. All rights reserved.

Testing Testing Testing.

Science.gov (United States)

Deville, Craig; O'Neill, Thomas; Wright, Benjamin D.; Woodcock, Richard W.; Munoz-Sandoval, Ana; Gershon, Richard C.; Bergstrom, Betty

1998-01-01

Articles in this special section consider (1) flow in test taking (Craig Deville); (2) testwiseness (Thomas O'Neill); (3) test length (Benjamin Wright); (4) cross-language test equating (Richard W. Woodcock and Ana Munoz-Sandoval); (5) computer-assisted testing and testwiseness (Richard Gershon and Betty Bergstrom); and (6) Web-enhanced testing…

Are thiazides effective on hypertensive vertigo? A preliminary study.

Science.gov (United States)

Eryaman, Esra; Gökcan, Gökçen; Parmaksız, Ergün; Acar, Nurhan Ozdemir; Ozlüoğlu, Levent Naci

2012-01-01

In this study, we aimed to investigate whether the symptoms of vertigo related to hypertension resulted from endolymphatic hydrops and the efficacy of the thiazides in the treatment. A total of 24 vertigo patients without peripheric or central vestibular pathologies or hyperlipidemia were included. The study group comprised 15 patients with hypertension, including nine with regulated non-insulin-dependent diabetes mellitus (DM). The control group comprised nine patients without hypertension or DM. The patients in the study group received hydrochlorothiazide treatment. The European Evaluation of Vertigo Scale (EEVS) and Vertigo Handicap Questionnaire (VHQ), puretone audiometry, tympanometry, electronystagmography (ENG) for nystagmus tests, oculomotor tests, and caloric test were carried out initially and at three weeks for both groups. The results of the study group were compared to those of the control group. There was a statistically significant decrease in the scores of EEVS and VHQ at three weeks in the study group, compared to the baseline scores (for both groups p≤0.01). Our study results showed that thiazides alleviated vertigo symptoms in hypertensive patients, as measured by qualitative methods (i.e. EEVS, VHQ), but not with quantitative measurements (i.e. ENG).

Ethylene glycol poisoning

African Journals Online (AJOL)

Ethylene glycol poisoning. A 22-year-old male presented to the emergency centre after drinking 300 ml of antifreeze. Clinical examination was unremarkable except for a respiratory rate of 28 bpm, GCS of 9 and slight nystagmus. Arterial blood gas revealed: pH 7.167, pCO2. 3.01 kPa, pO2 13.0 kPa (on room air), HCO3-.

Medical Science and Discovery

OpenAIRE

Kaba, Sultan; Dogan, Murat; Ceylan, Nesrin; Bulan, Keziban; Demir, Nihat; Dogan, Sekibe; Kocaman, Selami

2016-01-01

In present case report, four-months-old boy who referred to our pediatric endocrinology outpatient clinic from department of ophthalmology due to evaluation of endocrine and metabolic disorders for cataract was discussed. The characterized features of patient were hypotrichosis, microphthalmia, nystagmus, strabismus, congenital cataract, beaked nose, micrognathia,scaphocephaly, frontal and parietal bossing. The case has typical dysmorphic physical examination findings that appropriate diagnos...

Is the flumazenil administration diagnosis or treatment? Two case reports

OpenAIRE

YARDAN, Türker; ACAR, Ethem; AKDEMIR, Hızır Ufuk; BAYDIN, Ahmet; DURAN, Latif

2014-01-01

Benzodiazepine has the central nervous system (CNS), cardiac and respiratory side effects when intaked more than therapeutic doses. Acute benzodiazepine poisoning may be manifest taken in the form of dizziness, ataxia, nystagmus, dysarthria, hypoxia, hypothermia, hypotension, bradycardia, apnea, pulmonary aspiration, respiratory depression, coma, cardiopulmonary arrest and death. Alprazolam is the most toxic form of benzodiazepines and unless combined with the other CNS depressants such as ba...

Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

OpenAIRE

Jelić-Vuković Marija; Matić Suzana; Barać Josip; Novinščak Tomislav; Belovari Mirna; Barić Hrvoje

2017-01-01

Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed ele...

Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials.

Science.gov (United States)

Curthoys, Ian S; Manzari, Leonardo

2013-07-01

Through selective tests of the function of the canal and otolith sense organs, it is possible to assert that patient conditions are purely otolithic and that the canals are not involved. The video head impulse test selectively tests each semicircular canal; the ocular vestibular-evoked myogenic potential to 500 Hz Fz (Fz is the location on the forehead in the midline at the hairline) bone-conducted vibration (BCV) selectively tests the utricular macula and the cervical vestibular-evoked myogenic potential to 500 Hz Fz BCV selectively tests the saccular macula. The development of new specific tests of otolith function has shown that some patients may have specific deficits of just otolithic function. In the authors' experience, patients who complain strongly of postural unsteadiness should be suspected to have otolithic deficits. They may also have vertigo and in some cases have spontaneous nystagmus of peripheral origin, even though their semicircular canal function is normal. The prognosis for such patients is good. They usually appear to regain their postural stability spontaneously over weeks (or longer), even though they still have an otolithic deficit as shown by objective tests when they are free of symptoms. It is not known what procedures may accelerate the recovery of otolith function. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Parinaud syndrome: a 25-year (1991-2016) review of 40 consecutive adult cases.

Science.gov (United States)

Shields, Melissa; Sinkar, Swati; Chan, WengOnn; Crompton, John

2017-12-01

To characterize the clinical features, aetiology and management of ophthalmic symptoms in adult patients with Parinaud syndrome. This is a retrospective, non-comparative observational case series. We reviewed 40 consecutive charts of adult patients with the clinical diagnosis of Parinaud syndrome at the Royal Adelaide Hospital Department of Ophthalmology in Adelaide, South Australia, between 1991 and 2016. Charts were reviewed for the following: (1) demographic information, (2) clinical presentation, (3) neuro-ophthalmology signs, (4) aetiology of Parinaud syndrome, and (5) management. Examination findings were collected at initial evaluation, throughout the course of follow-up, and at last follow-up. All the cases were assessed by one of the authors (JLC). The commonest presenting symptoms were diplopia (67.5%) and blurred vision (25%) followed by visual field defect (12.5%), ataxia (7.5%) and manifest squint (7.5%). The commonest presenting signs were vertical gaze palsy (100%), convergence-retraction nystagmus (87.5%) and light-near dissociation (65.0%). Only 65.0% patients had the classical triad of vertical gaze palsy, convergence-retraction nystagmus and light-near dissociation. Midbrain pathologies including haemorrhage (30.0%), infarction (20.0%) and tumour (15.0%) were the commonest aetiology. Pineal region tumours accounted for 30.0% of presentations. Symptoms were managed conservatively in 45% of cases with temporary occlusion, prisms or refractive correction, and observation in 42.5% of cases. Surgical intervention for refractory diplopia was required in 12.5% of cases, of which 80% reported symptom resolution following surgery. Our series highlights the variable clinical presentation of Parinaud syndrome. The classic triad of conjugate upgaze paralysis, convergence-retraction nystagmus and light-near dissociation was only present in 65% of cases. Pineal neoplasms remain an important aetiological consideration; however, primary midbrain pathology

High Concentrations of Measles Neutralizing Antibodies and High-Avidity Measles IgG Accurately Identify Measles Reinfection Cases

Science.gov (United States)

Rota, Jennifer S.; Hickman, Carole J.; Mercader, Sara; Redd, Susan; McNall, Rebecca J.; Williams, Nobia; McGrew, Marcia; Walls, M. Laura; Rota, Paul A.; Bellini, William J.

2016-01-01

In the United States, approximately 9% of the measles cases reported from 2012 to 2014 occurred in vaccinated individuals. Laboratory confirmation of measles in vaccinated individuals is challenging since IgM assays can give inconclusive results. Although a positive reverse transcription (RT)-PCR assay result from an appropriately timed specimen can provide confirmation, negative results may not rule out a highly suspicious case. Detection of high-avidity measles IgG in serum samples provides laboratory evidence of a past immunologic response to measles from natural infection or immunization. High concentrations of measles neutralizing antibody have been observed by plaque reduction neutralization (PRN) assays among confirmed measles cases with high-avidity IgG, referred to here as reinfection cases (RICs). In this study, we evaluated the utility of measuring levels of measles neutralizing antibody to distinguish RICs from noncases by receiver operating characteristic curve analysis. Single and paired serum samples with high-avidity measles IgG from suspected measles cases submitted to the CDC for routine surveillance were used for the analysis. The RICs were confirmed by a 4-fold rise in PRN titer or by RT-quantitative PCR (RT-qPCR) assay, while the noncases were negative by both assays. Discrimination accuracy was high with serum samples collected ≥3 days after rash onset (area under the curve, 0.953; 95% confidence interval [CI], 0.854 to 0.993). Measles neutralizing antibody concentrations of ≥40,000 mIU/ml identified RICs with 90% sensitivity (95% CI, 74 to 98%) and 100% specificity (95% CI, 82 to 100%). Therefore, when serological or RT-qPCR results are unavailable or inconclusive, suspected measles cases with high-avidity measles IgG can be confirmed as RICs by measles neutralizing antibody concentrations of ≥40,000 mIU/ml. PMID:27335386

Progression of retinal pigment epithelial atrophy in antiangiogenic therapy of neovascular age-related macular degeneration.

Science.gov (United States)

Schütze, Christopher; Wedl, Manuela; Baumann, Bernhard; Pircher, Michael; Hitzenberger, Christoph K; Schmidt-Erfurth, Ursula

2015-06-01

To monitor retinal pigment epithelial (RPE) atrophy progression during antiangiogenic therapy of neovascular age-related macular degeneration (AMD) over 2 years using polarization-sensitive optical coherence tomography (OCT). Prospective interventional case series. setting: Clinical practice. Thirty patients (31 eyes) with treatment-naïve neovascular AMD. Standard intravitreal therapy (0.5 mg ranibizumab) was administered monthly during the first year and pro re nata (PRN; as-needed) during the second year. Spectral-domain (SD) OCT and polarization-sensitive OCT (selectively imaging the RPE) examinations were performed at baseline and at 1, 3, 6, 12, and 24 months using a standardized protocol. RPE-related changes were evaluated using a semi-automated polarization-sensitive OCT segmentation algorithm and correlated with SD OCT and fundus autofluorescence (FAF) findings. RPE response, geographic atrophy (GA) progression. Atrophic RPE changes included RPE thinning, RPE porosity, focal RPE atrophy, and development of GA. Early RPE loss (ie, RPE porosity, focal atrophy) increased progressively during initial monthly treatment and remained stable during subsequent PRN-based therapy. GA developed in 61% of eyes at month 24. Mean GA area increased from 0.77 mm(2) at 12 months to 1.10 mm(2) (standard deviation = 1.09 mm(2)) at 24 months. Reactive accumulation of RPE-related material at the lesion borders increased until month 3 and subsequently decreased. Progressive RPE atrophy and GA developed in the majority of eyes. RPE migration signifies certain RPE plasticity. Polarization-sensitive OCT specifically images RPE-related changes in neovascular AMD, contrary to conventional imaging methods. Polarization-sensitive OCT allows for precisely monitoring the sequence of RPE-related morphologic changes. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Host Competence: An Organismal Trait to Integrate Immunology and Epidemiology.

Science.gov (United States)

Martin, Lynn B; Burgan, S C; Adelman, James S; Gervasi, Stephanie S

2016-12-01

The new fields of ecological immunology and disease ecology have begun to merge, and the classic fields of immunology and epidemiology are beginning to blend with them. This merger is occurring because the integrative study of host-parasite interactions is providing insights into disease in ways that traditional methods have not. With the advent of new tools, mathematical and technological, we could be on the verge of developing a unified theory of infectious disease, one that supersedes the barriers of jargon and tradition. Here we argue that a cornerstone of any such synthesis will be host competence, the propensity of an individual host to generate new infections in other susceptible hosts. In the last few years, the emergence of systems immunology has led to novel insight into how hosts control or eliminate pathogens. Most such efforts have stopped short of considering transmission and the requisite behaviors of infected individuals that mediate it, and few have explicitly incorporated ecological and evolutionary principles. Ultimately though, we expect that the use of a systems immunology perspective will help link suborganismal processes (i.e., health of hosts and selection on genes) to superorganismal outcomes (i.e., community-level disease dynamics and host-parasite coevolution). Recently, physiological regulatory networks (PRNs) were cast as whole-organism regulatory systems that mediate homeostasis and hence link suborganismal processes with the fitness of individuals. Here, we use the PRN construct to develop a roadmap for studying host competence, taking guidance from systems immunology and evolutionary ecology research. We argue that PRN variation underlies heterogeneity in individual host competence and hence host-parasite dynamics. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study.

Science.gov (United States)

Ogura, Yuichiro; Roider, Johann; Korobelnik, Jean-François; Holz, Frank G; Simader, Christian; Schmidt-Erfurth, Ursula; Vitti, Robert; Berliner, Alyson J; Hiemeyer, Florian; Stemper, Brigitte; Zeitz, Oliver; Sandbrink, Rupert

2014-11-01

To evaluate intravitreal aflibercept for treatment of macular edema secondary to central retinal vein occlusion (CRVO). Randomized, double-masked, phase 3 study. A total of 177 patients with macular edema secondary to CRVO were randomized to receive 2 mg intravitreal aflibercept (n = 106) or sham (n = 71) every 4 weeks for 20 weeks. From weeks 24 to 48, patients were monitored every 4 weeks; the former group received intravitreal aflibercept as needed (PRN), and the sham group received sham. From weeks 52 to 76, patients were monitored every 8 weeks, and both groups received intravitreal aflibercept PRN. The primary endpoint (proportion of patients who gained ≥15 letters) was at week 24. This study reports exploratory outcomes at week 76. The proportion of patients who gained ≥15 letters in the intravitreal aflibercept and sham groups was 60.2% vs 22.1% at week 24 (patients discontinued before week 24 were considered nonresponders; P < .0001), 60.2% vs 32.4% at week 52 (last observation carried forward, P < .001), and 57.3% vs 29.4% at week 76 (last observation carried forward; P < .001). Mean μm change from baseline central retinal thickness was -448.6 vs -169.3 at week 24 (P < .0001), -423.5 vs -219.3 at week 52 (P < .0001), and -389.4 vs -306.4 at week 76 (P = .1122). Over 76 weeks, the most common ocular serious adverse event in the intravitreal aflibercept group was macular edema (3.8%). The visual and anatomic improvements seen after fixed, monthly dosing at week 24 were largely maintained when treatment intervals were extended. Patients with macular edema following CRVO benefited from early treatment with intravitreal aflibercept. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical correlation to differences in ranibizumab and aflibercept vascular endothelial growth factor suppression times.

Science.gov (United States)

Fauser, Sascha; Muether, Philipp S

2016-11-01

To determine clinical correlations to intraocular vascular endothelial growth factor A (VEGF-A) suppression times (VSTs) on the treatment of neovascular age-related macular degeneration (nAMD) with ranibizumab (Lucentis) or aflibercept (Eylea). Seven of 89 treatment-naïve nAMD eyes showed persistent choroidal neovascular membrane (CNV) activity throughout a spectral domain optical coherence tomography (SD-OCT)-driven pro re nata (PRN) regimen of intravitreal ranibizumab injections over 28±4 months. The treatment was switched to PRN aflibercept injections and patients were followed for another 15±2 months. A total of 160 aqueous humour specimens were collected before the intravitreal injections, and their VEGF-A concentrations were assayed by Luminex multiplex bead analysis (Luminex, Austin, Texas, USA). Intraocular VEGF-A concentrations were correlated to CNV activity shown by SD-OCT. The mean duration of suppression of VEGF-A concentrations in aqueous humour below the lower limit of quantification of our assay was 34±5 (26-69) days for ranibizumab and 67±14 (49-89) days for aflibercept (p<0.001). The percentual reduction of central retinal volume (CRV) 6 weeks after injection was higher for aflibercept compared with ranibizumab (p=0.009). The time point of clinical re-activity occurred about 50% earlier than the respective VST for each ranibizumab and aflibercept. The VST under aflibercept treatment exceeded that under ranibizumab treatment by a factor of 2. This difference correlated with differential clinical CRV reduction 6 weeks after the respective injection. For both medications, clinical activity was found at a time point as early as 50% of the individual VST. NCT01213667, post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[High-frequency rotation sensation function damage of the crista of the horizontal semicircular canal induced by gentamicin and its morphological basis.].

Science.gov (United States)

Chen, Liang; He, Ming; Wang, Wu-Qing

2009-12-25

The goal of the present study was to explore high-frequency rotation sensation function damage of the crista of the horizontal semicircular canal induced by gentamicin and its morphological basis. The guinea pigs were randomly divided into four groups (group 1, 2, 3 and control group, n=20). The animals of treated groups received gentamicin subcutaneously (50 mg/kg per day) for 1 week (group 1), 2 weeks (group 2) and 3 weeks (group 3), respectively. The animals of control group were administered with equal volume of saline subcutaneously. Videonystagmography (VNG) evoked by ice water or high-frequency rotations, and vestibular evoked potential (VsEP) evoked by low- and high-frequency rotations were recorded after the administration. After VNG and VsEP were examined, the cristae of the horizontal semicircular canals were prepared for scanning and transmission electron microscopy. The results are as follows: (1) In VNG examination, after ice water stimulation, no obvious nystagmus was observed in the animals of group 3, and there was no significant difference in nystagmus frequency and duration among group 1, 2 and control group (P>0.05). After high- frequency rotations, no obvious nystagmus was yet observed in the animals of group 3. There were significant differences in the nystagmus frequency and duration of the VNG waves between the experimental group 2 and control group (P0.05). (2) In VsEP examination, there was no significant difference in the parameters of VsEP among group 1, 2 and control group (P>0.05), and VsEP was not observed in group 3 after low-frequency rotations. After high- frequency rotations, compared with control group, the latencies and amplitudes of P1 and P2 in group 2 significantly decreased (P0.05). Group 3 had no response of VsEP to high-frequency rotations. (3) Electron microscopy was used to observe the crista hair cells of the four groups. In control group, the hair cells were normal. In group 1, almost normal appearance with slight

Acute necrosis after Gamma Knife surgery in vestibular schwannoma leading to multiple cranial nerve palsies.

Science.gov (United States)

Kapitza, Sandra; Pangalu, Athina; Horstmann, Gerhard A; van Eck, Albert T; Regli, Luca; Tarnutzer, Alexander A

2016-08-01

We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss. A diagnosis of acute vestibulocochlear and facial neuropathy was made. Brain MRI demonstrated focal contrast sparing within the schwannoma, likely related to acute radiation necrosis. Acute multiple cranial neuropathies of the cerebellopontine angle after Gamma Knife treatment should raise suspicion of acute tissue damage within the schwannoma and should result in urgent MRI. Treatment with steroids may be considered based on accompanying swelling and edema. Copyright © 2016 Elsevier Ltd. All rights reserved.

Aniridia--Wilms′ tumour association--a case with 11p 13-14.1 deletion and ventricular septal defect.

OpenAIRE

Rao S; Athale U; Kadam P; Gladstone B; Nair C; Pai S; Kurkure P; Advani S

1992-01-01

A two year old female child with bilateral wilms tumor (WT) along with multiple congenital anomalies like bilateral aniridia with congenital cataracts and nystagmus, microcephaly, mental retardation and ventricular septal defect has been described. The karyotype analysis revealed 46 xx, del 11p 13-14.1. Association of ventricular septal defect with the classical features of ′Aniridia-Wilms′ tumor association′ is an unusual feature in this case.

Central Acetylcholinesterase Reactivation by Oximes Improves Survival and Terminates Seizures Following Nerve Agent Intoxication

Science.gov (United States)

2009-01-01

DTNB was prepared in Tris buffer (0.05 M, pH 8.2) to a concentration of 0.424 M. AttaneTM (Isoflurane, USP) was purchased from Minrad, Inc...signs of cholinergic toxicity (Table 1), including secretions ( salivation or lacrimation), motor deficits, and general state (activity and...rats. They were scored for absence [0] or presence [1] of each of the following signs: salivation , lacrimation, and nystagmus. General motor

Large Sphenoethmoidal Encephalocele Associated with Agenesis of Corpus Callosum and Cleft Palate

Directory of Open Access Journals (Sweden)

Basir Hashemi

2010-06-01

Full Text Available AbstractBasal encephalocele is a rare craniofacial anomaly. In the presentpaper we report a 10-year-old boy presented with cleftpalate, congenital nystagmus, and hypertelorism. During preoperativeevaluation for cleft palate repair, a pulsatile masswas detected in the pharynx. Magnetic resonance imagingshowed sphenoethmoidal type of basal encephalocele andagenesis of corpus callosum. Neurosurgical consultation wasperformed for further evaluation and management.Iran J Med Sci 2010; 35(2: 154-156.

Signe de « la dent molaire »: aspect caractéristique en IRM du ...

African Journals Online (AJOL)

Le syndrome de Joubert est une affection génétique rare, de transmission autosomique récessive, caractérisé par une malformation congénitale du tronc cérébral et une agénésie ou une hypoplasie du vermis cérébelleux entraînant des troubles respiratoires, un nystagmus, une hypotonie, une ataxie et un retard du ...

Bedside examination for vestibular screening in occupational medicine.

Science.gov (United States)

Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola

2015-01-01

The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG) oculomotor tests (central group) and 43 subjects with normal VNG. Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT), Dynamic Visual Acuity (DVA) and gaze nystagmus assessment. Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73%) had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Anatomic features and function of the macula and outcome of surgical tenotomy and reattachment in achiasma.

Science.gov (United States)

Weiss, Avery H; Phillips, James O; Kelly, John P

2013-07-01

To examine the anatomic features and function of the macula in achiasma and to compare visual acuity, eye movements, foveation, and eye velocity before and after tenotomy and reattachment (T&R) surgery. Case series. Two children with isolated achiasma. Ophthalmologic examinations, brain magnetic resonance imaging, full-field and multifocal electroretinography (ERG), visual evoked potentials (VEPs), spectral-domain optical coherence tomography (OCT), eye-movement recordings, and unilateral T&R in 1 patient. Visual acuity before and after surgery, macular anatomic features and function, and eye velocity before and after T&R surgery in 1 patient. Magnetic resonance imaging and VEP confirmed absence of decussation of retinofugal fibers in both patients. Visual acuity was 20/100 and 20/200. The anatomic features and function of the fovea and macula were normal by OCT and multifocal ERG. After T&R, there was a marked reduction in horizontal eye velocity and monocular visual acuity improved to 20/80. The finding that the macula is normal in achiasma suggests that reduced acuity is the result of retinal image motion from nystagmus. Two-muscle T&R reduces horizontal retinal image motion and can improve visual acuity in achiasma or patients with infantile nystagmus. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

The Relationship between Vestibular Function and Topographical Memory in Older Adults

Directory of Open Access Journals (Sweden)

Fred Henry Previc

2014-06-01

Full Text Available Research during the past two decades has demonstrated an important role of the vestibular system in topographical orientation and memory and the network of neural structures associated with them. Almost all of the supporting data have come from animal or human clinical studies, however. The purpose of the present study was to investigate the link between vestibular function and topographical memory in normal elderly humans. Twenty-five participants aged 70 to 85 years who scored from mildly impaired to normal on the Montreal Cognitive Assessment received three topographical memory tests: the Camden Topographical Recognition Memory Test (CTMRT, a computerized topographical mental rotation test (TMRT, and a virtual pond maze (VPM. They also received six vestibular or oculomotor tests: optokinetic nystagmus (OKN, visual pursuit (VP, actively generated vestibulo-ocular reflex (VOR, the sensory orientation test (SOT for posture, and two measures of rotational memory (error in degrees, or RMº, and correct directional recognition, or RM→. The only significant bivariate correlations were among the three vestibular measures primarily assessing horizontal canal function (VOR, RMº, and RM→. A multiple regression analysis showed significant relationships between vestibular and demographic predictors and both the TMRT (R=.78 and VPM (R=.66 measures. The significant relationship between the vestibular and topographical memory measures supports the theory that vestibular loss may contribute to topographical memory impairment in the elderly.

Automating Test Activities: Test Cases Creation, Test Execution, and Test Reporting with Multiple Test Automation Tools

OpenAIRE

Loke Mun Sei

2015-01-01

Software testing has become a mandatory process in assuring the software product quality. Hence, test management is needed in order to manage the test activities conducted in the software test life cycle. This paper discusses on the challenges faced in the software test life cycle, and how the test processes and test activities, mainly on test cases creation, test execution, and test reporting is being managed and automated using several test automation tools, i.e. Jira, ...

Effects of Low and High Oxygen Tensions and Related Respiratory Conditions on Visual Performance: A Literature Review

Science.gov (United States)

1988-07-01

and of the same subject after a diet that made him deficient in Vitamin A. They used only one healthy well-trained observer. Measurementv of...background intensity. The authors do not discuss hypoxia changes in some other visual process, but this improvement above 15,000 feet may reflect hypo ...these studies, Gellhorn and Spiesman (1935) induced caloric nystagmus while subjects breathed mixtures high in CO2 and low in oxygen, and also after

X-linked ocular albinism in Blacks. Ocular albinism cum pigmento.

Science.gov (United States)

O'Donnell, F E; Green, W R; Fleischman, J A; Hambrick, G W

1978-07-01

X-linked ocular albinism can be an unsuspected cause of congenital nystagmus in blacks. In this study, eight of ten black ocular albinos from two kindreds had nonalbinotic, moderately pigmented fundi and no transillumination of the iris. We refer to this paradoxical condition as "ocular albinism cum pigmento." The only constant ophthalmoscopic feature was a foveal hypoplasia. Biopsy of clinically normal skin to demonstrate giant pigment granules is the most accurate means of diagnosis.

Two Cases of Isolated Internuclear Presenting Ophthalmoplegia

OpenAIRE

Tuğçe Mengi; Özge Gökmuharremoğlu; Nazlı Hasanzadeh; Mehmet Çelebisoy; Mustafa Fazıl Gelal

2014-01-01

Internuclear ophtalmoplegia (INO) is a gaze disorder caused by medial longitudinal fasciculus (MLF) injury and is characterized by impairment of adduction in the ipsilateral eye and dissociated nystagmus in the contralateral eye. INO usually develops due to lesions caused by multiple sclerosis or stroke, and rarely to head trauma. Disseciton of vertebral artery is an often overlooked cause of stroke, especially in young adults. Dissection of vertebral artery should be considered in differenti...

Visual electrophysiology in children

Directory of Open Access Journals (Sweden)

Jelka Brecelj

2005-10-01

Full Text Available Background: Electrophysiological assessment of vision in children helps to recognise abnormal development of the visual system when it is still susceptible to medication and eventual correction. Visual electrophysiology provides information about the function of the retina (retinal pigment epithelium, cone and rod receptors, bipolar, amacrine, and ganglion cells, optic nerve, chiasmal and postchiasmal visual pathway, and visual cortex.Methods: Electroretinograms (ERG and visual evoked potentials (VEP are recorded non-invasively; in infants are recorded simultaneously ERG with skin electrodes, while in older children separately ERG with HK loop electrode in accordance with ISCEV (International Society for Clinical Electrophysiology of Vision recommendations.Results: Clinical and electrophysiological changes in children with nystagmus, Leber’s congenital amaurosis, achromatopsia, congenital stationary night blindness, progressive retinal dystrophies, optic nerve hypoplasia, albinism, achiasmia, optic neuritis and visual pathway tumours are presented.Conclusions: Electrophysiological tests can help to indicate the nature and the location of dysfunction in unclear ophthalmological and/or neurological cases.

Severe anemia caused by babesiosis in a maned wolf (Chrysocyon brachyurus).

Science.gov (United States)

Phair, Kristen A; Carpenter, James W; Smee, Nicole; Myers, Carl B; Pohlman, Lisa M

2012-03-01

An 8-yr-old, captive, spayed, female maned wolf (Chrysocyon brachyurus) developed progressive lethargy and weakness over a 24-hr period. Clinical signs included vomiting, recumbency, horizontal nystagmus, possible blindness, pale icteric mucus membranes, and port-wine colored urine. A complete blood cell count revealed severe anemia (packed cell volume [PCV], 6%) and intraerythrocytic piroplasms consistent with a Babesia species. Polymerase chain reaction testing later confirmed babesiosis. The wolf was treated with imidocarb dipropionate, antibiotics, and fluid therapy. A whole-blood transfusion from a sibling maned wolf also was performed. Despite aggressive treatment, the wolf failed to improve and was euthanized. To the authors' knowledge, this is the first documented case of babesiosis in a captive maned wolf in North America. Surveillance of infectious diseases in captive and wild maned wolf populations should be expanded to include screening for Babesia species. Tick control also should be implemented to prevent and decrease transmission of the disease to this endangered species.

Exploring Monte Carlo Simulation Strategies for Geoscience Applications

Science.gov (United States)

Blais, J.; Grebenitcharsky, R.; Zhang, Z.

2008-12-01

Computer simulations are an increasingly important area of geoscience research and development. At the core of stochastic or Monte Carlo simulations are the random number sequences that are assumed to be distributed with specific characteristics. Computer generated random numbers, uniformly distributed on [0, 1], can be very different depending on the selection of pseudo-random number (PRN), quasi-random number (QRN) or chaotic random number (CRN) generators. In the evaluation of some definite integrals, the expected error variances are generally of different orders for the same number of random numbers. A comparative analysis of these three strategies has been carried out for geodetic and related applications in planar and spherical contexts. Based on these computational experiments, conclusions and recommendations concerning their performance and error variances are included.

Evaluation of components of X-ray irradiated 7-valent pneumococcal conjugate vaccine and pneumococcal vaccine polyvalent and X-ray and gamma-ray irradiated acellular pertussis component of DTaP vaccine products

International Nuclear Information System (INIS)

May, J.C.; Rey, L.; Lee, C.-J.; Arciniega, Juan

2004-01-01

Samples of pneumococcal vaccine polyvalent, 7-valent pneumococcal conjugate vaccine, and two different diphtheria and tetanus toxoids and acellular pertussis vaccines adsorbed were irradiated with X-rays and/or gamma-rays (Co-60). Mouse IgG and IgM antibody responses (ELISA) for types 9V, 14, 18C, and 19F pneumococcal polysaccharides and conjugates indicated that the polysaccharides were more tolerant of the radiation than the conjugates. The mouse antibody response for the detoxified pertussis toxin (PT) antigen, filamentous hemagglutinin antigen (FHA), pertactin (PRN), and fimbriae types 2 and 3 (FIM) antigens for the appropriate vaccine type indicated that the antibody response was not significantly changed in the 25 kGy X-ray irradiated vaccines frozen in liquid nitrogen compared to the control vaccine

Evaluation of components of X-ray irradiated 7-valent pneumococcal conjugate vaccine and pneumococcal vaccine polyvalent and X-ray and gamma-ray irradiated acellular pertussis component of DTaP vaccine products

Energy Technology Data Exchange (ETDEWEB)

May, J.C. E-mail: may@cber.fda.gov; Rey, L. E-mail: louis.rey@bluewin.ch; Lee, C.-J.; Arciniega, Juan

2004-10-01

Samples of pneumococcal vaccine polyvalent, 7-valent pneumococcal conjugate vaccine, and two different diphtheria and tetanus toxoids and acellular pertussis vaccines adsorbed were irradiated with X-rays and/or gamma-rays (Co-60). Mouse IgG and IgM antibody responses (ELISA) for types 9V, 14, 18C, and 19F pneumococcal polysaccharides and conjugates indicated that the polysaccharides were more tolerant of the radiation than the conjugates. The mouse antibody response for the detoxified pertussis toxin (PT) antigen, filamentous hemagglutinin antigen (FHA), pertactin (PRN), and fimbriae types 2 and 3 (FIM) antigens for the appropriate vaccine type indicated that the antibody response was not significantly changed in the 25 kGy X-ray irradiated vaccines frozen in liquid nitrogen compared to the control vaccine.

Dizziness in stroke

Directory of Open Access Journals (Sweden)

M. V. Zamergrad

2015-01-01

Full Text Available Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness. The treatment of patients with stroke-induced dizziness involves a wide range of medications for the reduction of the degree of dizziness and unsteadiness and for the secondary prevention of stroke. Vestibular rehabilitation is an important component of treatment. The paper describes an observation of a patient with poorly controlled hypertension, who developed new-onset acute systemic dizziness. Vestibular neuronitis might be presumed to be a peripheral cause of vestibular disorders, by taking into account the absence of additional obvious neurological symptoms (such as pareses, defective sensation, diplopia, etc. and the nature of nystagmus. However, intention tremor in fingernose and heel-knee tests on the left side, a negative Halmagyi test, and results of Romberg’s test could suggest that stroke was a cause ofdizziness.

East London Modified-Broset as Decision-Making Tool to Predict Seclusion in Psychiatric Intensive Care Units

Directory of Open Access Journals (Sweden)

Felice Loi

2017-10-01

Full Text Available Seclusion is a last resort intervention for management of aggressive behavior in psychiatric settings. There is no current objective and practical decision-making instrument for seclusion use on psychiatric wards. Our aim was to test the predictive and discriminatory characteristics of the East London Modified-Broset (ELMB, to delineate its decision-making profile for seclusion of adult psychiatric patients, and second to benchmark it against the psychometric properties of the Broset Violence Checklist (BVC. ELMB, an 8-item modified version of the 6-item BVC, was retrospectively employed to evaluate the seclusion decision-making process on two Psychiatric Intensive Care Units (patients n = 201; incidents n = 2,187. Data analyses were carried out using multivariate regression and Receiver Operating Characteristic (ROC curves. Predictors of seclusion were: physical violence toward staff/patients OR = 24.2; non-compliance with PRN (pro re nata medications OR = 9.8; and damage to hospital property OR = 2.9. ROC analyses indicated that ELMB was significantly more accurate that BVC, with higher sensitivity, specificity, and positive likelihood ratio. Results were similar across gender. The ELMB is a sensitive and specific instrument that can be used to guide the decision-making process when implementing seclusion.

East London Modified-Broset as Decision-Making Tool to Predict Seclusion in Psychiatric Intensive Care Units.

Science.gov (United States)

Loi, Felice; Marlowe, Karl

2017-01-01

Seclusion is a last resort intervention for management of aggressive behavior in psychiatric settings. There is no current objective and practical decision-making instrument for seclusion use on psychiatric wards. Our aim was to test the predictive and discriminatory characteristics of the East London Modified-Broset (ELMB), to delineate its decision-making profile for seclusion of adult psychiatric patients, and second to benchmark it against the psychometric properties of the Broset Violence Checklist (BVC). ELMB, an 8-item modified version of the 6-item BVC, was retrospectively employed to evaluate the seclusion decision-making process on two Psychiatric Intensive Care Units (patients n  = 201; incidents n  = 2,187). Data analyses were carried out using multivariate regression and Receiver Operating Characteristic (ROC) curves. Predictors of seclusion were: physical violence toward staff/patients OR = 24.2; non-compliance with PRN (pro re nata) medications OR = 9.8; and damage to hospital property OR = 2.9. ROC analyses indicated that ELMB was significantly more accurate that BVC, with higher sensitivity, specificity, and positive likelihood ratio. Results were similar across gender. The ELMB is a sensitive and specific instrument that can be used to guide the decision-making process when implementing seclusion.

Misdiagnosis of acute peripheral vestibulopathy in central nervous ischemic infarction.

Science.gov (United States)

Braun, Eva Maria; Tomazic, Peter Valentin; Ropposch, Thorsten; Nemetz, Ulrike; Lackner, Andreas; Walch, Christian

2011-12-01

Vertigo is a very common symptom at otorhinolaryngology (ENT), neurological, and emergency units, but often, it is difficult to distinguish between vertigo of peripheral and central origin. We conducted a retrospective analysis of a hospital database, including all patients admitted to the ENT University Hospital Graz after neurological examination, with a diagnosis of peripheral vestibular vertigo and subsequent diagnosis of central nervous infarction as the actual cause for the vertigo. Twelve patients were included in this study. All patients with acute spinning vertigo after a thorough neurological examination and with uneventful computed tomographic scans were referred to our ENT department. Nine of them presented with horizontal nystagmus. Only 1 woman experienced additional hearing loss. The mean diagnostic delay to the definite diagnosis of a central infarction through magnetic resonance imaging was 4 days (SD, 2.3 d). A careful otologic and neurological examination, including the head impulse test and caloric testing, is mandatory. Because ischemic events cannot be diagnosed in computed tomographic scans at an early stage, we strongly recommend to perform cranial magnetic resonance imaging within 48 hours from admission if vertigo has not improved under conservative treatment.

Mutations in the Human Orthologue of the Mouse underwhite Gene (uw) Underlie a New Form of Oculocutaneous Albinism, OCA4

OpenAIRE

Newton, J. M.; Cohen-Barak, Orit; Hagiwara, Nobuko; Gardner, John M.; Davisson, Muriel T.; King, Richard A.; Brilliant, Murray H.

2001-01-01

Oculocutaneous albinism (OCA) affects ∼1/20,000 people worldwide. All forms of OCA exhibit generalized hypopigmentation. Reduced pigmentation during eye development results in misrouting of the optic nerves, nystagmus, alternating strabismus, and reduced visual acuity. Loss of pigmentation in the skin leads to an increased risk for skin cancer. Two common forms and one infrequent form of OCA have been described. OCA1 (MIM 203100) is associated with mutations of the TYR gene encoding tyrosinas...

Systems analysis of the vestibulo-ocular system. [mathematical model of vestibularly driven head and eye movements

Science.gov (United States)

Schmid, R. M.

1973-01-01

The vestibulo-ocular system is examined from the standpoint of system theory. The evolution of a mathematical model of the vestibulo-ocular system in an attempt to match more and more experimental data is followed step by step. The final model explains many characteristics of the eye movement in vestibularly induced nystagmus. The analysis of the dynamic behavior of the model at the different stages of its development is illustrated in time domain, mainly in a qualitative way.

Habituation and adaptation of the vestibuloocular reflex: a model of differential control by the vestibulocerebellum

Science.gov (United States)

Cohen, H.; Cohen, B.; Raphan, T.; Waespe, W.

1992-01-01

We habituated the dominant time constant of the horizontal vestibuloocular reflex (VOR) of rhesus and cynomolgus monkeys by repeated testing with steps of velocity about a vertical axis and adapted the gain of the VOR by altering visual input with magnifying and reducing lenses. After baseline values were established, the nodulus and ventral uvula of the vestibulocerebellum were ablated in two monkeys, and the effects of nodulouvulectomy and flocculectomy on VOR gain adaptation and habituation were compared. The VOR time constant decreased with repeated testing, rapidly at first and more slowly thereafter. The gain of the VOR was unaffected. Massed trials were more effective than distributed trials in producing habituation. Regardless of the schedule of testing, the VOR time constant never fell below the time constant of the semicircular canals (approximately 5 s). This finding indicates that only the slow component of the vestibular response, the component produced by velocity storage, was habituated. In agreement with this, the time constant of optokinetic after-nystagmus (OKAN) was habituated concurrently with the VOR. Average values for VOR habituation were obtained on a per session basis for six animals. The VOR gain was adapted by natural head movements in partially habituated monkeys while they wore x 2.2 magnifying or x 0.5 reducing lenses. Adaptation occurred rapidly and reached about +/- 30%, similar to values obtained using forced rotation. VOR gain adaptation did not cause additional habituation of the time constant. When the VOR gain was reduced in animals with a long VOR time constant, there were overshoots in eye velocity that peaked at about 6-8 s after the onset or end of constant-velocity rotation. These overshoots occurred at times when the velocity storage integrator would have been maximally activated by semicircular canal input. Since the activity generated in the canals is not altered by visual adaptation, this finding indicates that the gain

PRN 98-5: New Forms for the Certification with Respect to Citation of Data

Science.gov (United States)

In 1998, EPA established new forms for citation of data to support the registration or reregistration of pesticide products. These forms are EPA Form 8570-34 (“Certification with Respect to Citation of Data”) and 8570-35 (“Data Matrix”).

Oculomotor and Vestibular Findings in Gaucher Disease Type 3 and Their Correlation with Neurological Findings

Directory of Open Access Journals (Sweden)

Tatiana Bremova-Ertl

2018-01-01

Full Text Available ObjectivesTo evaluate the function of the oculomotor and vestibular systems and to correlate these findings with the clinical status of patients with Gaucher disease type 3 (GD3. The goal of this cross-sectional and longitudinal study was to find oculomotor biomarkers for future clinical trials.MethodsTwenty-six patients with GD3 were assessed for eligibility and 21 were able to perform at least one task. Horizontal and vertical reflexive saccades, smooth pursuit, gaze-holding, optokinetic nystagmus, and horizontal vestibulo-ocular reflex (VOR were examined by video-oculography/video-head impulse test and compared concurrently with 33 healthy controls. The Scale for the Assessment and Rating of Ataxia (SARA, the modified Severity Scoring Tool (mSST, and Grooved Pegboard Test (GPT were administered to assess overall neurological function. Eleven patients were also re-assessed after 1 year.ResultsNine out of 17 patients exhibited gaze-holding deficits. One patient had upbeat nystagmus. Three patients presented with bilateral abducens palsy in combination with central oculomotor disorders, suggesting a bilateral involvement of the abducens nucleus. Horizontal angular VOR gain was reduced in all patients (0.66 ± 0.37 compared with controls (1.1 ± 0.11, p < 0.001. Most strongly correlated with clinical rating scales were peak velocity of downward saccades (SARA: ρ = −0.752, p < 0.0005; mSST: ρ = −0.611, p = 0.003; GPT: ρ = −0.649, p = 0.005 and duration of vertical saccades (SARA: ρ = 0.806, p < 0.001; mSST: ρ = 0.700, p < 0.0005; GPT: ρ = 0.558, p = 0.02 together with the VOR gain (SARA: ρ = −0.63, p = 0.016; mSST: ρ = −0.725, p = 0.003; GPT: ρ = −0.666, p = 0.004. Vertical smooth pursuit gain decreased significantly at follow-up.InterpretationThis study shows neuronal degeneration of the brainstem and cerebellum with combined involvement of

Intravitreal Aflibercept Injection for Macular Edema Resulting from Central Retinal Vein Occlusion: One-Year Results of the Phase 3 GALILEO Study.

Science.gov (United States)

Korobelnik, Jean-François; Holz, Frank G; Roider, Johann; Ogura, Yuichiro; Simader, Christian; Schmidt-Erfurth, Ursula; Lorenz, Katrin; Honda, Miki; Vitti, Robert; Berliner, Alyson J; Hiemeyer, Florian; Stemper, Brigitte; Zeitz, Oliver; Sandbrink, Rupert

2014-01-01

To evaluate the efficacy and safety of intravitreal aflibercept injections for treatment of macular edema secondary to central retinal vein occlusion (CRVO). A randomized, multicenter, double-masked phase 3 study. A total of 177 treatment-naive patients with macular edema secondary to CRVO were randomized in a 3:2 ratio. Patients received either 2-mg intravitreal aflibercept or sham injections every 4 weeks for 20 weeks. From week 24 to 48, the aflibercept group received aflibercept as needed (pro re nata [PRN]), and the sham group continued receiving sham injections. The primary efficacy end point was the proportion of patients who gained 15 letters or more in best-corrected visual acuity (BCVA) at week 24. This study reports week 52 results including the proportion of patients who gained 15 letters or more in BCVA and the mean change from baseline BCVA and central retinal thickness. Efficacy end points at week 52 were all exploratory. At week 52, the mean percentage of patients gaining 15 letters or more was 60.2% in the aflibercept group and 32.4% in the sham group (P = 0.0004). Aflibercept patients, compared with sham patients, had a significantly higher mean improvement in BCVA (+16.9 letters vs. +3.8 letters, respectively) and reduction in central retinal thickness (-423.5 μm vs. -219.3 μm, respectively) at week 52 (P < 0.0001 for both). Aflibercept patients received a mean of 2.5 injections (standard deviation, 1.7 injections) during PRN dosing. The most common ocular adverse events in the aflibercept group were related to the injection procedure or the underlying disease, and included macular edema (33.7%), increased intraocular pressure (17.3%), and eye pain (14.4%). Treatment with intravitreal aflibercept provided significant functional and anatomic benefits after 52 weeks as compared with sham. The improvements achieved after 6 monthly doses at week 24 largely were maintained until week 52 with as-needed dosing. Intravitreal aflibercept

Hospice Use and Pain Management in Elderly Nursing Home Residents With Cancer.

Science.gov (United States)

Hunnicutt, Jacob N; Tjia, Jennifer; Lapane, Kate L

2017-03-01

Pain management is suboptimal in nursing homes. To estimate the extent to which receipt of hospice in nursing homes (NHs) increases the receipt of pain management for residents with cancer at the end of life. Study participants included Medicare beneficiaries with cancer who were NH residents in the last 90 days of life in 2011-2012 (n = 78,160). Residents in pain on hospice were matched to like residents without hospice by facility, type of pain assessment (self-report/staff assessment), and weeks until death (9064 matched strata, 16,968 unique residents). Minimum Data Set 3.0 provided information on residents' pain prevalence and receipt of pain management (scheduled analgesics, as needed [pro re nata {PRN}] medication, nonpharmacologic interventions). We developed conditional logistic models to estimate the association between hospice use and pain management, stratified by self-reported and staff-assessed pain. We found that pain prevalence was higher in residents using hospice versus those without hospice (e.g., residents who self-reported pain: hospice: 59.9%, 95% CIs = 59.3%-60.5%; nonhospice: 50.0%, 95% CI = 49.4%-50.6%). In matched analyses, untreated pain was uncommon (self-reported pain: 2.9% and 5.6% in hospice users and nonusers, respectively). Hospice use was associated with receipt of scheduled analgesics (self-reported: adjusted odds ratio = 1.85, 95% CI = 1.73-1.971) and PRN medication (self-reported: adjusted odds ratio = 1.31, 95% CI = 1.20-1.43). Pain prevalence and the association between hospice and pain management were similar in residents with staff-assessed pain. Untreated pain at the end of life among residents with cancer in NHs is unusual. Hospice is associated with increased pain management among those with documented pain. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Defective balancing ability and hyperactivity in the CLX (circling behavior linked to the X-chromosome) mutant rat.

Science.gov (United States)

Fuji, Jun-ichiro; Tanabe, Hiroyuki; Fukuda, Ryo; Ooshima, Yojiro

2003-12-01

We have reported that the recently described circling behavior rat (CLX) is a hereditary mutant controlled by a single sex-linked recessive gene (gene symbol: clx). This mutant shows intermittent circle walking and/or running and head tossing with the neck twisted. The abnormal behavior begins to appear around weaning and continues throughout life. In the present study, behavioral tests were performed during the suckling and post-weaning periods and when the rats reached maturity, and the following peculiar abnormalities were revealed: (1) in the righting reflex test, the CLX young show a tendency to take a longer time to revert to normal posture; (2) in the negative geotaxis test, they had difficulty moving upward at 12 days of age; (3) in the air righting reflex test, they frequently fell on their backs or shoulders even after weaning; (4) almost none of the CLX rats showed nystagmus, which is invariably observed in normal rats after rotating stimulation, at 20 weeks of age; and (5) they showed hyperactivity in the open field test at the age of 5 or 6 weeks and a higher degree of locomotor activity in the home cage at the age of 7 and 15 weeks. These results suggest that CLX mutant rats may have some defect in vestibular function (balance sense) or abnormalities in an area of the central nervous system responsible for posture control, e.g., in the dopaminergic or GABAergic neurons.

Labyrinthine Artery Aneurysm as an Internal Auditory Canal Mass

OpenAIRE

Diaz, Rodney C.; Konia, Thomas; Brunberg, James

2013-01-01

We present the first case report of a labyrinthine artery aneurysm masquerading as an internal auditory canal tumor. A 72-year-old woman presented with sudden onset right facial paralysis, facial pain, hearing loss, and vertigo. She demonstrated dense right-sided facial paralysis involving all branches of the facial nerve, left beating horizontal nystagmus, and anacusis of the right ear. Magnetic resonance imaging with contrast demonstrated a 6 × 7 mm peripherally enhancing lesion with lack o...

Abnormal Vestibulo-Ocular Reflexes in Autism: A Potential Endophenotype

Science.gov (United States)

2011-06-01

thus enhancing the normal optokinetic suppression of nystagmus. We propose an extension of the previous interpretation based on a recent theory ...ASD have a tendency to focus on the details or parts of an object, scene or idea rather than the whole or gestalt of it (i.e., they fail to see the...Disorders, 30 (2000), 519-524. [17] E.J. Grinter, M.T. Maybery, E. Pellicano, J.C. Badcock, and D.R Badcock, Perception of shapes targeting local and

Complete genome sequence of a clinical Bordetella pertussis isolate from Brazil

Directory of Open Access Journals (Sweden)

Bruno Gabriel N Andrade

2014-11-01

Full Text Available There has been a resurgence in the number of pertussis cases in Brazil and around the world. Here, the genome of a clinical Bordetella pertussis strain (Bz181 that was recently isolated in Brazil is reported. Analysis of the virulence-associated genes defining the pre- and post-vaccination lineages revealed the presence of the prn2-ptxS1A-fim3B-ptxP3 allelic profile in Bz181, which is characteristic of the current pandemic lineage. A putative metallo-β-lactamase gene presenting all of the conserved zinc-binding motifs that characterise the catalytic site was identified, in addition to a multidrug efflux pump of the RND family that could confer resistance to erythromycin, which is the antibiotic of choice for treating pertussis disease.

Test Review: TestDaF

Science.gov (United States)

Norris, John; Drackert, Anastasia

2018-01-01

The Test of German as a Foreign Language (TestDaF) plays a critical role as a standardized test of German language proficiency. Developed and administered by the Society for Academic Study Preparation and Test Development (g.a.s.t.), TestDaF was launched in 2001 and has experienced persistent annual growth, with more than 44,000 test takers in…

Chiropractic management of a patient with benign paroxysmal positional vertigo

DEFF Research Database (Denmark)

Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

2009-01-01

OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year......-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged...

Temporal changes in postural sway caused by ultrashort-acting hypnotics: triazolam and zolpidem.

Science.gov (United States)

Nakamura, M; Ishii, M; Niwa, Y; Yamazaki, M; Ito, H

2005-01-01

Two ultrashort-acting hypnotics, triazolam 0.25 mg and zolpidem 10 mg, were studied for their effects on equilibrium function in humans. Eight healthy male subjects participated in a double-blind, placebo-controlled study after informed consent. They subjected to static equilibrium tests, oculomotor tests and an assay of drug concentrations in the blood. Zolpidem was statistically significant in postural sway in tandem stance test, as defined by parametric values of tracing sum length and polygonal area of foot pressure center measured by a gait analysis system. In the tandem stance test, triazolam was statistically significant in postural sway only as defined by the polygonal area. However, in the Romberg test, the only statistically significant difference in zolpidem use was observed in polygonal area values. Blood concentrations of triazolam and zolpidem were found to closely correlate with the extent of postural sway in both tandem stance and Romberg tests. In this study, zolpidem with minimal muscle-relaxant effect incurred imbalance more extensively than triazolam, which is known for its effect of muscle relaxation. In addition, gaze deviation nystagmus was observed only in zolpidem use in 5 of 8 subjects (62.5%). From these results, it is suggested that in the use of hypnotics, sway derives from the suppression of the central nervous system relevant to awakening rather than from muscle relaxation. The prior reference to blood concentrations of hypnotics should help improve safety care in minimizing loss of balance control and possible fall. Copyright 2005 S. Karger AG, Basel.

Vestibulo-cortical Hemispheric Dominance: the link between Anxiety and the Vestibular System?

Science.gov (United States)

Bednarczuk, Nadja F; Casanovas Ortega, Marta; Fluri, Anne-Sophie; Arshad, Qadeer

2018-05-16

Vestibular processing and anxiety networks are functionally intertwined, as demonstrated by reports of reciprocal influences upon each other. Yet whether there is an underlying link between these two systems remains unknown Previous findings have highlighted the involvement of hemispheric lateralisation in processing of both anxiety and vestibular signals. Accordingly, we explored the interaction between vestibular cortical processing and anxiety by assessing the relationship between anxiety levels and the degree of hemispheric lateralisation of vestibulo-cortical processing in 64 right-handed, healthy individuals. Vestibulo-cortical hemispheric lateralisation was determined by gaging the degree of caloric-induced nystagmus suppression following modulation of cortical excitability using trans-cranial direct current stimulation targeted over the posterior parietal cortex, an area implicated in the processing of vestibular signals. The degree of nystagmus suppression yields an objective biomarker, allowing the quantification of the degree of right vestibulo-cortical hemisphere dominance. Anxiety levels were quantified using the Trait component of the Spielberger State-Trait Anxiety Questionnaire. Our findings demonstrate that the degree of an individual's vestibulo-cortical hemispheric dominance correlates with their anxiety levels. That is, those individuals with greater right hemispheric vestibulo-cortical dominance exhibited lower levels of anxiety. By extension, our results support the notion that hemispheric lateralisation determines an individual's emotional processing, thereby linking cortical circuits involved in processing anxiety and vestibular signals respectively. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Neuro-otological Studies of Patients Suffering from Dizziness with Cerebrospinal Fluid Hypovolemia after Traffic Accident-associated Whiplash Injuries].

Science.gov (United States)

Yokota, Jun-Ichi; Shimoda, Satoe

2015-05-01

Vertigo and dizziness are common clinical manifestations after traffic accident-associated whiplash injury. Recently, Shinonaga et al. (2001) suggested that more than 80% of patients with whiplash injury complaining of these symptoms showed cerebrospinal (CSF) hypovolemia on radioisotope (RI) cisternography (111In-DTPA). However, neuro-otological studies to investigate the pathophysiological mechanisms underlying these symptoms have been insufficient. In the present study, patients complaining of these symptoms with CSF hypovolemia after traffic accidents were investigated with posturography and electronystagmography (ENG). Fourteen patients (4 men, 10 women; 24-52 yr) were examined with posturography and showed parameters (tracking distance & area) significantly (p<0.01) larger than those of healthy subjects. Among them, five cases (1 man, 4 women; 31-52 yr) were further investigated with ENG. The slow phase peak velocities of optokinetic nystagmus (OKN) and optokinetic-after nystagmus (OKAN) were significantly (p<0.01) reduced (62.64±6.9 SD deg/sec, 60.76±10.74 SD deg/sec, respectively) and frequencies of OKN were reduced (139.7±10.75 SD), while the ocular smooth pursuit was relatively preserved. Magnetic resonance images (sagittal view) of these five patients demonstrated the downward displacement of the cerebellar tonsils and flattening of the pons, which are characteristic features of CSF hypovolemia, called "brain sagging." Our results suggest that brain sagging due to CSF hypovolemia impairs vestibular and vestibulocerebellar functions, which may cause dizziness and vertigo.

Spatio-temporal pattern of vestibular information processing after brief caloric stimulation

International Nuclear Information System (INIS)

Marcelli, Vincenzo; Esposito, Fabrizio; Aragri, Adriana; Furia, Teresa; Riccardi, Pasquale; Tosetti, Michela; Biagi, Laura; Marciano, Elio; Di Salle, Francesco

2009-01-01

Processing of vestibular information at the cortical and subcortical level is essential for head and body orientation in space and self-motion perception, but little is known about the neural dynamics of the brain regions of the vestibular system involved in this task. Neuroimaging studies using both galvanic and caloric stimulation have shown that several distinct cortical and subcortical structures can be activated during vestibular information processing. The insular cortex has been often targeted and presented as the central hub of the vestibular cortical system. Since very short pulses of cold water ear irrigation can generate a strong and prolonged vestibular response and a nystagmus, we explored the effects of this type of caloric stimulation for assessing the blood-oxygen-level-dependent (BOLD) dynamics of neural vestibular processing in a whole-brain event-related functional magnetic resonance imaging (fMRI) experiment. We evaluated the spatial layout and the temporal dynamics of the activated cortical and subcortical regions in time-locking with the instant of injection and were able to extract a robust pattern of neural activity involving the contra-lateral insular cortex, the thalamus, the brainstem and the cerebellum. No significant correlation with the temporal envelope of the nystagmus was found. The temporal analysis of the activation profiles highlighted a significantly longer duration of the evoked BOLD activity in the brainstem compared to the insular cortex suggesting a functional de-coupling between cortical and subcortical activity during the vestibular response.

Differences in gaze anticipation for locomotion with and without vision

Science.gov (United States)

Authié, Colas N.; Hilt, Pauline M.; N'Guyen, Steve; Berthoz, Alain; Bennequin, Daniel

2015-01-01

Previous experimental studies have shown a spontaneous anticipation of locomotor trajectory by the head and gaze direction during human locomotion. This anticipatory behavior could serve several functions: an optimal selection of visual information, for instance through landmarks and optic flow, as well as trajectory planning and motor control. This would imply that anticipation remains in darkness but with different characteristics. We asked 10 participants to walk along two predefined complex trajectories (limaçon and figure eight) without any cue on the trajectory to follow. Two visual conditions were used: (i) in light and (ii) in complete darkness with eyes open. The whole body kinematics were recorded by motion capture, along with the participant's right eye movements. We showed that in darkness and in light, horizontal gaze anticipates the orientation of the head which itself anticipates the trajectory direction. However, the horizontal angular anticipation decreases by a half in darkness for both gaze and head. In both visual conditions we observed an eye nystagmus with similar properties (frequency and amplitude). The main difference comes from the fact that in light, there is a shift of the orientations of the eye nystagmus and the head in the direction of the trajectory. These results suggest that a fundamental function of gaze is to represent self motion, stabilize the perception of space during locomotion, and to simulate the future trajectory, regardless of the vision condition. PMID:26106313

Contributing factors to VEP grating acuity deficit and inter-ocular acuity difference in children with cerebral visual impairment.

Science.gov (United States)

Cavascan, Nívea Nunes; Salomão, Solange Rios; Sacai, Paula Yuri; Pereira, Josenilson Martins; Rocha, Daniel Martins; Berezovsky, Adriana

2014-04-01

To investigate contributing factors to visual evoked potential (VEP) grating acuity deficit (GAD) and inter-ocular acuity difference (IAD) measured by sweep-VEPs in children with cerebral visual impairment (CVI). VEP GAD was calculated for the better acuity eye by subtracting acuity thresholds from mean normal VEP grating acuity according to norms from our own laboratory. Deficits were categorized as mild (0.17 ≤ deficit children (66 males-57 %) with ages ranging from 1.2 to 166.5 months (median = 17.7) was examined. VEP GAD ranged from 0.17 to 1.28 log units (mean = 0.68 ± 0.27; median = 0.71), and it was mild in 23 (20 %) children, moderate in 32 (28 %) and severe in 60 (52 %). Severe deficit was significantly associated with older age and anti-seizure drug therapy. IAD ranged from 0 to 0.49 log units (mean = 0.06 ± 0.08; median = 0.04) and was acceptable in 96 (83 %) children. Children with strabismus and nystagmus had IAD significantly larger compared to children with orthoposition. In a large cohort of children with CVI, variable severity of VEP GAD was found, with more than half of the children with severe deficits. Older children and those under anti-seizure therapy were at higher risk for larger deficits. Strabismus and nystagmus provided larger IADs. These results should be taken into account on the clinical management of children with this leading cause of bilateral visual impairment.

Ophthalmic manifestations of methylmalonic aciduria accompanied with homocystinuria

Directory of Open Access Journals (Sweden)

Qiu-Jing Huang

2015-12-01

Full Text Available Methylmalonicaciduia(MMAaccompanied with homocystinuria is a rare autosomal-recessive with congenital metabolic disorder of Vitamin B12. There are three subtypes, cblC, cblD, cblF, in which cblC is the most common one. The diagnostic tests are tandem mass spectrometry and gas chromatography-mass spectrometry. Tests for activity of enzyme in fibroblasts from skin, complementary assay and genetic analysis can be used to make the subtype clear. Early-onset patients, defined by onset of symptoms before the age of 1 year, may have severe ocular involvement, including visual loss, nystagmus, strabismus, retinopathy, maculopathy, optic atrophy, abnormal electroretinography. Late-onset patients, defined by onset of symptoms after the age of 4 year, rarely have ocular manifestations. The pathogenesis of the ophthalmic symptoms may be related to the high level of homocystine, oxidative stress and the abnormal development of nervous systems. The treatment for MMA accompanied with homocystinuria is mostly symptomatic based. Ophthalmic treatment is limited. Early supplement of methionine,GSH or other antioxidants may be helpful for retinopathy. There is no standard ophthalmological examination for those patients in China. It is critical to set up inter-departmental cooperation and early stage examination for the treatments and outcomes of the patients.

New Data on Vaccine Antigen Deficient Bordetella pertussis Isolates

Directory of Open Access Journals (Sweden)

Valérie Bouchez

2015-09-01

Full Text Available Evolution of Bordetella pertussis is driven by natural and vaccine pressures. Isolates circulating in regions with high vaccination coverage present multiple allelic and antigenic variations as compared to isolates collected before introduction of vaccination. Furthermore, during the last epidemics reported in regions using pertussis acellular vaccines, isolates deficient for vaccine antigens, such as pertactin (PRN, were reported to reach high proportions of circulating isolates. More sporadic filamentous hemagglutinin (FHA or pertussis toxin (PT deficient isolates were also collected. The whole genome of some recent French isolates, deficient or non-deficient in vaccine antigens, were analyzed. Transcription profiles of the expression of the main virulence factors were also compared. The invasive phenotype in an in vitro human tracheal epithelial (HTE cell model of infection was evaluated. Our genomic analysis focused on SNPs related to virulence genes known to be more likely to present allelic polymorphism. Transcriptomic data indicated that isolates circulating since the introduction of pertussis vaccines present lower transcription levels of the main virulence genes than the isolates of the pre-vaccine era. Furthermore, isolates not producing FHA present significantly higher expression levels of the entire set of genes tested. Finally, we observed that recent isolates are more invasive in HTE cells when compared to the reference strain, but no multiplication occurs within cells.

Comparative clinical characteristics of neuromyelitis optica spectrum disorders with and without medulla oblongata lesions.

Science.gov (United States)

Wang, Yanqiang; Zhang, Lei; Zhang, Bingjun; Dai, Yongqiang; Kang, Zhuang; Lu, Ciyong; Qiu, Wei; Hu, Xueqiang; Lu, Zhengqi

2014-05-01

Brainstem involvement, especially the medulla oblongata (MO), has been reported in neuromyelitis optica spectrum disorders (NMOSDs). The purpose of this study was to investigate retrospectively and compare clinical, laboratory, and imaging features of NMOSDs with and without MO lesions. A total of 170 patients with NMOSDs were enrolled, including 44 patients with MO lesions and 126 patients without MO lesions. Clinical features, laboratory tests, and magnetic resonance imaging findings among these patients were assessed. MO lesions were found in 25.9 % of the NMOSDs patients. The mean duration was 13 months. Patients with MO lesions had a higher Annualized relapse rate and Expanded Disability Status Score Scale. Headache, dizziness, nystagmus, dysarthria, intractable hiccup and nausea, choking cough or dysphagia, movement disorders, and neuropathic pain were more common in MO lesion patients. Patients with MO lesions were more frequently complicated with thyroid diseases. Multiple brain involvement, More importantly, Longitudinally extensive transverse myelitis were more frequently found in patients with MO lesions. MO lesions might be a symbol of more severe neurologic deficits and worse prognosis of NMOSDs.

Tale of two rare diseases

Directory of Open Access Journals (Sweden)

Ravindra Shukla

2013-01-01

Full Text Available Idiopathic Hypogonadotropic hypogonadism (IHH phenotype is variable & various genes have been decribed in association with IHH.We describe association of IHH with mosaic trisomy 13. A 20 year old male presented with lack of development of secondary sexual characters, normal height, micropenis, small testes, gynaecomastia, absence of axillary and pubic hairs, hyposmia,synkinesis, bilateral horizontal nystagmus and high arched palate. Investigations showed low gonadotropin,low total testosterone, LH after stimulation with 100 mcg tryptorelin sc was 11.42 mU/mL at 40 min. MRI of hypothalamo-pituitary region showed normal olfactory bulb and tract but shallow olfactory sulcus . Karyotype showed homologous Robertsonian translocation of chromosome 13. This case fits classical IHH except for LH rise on stimulation.Features of Patau syndrome which is associated with trisomy 13 are absent in our case. Mosaic trisomy 13, which can otherwise be rare incidental finding , has not been described in association with IHH.Causal association of novel mutation on chromosome 13 leading to aforementioned phenotype cannot be rule out.

Spinocerebellar ataxia-10 with paranoid schizophrenia

Directory of Open Access Journals (Sweden)

Bhavesh Trikamji

2015-01-01

Full Text Available Spino-cerebellar ataxia type 10 (SCA10 is an autosomal dominant disorder that is characterized by cerebellar ataxia, seizures and nystagmus with a fragmented pursuit. Schizophrenia has been reported with SCAs 1 and 2 yet in SCA 10, psychiatric manifestations are uncommon. We report a Hispanic family involving a father and his four children with SCA10 genetic mutation. Two of his children, a 20-year-old female and a 23-year-old male, presented with gradually progressive spino-cerebellar ataxia and paranoid schizophrenia. Neurological examination revealed ocular dysmetria, dysdiadokinesia, impaired finger-to-nose exam, gait ataxia and hyperreflexia in both the cases. Additionally, they had a history of psychosis with destructive behavior, depression and paranoid delusions with auditory hallucinations. Serology and CSF studies were unremarkable and MRI brain revealed cerebellar volume loss. Ultimately, a test for ATAXIN-10 mutation was positive thus confirming the diagnosis of SCA10 in father and his four children. We now endeavor to investigate the association between schizophrenia and SCA10.

Decree 2006-265/PRN of 18 August 2006 fixing the modalities of mining law application

International Nuclear Information System (INIS)

2006-01-01

This decree fixes modalities of applying ordinance 93-16 of 2 march 1993 concerning mining law in Niger Republic and its subsequent modified text. Any petitioner, owner of mining title, prospecting authorization, opening and mining quarry, sub-leaser shall have an office in Niger Republic and notify it to the Minister of Mines and energy. each licence or lease is based on an agreement between the government and the society. Any change of status, capital or personnel of the company shall be noted to the Minister of Mines and energy. The company shall pay fiscal duties and respect rules and regulations concerning mines and quarries health and safety [fr

UPTF test 21D counterpart test in the MIDAS test facility

International Nuclear Information System (INIS)

Yoon, B. C.; Ah, D. J.; Joo, I. C.; Kwon, T. S.; Park, W. M.; Song, C. H.

2002-01-01

This paper describes the experimental results of UPTF Test 21D counterpart tests in the downcomer during the late reflood phase of LBLOCA. The experiments have been performed in the MIDAS test facility using superheated steam and water. The test condition was determined,based on the test results of UPTF Test 21D, by applying the 'modified linear scaling method of 1/4.077 length scale. The tests of ECC direct bypass and void height are performed separately to estimate each phenomena quantitatively. The tests were carried out by varying the injection steam flow rate of intact cold legs widely to investigate the effect of steam flow rate on the direct bypass fraction and void height. In the tests, separate effect tests have been performed in cases of DVI-1,DVI- 2 and DVI-1 and 2 injections to see the direct bypass fraction according to the DVI nozzle combination. From the tests, we found that the fraction of direct ECC bypass and the void height observed in the MIDAS test facility reasonably well agree with those of UPTF test 21- D. It confirms that the applied 'modified linear scaling law' reproduces major thermal hydraulics phenomena in the downcomer during the LBLOCA reflood phase

High-Accuracy Global Time and Frequency Transfer with a Space-Borne Hydrogen Maser Clock

Science.gov (United States)

1982-12-01

of t h e s p a c e c l o c k is modu la t ed on t h e c l o c k downl ink car r ie r using PRN p h a s e modula- t i o n (5). The s p a...is t o a c c o u n t f o r r e la t i s t i c e f f e c t s w i t h i n a f r a c t i o n a l f r e q u e n c y error of 0 . T h i s r...Mockler , and J . M . R ichardson , Metrologia , 1, p. 114, 1965. ( 1 3 ) Glaze, D . J . , Helmut Hellwig, Steve J a r v i s , J r . , A

Changing paradigms of anti-VEGF in the Indian scenario

Directory of Open Access Journals (Sweden)

P Mahesh Shanmugam

2014-01-01

Full Text Available Anti-vascular endothelial growth factors (VEGF agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.

Test report: Electron-proton spectrometer qualification test unit, qualification test

Science.gov (United States)

Vincent, D. L.

1972-01-01

Qualification tests of the electron-proton spectrometer test unit are presented. The tests conducted were: (1) functional, (2) thermal/vacuum, (3) electromagnetic interference, (4) acoustic, (5) shock, (6) vibration, and (7) humidity. Results of each type of test are presented in the form of data sheets.

Albinism: particular attention to the ocular motor system.

Science.gov (United States)

Hertle, Richard W

2013-01-01

The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.

An Expanded Multi-Organ Disease Phenotype Associated with Mutations in YARS

DEFF Research Database (Denmark)

Tracewska-Siemiątkowska, Anna; Haer-Wigman, Lonneke; Bosch, Danielle G M

2017-01-01

Whole exome sequence analysis was performed in a Swedish mother-father-affected proband trio with a phenotype characterized by progressive retinal degeneration with congenital nystagmus, profound congenital hearing impairment, primary amenorrhea, agenesis of the corpus callosum, and liver disease....... A homozygous variant c.806T > C, p.(F269S) in the tyrosyl-tRNA synthetase gene (YARS) was the only identified candidate variant consistent with autosomal recessive inheritance. Mutations in YARS have previously been associated with both autosomal dominant Charcot-Marie-Tooth syndrome and a recently reported...

Leopard spot retinal pigmentation in infancy indicating a peroxisomal disorder.

Science.gov (United States)

Lyons, C J; Castano, G; McCormick, A Q; Applegarth, D

2004-02-01

Neonatal adrenoleucodystrophy (NALD) is a rare disorder resulting from abnormal peroxisomal biogenesis. Affected patients present in infancy with developmental delay, hypotonia, and seizures. Blindness and nystagmus are prominent features. The authors suggest a characteristic leopard spot pigmentary pattern in the peripheral retina to be diagnostic. Three patients are reported with this presentation; the characteristic retinal appearance resulted in early diagnosis for one of these. Leopard spot retinopathy in an infant with hypotonia, seizures, developmental delay, with or without dysmorphic features and hearing impairment, is a clue to the diagnosis of NALD.

Computer-Based Testing: Test Site Security.

Science.gov (United States)

Rosen, Gerald A.

Computer-based testing places great burdens on all involved parties to ensure test security. A task analysis of test site security might identify the areas of protecting the test, protecting the data, and protecting the environment as essential issues in test security. Protecting the test involves transmission of the examinations, identifying the…

SLC45A2 mutation frequency in Oculocutaneous Albinism Italian patients doesn't differ from other European studies.

Science.gov (United States)

Mauri, Lucia; Barone, Luca; Al Oum, Muna; Del Longo, Alessandra; Piozzi, Elena; Manfredini, Emanuela; Stanzial, Franco; Benedicenti, Francesco; Penco, Silvana; Patrosso, Maria Cristina

2014-01-01

Oculocutaneous Albinism (OCA) is a heterogeneous group of inherited diseases involving hair, skin and eyes. To date, six forms are recognized on the effects of different melanogenesis genes. OCA4 is caused by mutations in SLC45A2 showing a heterogeneous phenotype ranging from white hair, blue irides and nystagmus to brown/black hair, brown irides and no nystagmus. The high clinic variety often leads to misdiagnosis. Our aim is to contribute to OCA4 diagnosis defining SLC45A2 genetic variants in Italian patients with OCA without any TYR, OCA2 and TYRP1 gene defects. After the clinical diagnosis of OCA, all patients received genetic counseling and genetic test. Automatic sequencing of TYR, OCA2, and TYRP1 genes was performed on DNA of 117 albino patients. Multiplex Ligation-dependent Probe Amplification (MLPA) was carried out on TYR and OCA2 genes to increase the mutation rate. SLC45A2 gene sequencing was then executed in the patients with a single mutation in one of the TYR, OCA2, TYRP1 genes and in the patients, which resulted negative at the screening of these genes. SLC45A2 gene analysis was performed in 41 patients and gene alterations were found in 5 patients. Four previously reported SLC45A2 mutations were found: p.G100S, p.W202C, p.A511E and c.986delC, and three novel variants were identified: p.M265L, p.H94D, and c.1156+1G>A. All the alterations have been detected in the group of patients without mutations in the other OCA genes. Three new variants were identified in OCA4 gene; the analysis allowed the classification of a patient previously misdiagnosed as OA1 because of skin and hair pigmentation presence. The molecular defects in SLC45A2 gene represent the 3.4% in this cohort of Italian patients, similar to other Caucasian populations; our data differ from those previously published by an Italian researcher group, obtained on a smaller cohort of patients. © 2013 Elsevier B.V. All rights reserved.

Oculocutaneous albinism

Directory of Open Access Journals (Sweden)

Brondum-Nielsen Karen

2007-11-01

Full Text Available Abstract Oculocutaneous albinism (OCA is a group of inherited disorders of melanin biosynthesis characterized by a generalized reduction in pigmentation of hair, skin and eyes. The prevalence of all forms of albinism varies considerably worldwide and has been estimated at approximately 1/17,000, suggesting that about 1 in 70 people carry a gene for OCA. The clinical spectrum of OCA ranges, with OCA1A being the most severe type with a complete lack of melanin production throughout life, while the milder forms OCA1B, OCA2, OCA3 and OCA4 show some pigment accumulation over time. Clinical manifestations include various degrees of congenital nystagmus, iris hypopigmentation and translucency, reduced pigmentation of the retinal pigment epithelium, foveal hypoplasia, reduced visual acuity usually (20/60 to 20/400 and refractive errors, color vision impairment and prominent photophobia. Misrouting of the optic nerves is a characteristic finding, resulting in strabismus and reduced stereoscopic vision. The degree of skin and hair hypopigmentation varies with the type of OCA. The incidence of skin cancer may be increased. All four types of OCA are inherited as autosomal recessive disorders. At least four genes are responsible for the different types of the disease (TYR, OCA2, TYRP1 and MATP. Diagnosis is based on clinical findings of hypopigmentation of the skin and hair, in addition to the characteristic ocular symptoms. Due to the clinical overlap between the OCA forms, molecular diagnosis is necessary to establish the gene defect and OCA subtype. Molecular genetic testing of TYR and OCA2 is available on a clinical basis, while, at present, analysis of TYRP1 and MATP is on research basis only. Differential diagnosis includes ocular albinism, Hermansky-Pudlak syndrome, Chediak-Higashi syndrome, Griscelli syndrome, and Waardenburg syndrome type II. Carrier detection and prenatal diagnosis are possible when the disease causing mutations have been

Accuracy Analysis of a Box-wing Theoretical SRP Model

Science.gov (United States)

Wang, Xiaoya; Hu, Xiaogong; Zhao, Qunhe; Guo, Rui

2016-07-01

For Beidou satellite navigation system (BDS) a high accuracy SRP model is necessary for high precise applications especially with Global BDS establishment in future. The BDS accuracy for broadcast ephemeris need be improved. So, a box-wing theoretical SRP model with fine structure and adding conical shadow factor of earth and moon were established. We verified this SRP model by the GPS Block IIF satellites. The calculation was done with the data of PRN 1, 24, 25, 27 satellites. The results show that the physical SRP model for POD and forecast for GPS IIF satellite has higher accuracy with respect to Bern empirical model. The 3D-RMS of orbit is about 20 centimeters. The POD accuracy for both models is similar but the prediction accuracy with the physical SRP model is more than doubled. We tested 1-day 3-day and 7-day orbit prediction. The longer is the prediction arc length, the more significant is the improvement. The orbit prediction accuracy with the physical SRP model for 1-day, 3-day and 7-day arc length are 0.4m, 2.0m, 10.0m respectively. But they are 0.9m, 5.5m and 30m with Bern empirical model respectively. We apply this means to the BDS and give out a SRP model for Beidou satellites. Then we test and verify the model with Beidou data of one month only for test. Initial results show the model is good but needs more data for verification and improvement. The orbit residual RMS is similar to that with our empirical force model which only estimate the force for along track, across track direction and y-bias. But the orbit overlap and SLR observation evaluation show some improvement. The remaining empirical force is reduced significantly for present Beidou constellation.

Testing Practices and Attitudes Toward Tests and Testing: An International Survey

Czech Academy of Sciences Publication Activity Database

Evers, A.; McCormick, C. M.; Hawley, L. R.; Muñiz, J.; Balboni, G.; Bartram, D.; Boben, D.; Egeland, J.; El-Hassan, K.; Fernández-Hermida, J.R.; Fine, S.; Frans, Ö.; Gintiliéne, G.; Hagemeister, C.; Halama, P.; Iliescu, D.; Jaworowska, A.; Jiménez, P.; Manthouili, M.; Matesic, K.; Michaelsen, L.; Mogaji, A.; Morley-Kirk, J.; Rózsa, S.; Rowlands, L.; Schittekatte, M.; Sümer, H.C.; Suwartono, T.; Urbánek, Tomáš; Wechsler, S.; Zelenevska, T.; Zanev, S.; Zhang, J.

2017-01-01

Roč. 17, č. 2 (2017), s. 158-190 ISSN 1530-5058 Institutional support: RVO:68081740 Keywords : psychological testing * testing practices * test use * International Test Commission * European Federation of Psychologists' Associations Subject RIV: AN - Psychology OBOR OECD: Psychology (including human - machine relations)

Learning software testing with Test Studio

CERN Document Server

Madi, Rawane

2013-01-01

Learning Software Testing with Test Studio is a practical, hands-on guide that will help you get started with Test Studio to design your automated solution and tests. All through the book, there are best practices and tips and tricks inside Test Studio which can be employed to improve your solution just like an experienced QA.If you are a beginner or a professional QA who is seeking a fast, clear, and direct to the point start in automated software testing inside Test Studio, this book is for you. You should be familiar with the .NET framework, mainly Visual Studio, C#, and SQL, as the book's

Energy Systems Test Area (ESTA) Battery Test Operations User Test Planning Guide

Science.gov (United States)

Salinas, Michael

2012-01-01

Test process, milestones and inputs are unknowns to first-time users of the ESTA Battery Test Operations. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Open test assembly (OTA) shear demonstration testing work/test plan

International Nuclear Information System (INIS)

Hiller, S.W.

1998-01-01

This document describes the development testing phase associated with the OTA Shear activity and defines the controls to be in place throughout the testing. The purpose of the OTA Shear Program was to provide equipment that is needed for the processing of 40 foot long, sodium wetted, irradiated core components previously used in the FFTF reactor to monitor fuel and materials tests. There are currently 15 of these OTA test stalks located in the Test Assembly Conditioning Station (TACS) inerted vault. These need to be dispositioned for a shutdown mission to eliminate this highly activated, high dose inventory prior to turnover to the ERC since they must be handled by remote operations. These would also need to be dispositioned for a restart mission to free up the vault they currently reside in. The waste handling and cleaning equipment in the J33M Cell was designed and built for the handling of reactor components up to the standard 12 foot length. This program will provide the equipment to the IEM Cell to remotely section the OTAS into pieces less than 12 feet in length to allow for the necessary handling and cleaning operations required for proper disposition. Due to the complexity of all operations associated with remote handling, the availability of the IEM Cell training facility, and the major difficulty with reworking contaminated equipment, it was determined that preliminary testing of the equipment was desirable, This testing activity would provide the added assurance that the equipment will operate as designed prior to performance of the formal Acceptance Test Procedure (ATP) at the IEM Cell, This testing activity will also allow for some operator familiarity and procedure checkout prior to actual installation into the IEM Cell. This development testing will therefore be performed at the conclusion of equipment fabrication and prior to transfer of the equipment to the 400 Area

Underground Nuclear Testing Program, Nevada Test Site

International Nuclear Information System (INIS)

1975-09-01

The Energy Research and Development Administration (ERDA) continues to conduct an underground nuclear testing program which includes tests for nuclear weapons development and other tests for development of nuclear explosives and methods for their application for peaceful uses. ERDA also continues to provide nuclear explosive and test site support for nuclear effects tests sponsored by the Department of Defense. This Supplement extends the Environmental Statement (WASH-1526) to cover all underground nuclear tests and preparations for tests of one megaton (1 MT) or less at the Nevada Test Site (NTS) during Fiscal Year 1976. The test activities covered include numerous continuing programs, both nuclear and non-nuclear, which can best be conducted in a remote area. However, if nuclear excavation tests or tests of yields above 1 MT or tests away from NTS should be planned, these will be covered by separate environmental statements

To test or not to test

DEFF Research Database (Denmark)

Rochon, Justine; Gondan, Matthias; Kieser, Meinhard

2012-01-01

Background: Student's two-sample t test is generally used for comparing the means of two independent samples, for example, two treatment arms. Under the null hypothesis, the t test assumes that the two samples arise from the same normally distributed population with unknown variance. Adequate...... control of the Type I error requires that the normality assumption holds, which is often examined by means of a preliminary Shapiro-Wilk test. The following two-stage procedure is widely accepted: If the preliminary test for normality is not significant, the t test is used; if the preliminary test rejects...... the null hypothesis of normality, a nonparametric test is applied in the main analysis. Methods: Equally sized samples were drawn from exponential, uniform, and normal distributions. The two-sample t test was conducted if either both samples (Strategy I) or the collapsed set of residuals from both samples...

The Role of Attention in Binocular Rivalry as Revealed through Optokinetic Nystagmus.

Science.gov (United States)

1995-11-01

break down selectively when parts of the stri- ate and prestriate cortex is damaged. Speci cally, a group of patients su ering fromApperceptive Agnosia ...1981). Visual performance in cases of visual agnosia . In M. van- Ho , & G. Hohn (Eds.), Functional recovery from brain damage (pp. 275{286...macaques. Nature, 373, 609{611. Breese, B. (1899). On inhibition. Psychol.Rev., 3, 1{65. Campion, J., & Latto, R. (1985). Apperceptive agnosia due to

Emergency Physician Attitudes, Preferences, and Risk Tolerance for Stroke as a Potential Cause of Dizziness Symptoms

Directory of Open Access Journals (Sweden)

Mamata V. Kene

2015-10-01

Full Text Available Introduction: We evaluated emergency physicians’ (EP current perceptions, practice, and attitudes towards evaluating stroke as a cause of dizziness among emergency department patients. Methods: We administered a survey to all EPs in a large integrated healthcare delivery system. The survey included clinical vignettes, perceived utility of historical and exam elements, attitudes about the value of and requisite post-test probability of a clinical prediction rule for dizziness. We calculated descriptive statistics and post-test probabilities for such a clinical prediction rule. Results: The response rate was 68% (366/535. Respondents’ median practice tenure was eight years (37% female, 92% emergency medicine board certified. Symptom quality and typical vascular risk factors increased suspicion for stroke as a cause of dizziness. Most respondents reported obtaining head computed tomography (CT (74%. Nearly all respondents used and felt confident using cranial nerve and limb strength testing. A substantial minority of EPs used the Epley maneuver (49% and HINTS (head-thrust test, gaze-evoked nystagmus, and skew deviation testing (30%; however, few EPs reported confidence in these tests’ bedside application (35% and 16%, respectively. Respondents favorably viewed applying a properly validated clinical prediction rule for assessment of immediate and 30-day stroke risk, but indicated it would have to reduce stroke risk to <0.5% to be clinically useful. Conclusion: EPs report relying on symptom quality, vascular risk factors, simple physical exam elements, and head CT to diagnose stroke as the cause of dizziness, but would find a validated clinical prediction rule for dizziness helpful. A clinical prediction rule would have to achieve a 0.5% post-test stroke probability for acceptability.

Tests in Print II: An Index to Tests, Test Reviews, and the Literature on Specific Tests.

Science.gov (United States)

Buros, Oscar K., Ed.

Tests in Print II is a comprehensive, annotated bibliography of all in-print tests published as separates for use with English-speaking subjects. The 1,155 two-column pages list 2,467 tests in print as of early 1974; 16,574 references through 1971 on specific tests; a reprinting of the 1974 APA-AERA-NCME Standards for Educational andPsychological…

Visual acuity loss associated with excessive “dry macula” in exudative age-related macular degeneration

Directory of Open Access Journals (Sweden)

Takahashi H

2018-02-01

Full Text Available Hidenori Takahashi,1–3 Yuji Inoue,1,2 Xue Tan,2,3 Satoru Inoda,1 Shinichi Sakamoto,1 Yusuke Arai,1 Yasuo Yanagi,4–6 Yujiro Fujino,2,3 Hidetoshi Kawashima1 1Department of Ophthalmology, Jichi Medical University, Shimotsuke, 2Department of Ophthalmology, The University of Tokyo, Bunkyo, 3Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Shinjuku, Japan; 4Medical Retina, Singapore National Eye Centre, 5Medical Retina, Singapore Eye Research Institute, 6Eye-ACP, Duke NUS Medical School, National University of Singapore, Singapore Purpose: To investigate the correlation between visual acuity and central macular thickness (CMT and choroidal thickness (CCT in patients with wet age-related macular degeneration (AMD. Methods: In this retrospective analysis, 14 eyes that received >10 ranibizumab injections (based on pro re nata [PRN] regimen and maintained initial visual acuity gain were analyzed. The following 5 parameters were measured at the foveal center: CMT (distance from the inner limiting membrane [ILM] to Bruch’s membrane; central retinal thickness (CRT; distance from the ILM to the inner limit of the retinal pigment epithelium or subretinal fluid [SRF]; SRF thickness (SRFT; pigment epithelium detachment thickness (PEDT; and CCT. The correlation between the logarithm of the minimum angle of resolution (logMAR best-corrected visual acuity (BCVA and the 5 parameters was examined with generalized estimating equations. Results: CMT, CRT, and CCT were negatively correlated with logMAR BCVA (P=0.031, 0.023, and 0.036, respectively when only CMT values less than the thickness that maximized visual acuity for each eye were used for the analysis. Each 100-µm reduction in CMT, CRT, or CCT improved logMAR BCVA by -0.1, -0.08, or -0.07, respectively. SRFT and PEDT were not correlated with BCVA. The median CMT that maximized the visual acuity was 230 µm. Conclusion: Dry macula with CMT <230 µm was

Analysis of opioid-mediated analgesia in Phase III studies of methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain

Directory of Open Access Journals (Sweden)

Webster LR

2015-10-01

Full Text Available Lynn R Webster,1 Darren M Brenner,2 Andrew C Barrett,3 Craig Paterson,3 Enoch Bortey,3 William P Forbes3 1PRA Health Sciences, Salt Lake City, UT, 2Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 3Salix, a Division of Valeant Pharmaceuticals North America LLC, Bridgewater, NJ, USA Background: Subcutaneous methylnaltrexone is efficacious and well tolerated for opioid-induced constipation (OIC but may theoretically disrupt opioid-mediated analgesia. Methods: Opioid use, pain intensity, and opioid withdrawal (Objective Opioid Withdrawal Scale [OOWS] and Subjective Opiate Withdrawal Scale [SOWS] scores were reported in a randomized, double-blind trial with an open-label extension (RCT and an open-label trial (OLT evaluating safety in adults with chronic noncancer pain. In the RCT, patients taking ≥50 mg of oral morphine equivalents daily with <3 rescue-free bowel movements weekly received methylnaltrexone 12 mg once daily (n=150, every other day (n=148, or placebo (n=162 for 4 weeks, followed by open-label methylnaltrexone 12 mg (as needed [prn]; n=364 for 8 weeks. In the OLT, patients (n=1,034 on stable opioid doses with OIC received methylnaltrexone 12 mg prn for up to 48 weeks. Results: Minimal fluctuations of median morphine equivalent dose from baseline (BL were observed in the RCT double-blind period (BL, 154.8–161.0 mg/d; range, 137.1–168.0 mg/d, RCT open-label period (BL, 156.3–174.6; range, 144.0–180.0 and OLT (BL, 120 mg/d; range, 117.3–121.1 mg/d. No significant change from BL in pain intensity score occurred in any group at weeks 2 or 4 (both P≥0.1 of the RCT double-blind period, and scores remained stable during the open-label period and in the OLT (mean change, —0.2 to 0.1. Changes from BL in OOWS and SOWS scores during the double-blind period were not significantly impacted by methylnaltrexone exposure at weeks 2 or 4 (P>0.05 for all. Conclusion: Methylnaltrexone did not affect

Pigment epithelial detachment followed by retinal cystoid degeneration leads to vision loss in treatment of neovascular age-related macular degeneration.

Science.gov (United States)

Schmidt-Erfurth, Ursula; Waldstein, Sebastian M; Deak, Gabor-Gyoergy; Kundi, Michael; Simader, Christian

2015-04-01

Intravitreal antiangiogenic therapy is the major therapeutic breakthrough in neovascular age-related macular degeneration (AMD). Optical coherence tomography (OCT) is the leading diagnostic tool, but solid criteria for optimal therapeutic outcomes are lacking. A comprehensive analysis of structure/function correlations using Food and Drug Administration- and European Medicines Agency-approved substances and fixed and flexible regimens was performed. Post hoc analysis of a prospective, randomized multicenter clinical trial including 189 study sites. A total of 1240 patients with active neovascular AMD. Participants received intravitreal ranibizumab or aflibercept. A fixed regimen was used for 48 weeks followed by a flexible regimen until week 96. At monthly intervals, best-corrected visual acuity (BCVA) was measured and retinal morphology was assessed by standardized OCT, including intraretinal cysts (IRCs), subretinal fluid (SRF), and pigment epithelial detachment (PED), presenting with a width ≥400 μm or a height of ≥200 μm. Results were correlated for each regimen, feature, and time. The BCVA outcomes in relation to retinal pathomorphology based on noninferiority for all treatment arms. In neovascular AMD, only IRC at baseline and persistent through week 12 had a negative impact on BCVA. With therapeutic intervention, exudative features such as IRC and SRF resolved rapidly in 74% of eyes, whereas PED responded only slowly with 38%. Independent of the type of regimen, fixed or flexible, retinal morphology correlated tightly with visual function. Intraretinal cysts consistently showed the lowest BCVA gains with either regimen or substance. With the switch from a fixed to a flexible pro re nata (PRN) regimen, progressive visual loss occurred exclusively in the group with primary PED presenting as the hallmark of neovascular activity and was induced by secondary formation of IRC in the neurosensory retina. The efficacy of antiangiogenic therapy in neovascular

Electrical and electrochemical properties of architectured electrodes based on perovskite and A2MO4-type oxides for Protonic Ceramic Fuel Cell

International Nuclear Information System (INIS)

Batocchi, P.; Mauvy, F.; Fourcade, S.; Parco, M.

2014-01-01

Two mixed ionic-electronic conducting oxides (MIEC) have been investigated as potential cathode materials for protonic ceramic fuel cell (PCFC): the perovskite Ba 0.5 Sr 0.5 Co 0.8 Fe 0.2 O 3-δ (BSCF) and the Ruddlesden Popper Pr 2 NiO 4+δ (PrN). Their electrical properties have been studied over a large range of water vapour partial pressure. All compounds exhibit high electronic conductivities (σ ≥ 40 S.cm −1 at 600 °C) whatever the pH 2 O of the surrounding atmosphere. Electrochemical characterizations have been performed as a function of pH 2 O, under zero dc conditions and under dc polarization using symmetrical cells based on BaCe 0.9 Y 0.1 O 3-δ (BCY10) as electrolyte. For this purpose, two electrode architectures have been elaborated: a single phase electrode and a composite cathode/BCY10 architectured electrode. All electrodes showed pH 2 O-dependence with promising polarization resistance values lower than 0.8 Ω cm 2 at 600 °C under air whatever the gas humidification rate. The use of architectured electrodes led to a significant decrease of the polarization resistance with values as low as 0.23 and 0.19 Ω cm 2 for PrN and BSCF respectively, at 600 °C and pH 2 O = 0.20 bar. Concerning the oxygen reduction reaction (ORR) mechanisms, rate determining steps involving protons have been identified. They have been respectively assigned to the proton interface transfer and to the water formation and/or desorption for single phase and architectured electrodes. This change has been attributed to an extent of the electrochemically active area and to an enhancement of the protonic transport properties in the architectured electrodes. However electrodes performances seem to be governed by the dissociative adsorption of oxygen species and/or the charge transfer. Concerning performances under dc current, cathodic polarization is reduced when architectured electrodes are used. An enhancement of the electrodes performances has been also evidenced with water

Tractor accelerated test on test rig

Directory of Open Access Journals (Sweden)

M. Mattetti

2013-09-01

Full Text Available The experimental tests performed to validate a tractor prototype before its production, need a substantial financial and time commitment. The tests could be reduced using accelerated tests able to reproduce on the structural part of the tractor, the same damage produced on the tractor during real life in a reduced time. These tests were usually performed reproducing a particular harsh condition a defined number of times, as for example using a bumpy road on track to carry out the test in any weather condition. Using these procedures the loads applied on the tractor structure are different with respect to those obtained during the real use, with the risk to apply loads hard to find in reality. Recently it has been demonstrated how, using the methodologies designed for cars, it is possible to also expedite the structural tests for tractors. In particular, automotive proving grounds were recently successfully used with tractors to perform accelerated structural tests able to reproduce the real use of the machine with an acceleration factor higher than that obtained with the traditional methods. However, the acceleration factor obtained with a tractor on proving grounds is in any case reduced due to the reduced speed of the tractors with respect to cars. In this context, the goal of the paper is to show the development of a methodology to perform an accelerated structural test on a medium power tractor using a 4 post test rig. In particular, several proving ground testing conditions have been performed to measure the loads on the tractor. The loads obtained were then edited to remove the not damaging portion of signals, and finally the loads obtained were reproduced in a 4 post test rig. The methodology proposed could be a valid alternative to the use of a proving ground to reproduce accelerated structural tests on tractors.

Formal Functional Test Designs: Bridging the Gap Between Test Requirements and Test Specifications

Science.gov (United States)

Hops, Jonathan

1993-01-01

This presentation describes the testing life cycle, the purpose of the test design phase, and test design methods and gives an example application. Also included is a description of Test Representation Language (TRL), a summary of the language, and an example of an application of TRL. A sample test requirement and sample test design are included.

The role of temporomandibular joint dysfunction and occlusal disorders in the pathophysiology of somatogenic cochlear and vestibular syndrome

Directory of Open Access Journals (Sweden)

A. V. Boldin

2016-01-01

Full Text Available Rationale: Temporomandibular joint (TMJ dysfunction and occlusion abnormalities can cause cochlear and vestibular disorders. This issue is at the crossroads of several disciplines: otoneurology, physiotherapy, dentistry, medical rehabilitation and posturology, which often makes it difficult to timely diagnose them and delays the onset of treatment. Aim: To assess the role of abnormal dental occlusion and TMJ disorders in the pathophysiology and clinical manifestation of cochleovestibular syndrome. Materials and methods: We examined 300 subjects with clinical signs of cochleovestibular syndrome, asymmetry of occlusion and/or TMJ dysfunction (the main group, 55 patients with signs of TMJ structural and functional disorders and occlusal disorders without a cochleovestibular syndrome (the reference group, and 35 healthy volunteers (the control group. All patients were examined by a neurologist, an ENT specialist, a dentist and a physiotherapist. A series of additional investigations of the brachiocephalic vessels, cervical spine, TMJ, auditory and vestibular function, premature tooth contacts were performed. Results: The main group patients had high values of TMJ dysfunction in the Hamburg test (5.85 vs 2.2 in the reference group and higher proportions of patients with moderate and severe TMJ dysfunction (n = 243, 81% and n = 13, 23.7%, respectively. The functional muscle test parameters and the results of manual muscle testing in the main group patients were significantly different from those in the control group (р < 0.05, whereas most values obtained in the reference group did not differ significantly (р > 0.05. Patients with cochleoves-tibular syndrome had 2 to 3-fold higher rates of vertebrogenic dysfunctions than those from the reference group. The video nystamography technique detected the positional cervical nystagmus in 100% (n = 300 of patients from the main group, whereas there were no nystagmus in those from the reference group

Are there any disturbances in vestibular organ of children and young adults with Type I diabetes?

Science.gov (United States)

Gawron, W; Pospiech, L; Orendorz-Fraczkowska, K; Noczynska, A

2002-05-01

The aim of the work was to evaluate the vestibular organ condition in children and young adults suffering from Type I (insulin-dependent) diabetes mellitus. The group examined consisted of 95 children and young adults aged from 6 to 28 years with Type I diabetes diagnosed. The diabetic group was divided into subgroups according to duration of the disease, compensation of the disease, and presence and character of hypoglycaemic incidents, and presence of diabetic complications. The control group consisted of 44 healthy children and young adults aged 6 to 28 years. After collecting detailed medical history in each case an electronystagmographic test was performed using the computed two-canal electronystagmographer. Within the diabetic group 6 patients complained about vertigo and balance disorders. Spontaneous nystagmus occurred in 10 cases, positional one in 21 cases. Impaired optokinesis occurred in 36 cases and impaired eye tracking test in 33 cases. In caloric tests there was partial canal paresis in 4 cases and directional preponderance in 7 cases. Metabolic disturbances present in Type I diabetes cause disturbances in different parts of vestibular organ but mostly in its central part. Comparing disturbances in the vestibular organ with clinical and biochemical parameters characterising diabetes, the range of vestibular organ impairment in diabetes mellitus type 1 seems to depend mainly on the presence and character of hypoglycaemic incidents and the duration of the disease and to some extent on the compensation of diabetes.

CANFLEX fuel bundle strength tests (test report)

International Nuclear Information System (INIS)

Chang, Seok Kyu; Chung, C. H.; Kim, B. D.

1997-08-01

This document outlines the test results for the strength tests of the CANFLEX fuel bundle. Strength tests are performed to determine and verify the amount of the bundle shape distortion which is against the side-stops when the bundles are refuelling. There are two cases of strength test; one is the double side-stop test which simulates the normal bundle refuelling and the other is the single side-stop test which simulates the abnormal refuelling. the strength test specification requires that the fuel bundle against the side-stop(s) simulators for this test were fabricated and the flow rates were controlled to provide the required conservative hydraulic forces. The test rig conditions of 120 deg C, 11.2 MPa were retained for 15 minutes after the flow rate was controlled during the test in two cases, respectively. The bundle loading angles of number 13- number 15 among the 15 bundles were 67.5 deg CCW and others were loaded randomly. After the tests, the bundle shapes against the side-stops were measured and inspected carefully. The important test procedures and measurements were discussed as follows. (author). 5 refs., 22 tabs., 5 figs

Causes of visual impairment in children with low vision.

Science.gov (United States)

Shah, Mufarriq; Khan, Mirzaman; Khan, Muhammad Tariq; Khan, Mohammad Younas; Saeed, Nasir

2011-02-01

To determine the main causes of visual impairment in children with low vision. To assess the need of spectacles and low vision devices (LVDs) in children and to evaluate visual outcome after using their LVDs for far and near distance. Observational study. Khyber Institute of Ophthalmic Medical Sciences, Peshawar, Pakistan, from June 2006 to December 2007. The clinical record of 270 children with low vision age 4-16 years attending the Low Vision Clinic were included. All those children, aged 4-16 years, who had corrected visual acuity (VA) less than 6/18 in the better eye after medical or surgical treatment, were included in the study. WHO low vision criteria were used to classify into visually impaired, severe visually impaired and blind. Results were described as percentage frequencies. One hundred and eighty nine (70%) were males and 81 (30%) were females. The male to female ratio was 2.3:1. The main causes of visual impairment included nystagmus (15%), Stargardt's disease (14%), maculopathies (13%), myopic macular degeneration (11%) and oculocutaneous albinism (7%). The percentages of visually impaired, severe visually impaired and blind were 33.8%, 27.2% and 39.0% respectively. Spectacles were prescribed to 146 patients and telescopes were prescribed to 75 patients. Spectacles and telescope both were prescribed to 179 patients while Ocutech telescope was prescribed to 4 patients. Retinal diseases nystagmus and macular conditions were mainly responsible for low vision in children. Visually impaired children especially with hereditary/congenital ocular anomalies benefit from refraction and low vision services which facilitate vision enhancement and inclusive education.

Optical Coherence Tomography in Optic Nerve Hypoplasia: Correlation With Optic Disc Diameter, Nerve Fiber Layer Thickness, and Visual Function.

Science.gov (United States)

Kelly, John P; Baran, Francine; Phillips, James O; Weiss, Avery H

2017-12-15

The correlation between optic disc diameters (DDs) with average retinal nerve fiber layer thickness (RNFLT) and visual function in children with optic nerve hypoplasia (ONH) having nystagmus is unknown. Data were obtained from a retrospective review of 28 children (mean age: 9.4 years; ±5.1). Optic DD was defined as the maximal horizontal opening of Bruch membrane with spectral optical coherence tomography combined with a confocal laser ophthalmoscope. Average RNFLT was obtained from circumpapillary b-scans. RNFLT was also remeasured at eccentricities that were proportionate with DD to rule out potential sampling artifacts. Visual function was assessed by visual acuity at last follow-up and by visual evoked potentials (VEP) in 11 patients. The eye with the larger DD, which had better visual acuity, was analyzed to exclude potential effects of amblyopia. DD was correlated with average RNFLT (r = 0.61), visual acuity (r = 0.32), and VEPs (r = 0.66). The relationship between RNFLT and DD was as follows: average RNFLT (μm) = 0.074 * DD (μm) - 18.8. RNFLT also correlated with the ratio of horizontal optic DD to macula-disc-margin distance (DD:DM; r = 0.59). RNFLT measured at eccentricities proportionate with DD showed progressive decrease in thickness only for DDs <1,100 μm. All patients with DD <1,000 μm had subnormal visual acuity, whereas those with DD <1,200 μm had subnormal VEPs. DD correlates with average RNFLT and with visual function in children with ONH. Using OCT imaging, DD can be obtained in children with nystagmus and provides objective information.

Design Driven Testing Test Smarter, Not Harder

CERN Document Server

Stephens, M

2010-01-01

The groundbreaking book Design Driven Testing brings sanity back to the software development process by flipping around the concept of Test Driven Development (TDD) - restoring the concept of using testing to verify a design instead of pretending that unit tests are a replacement for design. Anyone who feels that TDD is "Too Damn Difficult" will appreciate this book. Design Driven Testing shows that, by combining a forward-thinking development process with cutting-edge automation, testing can be a finely targeted, business-driven, rewarding effort. In other words, you'll learn how to test

Prediction of Vestibular Imbalance in Acute Peripheral Vestibulopathy by Measuring Horizontal Ocular Deviation on Magnetic Resonance Imaging.

Science.gov (United States)

Yang, Yeon-Jun; Kim, Kun Woo; Choi, Ji Eun; Lee, Min Young; Yoo, Dong Soo; Jung, Jae Yun

2018-02-01

The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls. Retrospective review. A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Horizontal OD was quantified by using the axial T2-weighted fast-spin echo (FSE) images of the brain at 1.5 T. In the study group, the results of VFTs (videonystagmography [VNG], caloric test, rotary chair test, and cervical vestibular evoked myogenic potentials [cVEMP]) were also reviewed. The averaged angle of right and left horizontal ODs was compared between patients with acute unilateral vestibulopathy and healthy controls. Also, the correlation between horizontal OD and results of VFTs was analyzed in the study group. The averaged angle of horizontal OD in study group (23.7° ± 11.6°) was significantly greater than that of control group (4.27° ± 3.7°) (p < 0.05). Horizontal OD significantly correlated with slow phase velocity of spontaneous nystagmus (SN), the value of caloric paresis (CP) on caloric testing, rotary chair gain, asymmetry ratio of rotary chair test and interaural difference (IAD) of cVEMP, regardless of time intervals between magnetic resonance imaging (MRI) and VFTs. Horizontal OD significantly correlated with parameters of VFT which reflect the vestibular imbalance. Therefore, horizontal OD can be used as an indicator of unilateral peripheral vestibular weakness.

A blind video watermarking scheme resistant to rotation and collusion attacks

Directory of Open Access Journals (Sweden)

Amlan Karmakar

2016-04-01

Full Text Available In this paper, Discrete Cosine Transform (DCT based blind video watermarking algorithm is proposed, which is perceptually invisible and robust against rotation and collusion attacks. To make the scheme resistant against rotation, watermark is embedded within the square blocks, placed on the middle position of every luminance channel. Then Zernike moments of those square blocks are calculated. The rotation invariance property of the Complex Zernike moments is exploited to predict the rotation angle of the video at the time of extraction of watermark bits. To make the scheme robust against collusion, design of the scheme is done in such a way that the embedding blocks will vary for the successive frames of the video. A Pseudo Random Number (PRN generator and a permutation vector are used to achieve the goal. The experimental results show that the scheme is robust against conventional video attacks, rotation attack and collusion attacks.

Cross section measurements of the (n,2n) reaction with 14 MeV neutrons

Energy Technology Data Exchange (ETDEWEB)

Kaji, Harumi; Shiokawa, Takanobu [Tohoku Univ., Sendai (Japan). Faculty of Science; Suehiro, Teruo; Yagi, Masuo

1975-07-01

Cross sections are measured for the reactions /sup 64/Zn(n, 2n)/sup 63/Zn, /sup 75/As(n, 2n)/sup 74/As, /sup 79/Br(n, 2n)/sup 78/Br, /sup 90/Zr(n, 2n)/sup 89/Zr, /sup 141/Pr(n, 2n)/sup 140/Pr and /sup 144/Sm(n, 2n)/sup 143/Sm by activation method in the energy range 13.5-14.8 MeV. The cross sections are determined relatively to the cross section for the /sup 63/Cu(n, 2n)/sup 62/Cu and /sup 19/F(n, 2n)/sup 18/F reactions. Before the cross section measurement, incident-neutron energies are measured by recoil proton method. The results of the cross sections are compared with data existing in the literatures and are discussed with reference to the theory of Weisskopf and Ewing.

Test design requirements: Canister-scale heater test

International Nuclear Information System (INIS)

Schauer, M.I.; Craig, P.A.; Stickney, R.G.

1986-03-01

This document establishes the Test Design Requirements for the design of a canister scale heater test to be performed in the Exploratory Shaft test facility. The purpose of the test is to obtain thermomechanical rock mass response data for use in validation of the numerical models. The canister scale heater test is a full scale simulation of a high-level nuclear waste container in a prototypic emplacement borehole. Electric heaters are used to simulate the heat loads expected in an actual waste container. This document presents an overview of the test including objectives and justification for the test. A description of the test as it is presently envisioned is included. Discussions on Quality Assurance and Safety are also included in the document. 12 refs., 1 fig

Hermansky-Pudlak syndrome; a Case Report

Directory of Open Access Journals (Sweden)

Abbas Bagheri

2010-01-01

Full Text Available Purpose: To report a case of Hermansky-Pudlak syndrome. Case Report: A seven-year-old boy presented with marked generalized hypopigmentation, ocular exodeviation and nystagmus. He had history of easy bruising. Examination revealed green irides with marked transillumination, hypopigmented fundi and foveal hypoplasia. Further investigations disclosed platelet storage defect with adenosine diphosphate deficiency and abnormal aggregation compatible with Hermansky-Pudlak syndrome. The patient underwent strabismus surgery taking necessary precautions such as reserving platelet concentrates in case of a hemorrhagic event. Conclusion: Patients with albinism should be evaluated for Hermansky-Pudlak syndrome especially before surgery to prevent life-threatening complications.

Presentation of moyamoya disease with occipital hemorrhage: a case report

Directory of Open Access Journals (Sweden)

Serkan Demir

2012-12-01

Full Text Available Moyamoya disease is a cerebrovascular disease which is characterized with stenosis and occlusions at the distal part of internal carotid artery and at the proximal part of anterior and middle cerebral arteries. It rarely causes temporary or recurrent hemiparesis due to intracranial hemorrhage while symptoms like headache, convulsion, nystagmus, aphasia and ataxia may also occur. In this paper, we present a case of Moyamoya disease which was diagnosed with a 23 year old female patient who was admitted to our emergency department with headache, nausea and vomiting complaints and whose radiological findings showed occipital lobe hemorrhage.

Atypical Wernicke′s syndrome sans encephalopathy with acute bilateral vision loss due to post-chiasmatic optic tract edema

Directory of Open Access Journals (Sweden)

Soaham Dilip Desai

2014-01-01

Full Text Available A middle aged male presented with acute bilateral vision loss, 4 weeks after undergoing gastric bypass surgery for gastric carcinoma. He had normal sensorium, fundoscopy, normal pupillary reaction to light, but had mild opthalmoparesis and nystagmus with ataxia. Magnetic resonance imaging of the brain revealed post-chiasmatic optic tract edema along with other classical features of Wernicke′s syndrome. Thiamine supplementation leads to complete resolution of clinical as well as imaging findings. In appropriate clinical settings, a high index of suspicion and early treatment are essential for managing Wernicke′s syndrome even in patients with atypical clinical and imaging presentation.

Leigh's subacute necrotizing encephalomyelopathy: Possible diagnosis by CT scan

International Nuclear Information System (INIS)

Chi, J.G.; Yoo, H.W.; Chang, K.H.; Kim, C.W.; Moon, H.R.; Ko, K.W.

1981-01-01

A 28-month-old Korean girl developed a rapidly progressive disease, characterized by disturbance of consciousness, tremor, nystagmus, ophthalmoplegia, irregular deep respiration and vomiting. The patient succumbed 2 weeks after the onset of the illness. CT scan disclosed bilaterally symmetrical, low density lesions in the white matter and lateral basal ganglia. Distinctive histopathological findings at postmortem included spongiotic necrosis of the neuropil, marked capillary vascularity, persistence of relatively normal neurons in severely damaged zones, and comparatively little astrocytosis. The bilaterally symmetrical distribution of these changes in the putamen and periaqueductal gray matter of the midbrain were compatible with Leigh's disease. (orig.)

Joubert syndrome: large clinical variability and a unique neuroimaging aspect

International Nuclear Information System (INIS)

Leao, Emilia Katiane Embirucu; Lima, Marcilia Martyn; Kok, Fernando; Parizotto, Juliana; Maia Junior, Otacilio de Oliveira

2010-01-01

Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g. pigmentary retinopathy, oculomotor apraxia and nystagmus), renal cysts and hepatic fibrosis. Respiratory abnormalities, as apnoea and hyperpnoea, may be present, as well as mental retardation. At least seven JS loci have been determined and five genes identified. Herein, we report five children, belonging to independent families, with JS: they shared the same typical MRI abnormality, known as molar tooth sign, but had an otherwise quite variable phenotype, regarding mostly their cognitive performance, visual abilities and extra-neurological compromise. (author)

Joubert syndrome: large clinical variability and a unique neuroimaging aspect

Energy Technology Data Exchange (ETDEWEB)

Leao, Emilia Katiane Embirucu; Lima, Marcilia Martyn; Kok, Fernando; Parizotto, Juliana [University of Sao Paulo (USP), Sao Paulo, SP (Brazil). Clinical Hospital. Dept. of Child Neurology; Maia Junior, Otacilio de Oliveira [University of Sao Paulo (USP), Sao Paulo, SP (Brazil). Clinical Hospital. Dept. of Child Ophthalmology

2010-04-15

Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g. pigmentary retinopathy, oculomotor apraxia and nystagmus), renal cysts and hepatic fibrosis. Respiratory abnormalities, as apnoea and hyperpnoea, may be present, as well as mental retardation. At least seven JS loci have been determined and five genes identified. Herein, we report five children, belonging to independent families, with JS: they shared the same typical MRI abnormality, known as molar tooth sign, but had an otherwise quite variable phenotype, regarding mostly their cognitive performance, visual abilities and extra-neurological compromise. (author)

Two Cases of Isolated Internuclear Presenting Ophthalmoplegia

Directory of Open Access Journals (Sweden)

Tuğçe Mengi

2014-12-01

Full Text Available Internuclear ophtalmoplegia (INO is a gaze disorder caused by medial longitudinal fasciculus (MLF injury and is characterized by impairment of adduction in the ipsilateral eye and dissociated nystagmus in the contralateral eye. INO usually develops due to lesions caused by multiple sclerosis or stroke, and rarely to head trauma. Disseciton of vertebral artery is an often overlooked cause of stroke, especially in young adults. Dissection of vertebral artery should be considered in differential diagnosis in patients with clinical findings of brain stem dysfunction and a history of head trauma. This paper discusses two cases of INO.

Testing on air cleaning systems: Testing of the components in-place tests

International Nuclear Information System (INIS)

Billard, F.; Brion, J.

1967-01-01

The reliability of air cleaning systems is dependent on testing they are submitted to. Although in-place tests are the most important as they act as final tests upon achieved plants, component tests are necessary too. They allow detection of defective units before they are installed, partition of unit defects from mounting defects and they are more sensitive. For similar reasons, material teats are most useful. The various tests are described, about aerosol filters for one part, iodine trap for the other. The checked features are: materials nature, units sizes, efficiency, air resistance, flammability, humidity resistance, temperature resistance, adsorbent friability, etc... On iodine trapping systems, small check traps, working by-pass with the main trap are periodically subjected to efficiency test. This control allow to cut down the in-place tests frequency, particularly when poisoning from organic vapours is to be feared. (authors) [fr

Irradiation effects test series test IE-1 test results report

International Nuclear Information System (INIS)

Quapp, W.J.; Allison, C.M.; Farrar, L.C.; Mehner, A.S.

1977-03-01

The report describes the results of the first programmatic test in the Nuclear Regulatory Commission Irradiation Effects Test Series. This test (IE-1) used four 0.97m long PWR-type fuel rods fabricated from previously irradiated Saxton fuel. The objectives of this test were to evaluate the effect of fuel pellet density on pellet-cladding interaction during a power ramp and to evaluate the influence of the irradiated state of the fuel and cladding on rod behavior during film boiling operation. Data are presented on the behavior of irradiated fuel rods during steady-state operation, a power ramp, and film boiling operation. The effects of as-fabricated gap size, as-fabricated fuel density, rod power, and power ramp rate on pellet-cladding interaction are discussed. Test data are compared with FRAP-T2 computer model predictions, and comments on the consequences of sustained film boiling operation on irradiated fuel rod behavior are provided

Diagnostic potential of iris cross-sectional imaging in albinism using optical coherence tomography.

Science.gov (United States)

Sheth, Viral; Gottlob, Irene; Mohammad, Sarim; McLean, Rebecca J; Maconachie, Gail D E; Kumar, Anil; Degg, Christopher; Proudlock, Frank A

2013-10-01

To characterize in vivo anatomic abnormalities of the iris in albinism compared with healthy controls using anterior segment optical coherence tomography (AS-OCT) and to explore the diagnostic potential of this technique for albinism. We also investigated the relationship between iris abnormalities and other phenotypical features of albinism. Prospective cross-sectional study. A total of 55 individuals with albinism and 45 healthy controls. We acquired 4.37×4.37-mm volumetric scans (743 A-scans, 50 B-scans) of the nasal and temporal iris in both eyes using AS-OCT (3-μm axial resolution). Iris layers were segmented and thicknesses were measured using ImageJ software. Iris transillumination grading was graded using Summers and colleagues' classification. Retinal OCT, eye movement recordings, best-corrected visual acuity (BCVA), visual evoked potential (VEP), and grading of skin and hair pigmentation were used to quantify other phenotypical features associated with albinism. Iris AS-OCT measurements included (1) total iris thickness, (2) stroma/anterior border (SAB) layer thickness, and (3) posterior epithelial layer (PEL) thickness. Correlation with other phenotypical measurements, including (1) iris transillumination grading, (2) retinal layer measurements at the fovea, (3) nystagmus intensity, (4) BCVA, (5) VEP asymmetry, (6) skin pigmentation, and (7) hair pigmentation (of head hair, lashes, and brows). The mean iris thickness was 10.7% thicker in controls (379.3 ± 44.0 μm) compared with the albinism group (342.5 ± 52.6 μm; P>0.001), SAB layers were 5.8% thicker in controls (315.1 ± 43.8 μm) compared with the albinism group (297.7 ± 50.0 μm; P=0.044), and PEL was 44.0% thicker in controls (64.1 ± 11.7 μm) compared with the albinism group (44.5 ± 13.9 μm; Palbinism. Phenotypic features of albinism, such as skin and hair pigmentation, BCVA, and nystagmus intensity, were significantly correlated to AS-OCT iris thickness measurements. We have

Irradiation effects test Series Scoping Test 1: test results report

International Nuclear Information System (INIS)

Quapp, W.J.; Allison, C.M.; Farrar, L.C.

1977-09-01

The report describes the results of the first scoping test in the Irradiation Effects Test Series conducted by the Thermal Fuels Behavior Program, which is part of the Water Reactor Research Program of EG and G Idaho, Inc. The research is sponsored by the United States Nuclear Regulatory Commission. This test used an unirradiated, three-foot-long, PWR-type fuel rod. The objective of this test was to thoroughly evaluate the remote fabrication procedures to be used for irradiated rods in future tests, handling plans, and reactor operations. Additionally, selected fuel behavior data were obtained. The fuel rod was subjected to a series of preconditioning power cycles followed by a power increase which brought the fuel rod power to about 20.4 kW/ft peak linear heat rating at a coolant mass flux of 1.83 x 10 6 lb/hr-ft 2 . Film boiling occurred for a period of 4.8 minutes following flow reductions to 9.6 x 10 5 and 7.5 x 10 5 lb/hr-ft 2 . The test fuel rod failed following reactor shutdown as a result of heavy internal and external cladding oxidation and embrittlement which occurred during the film boiling operation

Testing Significance Testing

Directory of Open Access Journals (Sweden)

Joachim I. Krueger

2018-04-01

Full Text Available The practice of Significance Testing (ST remains widespread in psychological science despite continual criticism of its flaws and abuses. Using simulation experiments, we address four concerns about ST and for two of these we compare ST’s performance with prominent alternatives. We find the following: First, the 'p' values delivered by ST predict the posterior probability of the tested hypothesis well under many research conditions. Second, low 'p' values support inductive inferences because they are most likely to occur when the tested hypothesis is false. Third, 'p' values track likelihood ratios without raising the uncertainties of relative inference. Fourth, 'p' values predict the replicability of research findings better than confidence intervals do. Given these results, we conclude that 'p' values may be used judiciously as a heuristic tool for inductive inference. Yet, 'p' values cannot bear the full burden of inference. We encourage researchers to be flexible in their selection and use of statistical methods.

Test report - caustic addition system operability test procedure

International Nuclear Information System (INIS)

Parazin, R.E.

1995-01-01

This Operability Test Report documents the test results of test procedure WHC-SD-WM-OTP-167 ''Caustic Addition System Operability Test Procedure''. The Objective of the test was to verify the operability of the 241-AN-107 Caustic Addition System. The objective of the test was met

Atypical Alstrom syndrome with novel ALMS1 mutations precluded by current diagnostic criteria.

LENUS (Irish Health Repository)

Casey, Jillian

2014-02-01

We report on clinical and genetic studies in a non-consanguineous Irish sib-pair with infantile dilated cardiomyopathy and retinopathy. A diagnosis of Alström Syndrome (AS) was considered and diagnostic testing pursued. The Alströms gene (ALMS1) is very large (23 exons) and diagnostic testing of mutational hotspots (exon 6, 8 and 10) was negative. Furthermore the siblings were tall and did not have the typical phenotype of nystagmus, photophobia, obesity or hearing loss and so the AS diagnosis was removed. We then sought to identify the causative gene in this family using whole exome sequencing. Unexpectedly, the exome analysis identified novel compound heterozygous ALMS1 mutations in exon 5 (c.777delT:p.D260fs*26) and exon 20 (c.12145_12146insC:p.S4049fs*36) that segregated with the phenotype. Although the siblings show some clinical overlap with AS, their phenotype is not classical. It is plausible that their atypical presentation may be due to the location of the ALMS1 mutations outside the usual mutational hotspots. Our findings show how atypical cases of AS may be missed under the current diagnostic guidelines and support consideration of complete ALMS1 sequencing in children with two or more features, even if all of the core clinical features of AS are not present.

Cognition and sensation in very high static magnetic fields: a randomized case-crossover study with different field strengths.

Science.gov (United States)

Heinrich, Angela; Szostek, Anne; Meyer, Patric; Nees, Frauke; Rauschenberg, Jaane; Gröbner, Jens; Gilles, Maria; Paslakis, Georgios; Deuschle, Michael; Semmler, Wolfhard; Flor, Herta

2013-01-01

To establish the extent to which representative cognitive functions in subjects undergoing magnetic resonance (MR) imaging are acutely impaired by static magnetic fields of varying field strengths. This study was approved by the local ethics committee, and informed consent was obtained from all subjects. In this single-blind case-crossover study, 41 healthy subjects underwent an extensive neuropsychologic examination while in MR units of differing field strengths (1.5, 3.0, and 7.0 T), including a mock imager with no magnetic field as a control condition. Subjects were blinded to field strength. Tests were performed while subjects were lying still in the MR unit and while the examination table was moved. The tests covered a representative set of cognitive functions, such as memory, eye-hand coordination, attention, reaction time, and visual discrimination. Subjective sensory perceptions were also assessed. Effects were analyzed with a repeated-measures analysis of variance; the within-subject factors were field strength (0, 1.5, 3.0, and 7.0 T) and state (static, dynamic). Static magnetic fields were not found to have a significant effect on cognitive function at any field strength. However, sensory perceptions did vary according to field strength. Dizziness, nystagmus, phosphenes, and head ringing were related to the strength of the static magnetic field. Static magnetic fields as high as 7.0 T did not have a significant effect on cognition. RSNA, 2012

Measuring caloric response: comparison of different analysis techniques.

Science.gov (United States)

Mallinson, A I; Longridge, N S; Pace-Asciak, P; Ngo, R

2010-01-01

Electronystagmography (ENG) testing has been supplanted by newer techniques of measuring eye movement with infrared cameras (VNG). Most techniques of quantifying caloric induced nystagmus measure the slow phase velocity in some manner. Although our analysis is carried out by very experienced assessors, some systems have computer algorithms that have been "taught" to locate and quantify maximum responses. We wondered what differences in measurement might show up when measuring calorics using different techniques and systems, the relevance of this being that if there was a change in slow phase velocity between ENG and VNG testing when measuring caloric response, then normative data would have to be changed. There are also some subjective but important aspects of ENG interpretation which comment on the nature of the response (e.g. responses which might be "sporadic" or "scant"). Our experiment compared caloric responses in 100 patients analyzed four different ways. Each caloric was analyzed by our old ENG system, our new VNG system, an inexperienced assessor and the computer algorithm, and data was compared. All four systems made similar measurements but our inexperienced assessor failed to recognize responses as sporadic or scant, and we feel this is a limitation to be kept in mind in the rural setting, as it is an important aspect of assessment in complex patients. Assessment of complex VNGs should be left to an experienced assessor.

Effect of vestibular neuritis on postural control using wavelets and fractal analysis.

Science.gov (United States)

Lorin, P; Manceau, C; Foubert, F

2010-01-01

What is the status of postural control a few months after an attack of vestibular neuritis (VN)? Using dynamic posturography and stabilometric signal treatment with wavelets and fractal analysis, we tried to answer this question by isolating the pathological postural parameters of VN. The study involved a group of 15 patients (GP) who suffered from VN and were compared to a group of control subjects (GC). Both groups underwent videonystagmography (VNG), dynamic posturography (PDY), and assessment using symptomatic scales (ES). GP and GC were comparable in terms of age mean, sex-ratio, average height and weight. The differences between GP and GC were the following videonystagmography criteria: Spontaneous nystagmus (NS) (P= 0.005), head shaking test (HST) (p= 0.001), vibratory test (TVO) (p= 0.009). There were also differences in the symptomatic scales scores for the vertigo symptom scale (VSS) (p= 0.011), the dizziness handicap inventory (DHI) (p= 0.001), and the short form 36 (SF36) (p= 0.01). All the 84 new parameters of both GP and GC differ. This difference was significant (p conditions were found to be non-discriminating. Vestibular neuritis affects new stabilometric parameters. These parameters are more adapted to the present setup compared to previous parameters which are used to analyse non-periodic oscillations of posture. They are important in follow-up and rehabilitation of patients.

Test Architecture, Test Retrofit

Science.gov (United States)

Fulcher, Glenn; Davidson, Fred

2009-01-01

Just like buildings, tests are designed and built for specific purposes, people, and uses. However, both buildings and tests grow and change over time as the needs of their users change. Sometimes, they are also both used for purposes other than those intended in the original designs. This paper explores architecture as a metaphor for language…

Standard test method for creep-fatigue testing

CERN Document Server

American Society for Testing and Materials. Philadelphia

2009-01-01

1.1 This test method covers the determination of mechanical properties pertaining to creep-fatigue deformation or crack formation in nominally homogeneous materials, or both by the use of test specimens subjected to uniaxial forces under isothermal conditions. It concerns fatigue testing at strain rates or with cycles involving sufficiently long hold times to be responsible for the cyclic deformation response and cycles to crack formation to be affected by creep (and oxidation). It is intended as a test method for fatigue testing performed in support of such activities as materials research and development, mechanical design, process and quality control, product performance, and failure analysis. The cyclic conditions responsible for creep-fatigue deformation and cracking vary with material and with temperature for a given material. 1.2 The use of this test method is limited to specimens and does not cover testing of full-scale components, structures, or consumer products. 1.3 This test method is primarily ...

Impact of daily cooling treatment on skin inflammation in patients with chronic venous disease.

Science.gov (United States)

Kelechi, Teresa J; Mueller, Martina; King, Dana E; Madisetti, Mohan; Prentice, Margie

2015-05-01

People with chronic venous disease are at high risk for developing venous leg ulcers. Inflammation is posited as a pathological factor for this chronic condition as evidenced by persistently elevated skin temperature. As part of a larger trial to test the effects of a cooling regimen on leg ulcer prevention, the objective of this preliminary study was to evaluate the first 30 days of intense daily cooling. Compared to a placebo control cuff, a gel cuff applied to the most severely affected lower leg skin for 30 min daily showed no statistically significant differences between temperatures taken in the home at baseline compared to those measured at the 1 month follow up visit. There were also no differences in temperatures noted between the two groups, although the temperatures in the treatment group were lower 30 min after treatment, an indication of adherence. There was no discernable decrease or increase in temperature at a given time point during the 30 day treatment period compared to the control group. It may be better to have patients monitor skin temperature on a daily basis and then apply the cuff as necessary, rather than requiring daily cooling based on baseline measurement. This "prn" approach may provide a sufficient cooling milieu to prevent escalation of inflammation and thwart ulcer occurrence or recurrence. Clinical trials registration #NCT01509599. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Energy Systems Test Area (ESTA) Electrical Power Systems Test Operations: User Test Planning Guide

Science.gov (United States)

Salinas, Michael J.

2012-01-01

Test process, milestones and inputs are unknowns to first-time users of the ESTA Electrical Power Systems Test Laboratory. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Digface characterization test plan (remote testing)

International Nuclear Information System (INIS)

Croft, K.; Hyde, R.; Allen, S.

1993-08-01

The objective of the Digface Characterization (DFC) Remote Testing project is to remotely deploy a sensor head (Mini-Lab) across a digface to determine if it can characterize the contents below the surface. The purpose of this project is to provide a robotics technology that allows removal of workers from hazards, increases speed of operations, and reduces life cycle costs compared to alternate methods and technologies. The Buried Waste Integrated Demonstration (BWID) is funding the demonstration, testing, and evaluation of DFC. This document describes the test plan for the DFC remote deployment demonstration for the BWID. The purposes of the test plan are to establish test parameters so that the demonstration results are deemed useful and usable and perform the demonstration in a safe manner and within all regulatory requirements

Including test errors in evaluating surveillance test intervals

International Nuclear Information System (INIS)

Kim, I.S.; Samanta, P.K.; Martorell, S.; Vesely, W.E.

1991-01-01

Technical Specifications require surveillance testing to assure that the standby systems important to safety will start and perform their intended functions in the event of plant abnormality. However, as evidenced by operating experience, the surveillance tests may be adversely impact safety because of their undesirable side effects, such as initiation of plant transients during testing or wearing-out of safety systems due to testing. This paper first defines the concerns, i.e., the potential adverse effects of surveillance testing, from a risk perspective. Then, we present a methodology to evaluate the risk impact of those adverse effects, focusing on two important kinds of adverse impacts of surveillance testing: (1) risk impact of test-caused trips and (2) risk impact of test-caused equipment wear. The quantitative risk methodology is demonstrated with several surveillance tests conducted at boiling water reactors, such as the tests of the main steam isolation valves, the turbine overspeed protection system, and the emergency diesel generators. We present the results of the risk-effectiveness evaluation of surveillance test intervals, which compares the adverse risk impact with the beneficial risk impact of testing from potential failure detection, along with insights from sensitivity studies

Endurance test of DUPIC irradiation test rig-003

Energy Technology Data Exchange (ETDEWEB)

Moon, J.S; Yang, M.S.; Lee, C.Y.; Ryu, J.S.; Jeon, H.G

2001-04-01

This report presents the pressure drop, vibration and endurance test results for DUPIC Irradiation Test Rig-003 which was design and fabricated by KAERI. From the pressure drop and vibration test results, it is verified that DUPIC Irradiation Test Rig-003 satisfied the limit conditions of HANARO. And, remarkable wear is not observed in DUPIC Irradiation Test Rig-003 during 40 endurance test days.

Ultrasonic Testing

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyeong Jun; Kuk, Jeong Han

2002-02-15

This book introduces ultrasonic testing, which tells of outline of ultrasonic testing, principle of ultrasonic testing, prosperities of ultrasonic waves, radiographic test and ultrasonic test, basic theory on ultrasonic testing, mode conversion, transmission and diffraction, ultrasonic flaw detection and probe, standard test piece and reference test piece, like KS(JIS) ASME and ASTM, classification and properties of ultrasonic testing, straight beam method, angle beam method, ASME SEC.V.Art.5 ASTMA 388 and KS B 0817 Korean industrial standard.

Extended shadow test approach for constrained adaptive testing

NARCIS (Netherlands)

Veldkamp, Bernard P.; Ariel, A.

2002-01-01

Several methods have been developed for use on constrained adaptive testing. Item pool partitioning, multistage testing, and testlet-based adaptive testing are methods that perform well for specific cases of adaptive testing. The weighted deviation model and the Shadow Test approach can be more

From Test Takers to Test Makers

Science.gov (United States)

Smith, Kari

2009-01-01

As a classroom teacher, Kari Smith realized that traditional objective tests don't always assess what students actually know. But tests are so deeply embedded in the education system that it would be difficult to do away with them entirely. Smith decided to make tests into learning tools. In this article, Smith describes three strategies for…

Presence of fusion in albinism after strabismus surgery augmented with botulinum toxin (type a) injection.

Science.gov (United States)

Tavakolizadeh, Sepideh; Farahi, Azadeh

2013-08-01

It is commonly accepted that albino patients with strabismus rarely achieve binocularity and depth perception after strabismus surgery. The presence of retino-geniculo-cortical misrouting, a hallmark of the visual system in albinism, does not necessarily cause total loss of binocular vision, however, not even in albino patients with strabismus. Recently some degrees of stereopsis were reported in albinism patients with minimal clinical nystagmus, if any, in the absence of strabismus. It is possible that patients with albinism and strabismus have binocular visual potential which appears after strabismus correction and provides appropriate postoperative alignment in the long term. Here we present two cases of clinically diagnosed oculocutaneous albinism, an 18-year-old girl and a 16-year-old boy, both with exotropia ≥40 prism diopter, who gained acceptable alignment and fusion after surgical correction of their strabismus as demonstrated on Bagolini testing. In cases of albinism accompanied by visual pathway abnormalities and strabismus, binocular visual potential is not impossible, and some levels can be expected. Thus, these patients, like other cases of strabismus, may benefit from treatment of strabismus at an earlier age to achieve appropriate alignment, cosmetic satisfaction, and a possibly increased chance of fusion.

oVEMP as an objective indicator of successful repositioning maneuver.

Science.gov (United States)

Asal, Samir; Sobhy, Osama; Balbaa, Amany

Benign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle. Air conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1-p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude. This study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week. oVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient's symptoms, which may be misleading due to a remission. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Color vision abnormality as an initial presentation of the complete type of congenital stationary night blindness.

Science.gov (United States)

Tan, Xue; Aoki, Aya; Yanagi, Yasuo

2013-01-01

Patients with the complete form of congenital stationary night blindness (CSNB) often have reduced visual acuity, myopia, impaired night vision, and sometimes nystagmus and strabismus, however, they seldom complain of color vision abnormality. A 17-year-old male who was at technical school showed abnormalities in the color perception test for employment, and was referred to our hospital for a detailed examination. He had no family history of color vision deficiency and no other symptoms. During the initial examination, his best-corrected visual acuity was 1.2 in both eyes. His fundus showed no abnormalities except for somewhat yellowish reflex in the fovea of both eyes. Electroretinogram (ERG) showed a good response in cone ERG and 30 Hz flicker ERG, however, the bright flash, mixed rod and cone ERG showed a negative type with a reduced b-wave (positive deflection). There was no response in the rod ERG, either. From the findings of the typical ERG, the patient was diagnosed with complete congenital stationary night blindness. This case underscores the importance of ERG in order to diagnose the cause of a color vision anomaly.

Test design requirements: Thermal conductivity probe testing

International Nuclear Information System (INIS)

Heath, R.E.

1985-01-01

This document establishes the test design requirements for development of a thermal conductivity probe test. The thermal conductivity probe determines in situ thermal conductivity using a line source transient heat conduction analysis. This document presents the rationale for thermal conductivity measurement using a thermal conductivity probe. A general test description is included. Support requirements along with design constraints are detailed to allow simple design of the thermal conductivity probe and test. The schedule and delivery requirements of the responsible test designer are also included. 7 refs., 1 fig

NIF ICCS Test Controller for Automated and Manual Testing

International Nuclear Information System (INIS)

Zielinski, J S

2007-01-01

The National Ignition Facility (NIF) Integrated Computer Control System (ICCS) is a large (1.5 MSLOC), hierarchical, distributed system that controls all aspects of the NIF laser [1]. The ICCS team delivers software updates to the NIF facility throughout the year to support shot operations and commissioning activities. In 2006, there were 48 releases of ICCS: 29 full releases, 19 patches. To ensure the quality of each delivery, thousands of manual and automated tests are performed using the ICCS Test Controller test infrastructure. The TestController system provides test inventory management, test planning, automated test execution and manual test logging, release testing summaries and test results search, all through a web browser interface. Automated tests include command line based frameworks server tests and Graphical User Interface (GUI) based Java tests. Manual tests are presented as a checklist-style web form to be completed by the tester. The results of all tests, automated and manual, are kept in a common repository that provides data to dynamic status reports. As part of the 3-stage ICCS release testing strategy, the TestController system helps plan, evaluate and track the readiness of each release to the NIF facility

Reiter haemagglutination test: a screening test for syphilis.

OpenAIRE

Al-Qudah, A A; Mostratos, A

1982-01-01

Using an ultrasonicate of the Reiter treponeme as antigen the Reiter haemagglutination test (RHA) was evaluated as a serological test for syphilis. Comparison of the results of the cardiolipin Wassermann reaction, Reiter protein complement-fixation test, the fluorescent treponemal antibody-absorbed (FTA-ABS) test, the Treponema pallidum haemagglutination test (TPHA) (at dilutions of 1/16 and 1/80), and the Venereal Disease Research Laboratory test with those of the RHA showed that the RHA was...

40 CFR 53.65 - Test procedure: Loading test.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedure: Loading test. 53.65... Characteristics of Class II Equivalent Methods for PM2.5 § 53.65 Test procedure: Loading test. (a) Overview. (1) The loading tests are designed to quantify any appreciable changes in a candidate method sampler's...

Parallelize Automated Tests in a Build and Test Environment

OpenAIRE

Durairaj, Selva Ganesh

2016-01-01

This thesis investigates the possibilities of finding solutions, in order to reduce the total time spent for testing and waiting times for running multiple automated test cases in a test framework. The “Automated Test Framework”, developed by Axis Communications AB, is used to write the functional tests to test both hardware and software of a resource. The functional tests that tests the software is considered in this thesis work. In the current infrastructure, tests are executed sequentially...

40 CFR 53.66 - Test procedure: Volatility test.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedure: Volatility test. 53.66... Characteristics of Class II Equivalent Methods for PM2.5 § 53.66 Test procedure: Volatility test. (a) Overview. This test is designed to ensure that the candidate method's losses due to volatility when sampling semi...

Hemoglobin Test: MedlinePlus Lab Test Information

Science.gov (United States)

... page: https://medlineplus.gov/labtests/hemoglobintest.html Hemoglobin Test To use the sharing features on this page, please enable JavaScript. What is a Hemoglobin Test? A hemoglobin test measures the levels of hemoglobin ...

Amylase Test: MedlinePlus Lab Test Information

Science.gov (United States)

... page: https://medlineplus.gov/labtests/amylasetest.html Amylase Test To use the sharing features on this page, please enable JavaScript. What is an Amylase Test? An amylase test measures the amount of amylase ...

Hematocrit Test: MedlinePlus Lab Test Information

Science.gov (United States)

... page: https://medlineplus.gov/labtests/hematocrittest.html Hematocrit Test To use the sharing features on this page, please enable JavaScript. What is a Hematocrit Test? A hematocrit test is a type of blood ...

Procalcitonin Test: MedlinePlus Lab Test Information

Science.gov (United States)

... page: https://medlineplus.gov/labtests/procalcitonintest.html Procalcitonin Test To use the sharing features on this page, please enable JavaScript. What is a Procalcitonin Test? A procalcitonin test measures the level of procalcitonin ...

Test re-test reliability and construct validity of the star-track test of manual dexterity

DEFF Research Database (Denmark)

Kildebro, Niels; Amirian, Ilda; Gögenur, Ismail

2015-01-01

Objectives. We wished to determine test re-test reliability and construct validity of the star-track test of manual dexterity. Design. Test re-test reliability was examined in a controlled study. Construct validity was tested in a blinded randomized crossover study. Setting. The study was performed...... at a university hospital in Denmark. Participants. A total of 11 subjects for test re-test and 20 subjects for the construct validity study were included. All subjects were healthy volunteers. Intervention. The test re-test trial had two measurements with 2 days pause in between. The interventions...... in the construct validity study included baseline measurement, intervention 1: fatigue, intervention 2: stress, and intervention 3: fatigue and stress. There was a 2 day pause between each intervention. Main outcome measure. An integrated measure of completion time and number of errors was used. Results. All...

Test quality

International Nuclear Information System (INIS)

Hartley, R.S.; Keller, A.E.

1992-01-01

Inservice testing of safety-related components at nuclear power plants is performed under the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (the Code). Subsections IWP and IWV of Section 11 of the Code state test method and frequency requirements for pumps and valves, respectively. Tests vary greatly in quality and frequency. This paper explores the concept of test quality and its relationship with operational readiness and preventive maintenance. This paper also considers the frequencies of component testing. Test quality is related to a test's ability to detect degradation that can cause component failure. The quality of the test depends on several factors, including specific parameters measured, system or component conditions, and instrument accuracy. The quality of some currently required tests for check valves, motor-operated valves, and pumps is also discussed. Suggestions are made to improve test quality by measuring different parameters, testing valves under load, and testing positive displacement pumps at high pressure and centrifugal pumps at high flow rate conditions. These suggestions can help to improve the level of assurance of component operational readiness gained from testing

Magnesium Test

Science.gov (United States)

... PF4 Antibody Hepatitis A Testing Hepatitis B Testing Hepatitis C Testing HER2/neu Herpes Testing High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV Antiretroviral Drug Resistance Testing, Genotypic HIV Viral Load HLA Testing HLA- ...

Lipase Test

Science.gov (United States)

... PF4 Antibody Hepatitis A Testing Hepatitis B Testing Hepatitis C Testing HER2/neu Herpes Testing High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV Antiretroviral Drug Resistance Testing, Genotypic HIV Viral Load HLA Testing HLA- ...

Rubella Test

Science.gov (United States)

... PF4 Antibody Hepatitis A Testing Hepatitis B Testing Hepatitis C Testing HER2/neu Herpes Testing High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV Antiretroviral Drug Resistance Testing, Genotypic HIV Viral Load HLA Testing HLA- ...

Mono Test

Science.gov (United States)

... PF4 Antibody Hepatitis A Testing Hepatitis B Testing Hepatitis C Testing HER2/neu Herpes Testing High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV Antiretroviral Drug Resistance Testing, Genotypic HIV Viral Load HLA Testing HLA- ...

AMA Test

Science.gov (United States)

... PF4 Antibody Hepatitis A Testing Hepatitis B Testing Hepatitis C Testing HER2/neu Herpes Testing High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV Antiretroviral Drug Resistance Testing, Genotypic HIV Viral Load HLA Testing HLA- ...

Irradiation Effects Test Series: Test IE-3. Test results report

International Nuclear Information System (INIS)

Farrar, L.C.; Allison, C.M.; Croucher, D.W.; Ploger, S.A.

1977-10-01

The objectives of the test reported were to: (a) determine the behavior of irradiated fuel rods subjected to a rapid power increase during which the possibility of a pellet-cladding mechanical interaction failure is enhanced and (b) determine the behavior of these fuel rods during film boiling following this rapid power increase. Test IE-3 used four 0.97-m long pressurized water reactor type fuel rods fabricated from previously irradiated fuel. The fuel rods were subjected to a preconditioning period, followed by a power ramp to 69 kW/m at a coolant mass flux of 4920 kg/s-m 2 . After a flow reduction to 2120 kg/s-m 2 , film boiling occurred on the fuel rods. One rod failed approximately 45 seconds after the reactor was shut down as a result of cladding embrittlement due to extensive cladding oxidation. Data are presented on the behavior of these irradiated fuel rods during steady-state operation, the power ramp, and film boiling operation. The effects of a power ramp and power ramp rates on pellet-cladding interaction are discussed. Test data are compared with FRAP-T3 computer model calculations and data from a previous Irradiation Effects test in which four irradiated fuel rods of a similar design were tested. Test IE-3 results indicate that the irradiated state of the fuel rods did not significantly affect fuel rod behavior during normal, abnormal (power ramp of 20 kW/m per minute), and accident (film boiling) conditions

Allergy tests: Comparison between the Radio-Allergo-Sorbent Test (RAST) and cutaneous test as well as inhalative provocation test

International Nuclear Information System (INIS)

Langenstrass, J.A.

1979-01-01

As this publication has shown, the Radio-Allergo-Sorbent Test (RAST) is well suited for investigation programs. Absence of physical strain for the patient, precise reproducibility of the results and fair agreement with other test methods are above all qualities in favour of RAST. Its main disadvantages are the as yet rather restricted spectrum of allergens and expensiveness and high technical requirement. Substantial technical requirements are also involved with the inhalative provocation test, if properly carried out, but here the spectrum of allergens is by far greater. On the other hand, it exposes patients to great physical strain. The skin tests are most simple to carry out but present the largest position of misresults and are less reproducible than the two former procedures. The Radio-Immuno-Sorbent Test (RIST) can provide very useful results as a preliminary test but is also very costly owing to its high technical demands. - In conclusion, RAST is most conveniently used as a co-test in a complete investigation program where it constitutes a valuable aid. As a sole alternative to skin tests and inhalative provocation tests it is a yet not recommendable for the above-mentioned reasons. Although not able to replace the two conventional methods within the foreseeable future, it is expected to be used more widely on further development. (orig./MG) [de

Re-test reliability of gustatory testing and introduction of the sensitive Taste-Drop-Test

DEFF Research Database (Denmark)

Fjaeldstad, A; Niklassen, A; Fernandes, H

2018-01-01

. Testing gustatory function can be important for diagnostics and assessment of treatment effects. However, the gustatory tests applied are required to be both sensitive and reliable.In this study, we investigate the re-test validity of popular Taste Strips gustatory test for gustatory screening....... Furthermore, we introduce a new sensitive Taste-Drop-Test, which was found to be superior for detecting a more accurate measure of tastant sensitivity....

Energy Systems Test Area (ESTA). Power Systems Test Facilities

Science.gov (United States)

Situ, Cindy H.

2010-01-01

This viewgraph presentation provides a detailed description of the Johnson Space Center's Power Systems Facility located in the Energy Systems Test Area (ESTA). Facilities and the resources used to support power and battery systems testing are also shown. The contents include: 1) Power Testing; 2) Power Test Equipment Capabilities Summary; 3) Source/Load; 4) Battery Facilities; 5) Battery Test Equipment Capabilities Summary; 6) Battery Testing; 7) Performance Test Equipment; 8) Battery Test Environments; 9) Battery Abuse Chambers; 10) Battery Abuse Capabilities; and 11) Battery Test Area Resources.

Seismic testing

International Nuclear Information System (INIS)

Sollogoub, Pierre

2001-01-01

This lecture deals with: qualification methods for seismic testing; objectives of seismic testing; seismic testing standards including examples; main content of standard; testing means; and some important elements of seismic testing

Proficiency Testing in Nondestructive Testing (NDT)

International Nuclear Information System (INIS)

Amry Amin Abbas; Suhairy Sani; Mohamad Pauzi Ismail; Abd Nassir Ibrahim

2014-01-01

Department of Standard Malaysia (DSM) launched myPTP programme on 31 December 2013 in accordance to ISO/IC 17043. The standard states the requirements for Proficiency Testing. The provider of these services is called Proficiency Testing Provider (PTP). The role of PTP is to compare the proficiency level between inspection bodies or laboratories. With the assistance of expert panel, the PTP will determine the assigned value as reference to be compared to the values obtained from the inspection bodies or laboratories. Quality wise, this services is important as participation will improve wuality of the inspection quality continuously and increase confidence level of client and improve safety level. Requirement of PT in NDT is mentioned in SC1.5- Specific Criteria for Accreditation of Mechanical Testing and Non-Destructive Testing (NDT) for MS ISO/IEC17025 and MTR2- MIBAS Technical Requirements for Accreditation of NDT. This paper explains and discusses the result of this proficiency test done on a number of NDT companies that participated. (author)

Built-In Test Engine For Memory Test

OpenAIRE

McEvoy, Paul; Farrell, Ronan

2004-01-01

In this paper we will present an on-chip method for testing high performance memory devices, that occupies minimal area and retains full flexibility. This is achieved through microcode test instructions and the associated on-chip state machine. In addition, the proposed methodology will enable at-speed testing of memory devices. The relevancy of this work is placed in context with an introduction to memory testing and the techniques and algorithms generally used today.

Schirmer test

Science.gov (United States)

Tear test; Tearing test; Dry eye test; Basal secretion test; Sjögren - Schirmer; Schirmer's test ... used when the eye doctor suspects you have dry eye. Symptoms include dryness of the eyes or excessive ...

The Relationship between Anxiety and Test-Taking C-Test and Cloze-Test

Science.gov (United States)

Azimi, Mozhgan

2016-01-01

Anxiety has an important role in teaching and learning. If teachers can recognize which kind of tests create high anxiety then they will be able to omit these kinds of tests. Then, the results of test can probably show the students' knowledge more carefully. The subjects of the present study were sixty Iranian female junior university students.…

Test quality

International Nuclear Information System (INIS)

Hartley, R.S.; Keller, A.E.

1992-01-01

This document discusses inservice testing of safety-related components at nuclear power plants which is performed under the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (the Code). Subsections IWP and IWV of Section XI of the Code state test method and frequency requirements for pumps and valves respectively. Tests vary greatly in quality and frequency. This paper explores the concept of test quality and its relationship with operational readiness and preventive maintenance. This paper also considers the frequencies of component testing. Test quality is related to a test's ability to detect degradation that can cause component failure. The quality of the test depends on several factors, including specific parameters measured, system or component conditions, and instrument accuracy. The quality of some currently required tests for check valves, motor-operated valves, and pumps is also discussed. Suggestions are made to improve test quality by measuring different parameters, testing valves under load, and testing positive displacement pumps at high pressure and centrifugal pumps at high flow rate conditions. These suggestions can help to improve the level of assurance of component operational readiness gained from testing

Exploring Various Monte Carlo Simulations for Geoscience Applications

Science.gov (United States)

Blais, R.

2010-12-01

Computer simulations are increasingly important in geoscience research and development. At the core of stochastic or Monte Carlo simulations are the random number sequences that are assumed to be distributed with specific characteristics. Computer generated random numbers, uniformly distributed on (0, 1), can be very different depending on the selection of pseudo-random number (PRN), or chaotic random number (CRN) generators. Equidistributed quasi-random numbers (QRNs) can also be used in Monte Carlo simulations. In the evaluation of some definite integrals, the resulting error variances can even be of different orders of magnitude. Furthermore, practical techniques for variance reduction such as Importance Sampling and Stratified Sampling can be implemented to significantly improve the results. A comparative analysis of these strategies has been carried out for computational applications in planar and spatial contexts. Based on these experiments, and on examples of geodetic applications of gravimetric terrain corrections and gravity inversion, conclusions and recommendations concerning their performance and general applicability are included.

Exploring pseudo- and chaotic random Monte Carlo simulations

Science.gov (United States)

Blais, J. A. Rod; Zhang, Zhan

2011-07-01

Computer simulations are an increasingly important area of geoscience research and development. At the core of stochastic or Monte Carlo simulations are the random number sequences that are assumed to be distributed with specific characteristics. Computer-generated random numbers, uniformly distributed on (0, 1), can be very different depending on the selection of pseudo-random number (PRN) or chaotic random number (CRN) generators. In the evaluation of some definite integrals, the resulting error variances can even be of different orders of magnitude. Furthermore, practical techniques for variance reduction such as importance sampling and stratified sampling can be applied in most Monte Carlo simulations and significantly improve the results. A comparative analysis of these strategies has been carried out for computational applications in planar and spatial contexts. Based on these experiments, and on some practical examples of geodetic direct and inverse problems, conclusions and recommendations concerning their performance and general applicability are included.

Production of R,R-2,3-butanediol of ultra-high optical purity from Paenibacillus polymyxa ZJ-9 using homologous recombination.

Science.gov (United States)

Zhang, Li; Cao, Can; Jiang, Ruifan; Xu, Hong; Xue, Feng; Huang, Weiwei; Ni, Hao; Gao, Jian

2018-08-01

The present study describes the use of metabolic engineering to achieve the production of R,R-2,3-butanediol (R,R-2,3-BD) of ultra-high optical purity (>99.99%). To this end, the diacetyl reductase (DAR) gene (dud A) of Paenibacillus polymyxa ZJ-9 was knocked out via homologous recombination between the genome and the previously constructed targeting vector pRN5101-L'C in a process based on homologous single-crossover. PCR verification confirmed the successful isolation of the dud A gene disruption mutant P. polymyxa ZJ-9-△dud A. Moreover, fermentation results indicated that the optical purity of R,R-2,3-BD increased from about 98% to over 99.99%, with a titer of 21.62 g/L in Erlenmeyer flasks. The latter was further increased to 25.88 g/L by fed-batch fermentation in a 5-L bioreactor. Copyright © 2018 Elsevier Ltd. All rights reserved.

Application of behavior-based ergonomics therapies to improve quality of life and reduce medication usage for Alzheimer's/dementia residents.

Science.gov (United States)

Mowrey, Corinne; Parikh, Pratik J; Bharwani, Govind; Bharwani, Meena

2013-02-01

Behavior-based ergonomics therapy (BBET) has been proposed in the past as a viable individualized non-pharmacological intervention to manage challenging behaviors and promote engagement among long-term care residents diagnosed with Alzheimer's/dementia. We evaluate the effect of BBET on quality of life and behavioral medication usage in an 18-bed dementia care unit at a not-for-profit continuing care retirement community in West Central Ohio. Comparing a target cohort during the 6-month pre-implementation period with the 6-month post-implementation period, our study indicates that BBET appears to have a positive impact on the resident's quality of life and also appears to correlate with behavioral medical reduction. For instance, the number of days with behavioral episodes decreased by 53%, the total Minimum Data Set (MDS) mood counts decreased by 70%, and the total MDS behavior counts decreased by 65%. From a medication usage standpoint, the number of pro re nata (PRN) Ativan doses decreased by 57%.

Virtual Turbine Engine Test Bench Using MGET Test Device

Science.gov (United States)

Kho, Seonghee; Kong, Changduk; Ki, Jayoung

2015-05-01

Test device using virtual engine simulator can help reduce the number of engine tests through tests similar to the actual engine tests and repeat the test under the same condition, and thus reduce the engine maintenance and operating costs [1]. Also, as it is possible to easily implement extreme conditions in which it is hard to conduct actual tests, it can prevent engine damages that may happen during the actual engine test under such conditions. In this study, an upgraded MGET test device was developed that can conduct both real and virtual engine test by applying real-time engine model to the existing MGET test device that was developed and has been sold by the Company. This newly developed multi-purpose MGET test device is expected to be used for various educational and research purposes.

Integrated Test and Evaluation Flight Test 3 Flight Test Plan

Science.gov (United States)

Marston, Michael Lawrence

2015-01-01

The desire and ability to fly Unmanned Aircraft Systems (UAS) in the National Airspace System (NAS) is of increasing urgency. The application of unmanned aircraft to perform national security, defense, scientific, and emergency management are driving the critical need for less restrictive access by UAS to the NAS. UAS represent a new capability that will provide a variety of services in the government (public) and commercial (civil) aviation sectors. The growth of this potential industry has not yet been realized due to the lack of a common understanding of what is required to safely operate UAS in the NAS. NASA's UAS Integration into the NAS Project is conducting research in the areas of Separation Assurance/Sense and Avoid Interoperability, Human Systems Integration (HSI), and Communication to support reducing the barriers of UAS access to the NAS. This research is broken into two research themes namely, UAS Integration and Test Infrastructure. UAS Integration focuses on airspace integration procedures and performance standards to enable UAS integration in the air transportation system, covering Sense and Avoid (SAA) performance standards, command and control performance standards, and human systems integration. The focus of Test Infrastructure is to enable development and validation of airspace integration procedures and performance standards, including the integrated test and evaluation. In support of the integrated test and evaluation efforts, the Project will develop an adaptable, scalable, and schedulable relevant test environment capable of evaluating concepts and technologies for unmanned aircraft systems to safely operate in the NAS. To accomplish this task, the Project will conduct a series of Human-in-the-Loop and Flight Test activities that integrate key concepts, technologies and/or procedures in a relevant air traffic environment. Each of the integrated events will build on the technical achievements, fidelity and complexity of the previous tests and

Test report for core drilling ignitability testing

International Nuclear Information System (INIS)

Witwer, K.S.

1996-01-01

Testing was carried out with the cooperation of Westinghouse Hanford Company and the United States Bureau of Mines at the Pittsburgh Research Center in Pennsylvania under the Memorandum of Agreement 14- 09-0050-3666. Several core drilling equipment items, specifically those which can come in contact with flammable gasses while drilling into some waste tanks, were tested under conditions similar to actual field sampling conditions. Rotary drilling against steel and rock as well as drop testing of several different pieces of equipment in a flammable gas environment were the specific items addressed. The test items completed either caused no ignition of the gas mixture, or, after having hardware changes or drilling parameters modified, produced no ignition in repeat testing

Neuropathy Tests

Science.gov (United States)

... LD) Lactoferrin Lactose Tolerance Tests LDL Cholesterol LDL Particle Testing (LDL-P) Lead Legionella Testing Leptin Levetiracetam Lipase ... tests, such as computed tomography (CT) scans or magnetic resonance imaging ... suspected, additional testing may be performed to evaluate heart rate, blood ...

Pinworm test

Science.gov (United States)

Oxyuriasis test; Enterobiasis test; Tape test ... diagnose this infection is to do a tape test. The best time to do this is in ... lay their eggs at night. Steps for the test are: Firmly press the sticky side of a ...

Coverage of the Test of Memory Malingering, Victoria Symptom Validity Test, and Word Memory Test on the Internet: is test security threatened?

Science.gov (United States)

Bauer, Lyndsey; McCaffrey, Robert J

2006-01-01

In forensic neuropsychological settings, maintaining test security has become critically important, especially in regard to symptom validity tests (SVTs). Coaching, which can entail providing patients or litigants with information about the cognitive sequelae of head injury, or teaching them test-taking strategies to avoid detection of symptom dissimulation has been examined experimentally in many research studies. Emerging evidence supports that coaching strategies affect psychological and neuropsychological test performance to differing degrees depending on the coaching paradigm and the tests administered. The present study sought to examine Internet coverage of SVTs because it is potentially another source of coaching, or information that is readily available. Google searches were performed on the Test of Memory Malingering, the Victoria Symptom Validity Test, and the Word Memory Test. Results indicated that there is a variable amount of information available about each test that could threaten test security and validity should inappropriately interested parties find it. Steps that could be taken to improve this situation and limitations to this exploration are discussed.

Test techniques for fracture mechanics testing

International Nuclear Information System (INIS)

Schwalbe, K.H.

1980-01-01

Test methods for fracture mechanics tests are described. Two groups of techniques are distinguished: Those for measurement of stable crack growth and those for determination of the loading parameters. (orig.) [de

Large scale reflood test with cylindrical core test facility (CCTF). Core I. FY 1979 tests

International Nuclear Information System (INIS)

Murao, Yoshio; Akimoto, Hajime; Okubo, Tsutomu; Sudoh, Takashi; Hirano, Kenmei

1982-03-01

This report presents the results of analysis of the data obtained in the CCTF Core I test series (19 tests) in FY. 1979 as an interim report. The Analysis of the test results showed that: (1) The present safety evaluation model on the reflood phenomena during LOCA conservatively represents the phenomena observed in the tests except for the downcomer thermohydrodynamic behavior. (2) The downcomer liquid level rose slowly and it took long time for the water to reach a terminal level or the spill-over level. It was presume that such a results was due to an overly conservative selection of the ECC flow rate. This presumption will be checked against a future test result for an increased flow rate. The loop-seal-water filling test was unsuccessful due to a premature power shutdown by the core protection circuit. The test will be conducted again. The tests to be performed in the future are summerized. Tests for investigation of the refill phenomena were also proposed. (author)