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Sample records for optica con emision

  1. Brain MRI lesions in neuromyelitis optica: clinical case; Lesiones cerebrales de resonancia magnetica en neuromielitis optica: caso clinico

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    Rosales Bravo, Luis Guillermo; Heyden Cordero, Marvin; Chinchilla Weinstok, Dennis; Mendelewicz Goldwaig, Isaias, E-mail: neurologia.cima@gmail.com [Caja Costarricense del Seguro Social, Hospital Mexico, Div. de Neurologia, San Jose (Costa Rica)

    2011-10-15

    Many cases of patients with neuromyelitis optica have submitted without demyelinating lesions in the cerebral white matter, it has documented that this entity can cause from the onset of illness or through its natural evolution. Diagnostic methods currently as Magnetic Resonance Imaging (MRI) and specific antibodies in plasma (such as antiaquaporin-4) have been diagnosed of neuromyelitis optica cases that were initially confused with multiple sclerosis. Disease in Costa Rica has been little prevalent and is not exactly known what the prevalence and incidence. The degree of disorder is illustrated through a case study, both in the cerebral white matter as spinal cord, in a patient with neuromyelitis optica during a follow-up period of 4 years. This is the first case that has been reported in the scientific literature of Costa Rica. (author) [Spanish] Muchos casos de pacientes con neuromielitis optica se han presentado sin lesiones desmielinizantes en la sustancia blanca cerebral, se ha documentado que esta entidad puede causarlas desde el inicio de la enfermedad o a traves de su evolucion natural. Los metodos de diagnostico en la actualidad como la Imagen por Resonancia Magnetica (IRM) y la determinacion de anticuerpos especificos en plasma (como la antiaquaporina-4) han logrado diagnosticar algunos casos de neuromielitis optica que inicialmente fueron confundidos con esclerosis multiple. La enfermedad en Costa Rica ha sido poco prevalente y no se ha conocido con exactitud cual es la prevalencia e incidencia. El grado de afeccion ha sido ilustrado a traves de un caso clinico, tanto en la sustancia blanca cerebral como espinal, en un paciente con neuromielitis optica durante un periodo de seguimiento de 4 anos. Este es el primer caso que ha sido reportado en la literatura cientifica de Costa Rica. (autor)

  2. Catálogo de Radio-Fuentes Opticas con Astrolabio Fotoeléctrico PAII

    Science.gov (United States)

    Manrique, W. T.; Podestá, R. C.; Alonso, E.; Actis, E. V.; Pacheco, A. M.; Bustos, G.; Lizhi, L.; Zezhi, W.; Fanmiao, Z.; Hongqi, W.; Perdomo, R.

    Usando los datos observados en San Juan con el Astrolabio Fotoeléctrico PAII desde Febrero de 1992 hasta Marzo de 1997, se ha realizado el Catálogo de Radio-Fuentes Opticas de San Juan conteniendo 69 estrellas. Las observaciones de las posiciones de las radio-fuentes están realizadas para la época y equinoccio J2000,0 y en un sistema cercano al del FK5. Las precisiones medias son ± 2,2 ms y ± 0,"035 en ascensión recta y declinación respectivamente. Las magnitudes de las estrellas son desde 0,9 a 10,7 . Las declinaciones son desde --2,5 grados a --60 grados. La época media es 1995,1. Se muestran también los resultados comparados con el Catálogo Hiparcos.

  3. Spectrum of pediatric neuromyelitis optica.

    Science.gov (United States)

    Lotze, Timothy E; Northrop, Jennifer L; Hutton, George J; Ross, Benjamin; Schiffman, Jade S; Hunter, Jill V

    2008-11-01

    Our goal was to describe the spectrum of clinical phenotypes, laboratory and imaging features, and treatment in pediatric patients with neuromyelitis optica. The study consisted of a retrospective chart review of patients followed in a pediatric multiple sclerosis center with a diagnosis of neuromyelitis optica spectrum disorder. Nine patients with neuromyelitis optica spectrum disorders were included, all of whom were female. There were 4 black children, 2 Latin American children, 2 white children, and 1 child of mixed Latin American/white heritage. Median age at initial attack was 14 years (range: 1.9-16 years). Median disease duration was 4 years (range: 0.6-9 years). Tests for neuromyelitis optica immunoglobulin G were positive for 7 patients. Eight patients had transverse myelitis and optic neuritis, and 1 patient had longitudinally extensive transverse myelitis without optic neuritis but had a positive neuromyelitis optica immunoglobulin G antibody titer. Cerebral involvement on MRI was found in all subjects, 5 of whom were symptomatic with encephalopathy, seizures, hemiparesis, aphasia, vomiting, or hiccups. Immunosuppressive therapy reduced attack frequency and progression of disability. Pediatric neuromyelitis optica has a diverse clinical presentation and may be difficult to distinguish from multiple sclerosis in the early stages of the disease. The recognition of the broad spectrum of this disease to include signs and symptoms of brain involvement is aided by the availability of a serum biomarker: neuromyelitis optica immunoglobulin G. Early diagnosis and immunosuppresive treatment may help to slow the accumulation of severe disability.

  4. Progressive cerebral atrophy in neuromyelitis optica.

    Science.gov (United States)

    Warabi, Yoko; Takahashi, Toshiyuki; Isozaki, Eiji

    2015-12-01

    We report two cases of neuromyelitis optica patients with progressive cerebral atrophy. The patients exhibited characteristic clinical features, including elderly onset, secondary progressive tetraparesis and cognitive impairment, abnormally elevated CSF protein and myelin basic protein levels, and extremely highly elevated serum anti-AQP-4 antibody titer. Because neuromyelitis optica pathology cannot switch from an inflammatory phase to the degenerative phase until the terminal phase, neuromyelitis optica rarely appears as a secondary progressive clinical course caused by axonal degeneration. However, severe intrathecal inflammation and massive destruction of neuroglia could cause a secondary progressive clinical course associated with cerebral atrophy in neuromyelitis optica patients. © The Author(s), 2015.

  5. Neuromyelitis optica: a diffusional kurtosis imaging study.

    Science.gov (United States)

    Doring, T M; Lopes, F C R; Kubo, T T A; Tukamoto, G; Kimura, M C; Strecker, R M; Domingues, R C; Gasparetto, E L

    2014-12-01

    Conventional MR imaging typically yields normal images of the brain or indicates lesions in areas of high aquaporin expression in patients with neuromyelitis optica. Diffusional kurtosis imaging was applied in patients with neuromyelitis optica to determine whether this technique could detect alterations in diffusion and diffusional kurtosis parameters in normal-appearing white matter and to explore the relationship between diffusional kurtosis imaging and DTI parameters. Thirteen patients with neuromyelitis optica and 13 healthy controls underwent MR imaging of the brain with conventional and diffusional kurtosis imaging sequences. Tract-based spatial statistics and region-of-interest-based analyses were conducted to identify differences between patients with neuromyelitis optica and controls through conventional DTI and diffusional kurtosis imaging parameters. The parameters were correlated to determine the potential relationship between them. Compared with healthy controls, several diffusional kurtosis imaging and DTI parameters were altered in various fiber tracts of patients with neuromyelitis optica (P optica. We found a negative correlation between diffusional kurtosis imaging (radial kurtosis, axial kurtosis, mean kurtosis) and the corresponding DTI parameters (radial diffusivity, axial diffusivity, mean diffusivity). Positive correlations were found for radial kurtosis and mean kurtosis with fractional anisotropy. This study demonstrated differences in conventional diffusion and diffusional kurtosis parameters, especially radial kurtosis, in the normal-appearing white matter of patients with neuromyelitis optica compared with healthy controls. Larger studies of patients with neuromyelitis optica should be performed to assess the potential clinical impact of these findings. © 2014 by American Journal of Neuroradiology.

  6. Neuromyelitis optica in a young child with positive serum autoantibody

    OpenAIRE

    Loma, Ingrid P.; Asato, Miya R.; Filipink, Robyn A.; Alper, Gulay

    2008-01-01

    Relapsing neuromyelitis optica is rare in children. The identification of highly specific serum autoantibody marker (neuromyelitis optica –immunoglobulin G) differentiates neuromyelitis optica from other demyelinating disorders particularly in clinically challenging cases. We present a child with multiple episodes of transverse myelitis and optic neuritis with positive neuromyelitis optica-immunoglobulin G titers consistent with a diagnosis of relapsing neuromyelitis optica. Serial titers of ...

  7. Neuromyelitis Optica Immunoglobulin G in a Child

    OpenAIRE

    Hudson, Lynsee A.; Bernard, Timothy J.; Tseng, Brian S.; Miller, Bradford R.; Corboy, John R.

    2006-01-01

    Neuromyelitis optica or Devic’s syndrome is an uncommon demyelinating disorder that preferentially attacks the spinal cord and optic nerves. Although it is well described in adults, childhood neuromyelitis optica has rarely been reported in the literature and is frequently misdiagnosed as severe multiple sclerosis. Recently, a serum immunoglobulin G test for neuromyelitis optica has become available which may clarify and accelerate the diagnosis. This report describes a child with recurrent m...

  8. Neuromyelitis Optica Lesion Mimicking Brainstem Glioma

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-12-01

    Full Text Available A 12-year-old girl who presented with weakness of the left extremities and right sided sixth cranial nerve palsy had neuromyelitis optica (NMO mistaken for brainstem glioma on MRI, in a report from Brain Research Institute, Yonsei University College of Medicine,Seoul, Republic of KoreaNeuromyelitis Optica, Optic-Spinal Syndrome, Spectroscopy.

  9. Longitudinally extensive optic neuritis in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Pula, John H; Kattah, Jorge C; Keung, Bonnie; Wang, Huaping; Daily, Jennifer

    2014-10-15

    Neuomyelitis optica, sarcoid, and multiple sclerosis can all cause optic neuritis. Further means of distinguishing the causes of optic neuritis among these etiologies would be valuable for the clinician. This is a retrospective, cohort study from a single university based hospital and neuro-ophthalmology clinic. Blinded interpretation of orbit MRIs was performed on patients with acute optic neuritis from multiple sclerosis (n=25), sarcoid (n=5) and neuromyelitis optica spectrum disorder (n=6). A length of >40 mm anterior visual pathway enhancement distinguished neuromyelitis optica spectrum disorder from multiple sclerosis (p=0.0376). No statistically significant differences were found for presence of pain or papillitis, however there was a trend for bilateral involvement and chiasmal involvement in neuromyelitis optica spectrum disorder compared to multiple sclerosis. In acute optic neuritis, enhancing anterior visual pathway lesion length >40 mm helps differentiate neuromyelitis optica spectrum disorder from multiple sclerosis. This degree of involvement can be considered longitudinally extensive optic neuritis. Further characterization is necessary as this degree of enhancement occurs in other clinical syndromes besides neuromyelitis optica. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. INTRODUCTION TO ACTA OPTICA SINICA

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Acta Optica Sinica is a scientific periodical on optics,sponsored by Chinese Optical Society, jointly undertaken by Shanghai Institute of Optics and Fine Mechanics,Changchun Institute of Optics, Fine Mechanics and Physics,the Chinese Academy of Sciences, monthly,first published in 1981. The chief editor is Professor Xu Zhizhan, Academician of the Chinese Academy of Sciences. Now Acta Optica Sinica is a source periodical of the following international index periodicals: SA,CA,EI and PЖ.

  11. Aquaporin 4 and neuromyelitis optica

    Science.gov (United States)

    Papadopoulos, Marios C; Verkman, A S

    2013-01-01

    Neuromyelitis optica is an inflammatory demyelinating disorder of the CNS. The discovery of circulating IgG1 antibodies against the astrocyte water channel protein aquaporin 4 (AQP4) and the evidence that AQP4-IgG is involved in the development of neuromyelitis optica revolutionised our understanding of the disease. However, important unanswered questions remain—for example, we do not know the cause of AQP4-IgG-negative disease, how astrocyte damage causes demyelination, the role of T cells, why peripheral AQP4-expressing organs are undamaged, and how circulating AQP4-IgG enters neuromyelitis optica lesions. New drug candidates have emerged, such as aquaporumab (non-pathogenic antibody blocker of AQP4-IgG binding), sivelestat (neutrophil elastase inhibitor), and eculizumab (complement inhibitor). Despite rapid progress, randomised clinical trials to test new drugs will be challenging because of the small number of individuals with the disorder. PMID:22608667

  12. Neuromyelitis optica-like pathology is dependent on type I interferon response.

    Science.gov (United States)

    Khorooshi, Reza; Wlodarczyk, Agnieszka; Asgari, Nasrin; Owens, Trevor

    2013-09-01

    Neuromyelitis optica is an antibody-mediated autoimmune inflammatory disease of the central nervous system. Reports have suggested that interferon beta which is beneficial for multiple sclerosis, exacerbates neuromyelitis optica. Our aim was to determine whether type I interferon plays a role in the formation of neuromyelitis optica lesions. Immunoglobulin G from a neuromyelitis optica patient was injected intracerebrally with human complement to type I interferon receptor deficient and wildtype mice. Loss of aquaporin-4 and glial fibrillary acidic protein was reduced in type I interferon receptor deficient mice brain. Our findings suggest that type I interferon signaling contributes to neuromyelitis optica pathogenesis. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Neuromyelitis optica with onset in childhood and adolescence.

    Science.gov (United States)

    Fragoso, Yara Dadalti; Ferreira, Maria L B; Oliveira, Enedina M L; Domingues, Renan B; Ribeiro, Taysa A G J; Brooks, Joseph B B; Claudino, Rinaldo; Netto, Jussara M K; Gomes, Sidney; Adoni, Tarso; Carneiro, Denise S D; Fonseca, Daiana R P; Fragomeni, Manuela O; Oliveira, Francisco T M; Oliveira, Celso L S; Saldanha, Patricia C O; Souza, Jorge M B

    2014-01-01

    Neuromyelitis optica with onset before the age of 18 years is a relatively rare, yet potentially devastating condition. The objective of the present study was to contribute to the study of early-onset neuromyelitis optica with a case series. Data were collected from medical records of Brazilian neurologists caring for patients with neuromyelitis optica occurring in childhood and adolescence. Twenty-nine patients with neuromyelitis optica occurring before the age of 18 years and fulfilling the diagnostic criteria were identified. The average age at disease onset was 13 years and the patients had had an average disease duration of 6 years. The expanded disability scale score at the latest consultation was, on average, 4.7, and one patient had died from the disease. The 29 patients had had an average 4.5 relapses during the disease, accounting for 0.75 relapses per year, irrespective of the medication used. All patients were using one or more of the following medications: azathioprine, prednisone, immunoglobulin, and glatiramer acetate. Neuromyelitis optica with onset in childhood and adolescence is a poorly understood condition that is often disabling and difficult to manage. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica.

    Science.gov (United States)

    Wang, Q; Zhang, N; Qin, W; Li, Y; Fu, Y; Li, T; Shao, J; Yang, L; Shi, F-D; Yu, C

    2015-10-01

    Whether gray matter impairment occurs in neuromyelitis optica is a matter of ongoing debate, and the association of gray matter impairment with cognitive deficits remains largely unknown. The purpose of this study was to investigate gray matter volume reductions and their association with cognitive decline in patients with neuromyelitis optica. This study included 50 patients with neuromyelitis optica and 50 sex-, age-, handedness-, and education-matched healthy subjects who underwent high-resolution structural MR imaging examinations and a battery of cognitive assessments. Gray matter volume and cognitive differences were compared between the 2 groups. The correlations of the regional gray matter volume with cognitive scores and clinical variables were explored in the patients with neuromyelitis optica. Compared with healthy controls (635.9 ± 51.18 mL), patients with neuromyelitis optica (602.8 ± 51.03 mL) had a 5.21% decrease in the mean gray matter volume of the whole brain (P optica affected the frontal and temporal cortices and the right thalamus (false discovery rate correction, P optica (Alphasim correction, P optica had impairments in memory, information processing speed, and verbal fluency (P optica and is associated with cognitive impairment and disease severity in this group. © 2015 by American Journal of Neuroradiology.

  15. Relapse of Neuromyelitis Optica Spectrum Disorder Associated with Intravenous Lidocaine

    Directory of Open Access Journals (Sweden)

    Akiyuki Uzawa

    2011-01-01

    Full Text Available Lidocaine unmasks silent symptoms and eases neuropathic pain in multiple sclerosis patients; however, the effects of lidocaine in neuromyelitis optica have never been reported. We describe the case of a 59-year-old Japanese woman with neuromyelitis optica spectrum disorder who developed optic neuritis 1 day after intravenous lidocaine injection for treating allodynia. Her symptom seemed to result from a relapse of neuromyelitis optica induced by lidocaine administration, and not because of the transient effects of intravenous lidocaine administration. The possibility that lidocaine administration results in relapse of neuromyelitis optica due to its immunomodulating effects cannot be ruled out.

  16. Prolonged Remission in Neuromyelitis Optica Following Cessation of Rituximab Treatment.

    Science.gov (United States)

    Weinfurtner, Kelley; Graves, Jennifer; Ness, Jayne; Krupp, Lauren; Milazzo, Maria; Waubant, Emmanuelle

    2015-09-01

    Neuromyelitis optica is an autoimmune disease characterized by acute episodes of transverse myelitis and optic neuritis. Several small, open-label studies suggest rituximab, a monoclonal antibody against CD20, prevents relapses in neuromyelitis optica; however, there is little consensus on timing or duration of treatment. Here we report four patients with severe relapsing neuromyelitis optica who were stabilized on rituximab and, after discontinuing treatment, continued to experience prolonged remission of their disease. Remission ranged from 4.5 to 10.5 years total, including 3 to 9 years off all therapies. The patients had sustained clinical responses despite normal B-lymphocyte levels and, in at least 2 patients, continued seropositivity for aquaporin-4 antibodies. These cases suggest that rituximab may induce prolonged remission in certain neuromyelitis optica patients, and they highlight the need for further elucidation of rituximab's mechanism in neuromyelitis optica. © The Author(s) 2014.

  17. Trigeminal root entry zone involvement in neuromyelitis optica and multiple sclerosis.

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    Sugiyama, Atsuhiko; Mori, Masahiro; Masuda, Hiroki; Uchida, Tomohiko; Muto, Mayumi; Uzawa, Akiyuki; Ito, Shoichi; Kuwabara, Satoshi

    2015-08-15

    Trigeminal root entry zone abnormality on brain magnetic resonance imaging has been frequently reported in multiple sclerosis patients, but it has not been investigated in neuromyelitis optica patients. Brain magnetic resonance imaging of 128 consecutive multiple sclerosis patients and 46 neuromyelitis optica patients was evaluated. Trigeminal root entry zone abnormality was present in 11 (8.6%) of the multiple sclerosis patients and two (4.3%) of the neuromyelitis optica patients. The pontine trigeminal root entry zone may be involved in both multiple sclerosis and neuromyelitis optica. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Asymmetric electrooptic response in a nematic liquid crystal

    Energy Technology Data Exchange (ETDEWEB)

    Dascalu, Constanta [Politechnica University of Bucharest, Bucharest (Romania)

    2001-06-01

    An asymmetric electrooptic response in nematic liquid crystal (LC) has been obtained. The liquid crystal hybrid cell was made by using a standard configuration. One of the ITO (Indium Tin Oxide) electrodes was covered with a surfactant, which induces a homeotropic alignment. The second of the indium tin oxide electrodes was covered by a thin layer of photopolymer, which was previously mixed with an acid, which favours a process of release of protons. Such cations are responsible of electrochemical process in the LC leading to an asymmetric electrooptic response, which depend on the polarity of the applied electric field. This fact is due to an internal field, which change the effective voltage thresholds for the reorientation of the liquid crystal. During the anodic polarization, the optical switching is inhibited because the effective field decreases below the threshold value. On contrary for the opposite polarization the effective field is enough to determine a homeotropic alignment. [Spanish] Se ha obtenido una respuesta electro-optica asimetrica en cristales liquidos neumaticos. La celula hibrida de cristal liquido fue construida utilizando una configuracion estandar. Uno de los electrodos ITO fue cubierto con una pelicula delgada de material organico para inducir una alineacion homeotropa. El otro electrodo ITO fue cubierto con una pelicula delgada de fotopolimero anteriormente mezclada con un acido para favorecer la emision de protones. Estos cationes son responsables del proceso electroquimico en LC, conduciendo a una respuesta electro-optica asimetrica que depende de la polaridad del campo electrico aplicado. Este efecto es originado por un campo interno que cambia el umbral efectivo del voltaje para la reorientacion del cristal liquido. Durante la polarizacion anodica, la conmutacion optica se inhibe debido a que el campo efectivo disminuye abajo del valor del umbral. Por el contrario, para la polarizacion opuesta el campo efectivo es suficiente para

  19. Detection of anti-aquaporin-4 autoantibodies in the sera of Chinese neuromyelitis optica patients

    Institute of Scientific and Technical Information of China (English)

    Miao Li; Weiheng Su; Jie Wang; Francesco Pisani; Antonio Frigeri; Tonghui Ma

    2013-01-01

    In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast (V79) cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica.

  20. Detection of anti-aquaporin-4 autoantibodies in the sera of Chinese neuromyelitis optica patients.

    Science.gov (United States)

    Li, Miao; Su, Weiheng; Wang, Jie; Pisani, Francesco; Frigeri, Antonio; Ma, Tonghui

    2013-03-15

    In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast (V79) cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica.

  1. Detection of anti-aquaporin-4 autoantibodies in the sera of Chinese neuromyelitis optica patients★

    Science.gov (United States)

    Li, Miao; Su, Weiheng; Wang, Jie; Pisani, Francesco; Frigeri, Antonio; Ma, Tonghui

    2013-01-01

    In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast (V79) cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica. PMID:25206717

  2. Imaging Surrogates of Disease Activity in Neuromyelitis Optica Allow Distinction from Multiple Sclerosis.

    Science.gov (United States)

    Matthews, Lucy; Kolind, Shannon; Brazier, Alix; Leite, Maria Isabel; Brooks, Jonathan; Traboulsee, Anthony; Jenkinson, Mark; Johansen-Berg, Heidi; Palace, Jacqueline

    2015-01-01

    Inflammatory demyelinating lesions of the central nervous system are a common feature of both neuromyelitis optica and multiple sclerosis. Despite this similarity, it is evident clinically that the accumulation of disability in patients with neuromyelitis optica is relapse related and that a progressive phase is very uncommon. This poses the question whether there is any pathological evidence of disease activity or neurodegeneration in neuromyelitis optica between relapses. To investigate this we conducted a longitudinal advanced MRI study of the brain and spinal cord in neuromyelitis optica patients, comparing to patients with multiple sclerosis and controls. We found both cross-sectional and longitudinal evidence of diffusely distributed neurodegenerative surrogates in the multiple sclerosis group (including thalamic atrophy, cervical cord atrophy and progressive widespread diffusion and myelin water imaging abnormalities in the normal appearing white matter) but not in those with neuromyelitis optica, where localised abnormalities in the optic radiations of those with severe visual impairment were noted. In addition, between relapses, there were no new silent brain lesions in the neuromyelitis optica group. These findings indicate that global central nervous system neurodegeneration is not a feature of neuromyelitis optica. The work also questions the theory that neurodegeneration in multiple sclerosis is a chronic sequela to prior inflammatory and demyelinating pathology, as this has not been found to be the case in neuromyelitis optica where the lesions are often more destructive.

  3. Brain MRI lesions in neuromyelitis optica: clinical case

    International Nuclear Information System (INIS)

    Rosales Bravo, Luis Guillermo; Heyden Cordero, Marvin; Chinchilla Weinstok, Dennis; Mendelewicz Goldwaig, Isaias

    2011-01-01

    Many cases of patients with neuromyelitis optica have submitted without demyelinating lesions in the cerebral white matter, it has documented that this entity can cause from the onset of illness or through its natural evolution. Diagnostic methods currently as Magnetic Resonance Imaging (MRI) and specific antibodies in plasma (such as antiaquaporin-4) have been diagnosed of neuromyelitis optica cases that were initially confused with multiple sclerosis. Disease in Costa Rica has been little prevalent and is not exactly known what the prevalence and incidence. The degree of disorder is illustrated through a case study, both in the cerebral white matter as spinal cord, in a patient with neuromyelitis optica during a follow-up period of 4 years. This is the first case that has been reported in the scientific literature of Costa Rica. (author) [es

  4. Imaging Surrogates of Disease Activity in Neuromyelitis Optica Allow Distinction from Multiple Sclerosis.

    Directory of Open Access Journals (Sweden)

    Lucy Matthews

    Full Text Available Inflammatory demyelinating lesions of the central nervous system are a common feature of both neuromyelitis optica and multiple sclerosis. Despite this similarity, it is evident clinically that the accumulation of disability in patients with neuromyelitis optica is relapse related and that a progressive phase is very uncommon. This poses the question whether there is any pathological evidence of disease activity or neurodegeneration in neuromyelitis optica between relapses. To investigate this we conducted a longitudinal advanced MRI study of the brain and spinal cord in neuromyelitis optica patients, comparing to patients with multiple sclerosis and controls. We found both cross-sectional and longitudinal evidence of diffusely distributed neurodegenerative surrogates in the multiple sclerosis group (including thalamic atrophy, cervical cord atrophy and progressive widespread diffusion and myelin water imaging abnormalities in the normal appearing white matter but not in those with neuromyelitis optica, where localised abnormalities in the optic radiations of those with severe visual impairment were noted. In addition, between relapses, there were no new silent brain lesions in the neuromyelitis optica group. These findings indicate that global central nervous system neurodegeneration is not a feature of neuromyelitis optica. The work also questions the theory that neurodegeneration in multiple sclerosis is a chronic sequela to prior inflammatory and demyelinating pathology, as this has not been found to be the case in neuromyelitis optica where the lesions are often more destructive.

  5. A population-based study of neuromyelitis optica in Caucasians

    DEFF Research Database (Denmark)

    Asgari, N; Lillevang, S T; Skejoe, H P B

    2011-01-01

    Epidemiologic studies have suggested different prevalence of neuromyelitis optica (NMO) in different ethnic groups. However, data on the incidence and prevalence of NMO in Caucasians are scarce.......Epidemiologic studies have suggested different prevalence of neuromyelitis optica (NMO) in different ethnic groups. However, data on the incidence and prevalence of NMO in Caucasians are scarce....

  6. [A treatment of neuromyelitis optica (Devic's disease) during pregnancy].

    Science.gov (United States)

    Daouda, Moussa Toudou; Obenda, Norlin Samuel; Assadeck, Hamid; Camara, Diankanagbe; Djibo, Fatimata Hassane

    2016-01-01

    Neuromyelitis optica (Devic's disease) is an inflammatory demyelinating disease of the central nervous system that mainly affects spinal cord, optic nerve and brain regions with high aquaporin 4 antigen expression. This is a severe autoimmune disease caused by autoantibodies directed against aquaporin 4 and associated with high morbidity and mortality. Unlike other inflammatory conditions such as multiple sclerosis or rheumatoid polyarthritis, pregnancy does not seem to influence the activity of neuromyelitis optica, hence the need for a thorough treatment during pregnancy. Corticosteroid therapy is the treatment of choice for neuromyelitis optica during pregnancy. Other treatments may also be used including rituximab, some immunosuppressive agents and immunoglobulins. Immunosuppressive treatment or rituximab is recommended when the long-term corticosteroid treatment is contraindicated, in case of inefficiency or if side effects are intolerable. Immunoglobulins are administered to patients with serious outbreaks of neuromyelitis optica which do not respond to bolus methylprednisolone. Immunoglobulins alone can also be continued at a dose of 0.4 g/kg/day for 6-8 weeks until delivery. Plasmapheresis is also a good alternative to bolus methylprednisolone when outbreaks are extremely severe.

  7. Clinical evaluation of rituximab treatment for neuromyelitis optica.

    Science.gov (United States)

    Fernández-Megía, M J; Casanova-Estruch, B; Pérez-Miralles, F; Ruiz-Ramos, J; Alcalá-Vicente, C; Poveda-Andrés, J L

    2015-10-01

    Neuromyelitis optica is an inflammatory and usually relapsing demyelinating autoimmune disease of the central nervous system that targets the optic nerves and spinal cord. Rituximab has been used for different neurological diseases that are probably immune-mediated or involving humoural immunity. The objective of this study is to evaluate the efficacy and safety of rituximab as treatment for neuromyelitis optica in a tertiary hospital. Retrospective study of patients with neuromyelitis optica treated with rituximab 1000mg on days 1 and 15, repeated every 6 to 8 months. We recorded EDSS score, relapse rate, overall condition, CD19+ count, presence of anti-NMO antibodies, and possible adverse reactions. Six patients were treated; all were women with a median age of 46 years (range, 38-58). Anti-NMO antibodies were detected in 3 patients (50%). Baseline EDSS was 4 (range 2.0-5.5). Two patients had previously been treated with an immunomodulatory drug. Median time from the first rituximab infusion to first relapse was 3.7 years (range 1.7-6.9). Two patients had infusion reactions after the first dose of rituximab. Four patients remained relapse-free and their EDSS score did not progress during rituximab treatment, one patient showed no clinical improvement, and one patient could not be evaluated. Rituximab can be considered an attractive therapeutic alternative for patients with neuromyelitis optica as there are no approved treatments for this disease. Further studies with rituximab are needed to establish the role of this drug in treating neuromyelitis optica. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Photo and cathode luminescence emission in oxide silicium films implanted with silicium; Emision de foto y catodoluminiscencia en peliculas de oxido de silicio termico implantadas con silicio

    Energy Technology Data Exchange (ETDEWEB)

    Flores, F; Aceves, M. [Instituto Nacional de Astrofisica Optica y Electronica, Mexico, D.F. (Mexico); Carrillo, J. [Benemrita Universidad Autonoma de Puebla, Puebla (Mexico); Dominguez, C. [Universida Autonoma de Barcelona, Barcelona (Spain); Falcony, C. [Instituto Politecnico Nacional, Mexico, D.F. (Mexico)

    2001-10-01

    We studied the photo and cathodoluminescence of Silicon Rich Oxides (SRO) obtained by ion implant of Si in thermal oxides. Doses of 10{sup 1}6 cm{sup -}2 (low dose) and 10{sup 1}7 cm{sup -}2 (high dose) and implant energy of 150 keV were used. The films were annealed for 30, 60 and 180 minutes in nitrogen at 1100 Celsius degrees. The spectra show photo and cathodoluminescence emission in the visible range, the bands in the spectra change with the conditions of ion implant and annealing. The films without thermal treatment in both dose present photoluminescence bands around 1.9 eV (band B) and 2.4 eV (band C). With the thermal treatments, the band B disappears. In the case of the films with low dose, the band C shows a blue shift and a decrease in intensity. The high dose films have a band centered in 1.7 eV (band A) that increases its intensity with annealings. The cathodoluminescence bands in all the cases are in 2.7 eV (band D) and they present changes with the thermal treatments that it seems they depend on the variation in the implant parameters. [Spanish] Se estudian las propiedades de foto y la catodoluminiscencia de peliculas de oxidos de silicio ricos en Si (Silicon Rich Oxide SRO) obtenidas por implantacion ionica de Si en oxidos termicos. Se usaron dosis de 10{sup 1}6 cm{sup -}2 (dosis baja) y 10{sup 1}7 cm{sup -}2 (dosis alta) y energia de implantacion de 150 keV. Las peliculas se sometieron a tratamientos termicos por 30, 60 y 180 minutos en nitrogeno de 1100 grados centigrados. Se encontro emision foto y catodoluminiscente en el rango visible, las bandas en los espectros cambian con las condiciones de implantacion ionica y con los tratamientos termicos. Las peliculas sin tratamiento termico en ambas dosis presentan bandas de fotoluminiscencia alrededor de 1.9 eV (banda B) y 2.4 eV (banda C). Con los tratamientos termicos, la banda B desaparece. En el caso de las peliculas con dosis baja, la banda C muestra un corrimiento hacia el azul junto con una

  9. Neuromyelitis Optica and Neuromyelitis Optica Spectrum Disorder Patients in Turkish Cohort: Demographic, Clinical, and Laboratory Features.

    Science.gov (United States)

    Altintas, Ayse; Karabudak, Rana; Balci, Belgin P; Terzi, Murat; Soysal, Aysun; Saip, Sabahattin; Tuncer Kurne, Asli; Uygunoglu, Ugur; Nalbantoglu, Mecbure; Gozubatik Celik, Gokcen; Isik, Nihal; Celik, Yahya; Gokcay, Figen; Duman, Taskin; Boz, Cavit; Yucesan, Canan; Mangan, Mehmet Serhat; Celebisoy, Nese; Diker, Sevda; Colpak Isikay, Ilksen; Kansu, Tulay; Siva, Aksel

    2015-10-01

    Neuromyelitis optica (NMO) is an immune-mediated, chronic relapsing, inflammatory disease characterized by severe attacks of optic neuritis and myelitis. To determine the demographic, clinical, and laboratory features; antibody status; and treatment modalities of patients with NMO and neuromyelitis optica spectrum disorders in a Turkish cohort from 11 centers. A total of 182 patients were included in this study. Data on age at disease onset, sex, type of attacks, clinical presentation, analysis of cerebrospinal fluid, serum antiaquaporin-4 antibody status, annual progression index, and medical and family histories were collected. Mean age was 38.43±12.40 years (range, 13 to 75 y), and mean age at disease onset was 31.29±12.40 years (median, 29 y; range, 10 to 74 y). In NMO group, the rate of NMO immunoglobulin (Ig)G positivity was 62.5%. The annual progression index was significantly higher in the longitudinally extending spinal cord lesion. The mean Expanded Disability Status Scale score was higher in the late than early-onset NMO group. Our results revealed a lower rate of NMO IgG positivity, more severe disability in patients with NMO/neuromyelitis optica spectrum disorders presenting with either transverse myelitis or late-onset NMO, and no correlation between disability and NMO IgG status.

  10. Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan.

    Science.gov (United States)

    Tatekawa, H; Sakamoto, S; Hori, M; Kaichi, Y; Kunimatsu, A; Akazawa, K; Miyasaka, T; Oba, H; Okubo, T; Hasuo, K; Yamada, K; Taoka, T; Doishita, S; Shimono, T; Miki, Y

    2018-05-03

    Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data. We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16-85 years; females, 77; aquaporin 4 immunoglobulin G-positive, 93%) and 89 with MS (median age, 36 years; range, 18-67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney U test or the Fisher exact test. We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, P optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders ( P = .001), but not in MS ( P = .80). Visually detailed

  11. Neuromyelitis optica-like pathology is dependent on type I interferon response

    DEFF Research Database (Denmark)

    Khorooshi, Reza; Wlodarczyk, Agnieszka; Asgari, Nasrin

    2013-01-01

    Neuromyelitis optica is an antibody-mediated autoimmune inflammatory disease of the central nervous system. Reports have suggested that interferon beta which is beneficial for multiple sclerosis, exacerbates neuromyelitis optica. Our aim was to determine whether type I interferon plays a role in ...

  12. Pediatric familial neuromyelitis optica in two sisters with long term follow-up.

    Science.gov (United States)

    Chuquilin, Miguel; Mullaguri, Naresh; Weinshenker, Brian

    2016-07-01

    Neuromyelitis optica causes bilateral optic neuritis and longitudinal extensive transverse myelitis. Although usually sporadic, 3% of cases of neuromyelitis optica are familial. The interval over which attacks continue and the long term prognosis for pediatric-onset neuromyelitis optica are not well defined. We describe two patients with pediatric familial neuromyelitis optica with the longest clinical follow-up of a pediatric case reported in the literature to our knowledge. One woman developed blindness with bilateral eye involvement within a few weeks at age 3. This was followed by transverse myelitis with paraparesis at age 19 leading to diagnosis of neuromyelitis optica. Her serum anti-aquaporin 4 antibody was later found to be positive. She continued with sporadic myelitis-related relapses but remained ambulant until age 40 when she had a more severe relapse. There was evidence of longitudinal extensive T2 hyperintensity in the thoracic spinal cord. Her sister also developed blindness at age 3.5 followed by myelitis 1year later with multiple relapses of gait impairment until her death from pneumonia at age 21. These patients represent the rare occurrence of neuromyelitis optica in children within the same family and show that this disease can have prolonged periods of remission but a continued tendency to relapse, supporting the need for lifelong immunosuppression. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Individualized rituximab treatment for relapsing neuromyelitis optica: a pediatric case report.

    Science.gov (United States)

    He, Dian; Yu, YunLi; Yan, WeiBo; Dai, QingQing; Xu, Zhu; Chu, Lan

    2014-08-01

    Neuromyelitis optica is an autoimmune inflammatory disorder of the central nervous system. Current therapeutic approaches are based on small uncontrolled trials, case series, or case reports. There are only a few case reports describing rituximab for pediatric neuromyelitis optica. A 7-year-old girl with neuromyelitis optica had high disease activity with recurrent myelitis and steroid dependence. A remarkable increase of CD19(+) B-cell count in the peripheral blood mononuclear cells and seropositivity for anti-aquaporin 4 antibody were detected at each attack. After induction therapy with rituximab, the CD19(+) B-cell number was significantly reduced and sustained at low levels. The level of serum anti-aquaporin 4 antibody normalized. She was relapse-free over 1-year follow-up period. An individualized maintenance therapy scheme is underway. Treatment with rituximab for relapsing neuromyelitis optica requires an individualized regimen to optimize the frequency and dosage of administration to maximize efficacy yet minimize overtreatment and cost. Personal levels of CD19(+) B cells in peripheral blood mononuclear cells at previous attacks and responsiveness to rituximab in induction therapy may be two useful indicators in establishing individualized maintenance therapy schemes for relapsing neuromyelitis optica. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Paucity of natural killer and cytotoxic T cells in human neuromyelitis optica lesions

    Science.gov (United States)

    Saadoun, Samira; Bridges, Leslie R.; Verkman, A. S.; Papadopoulos, Marios C.

    2013-01-01

    Neuromyelitis optica is a severe inflammatory demyelinating disease of the central nervous system. Most patients with neuromyelitis optica have circulating immunoglobulin G (IgG) antibodies against the astrocytic water channel protein aquaporin-4 (AQP4), which are pathogenic. Anti-AQP4 IgG-mediated complement-dependent astrocyte toxicity is a key mechanism of central nervous system damage in neuromyelitis optica, but the role of natural killer and cytotoxic T cells is unknown. Our objective was to determine whether natural killer and cytotoxic T cells play a role in human neuromyelitis optica lesions. We immunostained four actively demyelinating lesions, obtained from patients with anti-AQP4 IgG positive neuromyelitis optica, for Granzyme B and Perforin. The inflammatory cells were perivascular neutrophils, eosinophils and macrophages, with only occasional Granzyme B+ or Perforin + cells. Greater than 95% of inflamed vessels in each lesion had no surrounding Granzyme B+ or Perforin + cells. Granzyme B+ or Perforin+ cells were abundant in human spleen (positive control). Although natural killer cells produce central nervous system damage in mice injected with anti-AQP4 IgG, our findings here indicate that natural killer-mediated and T cell-mediated cytotoxicity are probably not involved in central nervous system damage in human neuromyelitis optica. PMID:23108041

  15. Neuromyelitis optica and multiple sclerosis

    DEFF Research Database (Denmark)

    Bennett, J. L.; de Seze, J.; Lana-Peixoto, M.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel...

  16. Neuromyelitis optica in an adolescent after bone marrow transplantation.

    Science.gov (United States)

    Baumer, Fiona M; Kamihara, Junne; Gorman, Mark P

    2015-01-01

    Central nervous system complications of bone marrow transplant are a common occurrence and the differential diagnosis is quite broad, including opportunistic infections, medications toxicities, graft versus host disease, and other autoimmune processes. We summarize previously reported cases of autoimmune myelitis in post-transplant patients and discuss a 17-year-old boy who presented with seronegative neuromyelitis optica after a bone marrow transplant for acute myeloid leukemia. Our patient had a marked improvement in symptoms after plasmapheresis. Including our patient, there have been at least eight cases of post-transplant autoimmune myelitis presented in the literature, and at least three of these are suspicious for neuromyelitis optica. Several of these patients had poor outcomes with persistent symptoms after the myelitis. Autoimmune processes such as neuromyelitis optica should be carefully considered in patients after transplant as aggressive treatment like early plasmapheresis may improve outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Hypertrophic pachymeningitis accompanying neuromyelitis optica spectrum disorder: A case report.

    Science.gov (United States)

    Kon, Tomoya; Nishijima, Haruo; Haga, Rie; Funamizu, Yukihisa; Ueno, Tatsuya; Arai, Akira; Suzuki, Chieko; Nunomura, Jin-ichi; Baba, Masayuki; Takahashi, Toshiyuki; Tomiyama, Masahiko

    2015-10-15

    We report a case of idiopathic cerebral hypertrophic pachymeningitis accompanying neuromyelitis optica spectrum disorder. No other identifiable cause of pachymeningitis was detected. Corticosteroid therapy was effective for both diseases. Hypertrophic pachymeningitis is closely related to autoimmune inflammatory disease of the central nervous system. This case supports the hypothesis that hypertrophic pachymeningitis can be a rare comorbidity of neuromyelitis optica spectrum disorder. Copyright © 2015. Published by Elsevier B.V.

  18. Immunology of neuromyelitis optica during pregnancy.

    OpenAIRE

    Bove, Riley; Davoudi, V; Keyhanian, K; Bove, RM; Chitnis, T

    2016-01-01

    Anti-aquaporin-4 (AQP4) autoantibody plays a key role in the pathogenesis of neuromyelitis optica (NMO). Studies have shown increased relapse rates in patients with NMO during pregnancy and postpartum. High estrogen levels during pregnancy can increase act

  19. Imaging the Visual Pathway in Neuromyelitis Optica

    OpenAIRE

    Pfueller, Caspar F.; Paul, Friedemann

    2011-01-01

    The focus of this paper is to summarize the current knowledge on visual pathway damage in neuromyelitis optica (NMO) assessed by magnetic resonance imaging (MRI) and optical coherence tomography (OCT).

  20. Cognitive impairment in Chinese neuromyelitis optica

    NARCIS (Netherlands)

    Zhang, N.; Li, Y.J.; Fu, Y.; Shao, J.H.; Luo, L.L.; Yang, L.; Shi, F.D.; Liu, Y.

    2015-01-01

    Background: Cognitive dysfunction is frequently seen in neuromyelitis optica (NMO). However, the features and influencing factors of cognitive impairment of Chinese NMO patients are unclear. Objective: To investigate the patterns of cognitive impairment in Chinese NMO patients, and correlate the

  1. Neuromyelitis optica antibody in Leber hereditary optic neuropathy: case report

    Directory of Open Access Journals (Sweden)

    Luciano Mesquita Simão

    2012-08-01

    Full Text Available Neuromyelitis optica antibody (or aquaporin-4 antibody is a well stablished serum marker associated to high-risk neuromyelitis optica syndrome that presents as an inflammatory demyelinating disease characterized by the occurrence of bilateral and simultaneous optic neuritis without complete visual recovery or it occurs as an isolated episode of transverse myelitis accompanied by longitudinally extensive spinal cord lesions. On the other hand, Leber hereditary optic neuropathy is a primarily hereditary disorder that affects all tissues of the body and its clinical presentation is tissue-specific for the optic nerve and, eventually, it might reach the spinal cord. Overlapping clinical features of neuromyelitis optica and Leber hereditary optic neuropathy may suggest common target organ diseases. The case report described herein emphasizes the coexistence of serum markers of both diseases, and suggests that further investigation of this challenging clinical presentation is warranted to confirm or rule out this association.

  2. Diagnostik og behandling af neuromyelitis optica

    DEFF Research Database (Denmark)

    Nielsen, Helle Hvilsted; Ravnborg, Mads; Illes, Zsolt

    2014-01-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease characterized by antibodies against aquaporin-4 in up to 80% of the cases and even less in the NMO spectrum disorders, which may be difficult to distinguish from early multiple sclerosis. While immunosuppressive therapy should...

  3. Interferon alpha association with neuromyelitis optica

    DEFF Research Database (Denmark)

    Asgari, Nasrin; Voss, Anne; Steenstrup, Troels

    2013-01-01

    Interferon-alpha (IFN- α ) has immunoregulatory functions in autoimmune inflammatory diseases. The goal of this study was to determine occurrence and clinical consequences of IFN- α in neuromyelitis optica (NMO) patients. Thirty-six NMO and 41 multiple sclerosis (MS) patients from a population...

  4. Subclinical primary retinal pathology in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Jeong, In Hye; Kim, Ho Jin; Kim, Nam-Hee; Jeong, Kyoung Sook; Park, Choul Yong

    2016-07-01

    Foveal thickness may be a more sensitive indicator of primary retinal pathology than retinal nerve fiber layer thickness since the fovea contains no or sparse retinal nerve fiber layer, which coalesces into axons of the optic nerve. To our knowledge, few quantitative in vivo studies have investigated foveal thickness. By using optical coherence tomography, we measured foveal thickness to evaluate intrinsic retinal pathology. Seventy-two neuromyelitis optica spectrum disorder patients (99 eyes with optic neuritis and 45 eyes without optic neuritis) and 34 age-matched controls were included. Foveal thinning was observed both in eyes with non-optic neuritis (185.1 µm, p optica spectrum disorder, foveal thickness correlated with 2.5 % low contrast visual acuity, while retinal nerve fiber layer thickness correlated with high or low contrast visual acuity, extended disability status scale, and disease duration. In this study, we observed foveal thinning irrespective of optic neuritis; thus, we believe that subclinical primary retinal pathology, prior to retinal nerve fiber layer thinning, may exist in neuromyelitis optica spectrum disorder.

  5. Hydrocephalus in neuromyelitis optica

    OpenAIRE

    Clardy, Stacey L.; Lucchinetti, Claudia F.; Krecke, Karl N.; Lennon, Vanda A.; O'Toole, Orna; Weinshenker, Brian G.; Boyd, Clara D.; Krieger, Stephen; McGraw, Corey; Guo, Yong; Pittock, Sean J.

    2014-01-01

    A majority of patients with neuromyelitis optica (NMO) spectrum disorders (NMOSD) have MRI brain abnormalities, some of which are “NMO-typical” with localization in aquaporin 4 (AQP4)–rich circumventricular and periaqueductal regions.1 Although uncommon in adult patients, symptomatic brain involvement occurs in approximately 50% of NMO–immunoglobulin G (IgG) seropositive children. Here we report the clinical characteristics, type, and frequency of hydrocephalus in NMOSD.

  6. Imaging the Visual Pathway in Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Caspar F. Pfueller

    2011-01-01

    Full Text Available The focus of this paper is to summarize the current knowledge on visual pathway damage in neuromyelitis optica (NMO assessed by magnetic resonance imaging (MRI and optical coherence tomography (OCT.

  7. Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Mealy, Maureen A; Kim, Su-Hyun; Schmidt, Felix; López, Reydmar; Jimenez Arango, Jorge A; Paul, Friedemann; Wingerchuk, Dean M; Greenberg, Benjamin M; Kim, Ho Jin; Levy, Michael

    2017-08-01

    Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.

  8. Movement disorders in multiple sclerosis and neuromyelitis optica: A clinical marker of neurological disability.

    Science.gov (United States)

    Candeias da Silva, Carolina; Bichuetti, Denis Bernardi; Azevedo Silva, Sonia Maria Cesar de; Ferraz, Henrique Ballalai; Oliveira, Enedina Maria Lobato de; Borges, Vanderci

    2018-03-03

    Movement disorders are not rare in demyelinating diseases but there are few studies comparing their frequency between multiple sclerosis and neuromyelitis optica spectrum disorder. Our aim was to determine the frequency and the related features of movement disorders in a cohort of patients with multiple sclerosis and neuromyelitis optica spectrum disorder. It is a cross-sectional study of patients with multiple sclerosis and neuromyelitis optica spectrum disorder. Patients were evaluated by a movement disorder specialist. Data from a personal interview and neurological examination were collected. Fahn-Tolosa-Marin tremor rating scale was used for tremor evaluation. Health-related quality of life was assessed using EuroQol instrument. Two hundred fifty-three patients were included (mean [SD] age, 40 [12] years; 74.3% female; median [IQR] EDSS score 2.5 [1.0-6.0]); 26% presented with movement disorders. Paroxysmal dystonia (n = 32) and tremor (n = 27) were the most common movement disorders. Patients with multiple sclerosis and low Expanded Disability Status Scale score (below 4.0) have fewer movement disorders than patients with neuromyelitis optica spectrum disorder. The diagnosis of neuromyelitis optica spectrum disorder was strongly associated with paroxysmal dystonia (OR = 22.07, 95% CI = 2.56-189.78; p = 0.005). Patients with multiple sclerosis and patients without movement disorders have a slightly better quality of life. Paroxysmal dystonia was the most common movement disorder in demyelinating diseases and strongly associated with neuromyelitis optica spectrum disorder. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Suspected bacterial meningomyelitis: The first presenting clinical feature of neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Li, Xiang; Lin, Jie; Pan, Sipei; Weng, Yiyun; Li, Jia; Zhang, Xu; Xia, Junhui; Tong, Qiaowen

    2017-08-15

    A rare case of neuromyelitis optica spectrum disorder, suspected to be bacterial meningomyelitis as the initial manifestation, is reported. The patient presented with initial symptoms of meningomyelitis and fever. Cerebrospinal fluid analysis revealed pleocytosis (1280×10 6 /L [98% lymphocytes]) and glucose level of 1.8mmol/L. Magnetic resonance imaging revealed >3 vertebral, longitudinally extensive transverse myelitis and area postrema lesions. Right optic neuritis was experienced 20months after the first attack. Serum anti-aquaporin-4 antibody was positive, and a diagnosis of neuromyelitis optica spectrum disorder was made, supporting the hypothesis that the pathogenesis of neuromyelitis optica is triggered by infection. Copyright © 2017. Published by Elsevier B.V.

  10. Transverse myelitis associated with an itchy rash and hyperckemia: neuromyelitis optica associated with dermatitis herpetiformis.

    Science.gov (United States)

    Iyer, Anand; Rathnasabapathi, Devipriya; Elsone, Liene; Mutch, Kerry; Terlizzo, Monica; Footitt, David; Jacob, Anu

    2014-05-01

    Neuromyelitis optica is associated with severe neurodisability if not recognized and treated promptly. Several autoimmune disorders are associated with this condition and may vary in their presentation. It is essential that clinicians are aware of the uncommon presenting features of neuromyelitis optica and associated autoimmune conditions. A 53-year-old woman presented with nausea and vomiting and was noted to have an asymptomatic elevated creatinine kinase level, which improved with conservative management. She had a history of iron-deficiency anemia due to long-standing celiac disease that was managed with a gluten-free diet. She then presented with recurrent transverse myelitis and a vesicobullous rash over her arms and feet that was pruritic and excoriating. Skin biopsy results confirmed a clinical diagnosis of dermatitis herpetiformis and antibody test findings against aquaporin-4 were positive, leading to a diagnosis of neuromyelitis optica spectrum disorder. She was treated with methylprednisolone sodium succinate, plasma exchange, and azathioprine and has remained in remission. This report highlights the association of neuromyelitis optica with dermatitis herpetiformis, which can present even without clinical features of celiac disease. Nausea, vomiting, and asymptomatic hyperCKemia should be recognized as rare presenting features of neuromyelitis optica.

  11. Olfactory dysfunction in neuromyelitis optica spectrum disorders

    NARCIS (Netherlands)

    Zhang, L.J.; Zhao, N.; Fu, Y.; Zhang, D.Q.; Wang, J.; Qin, W.; Zhang, N.N.N.; Wood, K.; Liu, Y.; Yu, C.S.; Shi, F.D.; Yang, L.

    2015-01-01

    Few data were available for the understanding of olfactory function in neuromyelitis optica spectrum disorders (NMOSDs). The aims of our study were to investigate the incidence of olfactory dysfunction and characterize olfactory structures, using MRI, in patients with NMOSDs. Olfactory function was

  12. Neuro-ophthalmic manifestation of neuromyelitis optica spectrum disorders

    Directory of Open Access Journals (Sweden)

    Xiao-jun ZHANG

    2014-10-01

    Full Text Available Neuromyelitis optica spectrum disorders (NMOSDs include classic neuromyelitis optica (NMO, opticospinal multiple sclerosis (OSMS, limited form of NMO and isolated optic neuritis or myelitis accompanied by either systemic autoimmune diseases or typical MRI findings of NMO. The common neuro-ophthalmic features of NMOSDs include simultaneous or consecutive bilateral optic neuritis, more commonly seen optic disk edema and surrounding exudate, poor visual recovery, steroid responsiveness and dependency. Combined with serum aquaporin 4 (AQP4 antibody and brain MRI examination, these clinical features can be helpful to the early differential diagnosis between NMOSDs and MS. Some types of eye movement abnormalities have been reported in patients with NMOSDs, but further investigation needs to be done before the specificity of these features are confirmed. doi: 10.3969/j.issn.1672-6731.2014.10.003

  13. Serological prevalence of celiac disease in Brazilian population of multiple sclerosis, neuromyelitis optica and myelitis.

    Science.gov (United States)

    de Oliveira, Pérola; de Carvalho, Daniel Rocha; Brandi, Ivar Viana; Pratesi, Riccardo

    2016-09-01

    Comorbidity of celiac disease with demyelinating diseases of the central nervous system has been reported since the 1960s. The objective of this study was to determine the serological prevalence of celiac disease in the largest series of patients diagnosed with multiple sclerosis, neuromyelitis optica, or myelitis. A prevalence study was conducted with patients evaluated at Sarah Network of Rehabilitation Hospitals between March 2012 and September 2013. They were previously diagnosed with multiple sclerosis, neuromyelitis optica, or idiopathic myelitis. The serum levels of antibodies against tissue transglutaminase and endomysium were assessed. Of the 379 patients evaluated, 249 (65.70%) were diagnosed with multiple sclerosis, 37 (9.56%) with neuromyelitis optica, and 96 (24.54%) with idiopathic myelitis. Two patients (0.53%), one with multiple sclerosis and other with myelitis, tested positive for both antibodies. Our study do not confirm the relationship between celiac serological antibodies with multiple sclerosis, neuromyelitis optica and inflammatory myelitis of an unknown etiology. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis.

    Science.gov (United States)

    Li, Hongyang; Wang, Yanling; Xu, Quangang; Zhang, Aidi; Zhou, Huanfen; Zhao, Shuo; Kang, Hao; Peng, Chunxia; Cao, Shanshan; Wei, Shihui

    2015-10-01

    The detection of anti-aquaporin-4 autoantibody (AQP-4 Ab) is crucial to detect patients who will develop neuromyelitis optica (NMO); however, there are few studies on the AQP-4 Ab serostatus of patients with neuromyelitis optica spectrum ON. We analyzed the clinical and paraclinical features of neuromyelitis optica spectrum ON patients in China according to the patients' AQP4-Ab serostatus. 125 patients with recurrent and bilateral ON with simultaneous attacks were divided into AQP-4 Ab-seropositive and -seronegative groups. Demographic, clinical, serum autoantibody data, connective tissue disorders (CTDs), visual performance were compared. A Visual Acuity (VA) of less than 0.1 during acute ON attacks occurred more frequently in the seropositive group (p = 0.023); however, there was not a significant difference between groups on VA recovery after the first attack. The seropositive group experienced the worst outcome during the last attack (p = 0.017). Other co-existing autoimmunity antibodies (p optica spectrum ON.

  15. Neuromyelitis optica (NMO) - an autoimmune disease of the central nervous system (CNS)

    DEFF Research Database (Denmark)

    Asgari, N; Owens, T; Frøkiaer, J

    2010-01-01

    Asgari N, Owens T, Frøkiaer J, Stenager E, Lillevang ST, Kyvik KO. Neuromyelitis optica (NMO) - an autoimmune disease of the central nervous system (CNS).
Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2010.01416.x.
© 2010 John Wiley & Sons A/S. In the past 10 years, neuromyelitis optica (NMO) has...... or by intrathecal administration to naive mice. NMO may be characterized as a channelopathy of the central nervous system with autoimmune characteristics....

  16. Neuromyelitis optica with linear enhancement of corpus callosum in brain magnetic resonance imaging with contrast: a case report.

    Science.gov (United States)

    Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser; Owji, Mahsa; Naghshineh, Hoda; Minagar, Alireza

    2015-06-10

    Neuromyelitis optica is a demyelinating disease of the central nervous system with various patterns of brain lesions. Corpus callosum may be involved in both multiple sclerosis and neuromyelitis optica. Previous case reports have demonstrated that callosal lesions in neuromyelitis optica are usually large and edematous and have a heterogeneous intensity showing a "marbled pattern" in the acute phase. Their size and intensity may reduce with time or disappear in the chronic stages. In this report, we describe a case of a 25-year-old Caucasian man with neuromyelitis optica who presented clinically with optic neuritis and myelitis. His brain magnetic resonance imaging demonstrated linear enhancement of the corpus callosum. Brain images with contrast agent added also showed linear ependymal layer enhancement of the lateral ventricles, which has been reported in this disease previously. Linear enhancement of corpus callosum in magnetic resonance imaging with contrast agent could help in diagnosing neuromyelitis optica and differentiating it from other demyelinating disease, especially multiple sclerosis.

  17. Immunotherapy of Neuromyelitis Optica

    Science.gov (United States)

    2013-01-01

    Neuromyelitis optica (NMO) is a chronic inflammatory disease of the central nervous system that affects the optic nerves and spinal cord resulting in visual impairment and myelopathy. There is a growing body of evidence that immunotherapeutic agents targeting T and B cell functions, as well as active elimination of proinflammatory molecules from the peripheral blood circulation, can attenuate disease progression. In this review, we discuss the immunotherapeutic options and the treatment strategies in NMO. We also analyze the pathogenic mechanisms of the disease in order to provide recommendations regarding treatments. PMID:24455211

  18. Neuromyelitis optica, atypical hemophagocytic lymphohistiocytosis and heterozygous perforin A91V mutation.

    Science.gov (United States)

    Palterer, Boaz; Brugnolo, Francesca; Sieni, Elena; Barilaro, Alessandro; Parronchi, Paola

    2017-10-15

    Neuromyelitis optica is an autoimmune demyelinating inflammatory disease characterized by optic neuritis and myelitis with anti-aquaporin 4 antibodies. Hemophagocytic lymphohistiocytosis is a severe systemic inflammatory syndrome that can present in a genetic primary form or secondarily to infective, neoplastic or autoimmune diseases. Our case discusses the first reported case of atypical late-onset hemophagocytic lymphohistiocytosis in a patient with neuromyelitis optica, with multiple triggering factors and carrying the common A91V hypomorphic perforin mutation, that blurs the distinction between primary and secondary forms. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Application of unimodal optic fiber to communications among electric substations; Aplicacion de fibra optica unimodal a comunicaciones entre subestaciones electricas

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Pinon, Fernando; Hernandez Juarez, Taide [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1992-07-01

    The utilization of the unimodal fiber optics technology in the electric power systems, represents one of the best communication options because of its multiple advantages, that results in a better coordination of the technical and administrative activities, needed to carry the electric energy from its generation site to the most remote locations. In this document a study, in accordance with the available options for the design of communication systems via unimodal optic fiber, is presented. With this technology, ties of more than 100 kilometers without the need of repeating stations, can be made. [Espanol] La utilizacion de la tecnologia de fibra optica unimodal en los sistemas electricos de potencia representa una de las mejores alternativas de comunicacion por sus multiples ventajas que se traducen en una mejor coordinacion de las acitividades tecnicas y administrativas necesarias para llevar la energia electrica desde el lugar de generacion hasta los puntos mas distantes. En este documento se presenta un estudio de acuerdo a las opciones disponibles para el diseno de sistemas de comunicacion por fibra optica unimodal. Con esta tecnologia se pueden realizar enlaces mayores que 100 km sin necesidad de repetidores.

  20. Neuromyelitis optica-- en vigtig differentialdiagnose til multipel sklerose

    DEFF Research Database (Denmark)

    Holbech, Jakob Vormstrup; Falah, Masoud

    2009-01-01

    Neuromyelitis optica (Devic's disease) is a rare autoimmune neuroinflammatory disease. The disease can often be difficult to distinguish from multiple sclerosis. It is important to be familiar with the disease because of the risk of rapid progression to disability or even death. We describe a 15...

  1. Seronegative neuromyelitis optica after cardiac transplantation.

    Science.gov (United States)

    Kim, Elecia; Van Vrancken, Michael; Shaji, Mohamed; Mir, Osman; Spak, Cedric W; Gupta, Manu; Shamim, Sadat A

    2016-01-01

    We report a case of a 42-year-old man who presented with progressive weakness and blindness over the course of several months and met criteria for seronegative neuromyelitis optica. This presentation was in the setting of immunosuppression following cardiac transplant. No infectious causes were found within the neuroaxis, and he ultimately died with complete blindness, quadriplegia, and respiratory failure attributed to panmyelitis and brain stem inflammation despite aggressive therapies.

  2. EFNS guidelines on diagnosis and management of neuromyelitis optica

    DEFF Research Database (Denmark)

    Sellner, J; Boggild, M; Clanet, M

    2010-01-01

    Neuromyelitis optica (NMO) or Devic's disease is a rare inflammatory and demyelinating autoimmune disorder of the central nervous system (CNS) characterized by recurrent attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM), which is distinct from multiple sclerosis...

  3. EFNS guidelines on diagnosis and management of neuromyelitis optica

    NARCIS (Netherlands)

    Sellner, J.; Boggild, M.; Clanet, M.; Hintzen, R.Q.; Illes, Z.; Montalban, X.; Du Pasquier, R.A.; Polman, C.H.; Sorensen, P.S.; Hemmer, B.

    2010-01-01

    Background and purpose: Neuromyelitis optica (NMO) or Devic's disease is a rare inflammatory and demyelinating autoimmune disorder of the central nervous system (CNS) characterized by recurrent attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM), which is distinct

  4. [Topics of neuromyelitis optica].

    Science.gov (United States)

    Miyamoto, Katsuichi

    2014-01-01

    Neuromyelitis optica (NMO) has been revealed the difference in the pathology of multiple sclerosis since the anti-aquaporin 4 (AQP4) antibody associated with NMO has been found. The clinical epidemiological study has been reviewed, NMO-related patient number in Japan is estimated to be about 4400 people. The antibody-positive patients against myelin-oligodendrocyte glycoprotein (MOG) are present in anti-AQP4 antibody-negative NMO patients. These patients have a characteristic with high frequency of optic neuritis and good response to therapy. In addition, by research in recent years, a new treatment such as anti-IL-6 therapy or anti-complement therapy has been attempted to NMO.

  5. Structural MRI substrates of cognitive impairment in neuromyelitis optica

    NARCIS (Netherlands)

    Liu, Y.; Fu, Y.; Schoonheim, M.M.; Zhang, N.; Fan, M.L.; Su, L.; Shen, Y.; Yan, Y.P.; Yang, L.; Wang, Q.H.; Zhang, N.N.N.; Yu, C.S.; Barkhof, F.; Shi, F.D.

    2015-01-01

    Objective: To identify the clinical and structural MRI markers for predicting cognitive impairment (CI) in patients with neuromyelitis optica (NMO). Methods: Fifty-four patients with NMO and 27 healthy controls underwent extensive neuropsychological testing and multimodal 3.0T MRI. The patient group

  6. Multisystem involvement in neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Megan M Langille

    2015-01-01

    Full Text Available We describe a case of pediatric neuromyelitis optica (NMO with muscle and lung involvement in addition to central nervous system disease. Our patient initially presented with features of area postrema syndrome, then subsequently with optic neuritis. The patient also had recurrent hyperCKemia that responded to corticosteroids. Finally, axillary and hilar adenopathy with pulmonary consolidation were noted as well and responded to immunomodulation. Our case highlights multisystem involvement in NMO including non-infectious pulmonary findings which have not been described in the pediatric population previously.

  7. Limits of reliability of optical properties of commercial glass in Mexico, a comparative analysis with experimental results; Limites de confiabilidad de propiedades opticas de vidrios comerciales en mexico, analisis comparativo con resultados experimentales

    Energy Technology Data Exchange (ETDEWEB)

    Barrios Rodriguez, Pilar; Dorantes Rodriguez, Ruben J. [Universidad Autonoma Metropolitana Azcapotzalco, Mexico, D.F. (Mexico)

    2000-07-01

    The heat transfer through the buildings has been increased by the intensive use of glass in the building's covering; this situation has demanded more electrical energy for compensate the heat's gain or loss. Energy use in buildings is responsible for some 50% of CO{sub 2} emissions in many countries, so it's necessary a building's thermal design for a rational use of energy. The glass is an important material in the building's encircling, so it's essential to count on precise values of the glass's properties for design building's covering. Experimental evaluation on optical properties in some building's glasses to compare the experimental values with manufacturer's reported values inside tolerance limits. [Spanish] La ganancia de calor solar al interior de las edificaciones se ha visto incrementada por la tendencia actual en el uso intensivo y extensivo del vidrio en la envolvente, lo que ha aumentado la necesidad del uso de energia electrica para compensar con climatizacion artificial las ganancias y/o perdidas termicas en los espacios interiores de las edificaciones. El gasto energetico en edificios es responsable de cerca del 50% de emision de CO{sub 2} en varios paises, por lo que es necesario un diseno termico de la envolvente que contempla un uso racional de la energia. Por la importancia termica que el vidrio tiene en la envolvente de las edificaciones y la necesidad de contar con el valor de las propiedades lo mas preciso posible para su diseno, se planteo evaluar en forma experimental el comportamiento termico de algunos vidrios que tuviesen uso tanto real como potencial en las edificaciones de nuestro pais y comparar los valores obtenidos con los valores reportados por los fabricantes dentro de limites de tolerancia o confiabilidad.

  8. Characterization of neuromyelitis optica and neuromyelitis optica spectrum disorder patients with a late onset.

    Science.gov (United States)

    Collongues, N; Marignier, R; Jacob, A; Leite, M I; Siva, A; Paul, F; Zephir, H; Akman-Demir, G; Elsone, L; Jarius, S; Papeix, C; Mutch, K; Saip, S; Wildemann, B; Kitley, J; Karabudak, R; Aktas, O; Kuscu, D; Altintas, A; Palace, J; Confavreux, C; De Seze, J

    2014-07-01

    Few data are available for patients with a late onset (≥ 50 years) of neuromyelitis optica (LONMO) or neuromyelitis optica spectrum disease (LONMOSD), defined by an optic neuritis/longitudinally extensive transverse myelitis with aquaporin-4 antibodies (AQP4-Ab). To characterize LONMO and LONMOSD, and to analyze their predictive factors of disability and death. We identified 430 patients from four cohorts of NMO/NMOSD in France, Germany, Turkey and UK. We extracted the late onset patients and analyzed them for predictive factors of disability and death, using the Cox proportional model. We followed up on 63 patients with LONMO and 45 with LONMOSD during a mean of 4.6 years. This LONMO/LONMOSD cohort was mainly of Caucasian origin (93%), women (80%), seropositive for AQP4-Ab (85%) and from 50 to 82.5 years of age at onset. No progressive course was noted. At last follow-up, the median Expanded Disability Status Scale (EDSS) scores were 5.5 and 6 in the LONMO and LONMOSD groups, respectively. Outcome was mainly characterized by motor disability and relatively good visual function. At last follow-up, 14 patients had died, including seven (50%) due to acute myelitis and six (43%) because of opportunistic infections. The EDSS 4 score was independently predicted by an older age at onset, as a continuous variable after 50 years of age. Death was predicted by two independent factors: an older age at onset and a high annualized relapse rate. LONMO/LONMOSD is particularly severe, with a high rate of motor impairment and death. © The Author(s) 2013.

  9. Idiopathic Transverse Myelitis and Neuromyelitis Optica: Clinical Profiles, Pathophysiology and Therapeutic Choices

    Science.gov (United States)

    Awad, Amer; Stüve, Olaf

    2011-01-01

    Transverse myelitis is a focal inflammatory disorder of the spinal cord which may arise due to different etiologies. Transverse myelitis may be idiopathic or related/secondary to other diseases including infections, connective tissue disorders and other autoimmune diseases. It may be also associated with optic neuritis (neuromyelitis optica), which may precede transverse myelitis. In this manuscript we review the pathophysiology of different types of transverse myelitis and neuromyelitis optica and discuss diagnostic criteria for idiopathic transverse myelitis and risk of development of multiple sclerosis after an episode of transverse myelitis. We also discuss treatment options including corticosteroids, immunosuppressives and monoclonal antibodies, plasma exchange and intravenous immunoglobulins. PMID:22379456

  10. Seronegative neuromyelitis optica spectrum disorder patients diagnosed using new diagnostic criteria.

    Science.gov (United States)

    Uzawa, Akiyuki; Mori, Masahiro; Uchida, Tomohiko; Masuda, Hiroki; Ohtani, Ryohei; Kuwabara, Satoshi

    2016-09-01

    Recently, new diagnostic criteria for neuromyelitis optica spectrum disorders (NMOSD) were published. Our primary aim was to evaluate the usefulness of the new diagnostic criteria in anti-aquaporin 4 (AQP4) antibody-negative cases. Consecutive 471 patients whose anti-AQP4 antibody was measured at Chiba University were reviewed. Four anti-AQP4 antibody negative-patients, who fulfilled the new diagnostic criteria for NMOSD but not 2006 diagnostic criteria for neuromyelitis optica (NMO), were identified. They showed high cerebrospinal fluid interleukin-6 and glial fibrillary acidic protein levels, an absence of oligoclonal bands and/or cloud-like enhancement on magnetic resonance imaging, which are compatible findings for NMO. The new diagnostic criteria are clinically useful in seronegative NMOSD. © The Author(s), 2015.

  11. Neuromyelitis Optica: An Often Forgotten Cause of Intractable Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Chijioke Enweluzo

    2013-07-01

    Full Text Available Neuromyelitis optica, also known as Devic's disease, is a rare autoimmune disorder in which a patient's immune system affects the optic nerves and the spinal cord, leading to loss of vision and spinal cord dysfunction. We present our experience with a 38-year-old female who presented to our facility with complaints of intractable nausea and vomiting. After extensive evaluation, she was found to have neuromyelitis optica. Her symptoms completely resolved following institution of appropriate therapy. She made a significant recovery and has since been placed on chronic immunosuppressive therapy. Through this article we hope to bring attention to a significant cause of intractable nausea and vomiting that may often be forgotten in general medicine or gastroenterology services.

  12. Systemic manifestations and pathogenesis exploration of neuromyelitis optica spectrum disorders

    Directory of Open Access Journals (Sweden)

    Hong JIANG

    2014-09-01

    Full Text Available Objective To investigate the immunological abnormalities beyond central nervous system (CNS associated with neuromyelitis optica spectrum disorders (NMOSDs.  Methods Clinical data of 56 patients with NMOSDs from January 2010 to December 2013 enrolled in Department of Neurology at Peking University People's Hospital were analyzed retrospectively. All patients were divided into 2 groups: neuromyelitis optica (N = 33 and non-neuromyelitis optica (N = 23. Each patient underwent detailed physical examination including internal medicine and nervous system. Records of complicated autoimmune diseases as well as scoring of Expanded Disability Status Scale (EDSS were used to evaluate disease severity. Part of patients received detection of multiple immunological indicators.  Results In all patients with NMOSDs, there were 3 cases with Hashimoto thyroiditis, one case with systemic lupus erythematosus (SLE and Sjögren's syndrome (SS, asthma, hyperthyroidism, rheumatoid arthritis and iridocyclitis, respectively. In patients whose immunological indices were available, the first three abnormal immunological changes were abnormal thyroid function (10/17, positive anti-nuclear antibody (14/28 and positive complement 3 (8/19. In addition, NMOSDs got worsen in 2 cases after delivery.  Conclusions NMOSDs coexist with many kinds of autoimmune diseases and multiple autoantibodies. The above-mentioned autoimmunity may be related to the pathogenesis of NMOSDs. Besides, pregnancy or delivery may aggravate the disease severity of NMOSDs. doi: 10.3969/j.issn.1672-6731.2014.09.009

  13. Severe optic neuritis in a patient with combined neuromyelitis optica spectrum disease and primary Sjögren’s syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Tan Petrina

    2012-11-01

    Full Text Available Abstract Introduction Optic neuritis, although uncommon, can be the initial presentation of Sjögren’s syndrome. Coexisting Sjögren’s syndrome has also been reported with neuromyelitis optica spectrum disorder. This case report highlights the association between the two diseases and the importance of rheumatological and neurological evaluations in patients with such diagnoses. Distinction of neuromyelitis optica with coexisting connective tissue disease has both prognostic and therapeutic significance for the patient. Case presentation We report a case of a 56-year-old Chinese woman who presented with bilateral asymmetric visual loss secondary to optic neuritis. She was subsequently found to be seropositive for neuromyelitis optica immunoglobulin G (NMO-IgG (anti-aquaporin-4 antibody and was diagnosed with neuromyelitis optica spectrum disorder. She also fulfilled the international criteria for Sjögren’s syndrome. Despite initial high dose immunosuppressive therapy, she failed to regain vision in one eye. Conclusion Patients presenting with optic neuritis and severe visual loss should be screened for neuromyelitis optica and treated appropriately. Neuromyelitis optica has been associated with systemic autoimmune diseases, in particular Sjögren’s syndrome, and current evidence indicates that they are two distinct entities. We recommend that both diagnoses be considered in cases of optic neuritis with severe visual loss.

  14. Update on neuromyelitis optica: natural history and management

    Science.gov (United States)

    Jindahra, Panitha; Plant, T

    2012-01-01

    Neuromyelitis optica or Devic disease is an inflammatory disorder of the central nervous system. It is caused by antibodies that attack aquaporin 4 water channels in the cell membrane of astrocytic foot processes at the blood brain barrier. It can involve the optic nerve, the spinal cord and beyond. Here we review its pathophysiology, clinical features, and therapy. PMID:28539779

  15. Higher frequency of brain abnormalities in neuromyelitis optica spectrum disorder patients without primary Sjögren's syndrome.

    Science.gov (United States)

    Gu, Li-Na; Zhang, Min; Zhu, Hui; Liu, Jing-Yao

    2016-10-01

    Neuromyelitis optica spectrum disorder often co-exists with primary Sjögren's syndrome. We compared the clinical features of 16 neuromyelitis optica spectrum disorder patients with ( n = 6) or without primary Sjögren's syndrome ( n = 10). All patients underwent extensive clinical, laboratory, and MRI evaluations. There were no statistical differences in demographics or first neurological involvement at onset between neuromyelitis optica spectrum disorder patients with and without primary Sjögren's syndrome. The laboratory findings of cerebrospinal fluid oligoclonal banding, serum C-reactive protein, antinuclear autoantibody, anti-Sjögren's-syndrome-related antigen A antibodies, anti-Sjögren's-syndrome-related antigen B antibodies, and anti-Sm antibodies were significantly higher in patients with primary Sjögren's syndrome than those without. Anti-aquaporin 4 antibodies were detectable in 67% (4/6) of patients with primary Sjögren's syndrome and in 60% (6/10) of patients without primary Sjögren's syndrome. More brain abnormalities were observed in patients without primary Sjögren's syndrome than in those with primary Sjögren's syndrome. Segments lesions (> 3 centrum) were noted in 50% (5/10) of patients without primary Sjögren's syndrome and in 67% (4/6) of patients with primary Sjögren's syndrome. These findings indicate that the clinical characteristics of neuromyelitis optica spectrum disorder patients with and without primary Sjögren's syndrome are similar. However, neuromyelitis optica spectrum disorder patients without primary Sjögren's syndrome have a high frequency of brain abnormalities.

  16. OPTICA: Our Path Together Initiating Cultural Access. Final Report.

    Science.gov (United States)

    Jackson, Susan, Comp.

    This final report describes the activities and outcomes of OPTICA (Our Path Together Initiating Cultural Access) programs. For each program an information sheet indicates the goal, total participation, status of the goal, and activities of the program. Programs included: (1) Hands On: ASL Creative Story Telling, a program that used children's…

  17. Neuromyelitis Optica Spectrum Disorders.

    Science.gov (United States)

    Akaishi, Tetsuya; Nakashima, Ichiro; Sato, Douglas Kazutoshi; Takahashi, Toshiyuki; Fujihara, Kazuo

    2017-05-01

    Neuromyelitis optica (NMO) is clinically characterized by severe optic neuritis and transverse myelitis, but recent studies with anti-aquaporin-4-antibody specific to NMO have revealed that the clinical spectrum is wider than previously thought. International consensus diagnostic criteria propose NMO spectrum disorders (NMOSD) as the term to define the entire spectrum including typical NMO, optic neuritis, acute myelitis, brain syndrome, and their combinations. NMOSD is now divided into anti-aquaporin-4-antibody-seropositive NMOSD and -seronegative NMOSD (or unknown serostatus). MR imaging and optical coherence tomography are indispensable in the diagnosis and evaluation of NMOSD. This article reviews the clinical and MR imaging findings of anti-aquaporin-4-antibody-seropositive and anti-myelin oligodendrocyte glycoprotein-antibody-seropositive NMOSD. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Neuromyelitis optica with clinical and histopathological involvement of the brain.

    NARCIS (Netherlands)

    Hengstman, G.J.D.; Wesseling, P.; Frenken, C.W.; Jongen, P.J.H.

    2007-01-01

    Diagnostic criteria for neuromyelitis optica (NMO) state that there should be no active disease outside the optic nerves and spinal cord. However, several cases have been described with symptomatic brain involvement. We describe an autopsy case of a patient with NMO and symptomatic involvement of

  19. Neuromyelitis optica spectrum disorders in Algeria: A preliminary study in the region of Tizi Ouzou.

    Science.gov (United States)

    Daoudi, Smail; Bouzar, Melissa

    2016-03-01

    Neuromyelitis optica (NMO) is a disabling inflammatory condition that targets astrocytes in the optic nerves and spinal cord. Recent advances led to the individualization of a set of conditions now referred as NMO spectrum disorder (NMOSD). To describe the prevalence and characteristics of NMO SD in north Algeria. The present study is a retrospective and descriptive work which took place in Nedir Mohamed teaching hospital, Tizi-Ouzou, Algeria. 938 Medical files of patients with CNS inflammatory demyelinating diseases were reviewed then patients with optic neuritis and/or myelitis were preselected. Patients who met the 2015 neuromyelitis optica spectrum disorders criteria were selected and analyzed 08 Patients (3.4%) met the 2015 criteria for neuromyelitis optica spectrum disorders, 3/8 (37.5%) were positive to AQ4-IgG and 5/8 (62.5%) were negative. Mean age of onset was 29 years, female to male ratio was 3:1, cerebral MRI was normal in 75% of cases and longitudinally extensive transverse myelitis was present in 75% of cases. 37/232 Patients (15.9%) were considered at high risk of neuromyelitis optica spectrum disorders The present study suggests that the spectrum of NMO disorders is a rare entity among patients with optic nerve and spinal cord demyelinating lesions in north Algeria. However, the lack of accurate AQ4-IgG test certainly underestimates its real prevalence. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Estudo de propriedades estruturais e opticas de multicamadas epitaxiais emissoras de luz baseadas em InGaN/GaN

    Science.gov (United States)

    Pereira, Sergio Manuel de Sousa

    Esta tese apresenta os resultados de uma investigacao experimental em filmes epitaxiais emissores de luz baseados em InxGa1-xN. O InxGa1-xN e uma liga semicondutora ternaria do grupo III-N muito utilizada como camada activa numa gama de dispositivos optoelectronicos em desenvolvimento, incluindo diodos emissores de luz (LEDs) e diodos laser (LDs), para operacao na regiao do visivel e ultravioleta do espectro electromagnetico. Neste estudo, caracterizam-se as propriedade opticas e estruturais de camadas simples e pocos quânticos multiplos (Multiple Quantum Wells, MQWs) de InxGa1-xN/GaN, com enfase nas suas propriedades fisicas fundamentais. O objectivo central do trabalho prende-se com a compreensao mais profunda dos processos fisicos que estao por tras das suas propriedades opticas, preenchendo o fosso existente entre aplicacoes tecnologicas e o conhecimento cientifico. Nomeadamente, a tese aborda os problemas da medicao da fraccao de InN (x) em multicamadas ultrafinas sujeitas a tensoes, a influencia da composicao e das tensoes microscopicas nas propriedades opticas e estruturais. A questao relativa a segregacao de fases em multicamadas de InxGa1-xN/GaN e tambem discutida a luz dos resultados obtidos. A metodologia seguida assenta na integracao de resultados obtidos por tecnicas complementares atraves de uma analise sistematica e multidisciplinar. Esta abordagem passa pela combinacao de: 1) Crescimento de amostras por deposicao epitaxial em fase de vapor organometalico (MOVPE) com caracteristicas especificas de forma a tentar isolar parâmetros estruturais, tais como espessura e composicao; 2) Caracterizacao nanoestrutural por microscopia de forca atomica (AFM), microscopica electronica de varrimento (SEM), difraccao de raios-X e retro-dispersao de Rutherford (RBS); 3) Caracterizacao optica a escalas complementares por: espectroscopia de absorcao optica (OA), fotoluminescencia (PL), catodoluminescencia (CL) e microscopia confocal (CM) com analise espectral. Com

  1. Diagnosis and management of Neuromyelitis Optica Spectrum Disorder (NMOSD) in Iran

    DEFF Research Database (Denmark)

    Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser; Azimi, Amir Reza

    2017-01-01

    Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been...

  2. Quantifying visual pathway axonal and myelin loss in multiple sclerosis and neuromyelitis optica.

    Science.gov (United States)

    Manogaran, Praveena; Vavasour, Irene M; Lange, Alex P; Zhao, Yinshan; McMullen, Katrina; Rauscher, Alexander; Carruthers, Robert; Li, David K B; Traboulsee, Anthony L; Kolind, Shannon H

    2016-01-01

    The optic nerve is frequently injured in multiple sclerosis and neuromyelitis optica, resulting in visual dysfunction, which may be reflected by measures distant from the site of injury. To determine how retinal nerve fiber layer as a measure of axonal health, and macular volume as a measure of neuronal health are related to changes in myelin water fraction in the optic radiations of multiple sclerosis and neuromyelitis optica participants with and without optic neuritis and compared to healthy controls. 12 healthy controls, 42 multiple sclerosis (16 with optic neuritis), and 10 neuromyelitis optica participants (8 with optic neuritis) were included in this study. Optical coherence tomography assessment involved measurements of the segmented macular layers (total macular, ganglion cell layer, inner plexiform layer, and inner nuclear layer volume) and paripapillary retinal nerve fiber layer thickness. The MRI protocol included a 32-echo T2-relaxation GRASE sequence. Average myelin water fraction values were calculated within the optic radiations as a measure of myelin density. Multiple sclerosis and neuromyelitis optica eyes with optic neuritis history had lower retinal nerve fiber layer thickness, total macular, ganglion cell and inner plexiform layer volumes compared to eyes without optic neuritis history and controls. Inner nuclear layer volume increased in multiple sclerosis with optic neuritis history (mean = 0.99 mm(3), SD = 0.06) compared to those without (mean = 0.97 mm(3), SD = 0.06; p = 0.003). Mean myelin water fraction in the optic radiations was significantly lower in demyelinating diseases (neuromyelitis optica: mean = 0.098, SD = 0.01, multiple sclerosis with optic neuritis history: mean = 0.096, SD = 0.01, multiple sclerosis without optic neuritis history: mean = 0.098, SD = 0.02; F3,55 = 3.35, p = 0.03) compared to controls. Positive correlations between MRI and optical coherence tomography measures were also apparent

  3. Spatial analysis of noise emission at the Los Azufres geothermal field, Mich.; Analisis espacial de emision de ruido en el campo geotermico de Los Azufres, Mich.

    Energy Technology Data Exchange (ETDEWEB)

    Camarena Magana, Emilio; Ordaz Mendez, Christian A. [Comision Federal de Electricidad, Residencia de Los Azufres, Morelia, Michoacan (Mexico)]. E-mail: emilio.camarena@cfe.gob.mx

    2010-01-15

    To verify noise emissions from the usual activities in an operating geothermal field, noise measurements were carried out in a 4.2 km{sup 2} area in the southern zone of the Los Azufres, Mich., geothermal field. There are seven production wells operating here and three abandoned wells. The average noise emission in the southern zone was 36.5 decibels (dB), regarded as the natural reading of environmental-noise emission. In the Christmas (valves) tree for operating production wells, the noise ranges from 70.9 to 91.7 dB, while in open discharging valves for steam-pipes, the noise can reach 118 dB. In Mexico the maximum permissible limit of noise on the periphery of a property is 68 dB in daytime and 65 dB at night. Based on measurements made at the periphery of lots where the geothermal wells are located, four out of seven production wells measured do not exceed the maximum allowable level, while the other three seem to exceed it. However no definite limits exist for the lots. It is recommended that the measurement points as indicated by the official standard in environmental matters be re-established, which will enable noise emissions by several wells that have exceeded the permissible limit, to actually fall within it. [Spanish] Se realizaron mediciones sonicas en un area de 4.2 km{sup 2} localizada en la zona sur del campo geotermico de Los Azufres, Mich., a fin de verificar la emision de ruido asociada a las actividades usuales en un campo geotermico en operacion. En esta area se encuentran siete pozos productores en operacion y tres pozos abandonados. La emision promedio de ruido en estos ultimos fue de 36.5 decibeles (dB), considerandose como la condicion natural de emision de ruido ambiental. En el arbol de valvulas de los pozos productores en operacion el ruido va de los 70.9 a los 91.7 dB, mientras que en valvulas abiertas de descarga de vaporductos la emision puede llegar hasta los 118 dB. En Mexico el limite maximo permisible de ruido en la periferia de

  4. Use of advanced magnetic resonance imaging techniques in neuromyelitis optica spectrum disorder

    NARCIS (Netherlands)

    S. Kremer (Stephane); F. Renard (Felix); S. Achard (Sophie); M.A. Lana-Peixoto (Marco A.); J. Palace (Jacqueline); N. Asgari (Nasrin); E.C. Klawiter (Eric C.); S. Tenembaum (Silvia); B. Banwell (Brenda); B.M. Greenberg (Benjamin M.); J.L. Bennett (Jeffrey); M. Levy (Michael); P. Villoslada (Pablo); A. Saiz (Albert Abe); K. Fujihara (Kazuo); K.H. Chan (Koon Ho); S. Schippling (Sven); F. Paul (Friedemann); H.J. Kim (Ho Jin); J. De Seze (Jerome); J.T. Wuerfel (Jens T.); P. Cabre (Philippe); R. Marignier (Romain); T. Tedder (Thomas); E.D. van Pelt - Gravesteijn (Daniëlle); S. Broadley (Simon); T. Chitnis (Tanuja); D. Wingerchuk (Dean); L. Pandit (Lekha); M.I. Leite (M. Isabel); M. Apiwattanakul (Metha); I. Kleiter (Ingo); N. Prayoonwiwat (Naraporn); M. Han (May); K. Hellwig (Kerstin); K. Van Herle (Katja); G. John (Gareth); D.C. Hooper (D. Craig); I. Nakashima (Ichiro); D. Sato (Douglas); M.R. Yeaman (Michael R.); E. Waubant (Emmanuelle); S. Zamvil (Scott); O. Stüve (Olaf); O. Aktas (Orhan); T.J. Smith (Terry J.); A. Jacob (Anu); K. O'Connor (Kevin)

    2015-01-01

    textabstractBrain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other

  5. New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Komolafe Morenikeji A

    2008-11-01

    Full Text Available Abstract Introduction Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person. Case presentation We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier. Conclusion Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.

  6. A Rare Case of Neuromyelitis Optica Spectrum Disorder in Patient with Sjogren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Supat Thongpooswan

    2014-01-01

    Full Text Available We report a 48-year-old female with the history of Sjogren’s syndrome who presented with 3-week history of tingling, numbness, and shooting back, waist, and bilateral leg pain and numbness in the pelvic region with urinary and bowel incontinence. Physical examination was remarkable for reduced motor power in both lower extremities with spasticity. Sensory deficit was noted at the T6 level. Laboratory investigation revealed elevated ESR and CRP and positive serum antiaquaporin-4 IgG. Thoracic and lumbar magnetic resonance imaging revealed abnormal patchy areas, leptomeningeal enhancement through the thoracic cord extending from T3 through T6 levels, without evidence of cord compression. Impression of neuromyelitis optica spectrum disorder was made and patient was treated with methylprednisolone intravenously followed by tapering oral prednisone. Neurological symptoms gradually improved with resolution of bowel and urinary incontinence. In a patient with Sjogren’s syndrome who presents with neurological complaints, the possibility of neuromyelitis optica or neuromyelitis optica spectrum disorder should be considered. Awareness of the possibility of CNS disease is important due to the serious nature of CNS complications, some of which are treatable with immunosuppressants. Our patient with Sjogren’s syndrome who presented with myelopathy benefited from early recognition and institution of appropriate therapy.

  7. Acquired Demyelinating Syndromes: Focus on Neuromyelitis Optica and childhood-onset Multiple Sclerosis

    NARCIS (Netherlands)

    E.D. van Pelt - Gravesteijn (Daniëlle)

    2016-01-01

    markdownabstractAcquired demyelinating syndromes (ADS) cover a broad spectrum of central nervous system (CNS) inflammatory demyelinating syndromes, of which multiple sclerosis (MS) is the most common subtype. This thesis focuses on two relatively rare clinical subtypes of ADS: neuromyelitis optica

  8. The history of neuromyelitis optica

    Science.gov (United States)

    2013-01-01

    The discovery of a novel serum autoantibody (termed NMO-IgG or AQP4-Ab) in a subset of patients in 2004 has revived interest in neuromyelitis optica (NMO). While the history of classical multiple sclerosis has been extensively studied, only little is known about the history of NMO. In the present article, we provide a comprehensive review of the early history of this rare but intriguing syndrome. We trace the origins of the concept of NMO in the 19th century medical literature and follow its evolution throughout the 20th and into the 21st century. Finally, we discuss recent proposals to revise the concept of NMO and explain why there is indeed a need for a more systematic and descriptive nomenclature. PMID:23320783

  9. Neuromyelitis optica and neuromyelitis optica spectrum disorder: Natural history and long-term outcome, an Indian experience

    Directory of Open Access Journals (Sweden)

    Sujit Abajirao Jagtap

    2015-01-01

    Full Text Available Background: Neuromyelitis optica (NMO has evolved from devic′s classical description to a broader disease spectrum, from monophasic illness to a polyphasic illness with multiple recurrences, disease confined to optic nerve and spinal cord to now brain stem, cerebrum and even endocrinopathy due to hypothalamic involvement. Objectives: To report, the epidemiological characteristics, clinical presentations, recurrence rate, treatment and response to therapy in 26 patients with NMO and NMO spectrum disorder among the Indian population. Methods: We performed observational, retrospective analysis of our prospectively maintained data base of patients with NMO, longitudinally extensive transverse myelitis during the period of January 2003-December 2012 who satisfied the national multiple sclerosis society (NMSS task force criteria for diagnosis of NMO and NMO spectrum disorder. Results: There were 26 patients (female: male, 21:5, the mean age of onset of symptom was 27 years (range 9-58, standard deviation = 12. Twenty-one patients (80% fulfilled NMSS criteria for NMO while rest 5 patients (20% were considered as NMO spectrum disorder. Seven patients (27% had a monophasic illness, 19 patients (73% had a polyphasic illness with recurrences. The Median recurrence rate was 4/patient in the polyphasic group. 13 (50% patient were tested for aquaporin 4 antibody, 8 (61% were positive while 5 patients (39% were negative. All patients received intravenous methyl prednisolone, 9 patients (35% required further treatment for acute illness in view of unresponsiveness to steroids. Thirteen patients (50% received disease-modifying agents for recurrences. Mean duration of follow-up was 5 years. All patients had a good outcome (modified Rankin scale, <3 except one who had poor visual recovery. Conclusion: Neuromyelitis optica/NMO spectrum disorder is demyelinating disorder with female predominance, polyphasic course, myelitis being most common event although brain

  10. Iron and Non-Iron-Related Characteristics of Multiple Sclerosis and Neuromyelitis Optica Lesions at 7T MRI.

    Science.gov (United States)

    Chawla, S; Kister, I; Wuerfel, J; Brisset, J-C; Liu, S; Sinnecker, T; Dusek, P; Haacke, E M; Paul, F; Ge, Y

    2016-07-01

    Characterization of iron deposition associated with demyelinating lesions of multiple sclerosis and neuromyelitis optica has not been well studied. Our aim was to investigate the potential of ultra-high-field MR imaging to distinguish MS from neuromyelitis optica and to characterize tissue injury associated with iron pathology within lesions. Twenty-one patients with MS and 21 patients with neuromyelitis optica underwent 7T high-resolution 2D-gradient-echo-T2* and 3D-susceptibility-weighted imaging. An in-house-developed algorithm was used to reconstruct quantitative susceptibility mapping from SWI. Lesions were classified as "iron-laden" if they demonstrated hypointensity on gradient-echo-T2*-weighted images and/or SWI and hyperintensity on quantitative susceptibility mapping. Lesions were considered "non-iron-laden" if they were hyperintense on gradient-echo-T2* and isointense or hyperintense on quantitative susceptibility mapping. Of 21 patients with MS, 19 (90.5%) demonstrated at least 1 quantitative susceptibility mapping-hyperintense lesion, and 11/21 (52.4%) had iron-laden lesions. No quantitative susceptibility mapping-hyperintense or iron-laden lesions were observed in any patients with neuromyelitis optica. Iron-laden and non-iron-laden lesions could each be further characterized into 2 distinct patterns based on lesion signal and morphology on gradient-echo-T2*/SWI and quantitative susceptibility mapping. In MS, most lesions (n = 262, 75.9% of all lesions) were hyperintense on gradient-echo T2* and isointense on quantitative susceptibility mapping (pattern A), while a small minority (n = 26, 7.5% of all lesions) were hyperintense on both gradient-echo-T2* and quantitative susceptibility mapping (pattern B). Iron-laden lesions (n = 57, 16.5% of all lesions) were further classified as nodular (n = 22, 6.4%, pattern C) or ringlike (n = 35, 10.1%, pattern D). Ultra-high-field MR imaging may be useful in distinguishing MS from neuromyelitis optica. Different

  11. Painful tonic spasms and brainstem involvement in a patient with neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Roman-Filip, Corina; Ungureanu, Aurelian; Cernuşcă-Miţaru, Mihaela

    2016-01-01

    Neuromyelitis optica (NMO) is an inflammatory-demyelinating disease of the central nervous system classically characterized by optic neuritis and severe myelitis. New diagnostic criteria defined neuromyelitis optica spectrum disorder as limited forms of NMO or diverse neurologic presentations in the presence of specific antiaquaporin-4 antibodies. We report the case of a 57-year-old woman admitted in our department for recurrent attacks of optic neuritis, tetraparesis with severe painful tonic spasms of the left limbs and brainstem involvement. Painful tonic spasms have been described as movement disorders associated with multiple sclerosis, but a growing number of reports describe them in cases of NMO. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  12. Neuromyelitis Optica (Devic's Syndrome): an Appraisal.

    Science.gov (United States)

    Crout, Teresa M; Parks, Laura P; Majithia, Vikas

    2016-08-01

    Neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD), previously known as Devic's syndrome, are a group of inflammatory disorders of the central nervous system (CNS) characterized by severe, immune-mediated demyelination and axonal damage, predominantly targeting optic nerves and the spinal cord typically associated with a disease-specific serum NMO-IgG antibody that selectively binds aquaporin-4 (AQP4). The classic and best-defined features of NMOSD include acute attacks of bilateral or rapidly sequential optic neuritis (leading to visual loss) or transverse myelitis (often causing limb weakness and bladder dysfunction) or both with a typically relapsing course. The diagnosis of NMO/NMOSD requires a consistent history and examination with typical clinical presentations, findings on spinal cord neuroimaging with MRI, cerebrospinal fluid analysis along with determination of AQP4-IgG serum autoantibody status, and exclusion of other disorders. Two major advances in this field has been the development of diagnostic criteria and treatment recommendations. Consensus diagnostic criteria have been established and were recently revised and published in 2015, enhancing the ability to make a diagnosis and appropriately evaluate these disorders. Expert recommendations and uncontrolled trials form the basis of treatment guidelines. All patients with suspected NMOSD should be treated for acute attacks as soon as possible with high-dose intravenous methylprednisolone -1 gram daily for three to five consecutive days and in some cases, plasma exchange should be used. It is recommended that every patient with NMOSD be started on an immunosuppressive agent, such as, azathioprine, methotrexate, or mycophenolate and in some cases, rituximab, soon after the acute attack and usually be treated for about 5 years after the attack. These advances have helped improve the prognosis and outcome in these disorders.

  13. Association between TPMT*3C and decreased thiopurine S-methyltransferase activity in patients with neuromyelitis optica spectrum disorders in China.

    Science.gov (United States)

    Gong, Xiaoqing; Mei, Shenghui; Li, Xindi; Li, Xingang; Zhou, Heng; Liu, Yonghong; Zhou, Anna; Yang, Li; Zhao, Zhigang; Zhang, Xinghu

    2018-06-01

    Thiopurines are effective drugs in treating neuromyelitis optica spectrum disorders and other diseases. Thiopurines' toxicity is mainly imputed to thiopurine S-methyltransferase activity. In Chinese population, the most common and important variation of thiopurine S-methyltransferase is TPMT*3C (rs1142345). This study aims to reveal the association between thiopurine S-methyltransferase activity and genetic polymorphisms of thiopurine S-methyltransferase in patients with neuromyelitis optica spectrum disorders in China. A liquid chromatography tandem mass/mass method was used to evaluate the thiopurine S-methyltransferase activity by using 6-mercapthioprine as the substrate in human erythrocyte haemolysate via 1 h incubation at 37 °C to form its methylated product 6-methylmercaptopurine. The amount of 6-methylmercaptopurine was adjusted by haematocrit and normalized to 8 × 10 8 erythrocytes. The selected polymorphisms of thiopurine S-methyltransferase were identified using MassARRAY system (Sequenom) and multiple SNaPshot technique. In 69 patients with neuromyelitis optica spectrum disorders, thiopurine S-methyltransferase activity was 80.29-154.53 (127.51 ± 16.83) pmol/h/8 × 10 8 erythrocytes. TPMT*3C (rs1142345) was associated with lower thiopurine S-methyltransferase activity (BETA = -25.37, P = 0.011). Other selected variants were not associated with thiopurine S-methyltransferase activity. TPMT*3C affects TPMT activity in Chinese patients with neuromyelitis optica spectrum disorders. Further studies are warranted to confirm the results. TPRs = thiopurines; NMOSD = neuromyelitis optica spectrum disorders; TPMT = thiopurine S-methyltransferase; LC-MS/MS = liquid chromatography tandem mass/mass; 6-MMP = 6-methylmercaptopurine; IS = internal standard; SNP = single nucleotide polymorphism; MAF = minor allele frequency; HWE = Hardy-Weinberg equilibrium; BETA = regression coefficients; UTR-3 = untranslated region 3.

  14. The Urine Proteome Profile Is Different in Neuromyelitis Optica Compared to Multiple Sclerosis

    DEFF Research Database (Denmark)

    Nielsen, Helle H; Beck, Hans C; Kristensen, Lars P

    2015-01-01

    OBJECTIVES: Inflammatory demyelinating diseases of the CNS comprise a broad spectrum of diseases like neuromyelitis optica (NMO), NMO spectrum disorders (NMO-SD) and multiple sclerosis (MS). Despite clear classification criteria, differentiation can be difficult. We hypothesized that the urine...

  15. Influence of female sex and fertile age on neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Borisow, Nadja; Kleiter, Ingo; Gahlen, Anna; Fischer, Katrin; Wernecke, Klaus-Dieter; Pache, Florence; Ruprecht, Klemens; Havla, Joachim; Krumbholz, Markus; Kümpfel, Tania; Aktas, Orhan; Ringelstein, Marius; Geis, Christian; Kleinschnitz, Christoph; Berthele, Achim; Hemmer, Bernhard; Angstwurm, Klemens; Weissert, Robert; Stellmann, Jan-Patrick; Schuster, Simon; Stangel, Martin; Lauda, Florian; Tumani, Hayrettin; Mayer, Christoph; Zeltner, Lena; Ziemann, Ulf; Linker, Ralf A; Schwab, Matthias; Marziniak, Martin; Then Bergh, Florian; Hofstadt-van Oy, Ulrich; Neuhaus, Oliver; Winkelmann, Alexander; Marouf, Wael; Rückriem, Lioba; Faiss, Jürgen; Wildemann, Brigitte; Paul, Friedemann; Jarius, Sven; Trebst, Corinna; Hellwig, Kerstin

    2017-07-01

    Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p 40 years. Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.

  16. Müller cells and retinal axons can be primary targets in experimental neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Zeka, Bleranda; Lassmann, Hans; Bradl, Monika

    2017-01-01

    Recent work from our laboratory, using different models of experimental neuromyelitis optica spectrum disorder (NMOSD), has led to a number of observations that might be highly relevant for NMOSD patients. For example: (i) in the presence of neuromyelitis optica immunoglobulin G, astrocyte-destructive lesions can be initiated by CD4+ T cells when these cells recognize aquaporin 4 (AQP4), but also when they recognize other antigens of the central nervous system. The only important prerequisite is that the T cells have to be activated within the central nervous system by "their" specific antigen. Recently activated CD4+ T cells with yet unknown antigen specificity are also found in human NMOSD lesions. (ii) The normal immune repertoire might contain AQP4-specific T cells, which are highly encephalitogenic on activation. (iii) The retina might be a primary target of AQP4-specific T cells and neuromyelitis optica immunoglobulin G: AQP4-specific T cells alone are sufficient to cause retinitis with low-grade axonal pathology in the retinal nerve fiber/ganglionic cell layer. A thinning of these layers is also observed in NMOSD patients, where it is thought to be a consequence of optic neuritis. Neuromyelitis optica immunoglobulin G might target cellular processes of Müller cells and cause their loss of AQP4 reactivity, when AQP4-specific T cells open the blood-retina barrier in the outer plexiform layer. Patchy loss of AQP4 reactivity on Müller cells of NMOSD patients has been recently described. Cumulatively, our findings in experimental NMOSD suggest that both CD4+ T cell and antibody responses directed against AQP4 might play an important role in the pathogenesis of tissue destruction seen in NMOSD.

  17. Neuromyelitis optica spectrum disorders: beyond longitudinally extensive transverse myelitis

    International Nuclear Information System (INIS)

    Lemos, M.D.; Carvalho, G.B.S.; Carvalho, R.S.; Bichuetti, D.B.; Oliveira, E.M.L. de; Abdala, N.

    2015-01-01

    Aim: To describe the neuroradiological features and their prevalence in patients with neuromyelitis optica (NMO). Materials and methods: Two neuroradiologists independently reviewed 35 spinal cord and 37 brain MRI studies from patients with NMO. The examinations were analysed for the presence of lesion, topography, enhancement, and brain lesions suggestive of multiple sclerosis and/or NMO. Results: Seventy percent of the spinal cord lesions involved over three or more vertebral segments. Seventy-eight percent of brain scans were abnormal, and the most prevalent findings were non-specific foci of T2 hyperintensities in the cerebral white matter (55%) and brainstem lesions (52%). One patient had lesions disseminated in space compatible with multiple sclerosis according to 2010 revised McDonald criteria. Brain lesions suggestive of NMO occurred at least once in 17 (59%) patients. Conclusion: Spinal cord lesions were often longitudinally extensive and brain lesions were common, with the majority of patients having at least one distinctive NMO lesion. - Highlights: • Neuromyelitis optica (NMO) affects mainly the spinal cord but also the brain. • We accessed the radiological features of patients with NMO in brain and spinal cord. • We found a high prevalence of extensive myelitis and specific brain lesions. • Some brainstem lesions could be misdiagnosed if not actively searched. • A practical approach to evaluate suspected NMO images is presented

  18. Membranous nephropathy with Neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Li, Xiangling; Wang, YanQiang

    2017-07-01

    Membranous nephropathy (MN) accompanying Neuromyelitis optica spectrum disorders (NMOSD) has rarely been described previously. We recently presented a 45-year-old Chinese male presenting with recurrent lower extremity pitting edema, or eyelid edema, proteinuria and hyperlipidemia. especially intractable hiccup and vomiting, painful tonic spasm (PTS) as the revealing symptom of a demyelinating disorder of central nervous system. The kindey biopsy specimen showed MN stage 2. Serological testing revealed antibodies AQP4, MRI head and spine revealed medulla oblongata and C1-C2 cervical vertebra lesions. Treatment with methylprednisolone, cyclophosphamide, azathioprine resulted in consistent clinical improvement. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Clinical characteristics of late-onset neuromyelitis optica spectrum disorder: A multicenter retrospective study in Korea.

    Science.gov (United States)

    Seok, Jin Myoung; Cho, Hye-Jin; Ahn, Suk-Won; Cho, Eun Bin; Park, Min Su; Joo, In-Soo; Shin, Ha Young; Kim, Sun-Young; Kim, Byung-Jo; Kim, Jong Kuk; Cho, Joong-Yang; Huh, So-Young; Kwon, Ohyun; Lee, Kwang-Ho; Kim, Byoung Joon; Min, Ju-Hong

    2017-11-01

    There are currently few studies regarding late-onset neuromyelitis optica spectrum disorder (LO-NMOSD). We aimed to describe the characteristic features of patients with LO-NMOSD in Korea. Anti-aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder (NMOSD) from nine tertiary hospitals were reviewed retrospectively. The patients were divided into two groups based on age of onset: LO-NMOSD (⩾50 years of age at onset) versus early-onset neuromyelitis optica spectrum disorder (EO-NMOSD) (<50 years of age at onset). Clinical, laboratory, and magnetic resonance imaging (MRI) parameters were investigated. Among a total of 147 patients (125 female; age of onset, 39.4 ± 15.2 years), 45 patients (30.6%) had an age of onset of more than 50 years. Compared to patients with EO-NMOSD, patients with LO-NMOSD had more frequent isolated spinal cord involvement at onset (64.4% vs 37.2%, p = 0.002), less frequent involvement of the optic nerve (40.0% vs 67.7%, p = 0.002), and less frequent brain MRI lesions (31.1% vs 50.0%, p = 0.034). Furthermore, there was a significant positive correlation between age of onset and Expanded Disability Status Scale (EDSS) score at last follow-up ( r = 0.246, p = 0.003). Age of onset could be an important predictor of lesion location and clinical course of patients with NMOSD.

  20. Brain perfusion SPECT analysis : New insights in mild cognitive impairment and neuromyelitis optica

    NARCIS (Netherlands)

    Sánchez Catasùs, Carlos Alfredo

    2018-01-01

    Het doel van dit proefschrift was om aan te tonen dat hersenperfusie SPECT kan helpen bij het verhelderen van belangrijke vragen met betrekking tot het prodromale “Mild Cognitive Impairment” (MCI) stadium van de ziekte van Alzheimer (AD) en recidiverende Neuromyelitis Optica (NMO). Dit is niet

  1. Th17 cells in neuromyelitis optica spectrum disorder: a review.

    Science.gov (United States)

    Lin, Jie; Li, Xiang; Xia, Junhui

    2016-12-01

    Neuromyelitis optica spectrum disorder (NMOSD) has been identified as a central nervous system (CNS) autoimmune inflammatory disorder, which has been recognized as a B cell-mediated humoral immune disease. However, cases have been reported indicating that some of the neuromyelitis optica (NMO) patients have been resistant to B cell-related treatments. Recently, more and more evidence has shown that T cell-mediated immunity may take part in the pathogenesis of NMOSD, especially in the Th17 phenotype. In our PUBMED search, we used the following keywords: Th17 cell, Th17 cell-related cytokines, T cells, B cells, B cell-related productions, NMO, NMOSD, recurrent/bilateral optic neuritis, recurrent transverse myelitis and longitudinally extensive transverse myelitis. We systemically reviewed the role of Th17 cells and Th17 cell-related cytokines in NMOSD. We found that Th17 cells and Th17-related cytokines, such as IL-6, IL-1β, IL-17, IL-21, IL-22, IL-23 and TGF-β, are not only directly involved in the pathogenesis but also collaborated with B cells and B cell-related antibody production to induce CNS lesions. Th17 cell-related therapy has also been reviewed in this article, and the data suggested that Th17 may be a new therapeutic target of NMOSD.

  2. High risk of postpartum relapses in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Klawiter, Eric C; Bove, Riley; Elsone, Liene; Alvarez, Enrique; Borisow, Nadja; Cortez, Melissa; Mateen, Farrah; Mealy, Maureen A; Sorum, Jaime; Mutch, Kerry; Tobyne, Sean M; Ruprecht, Klemens; Buckle, Guy; Levy, Michael; Wingerchuk, Dean; Paul, Friedemann; Cross, Anne H; Jacobs, Anu; Chitnis, Tanuja; Weinshenker, Brian

    2017-11-28

    To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting. We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications. There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected. The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery. © 2017 American Academy of Neurology.

  3. Antibodies against aquaporin-4 in neuromyelitis optica: distinction between recurrent and monophasic patients

    NARCIS (Netherlands)

    Ketelslegers, I.A.; Modderman, P.W.; Vennegoor, A.; Killestein, J.; Hamann, D.; Hintzen, R.Q.

    2011-01-01

    The detection of antibodies against aquaporin-4 (AQP4) has improved the diagnosis of neuromyelitis optica (NMO). We evaluated a recently established cell-based anti-AQP4 assay in 273 patients with inflammatory CNS demyelination. The assay had a specificity of 99% and a sensitivity of 56% to detect

  4. The Treatment of Neuromyelitis Optica

    Science.gov (United States)

    Kowarik, Markus C.; Soltys, John; Bennett, Jeffrey L.

    2014-01-01

    Neuromyelitis optica (NMO) is an autoimmune disorder of the central nervous system directed against astrocytes. Initially diagnosed in individuals with monophasic or relapsing optic neuritis and transverse myelitis, NMO is now recognized as a demyelinating disorder with pleiotropic presentations due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 in the majority of individuals. As visual impairment and neurologic dysfunction in NMO are commonly severe, aggressive treatment of relapses and prophylactic immunomodulatory therapy are the focus of treatment. Although there are no approved treatments for NMO, medications and therapeutic interventions for acute and chronic treatment have been the subject of retrospective study and case reports. The goal of this review is to familiarize the reader with biologic and clinical data supporting current treatments in NMO and highlight future strategies based on advancements in our understanding of NMO pathogenesis. PMID:24531318

  5. Treatment-resistant neuromyelitis optica spectrum disorders associated with Toxocara canis infection: A case report.

    Science.gov (United States)

    Kambe, Daisuke; Takeoka, Kayo; Ogawa, Kenta; Doi, Kosuke; Maruyama, Haruhiko; Yoshida, Ayako; Suenaga, Toshihiko; Kageyama, Takashi

    2017-04-01

    A 53-year-old woman was admitted to the department of neurology in Tenri Hospital because of progressive thoracic myelitis a month after she had eaten uncooked bovine liver. A previous episode of right optic neuritis and a positive test for serum anti-aquaporin-4 antibodies indicated a diagnosis of neuromyelitis optica spectrum disorders. Although the patient initially recovered with the reduction of anti-aquaporin-4 antibodies during treatment with intravenous methylprednisolone infusion and plasma exchange, her neurological symptoms deteriorated soon after the completion of plasma exchange. Western blotting analysis detected anti-Toxocara canis antibodies in the serum; thus, the patient underwent oral albendazole treatment. This resulted in the alleviation of her symptoms. We therefore consider that rigorous investigation should be encouraged to detect rare pathogens including parasites in cases of treatment-resistant neuromyelitis optica spectrum disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Neuromyelitis optica med udtalte cerebrale magnetisk resonans-skannings-forandringer hos en niårig pige

    DEFF Research Database (Denmark)

    Trautner, Simon; Pedersen, Hans Peder; Bendtson, Inger

    2009-01-01

    Neuromyelitis optica (NMO) is a rare inflammatory disorder characterised by optic neuritis and transverse myelitis. We report a severe pediatric case presenting with impaired vision, tetraparesis, bladder retention and lower extremity pain. Magnetic resonance imaging demonstrated longitudinally...

  7. Gaze palsy, hypogeusia and a probable association with miscarriage of pregnancy--the expanding clinical spectrum of non-opticospinal neuromyelitis optica spectrum disorders: a case report.

    Science.gov (United States)

    Chang, Thashi; Withana, Milinda

    2015-02-10

    Neuromyelitis optica is characterised by optic neuritis, longitudinally-extensive transverse myelitis and presence of anti-aquaporin-4 antibodies in the serum. However, non-opticospinal central nervous system manifestations have been increasingly recognised. Awareness of the widening clinical spectrum of neuromyelitis optica (unified within the nosology of 'neuromyelitis optica spectrum disorders') is key to earlier diagnosis and appropriate therapy. We report 2 patients to illustrate the varied clinical manifestations of neuromyelitis optica spectrum disorders while postulating an effect of anti-aquaporin-4 antibodies on the miscarriage of pregnancy. This is the first report of horizontal gaze palsy as a presenting symptom of neuromyelitis optica spectrum disorders. Patient 1: A 17-year-old Sri Lankan female presented with hypersomnolence, lateral gaze palsy and loss of taste of 1 week duration. Two years previously she had presented with intractable hiccups and vomiting followed by a brainstem syndrome. Magnetic resonance imaging showed a lesion in the left cerebellum extending into the pons while lesions in bilateral hypothalami and medulla noted 2 years ago had resolved. Autoimmune, vasculitis and infection screens were negative. Anti-aquaporin-4 antibodies were detected in serum. All her symptoms resolved with immunosuppressive therapy. Patient 2: A 47-Year-old Sri Lankan female presented with persistent vomiting lasting over 3 weeks. Three years previously, at 25-weeks of her 4(th) pregnancy, she had presented with quadriparesis and was found to have a longitudinally extensive transverse myelitis from C2 to T2 vertebral levels, which gradually improved following intravenous steroid therapy. Magnetic resonance imaging showed a hyper-intense lesion in the area postrema and longitudinally extensive atrophy of the cord corresponding to her previous myelitis. Autoimmune, vasculitis and infection screens were negative. Anti-aquaporin-4 antibodies were detected in

  8. Neuromyelitis optica with Hashimoto′s thyroiditis: A new syndrome or just coincidence

    Directory of Open Access Journals (Sweden)

    Abhishek Singhai

    2015-01-01

    Full Text Available Neuromyelitis optica (NMO is an uncommon disease syndrome of the central nervous system that affects the optic nerves and spinal cord. NMO with endocrinopathies has been described as being unique to black Antillean and Afro-Brazilian women. We describe one case of NMO with hashimoto′s thyroiditis in a young female, probably first case report in India.

  9. Brainstem and limbic encephalitis with paraneoplastic neuromyelitis optica.

    Science.gov (United States)

    Moussawi, Khaled; Lin, David J; Matiello, Marcelo; Chew, Sheena; Morganstern, Daniel; Vaitkevicius, Henrikas

    2016-01-01

    The spectrum of disorders associated with anti-neuromyelitis optica (NMO) antibody is being extended to include infrequent instances associated with cancer. We describe a patient with brainstem and limbic encephalitis from NMO-immunoglobulin G in serum and cerebrospinal fluid in the context of newly diagnosed breast cancer. The neurological features markedly improved with excision of her breast cancer and immune suppressive therapy. This case further broadens the NMO spectrum disorders (NMOSD) by an association between NMOSD and cancer and raises the question of coincidental occurrence and the appropriate circumstances to search for a tumor in certain instances of NMO. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Cognitive Impairment and Whole Brain Diffusion in Patients with Neuromyelitis Optica after Acute Relapse

    Science.gov (United States)

    He, Diane; Wu, Qizhu; Chen, Xiuying; Zhao, Daidi; Gong, Qiyong; Zhou, Hongyu

    2011-01-01

    The objective of this study investigated cognitive impairments and their correlations with fractional anisotropy (FA) and mean diffusivity (MD) in patients with neuromyelitis optica (NMO) without visible lesions on conventional brain MRI during acute relapse. Twenty one patients with NMO and 21 normal control subjects received several cognitive…

  11. Neuromyelitis optica spectrum disorder presenting with repeated hypersomnia due to involvement of the hypothalamus and hypothalamus-amygdala linkage.

    Science.gov (United States)

    Kume, Kodai; Deguchi, Kazushi; Ikeda, Kazuyo; Takata, Tadayuki; Kokudo, Yohei; Kamada, Masaki; Touge, Tetsuo; Takahashi, Toshiyuki; Kanbayashi, Takashi; Masaki, Tsutomu

    2015-06-01

    We report the case of a 46-year-old Japanese woman with neuromyelitis optica spectrum disorder presenting with repeated hypersomnia accompanied by decreased CSF orexin level. First episode associated with hypothalamic-pituitary dysfunction showed bilateral hypothalamic lesions that can cause secondary damage to the orexin neurons. The second episode associated with impaired memory showed a left temporal lesion involving the amygdala. The mechanism remains unknown, but the reduced blood flow in the hypothalamus ipsilateral to the amygdala lesion suggested trans-synaptic hypothalamic dysfunction secondary to the impaired amygdala. A temporal lesion involving the amygdala and hypothalamus could be responsible for hypersomnia due to neuromyelitis optica spectrum disorder. © The Author(s), 2015.

  12. An update on the evidence for the efficacy and safety of rituximab in the management of neuromyelitis optica

    Science.gov (United States)

    Collongues, Nicolas; de Seze, Jérôme

    2016-01-01

    Neuromyelitis optica spectrum disorders (NMOSDs) is a new concept which includes classical neuromyelitis optica (NMO) and partial forms of NMO such as recurrent optic neuritis with positive aquaporin-4 antibodies (AQP4) or brainstem symptoms (intractable hiccups or vomiting). This disease is clearly distinguished from multiple sclerosis (MS) and the therapeutic approach is clearly different. Rituximab is actually considered to be one of the most efficient treatments of NMOSD, even if class I studies are clearly lacking. In the present review, we describe the state of the art about rituximab treatment in NMOSD, including adults and children, plus its efficacy and tolerance and we also underline the questions that should be addressed in the near future. PMID:27134673

  13. An update on the evidence for the efficacy and safety of rituximab in the management of neuromyelitis optica.

    Science.gov (United States)

    Collongues, Nicolas; de Seze, Jérôme

    2016-05-01

    Neuromyelitis optica spectrum disorders (NMOSDs) is a new concept which includes classical neuromyelitis optica (NMO) and partial forms of NMO such as recurrent optic neuritis with positive aquaporin-4 antibodies (AQP4) or brainstem symptoms (intractable hiccups or vomiting). This disease is clearly distinguished from multiple sclerosis (MS) and the therapeutic approach is clearly different. Rituximab is actually considered to be one of the most efficient treatments of NMOSD, even if class I studies are clearly lacking. In the present review, we describe the state of the art about rituximab treatment in NMOSD, including adults and children, plus its efficacy and tolerance and we also underline the questions that should be addressed in the near future.

  14. Acute Respiratory Failure due to Neuromyelitis Optica Treated Successfully with Plasmapheresis

    Directory of Open Access Journals (Sweden)

    Massa Zantah

    2016-01-01

    Full Text Available Neuromyelitis Optica (NMO is a demyelinating autoimmune disease involving the central nervous system. Acute respiratory failure from cervical myelitis due to NMO is known to occur but is uncommon in monophasic disease and is treated with high dose steroids. We report a case of a patient with NMO who developed acute respiratory failure related to cervical spinal cord involvement, refractory to pulse dose steroid therapy, which resolved with plasmapheresis.

  15. Continuous Positive Airway Pressure (CPAP for prevention of recurrent pneumonia in the Neuromyelitis Optica patient

    Directory of Open Access Journals (Sweden)

    James A. Welker

    2014-01-01

    Conclusions: Patients with Neuromyelitis Optica differ from those with traumatic spinal cord injury as they have a chronic progressive systemic illness that causes continued deterioration of their nervous system resulting in the need for routine monitoring that ensures the timely addition of CPAP for the prevention of pneumonia and its associated medical expenses.

  16. A Case of Neuromyelitis Optica Masquerading as Miller Fisher Syndrome

    Directory of Open Access Journals (Sweden)

    Yuka Furutani

    2014-10-01

    Full Text Available A 22-year-old woman presented with double vision that she had experienced since an infection 2 weeks previously. A neurological examination showed limited bilateral eye abduction, mimicking Miller Fisher syndrome. However, T2-weighted magnetic resonance imaging of her brain revealed hyperintense areas in the tegmentum of the pons, including the abducens nucleus, and her serum anti-aquaporin-4 antibody test was positive. She was finally diagnosed with neuromyelitis optica. Intravenous high-dose steroid therapy immediately improved the patient's abduction palsy, but bilateral optic neuritis manifested during the treatment. Subsequent treatment with plasma exchange improved her optic neuritis symptoms.

  17. Neuromyelitis Optica: A Case Report

    Directory of Open Access Journals (Sweden)

    Wei-Chia Chia

    2010-12-01

    Full Text Available Neuromyelitis optica (NMO, Devic's syndrome is a demyelinating disease of the central nervous system that predominantly affects the spinal cord and optic nerves. It is often confused with multiple sclerosis. Early discrimination between NMO and multiple sclerosis is important because the two diseases have different natural histories and treatment regimens. Seropositivity for NMO-IgG and longitudinally extensive spinal cord lesions (3 or more spinal segments are characteristic of NMO. Despite the absence of a definitive therapeutic strategy for NMO syndrome, methylprednisolone pulse therapy is recommended in the acute phase. Treatment strategies in relapse phases are aimed at preventing relapses, and increasing evidence shows a better clinical response of immunosuppressive therapy than immuno-modulating therapy (a standard multiple sclerosis-modulating therapy. We describe a 10-year-old girl who had visual loss due to acute optic neuritis at 6 years old and suffered repetitive myelitis 2 years later. NMO was diagnosed because of characteristic longitudinal myelitis and positive NMO-IgG. After combining therapy with prednisolone and an immunosuppressant (cyclophosphamide, the patient's medical condition was stable and no relapse symptoms were observed.

  18. Change in autoantibody and cytokine responses during the evolution of neuromyelitis optica in patients with systemic lupus erythematosus

    DEFF Research Database (Denmark)

    Kovacs, Katalin T; Kalluri, Sudhakar Reddy; Boza-Serrano, Antonio

    2016-01-01

    BACKGROUND: Neuromyelitis optica (NMO)-systemic lupus erythematosus (SLE) association is a rare condition characterized by multiple autoantibodies. OBJECTIVE: To examine if, during the evolution of NMO, anti-AQP4 responses are part of polyclonal B cell activation, and if T cell responses contribute...

  19. Convergence spasm due to aquaporin-positive neuromyelitis optica spectrum disorder

    Directory of Open Access Journals (Sweden)

    Pınar Özçelik

    2017-06-01

    Full Text Available A female 27 presented with nausea and diplopia for 1 week. On examination she had normal vertical gaze but would develop convergence with miosis whenever she made horizontal saccades. Pupils were 6 mm and unreactive to light. MRI showed extensive hyperintensity in the dorsal midbrain and thalamus. Spinal MRI and CSF were both normal. Serum aquaporin-4-antibody was positive. She was treated with steroids and plasmapheresis and after 3 months convergence spasm resolved but pupils remained unreactive. Neuromyelitis optica often presents with brainstem signs, rarely a dorsal midbrain syndrome. Convergence spasm is occasionally of organic neurologic origin.

  20. Autoantibodies in patients with neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Xin FAN

    2016-10-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune disease of the central nervous system (CNS which primarily involves the optic nerve and spinal cord. Aquaporin 4 (AQP4 is the main objective antigen, and its specific antibody was NMO-IgG. It was found in clinic that most of NMO-IgG-positive patients were female, whose clinical symptoms were more severe, bilateral optic neuritis (BON or optic neuritis (ON and myelitis were more likely to appear at the same time, and involved spinal segments were longer. Recent studies discovered that anti-aquaporin 1 (AQP1 and anti-myelin oligodendrocyte glycoprotein (MOG antibodies existed in the serum of patients with NMO-IgG-negative. It was discovered that low proportions of women, more cases of long-segment spinal cord lesion, and rare cases of ON appeared in anti-AQP1 antibody-positive patients. Most of anti-MOG antibody-positive patients were male. ON was common, especially bilateral optic nerves involved at the same time, and thoracolumbar involvement was common. DOI: 10.3969/j.issn.1672-6731.2016.10.004

  1. Neuromyelitis optica presenting with horner syndrome: A case report and review of literature.

    Science.gov (United States)

    Uludağ, İrem Fatma; Sarıteke, Alp; Öcek, Levent; Zorlu, Yaşar; Şener, Ufuk; Tokuçoğlu, Figen; Uludağ, Burhanettin

    2017-05-01

    Neuromyelitis optica (NMO) is a demyelinating disease of the central nervous system that predominantly affects the spinal cord and optic nerves. We describe a 19 years old woman with left Horner syndrome (HS), who was diagnosed as NMO with characteristic longitudinally extensive myelitis and positive serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Our report describes one of the very rare ocular motor symptoms in NMO patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Molecular Pathogenesis of Neuromyelitis Optica

    Science.gov (United States)

    Bukhari, Wajih; Barnett, Michael H; Prain, Kerri; Broadley, Simon A

    2012-01-01

    Neuromyelitis optica (NMO) is a rare autoimmune disorder, distinct from multiple sclerosis, causing inflammatory lesions in the optic nerves and spinal cord. An autoantibody (NMO IgG) against aquaporin-4 (AQP4), a water channel expressed on astrocytes is thought to be causative. Peripheral production of the antibody is triggered by an unknown process in genetically susceptible individuals. Anti-AQP4 antibody enters the central nervous system (CNS) when the blood brain barrier is made permeable and has high affinity for orthogonal array particles of AQP4. Like other autoimmune diseases, Th17 cells and their effector cytokines (such as interleukin 6) have been implicated in pathogenesis. AQP4 expressing peripheral organs are not affected by NMO IgG, but the antibody causes extensive astrocytic loss in specific regions of the CNS through complement mediated cytotoxicity. Demyelination occurs during the inflammatory process and is probably secondary to oligodendrocyte apoptosis subsequent to loss of trophic support from astrocytes. Ultimately, extensive axonal injury leads to severe disability. Despite rapid advances in the understanding of NMO pathogenesis, unanswered questions remain, particularly with regards to disease mechanisms in NMO IgG seronegative cases. Increasing knowledge of the molecular pathology is leading to improved treatment strategies. PMID:23202933

  3. A systematic analysis of the complement pathways in patients with neuromyelitis optica indicates alteration but no activation during remission

    DEFF Research Database (Denmark)

    Veszeli, Nóra; Füst, György; Csuka, Dorottya

    2014-01-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating inflammatory disorder, mediated by pathogenic autoantibodies against aquaporin 4 (AQP4), the main water channel of the central nervous system (CNS). NMO is characterized by local IgG deposition and complement activation within the CNS...

  4. Sudden onset of sleep due to hypothalamic lesions in neuromyelitis optica spectrum disorder positive for anti-aquaporin-4 antibody.

    Science.gov (United States)

    Okuma, H; Matsumura, K; Hatanaka, Y; Saito, F; Sonoo, M

    2014-09-01

    We report a patient with neuromyelitis optica spectrum disorders who presented with sudden onset of sleep as the sole manifestation. Magnetic resonance imaging investigation revealed lesions in the hypothalamus bilaterally, which vanished completely after methylprednisolone pulse therapy. © The Author(s) 2014.

  5. Visual evoked potentials in neuromyelitis optica and its spectrum disorders.

    Science.gov (United States)

    Ringelstein, Marius; Kleiter, Ingo; Ayzenberg, Ilya; Borisow, Nadja; Paul, Friedemann; Ruprecht, Klemens; Kraemer, Markus; Cohn, Eva; Wildemann, Brigitte; Jarius, Sven; Hartung, Hans-Peter; Aktas, Orhan; Albrecht, Philipp

    2014-04-01

    Optic neuritis (ON) is a key feature of neuromyelitis optica (NMO). Recently, NMO patients of predominantly Afro-Brazilian origin were evaluated by visual evoked potentials (VEPs) and showed marked amplitude reductions. Here, we analyzed VEPs in a predominantly Caucasian cohort, consisting of 43 patients with definite NMO, 18 with anti-aquaporin (AQP) 4 antibody-seropositive NMO spectrum disorders and 61 matched healthy controls. We found reduced amplitudes in only 12.3%, prolonged latencies in 41.9% and a lack of response in 14.0% of NMO eyes. Delayed P100 latencies in eyes without prior ON suggested this was a subclinical affection. The data indicate heterogenous patterns in NMO, warranting further investigation.

  6. Protective effect of an elastase inhibitor in a neuromyelitis optica-like disease driven by a peptide of myelin oligodendroglial glycoprotein.

    NARCIS (Netherlands)

    Herges, K.; Jong, B.A. de; Kolkowitz, I.; Dunn, C.; Mandelbaum, G.; Ko, R.M.; Maini, A.; Han, M.H.; Killestein, J.; Polman, C.; Goodyear, A.L.; Dunn, J.; Steinman, L.; Axtell, R.C.

    2012-01-01

    BACKGROUND: The pathology of neuromyelitis optica (NMO), in contrast to multiple sclerosis, comprises granulocyte infiltrates along extensive lengths of spinal cord, as well as optic nerve. Furthermore, IFN-beta treatment worsens NMO. We recently found that experimental autoimmune encephalomyelitis

  7. Neuromielitis óptica con alta expresión de acuaporina-4 y anticuerpos anti-acuaporina-4 positivos en suero Neuromyelitis optica with high aquaporin-4 expression and positive serum aquaporin-4 autoantibodies

    Directory of Open Access Journals (Sweden)

    Alejandra Báez

    2012-04-01

    Full Text Available La presencia de anticuerpos IgG en suero, con blanco en los canales de acuaporina-4, es específica de la neuromielitis óptica (NMO. El 60% de los pacientes con NMO presentan lesiones cerebrales en la resonancia magnética (RM; en un 8% (mayoría niños estas lesiones se consideraron "atípicas". Presentamos dos pacientes con NMO y lesiones en el SNC de alta expresión de acuaporina-4. Caso 1: varón de 50 años, que comenzó con pérdida de visión en ojo derecho (OD. Recibió tratamiento empírico con metilprednisolona 1 g/d x 3 días. Al mes presentó dolor generalizado y hemiparesia derecha; nuevamente recibió metilprednisolona 1 g/d x 5 días e IgG IV 400 mg/kg/d × 5 días. Recuperó la deambulación persistiendo el dolor y fenómenos paroxísticos en los 4 miembros. Potenciales evocados visuales: P100, ojo izquierdo (OI 123 mseg. OD sin respuesta. La RM de cerebro (FLAIR mostró hiperintensidad en nervio óptico derecho, hipotálamo y comisura blanca anterior. RM cervical: lesión medular extensa (5 cuerpos vertebrales. Caso 2: mujer de 53 años, con disminución de la agudeza visual en ambos ojos y parestesias en miembros inferiores que remitieron espontáneamente. Evolucionó al mes con cuadriparesia e incontinencia esfinteriana. Recibió metilprednisolona 1 g/d x 5 días, sin mejoría. Potenciales evocados visuales: P100 OI 124 mseg. OD 128 mseg. RM cerebro: (FLAIR hiperintensidad hipotalámica y periacueductal. RM cervical: lesión medular extensa (7 cuerpos vertebrales. Anticuerpos anti-acuaporina-4 positivos en ambos pacientes (inmunofluorescencia indirecta. Las lesiones consideradas "atípicas", como aquí, en sitios con alta densidad de proteínas canales de agua AQP4 deberán considerarse para el diagnóstico diferencial.Disease-specific aquaporin-4 antibodies (NMO-IgG are the main effector of lesions in neuromyelitis optica (NMO patients. Brain MRI lesions are detected in 60% of them, with 8% (almost infants at sites of high

  8. Seronegative Neuromyelitis Optica Spectrum Disorder following Exposure to Hepatitis B Vaccination

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    Richard Heekin

    2015-04-01

    Full Text Available Controversy exists regarding a potential link between exposure to recombinant hepatitis B vaccine (HBV and central nervous system demyelinating diseases. Here, we present a case of seronegative neuromyelitis optica spectrum disorder (NMOSD following exposure to HBV. A 28-year-old man developed painful eye movements 11 days after exposure to HBV. Within 24 h, he experienced vision loss, ascending numbness, and ataxia. T-spine MRI showed a cord lesion spanning T6-T9. Brain MRI showed bilateral optic nerve contrast enhancement and a right-sided internal capsule lesion. Cerebrospinal fluid analysis was normal, including negative oligoclonal bands and normal IgG index. AQP4-IgG serology was negative. The patient's visual symptoms improved after treatment with steroids and plasma exchange. He received plasma exchange weekly for 4 weeks with decreased numbness and tingling as well as improved coordination. Treatment with mycophenolate mofetil was started, and the patient remains clinically stable with near resolution of his prior symptoms. Neuromyelitis optica is characterized by optic neuritis and/or longitudinally extensive transverse myelitis. While our patient tested seronegative for AQP4-IgG (which remains negative in 10-50% of NMOSD cases, despite testing with the most sensitive assays available, he did meet NMOSD diagnostic criteria. In a literature review, we found 7 cases of NMOSD onset or relapse associated with exposure to various vaccines, but to our knowledge this represents the first published report of NMOSD onset following exposure to HBV. While causality between vaccination and CNS demyelinating disease remains elusive, it is important to report these cases to help develop safer vaccinations and provoke further inquiry into the pathogenesis of NMOSD.

  9. Depressive state and chronic fatigue in multiple sclerosis and neuromyelitis optica.

    Science.gov (United States)

    Akaishi, Tetsuya; Nakashima, Ichiro; Misu, Tatsuro; Fujihara, Kazuo; Aoki, Masashi

    2015-06-15

    Depression and chronic fatigue are frequently present in multiple sclerosis (MS); however, the prevalence rates have not been investigated in neuromyelitis optica (NMO). Thirty-nine consecutive NMO and 75 MS patients were compared using self-rating questionnaires for depressive states, daily activity, and fatigue, as well as serum carnitine levels. A subgroup of patients with low carnitine levels were re-evaluated regarding depression and fatigue after levocarnitine treatment. Depression and fatigue were equally prevalent in MS and NMO and were strongly correlated with one another. Measurement of the serum carnitine levels and the administration of levocarnitine did not appear to be beneficial. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Brain MRI abnormalities in neuromyelitis optica

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    Wang Fei, E-mail: feiwang1973@gmail.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Liu Yaou, E-mail: asiaeurope80@gmail.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Duan Yunyun, E-mail: duanyun2003@sohu.com [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Li Kuncheng, E-mail: kunchengli@yahoo.com.cn [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China); Education Ministry Key Laboratory for Neurodegenerative Disease, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053 (China)

    2011-11-15

    Objective: The purpose of this study was to explore brain MRI findings in neuromyelitis optica (NMO) and to investigate specific brain lesions with respect to the localization of aquaporin-4 (AQP-4). Materials and methods: Forty admitted patients (36 women) who satisfied the 2006 criteria of Wingerchuk et al. for NMO were included in this study. All patients received a neurological examination and MRI scanning including brain and spinal cord. MRIs were classified as normal, nonspecific, multiple sclerosis-like, typical abnormalities. MS-like lesions were too few to satisfy the Barkhof et al. criteria for MS. Confluent lesions involving high AQP-4 regions were considered typical. Non-enhancing deep white matter lesions other than MS-like lesions or typical lesions were classified as nonspecific. Results: Brain MRI lesions were delineated in 12 patients (25%). Four patients (10%) had hypothalamus, brainstem or periventricle lesions. Six (15%) patients were nonspecific, and 2 (5%) patients had multiple sclerosis-like lesions. Conclusion: Brain MRIs are negative in most NMO, and brain lesions do not exclude the diagnosis of NMO. Hypothalamus, brainstem or periventricle lesions, corresponding to high sites of AQP-4 in the brain, are indicative of lesions of NMO.

  11. Brain MRI abnormalities in neuromyelitis optica

    International Nuclear Information System (INIS)

    Wang Fei; Liu Yaou; Duan Yunyun; Li Kuncheng

    2011-01-01

    Objective: The purpose of this study was to explore brain MRI findings in neuromyelitis optica (NMO) and to investigate specific brain lesions with respect to the localization of aquaporin-4 (AQP-4). Materials and methods: Forty admitted patients (36 women) who satisfied the 2006 criteria of Wingerchuk et al. for NMO were included in this study. All patients received a neurological examination and MRI scanning including brain and spinal cord. MRIs were classified as normal, nonspecific, multiple sclerosis-like, typical abnormalities. MS-like lesions were too few to satisfy the Barkhof et al. criteria for MS. Confluent lesions involving high AQP-4 regions were considered typical. Non-enhancing deep white matter lesions other than MS-like lesions or typical lesions were classified as nonspecific. Results: Brain MRI lesions were delineated in 12 patients (25%). Four patients (10%) had hypothalamus, brainstem or periventricle lesions. Six (15%) patients were nonspecific, and 2 (5%) patients had multiple sclerosis-like lesions. Conclusion: Brain MRIs are negative in most NMO, and brain lesions do not exclude the diagnosis of NMO. Hypothalamus, brainstem or periventricle lesions, corresponding to high sites of AQP-4 in the brain, are indicative of lesions of NMO.

  12. Neuromyelitis optica spectrum disease characteristics in Isfahan, Iran: A cross-sectional study

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    Fereshte Ashtari

    2017-01-01

    Full Text Available Background: Neuromyelitis optica spectrum disease (NMOSD is a severe autoimmune demyelinating disorder of the central nervous system that throughout epidemiological data, it has not been completely determined. The aim of this study was to assess characteristics of NMOSD patients in Isfahan as one of the most prevalent cities for multiple sclerosis in Iran. Materials and Methods: Forty-five patients diagnosed as neuromyelitis optica (NMO disease through 5 years enrolled in this study. Demographics and characteristics of disease such as Expanded Disability Status Scale (EDSS score, disease duration, clinical symptoms, laboratory data, and magnetic resonance imaging findings (including T1, T2, and flair protocols were recorded. NMO-immunoglobulin G serology assay was done in all of the patients by ELISA test. Results: Female to male ratio was 5.4:1. The mean age of disease onset was 29.8 ± 11.2 years. NMO antibody was positive in 24.4% of patients. The presenting symptoms were optic neuritis (55.5%, transverse myelitis (40%, and brainstem symptoms (4.5%. The interval between the first and second attack was 19.28 ± 31.27 months (range: 1 month to 17 years. The mean EDSS score of the patients was 2.8 ± 2.25. Frequency of long-extending cervical plaque was higher among men than women (85.7% vs. 57.9%. Conclusion: Based on this study, the mean age of NMOSD onset among Isfahan population was considerably lower than other studies, and there was higher frequency of long-extending cervical lesion among male patients which needs more consideration in further studies.

  13. Enhancing Brain Lesions during Acute Optic Neuritis and/or Longitudinally Extensive Transverse Myelitis May Portend a Higher Relapse Rate in Neuromyelitis Optica Spectrum Disorders.

    Science.gov (United States)

    Orman, G; Wang, K Y; Pekcevik, Y; Thompson, C B; Mealy, M; Levy, M; Izbudak, I

    2017-05-01

    Neuromyelitis optica spectrum disorders are inflammatory demyelinating disorders with optic neuritis and/or longitudinally extensive transverse myelitis episodes. We now know that neuromyelitis optica spectrum disorders are associated with antibodies to aquaporin-4, which are highly concentrated on astrocytic end-feet at the blood-brain barrier. Immune-mediated disruption of the blood-brain barrier may manifest as contrast enhancement on brain MR imaging. We aimed to delineate the extent and frequency of contrast enhancement on brain MR imaging within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and to correlate contrast enhancement with outcome measures. Brain MRIs of patients with neuromyelitis optica spectrum disorders were evaluated for patterns of contrast enhancement (periependymal, cloudlike, leptomeningeal, and so forth). The Fisher exact test was used to evaluate differences between the proportion of contrast enhancement in patients who were seropositive and seronegative for aquaporin-4 antibodies. The Mann-Whitney test was used to compare the annualized relapse rate and disease duration between patients with and without contrast enhancement and with and without seropositivity. Brain MRIs of 77 patients were evaluated; 59 patients (10 males, 49 females) were scanned within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and were included in the analysis. Forty-eight patients were seropositive, 9 were seronegative, and 2 were not tested for aquaporin-4 antibodies. Having brain contrast enhancement of any type during an acute attack was significantly associated with higher annualized relapse rates ( P = .03) and marginally associated with shorter disease duration ( P = .05). Having periependymal contrast enhancement was significantly associated with higher annualized relapse rates ( P = .03). Brain MRIs of patients with neuromyelitis optica spectrum disorders with contrast

  14. Pulmonary tuberculosis with neuromyelitis optica: an uncommon association of a common disease

    International Nuclear Information System (INIS)

    Siddiqi, S.A.; Hashmi, M.; Azmat, Z.; Mustafa, S.; Siddiqui, K.A.

    2012-01-01

    Systemic tuberculosis has been reported with varying neurological manifestations like meningitis, tuberculomas, myositis and neuropathy. Neuromyelitis optica (NMO) is a well known neurological entity which has been described in association with several systemic disorders like systemic lupus erythematosis, diabetes mellitus, hypothyroidism, exposure to Mycobacterium tuberculosis. insecticides etc. However, only a few cases of NMO have been reported in association with Here, we report a case of pulmonary tuberculosis in association with NMO to highlight the under-reported association of NMO with pulmonary tuberculosis presenting in a peculiar anatomical fashion i.e. longitudinal myelitis with predominant posterior column involvement. (author)

  15. Autoimmune thyroiditis associated with neuromyelitis optica (NMO

    Directory of Open Access Journals (Sweden)

    Sudulagunta, Sreenivasa Rao

    2015-11-01

    Full Text Available Neuromyelitis optica (NMO or Devic’s syndrome is a rare relapsing demyelinating disease of the central nervous system (CNS that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly. We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. The patient was also diagnosed to have autoimmune thyroiditis with lymphocytic infiltration of the thyroid which progressed from hyperthyroidism to hypothyroidism. NMO diagnosis was established with seropositivity for NMO-IgG and MRI showing longitudinally extensive spinal cord lesions (3 or more spinal segments. In spite of treatment, the response was poor due to lack of early diagnosis and aggressive immunosuppressant therapy.

  16. Finding NMO: The Evolving Diagnostic Criteria of Neuromyelitis Optica

    Science.gov (United States)

    Bennett, Jeffrey L.

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder of the central nervous system (CNS) with predilection for the optic nerves and spinal cord. Since its emergence in the medical literature in the late 1800’s, the diagnostic criteria for NMO has slowly evolved from the simultaneous presentation of neurologic and ophthalmic signs to a relapsing or monophasic CNS disorder defined by clinical, neuroimaging, and laboratory criteria. Due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 (AQP4) in the vast majority of affected individuals, the clinical spectrum of NMO has greatly expanded necessitating the development of new international criteria for the diagnosis of NMO spectrum disorder (NMOSD). The routine application of new diagnostic criteria for NMOSD in clinical practice will be critical for future refinement and correlation with therapeutic outcomes. PMID:27529327

  17. Seronegative neuromyelitis optica presenting with life-threatening respiratory failure.

    Science.gov (United States)

    Nardone, Raffaele; Zuccoli, Giulio; Brigo, Francesco; Trinka, Eugen; Fitzgerald, Ryan T

    2016-11-01

    Dyspnea has rarely been reported as a presenting symptom in patients with neuromyelitis optica (NMO). We report an unusual case of NMO relapse presenting with rapidly progressive respiratory failure and briefly discuss the possible pathophysiological mechanisms of this potential life-threatening complication of NMO. The 58-year-old woman with a history of bilateral optic neuritis presented to the emergency department with rapidly worsening dyspnea. Cervical spine magnetic resonance imaging showed extensive abnormal signal with involvement of the medulla oblongata. Since in our patient chest radiography failed to disclose a diaphragmatic palsy that is commonly observed in patients with phrenic nerve involvement, this acute manifestation of the disease may be attributed to brainstem involvement instead of cervical myelitis. Clinicians should be aware of this atypical presentation of NMO, which needs to be promptly recognized and aggressively treated.

  18. Plasma Exchange in Severe Attacks of Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Mickael Bonnan

    2012-01-01

    Full Text Available Background. Neuromyelitis optica (NMO attacks are poorly controlled by steroids and evolve in stepwise neurological impairments. Assuming the strong humoral response underlying NMO attacks, plasma exchange (PLEX is an appropriate technique in severe NMO attacks. Objective. Presenting an up-to-date review of the literature of PLEX in NMO. Methods. We summarize the rationale of PLEX in relation with the physiology of NMO, the main technical aspects, and the available studies. Results. PLEX in severe attacks from myelitis or optic neuritis are associated with a better outcome, depending on PLEX delay (“time is cord and eyes”. NMO-IgG status has no influence. Finally, we build up an original concept linking the inner dynamic of the lesion, the timing of PLEX onset and the expected clinical results. Conclusion. PLEX is a safe and efficient add-on therapy in NMO, in synergy with steroids. Large therapeutic trials are required to definitely assess the procedure and define the time opportunity window.

  19. Interferon Alpha Association with Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Nasrin Asgari

    2013-01-01

    Full Text Available Interferon-alpha (IFN-α has immunoregulatory functions in autoimmune inflammatory diseases. The goal of this study was to determine occurrence and clinical consequences of IFN-α in neuromyelitis optica (NMO patients. Thirty-six NMO and 41 multiple sclerosis (MS patients from a population-based retrospective case series were included. Expanded Disability Status Scale (EDSS score and MRI findings determined disease activity. Linear regression was used to assess the effects of the level of IFN-α on disability (EDSS. IFN-α was determined by sensitive ELISA assays. IFN-α was detectable in sera from 9/36 NMO patients, significantly more often than in the MS group (2/41 (P=0.0197. A higher frequency of IFN-α was observed in NMO patients with acute relapse compared to NMO patients in remission (P<0.001 and compared to the MS patients with relapse (P=0.010. In NMO patients, the levels of IFN-α were significantly associated with EDSS (P=0.0062. It may be concluded that IFN-α was detectable in a subgroup of NMO patients. Association of IFN-α levels with clinical disease activity and severity suggests a role for IFN-α in disease perpetuation and may provide a plausible explanation for a negative effect of IFN-1 treatment in NMO patients.

  20. What do we know about brain contrast enhancement patterns in neuromyelitis optica?☆

    Science.gov (United States)

    Pekcevik, Yeliz; Orman, Gunes; Lee, In Ho; Mealy, Maureen A.; Levy, Michael; Izbudak, Izlem

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune disorder of the central nervous system that usually presents with acute myelitis and/or optic neuritis. Recently, some brain magnetic resonance imaging findings have been described in NMO that are important in the differential diagnosis. Pencil-thin, leptomeningeal, and cloud-like enhancement may be specific to NMO. These patterns are usually seen during relapses. Recognizing these lesions and enhancement patterns may expedite the diagnosis and allows early effective treatment. The purpose of this article is to review the latest knowledge and to share our experience with the contrast enhancement patterns of NMO brain lesions. PMID:26615899

  1. Comparison of the efficacy of azathioprine and rituximab in neuromyelitis optica spectrum disorder

    DEFF Research Database (Denmark)

    Nikoo, Zahra; Badihian, Shervin; Shaygannejad, Vahid

    2017-01-01

    Neuromyelitis optica spectrum disorder (NMOSD) often follows a relapsing course. As disability in NMOSD is attack-related, effective treatments are needed. We aimed to compare the efficacy of azathioprine (AZA) and rituximab (RIT) as maintenance therapy in NMOSD patients. An open, randomized...... = 0–7). Patients were randomized into two groups, which did not differ according to age, gender distribution, and disease duration. In the AZA group, 35 patients [20 aquaporin-4 (AQP4)-IgG positive] were started on 50 mg/day oral AZA and increased to 2–3 mg/kg/day (with oral prednisolone as adjunctive...

  2. Epidemiological, clinical and immunological aspects of neuromyelitis optica (NMO)

    DEFF Research Database (Denmark)

    Asgari, Nasrin

    2013-01-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease (IDD) of the central nervous system (CNS) and probably the most common non-multiple sclerosis (MS) CNS IDD. Serum immunoglobulin G autoantibodies have been identified in the majority of NMO patients with the water channel aquaporin...... on either the Wingerchuk 2006 criteria or the United States National Multiple Sclerosis Society 2008 criteria could be made purely on clinical grounds in a high proportion (64%) of cases. Heterogeneity of clinical NMO manifestations including optic neuritis, longitudinal extensive transverse myelitis (LETM...... with specific clinical, immunogenetic and experimental perspectives. The yearly incidence rate of NMO in the population was estimated to be 0.4 per 105 person-years (95% CI 0.30-0.54) and the prevalence was 4.4 per 105 (95% CI 3.1-5.7). The results indicated that NMO is more common in a Caucasian population...

  3. OPTIC NEURITIS IN NEUROMYELITIS OPTICA

    Science.gov (United States)

    Levin, Marc H.; Bennett, Jeffrey L.; Verkman, A.S.

    2013-01-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating disease associated with recurrent episodes of optic neuritis and transverse myelitis, often resulting in permanent blindness and/or paralysis. The discovery of autoantibodies (AQP4-IgG) that target aquaporin-4 (AQP4) has accelerated our understanding of the cellular mechanisms driving NMO pathogenesis. AQP4 is a bidirectional water channel expressed on the plasma membranes of astrocytes, retinal Müller cells, skeletal muscle, and some epithelial cells in kidney, lung and the gastrointestinal tract. AQP4 tetramers form regular supramolecular assemblies at the cell plasma membrane called orthogonal arrays of particles. The pathological features of NMO include perivascular deposition of immunoglobulin and activated complement, loss of astrocytic AQP4, inflammatory infiltration with granulocyte and macrophage accumulation, and demyelination with axon loss. Current evidence supports a causative role of AQP4-IgG in NMO, in which binding of AQP4-IgG to AQP4 orthogonal arrays on astrocytes initiates complement-dependent and antibody-dependent cell-mediated cytotoxicity and inflammation. Immunosuppression and plasma exchange are the mainstays of therapy for NMO optic neuritis. Novel therapeutics targeting specific steps in NMO pathogenesis are entering the development pipeline, including blockers of AQP4-IgG binding to AQP4 and inhibitors of granulocyte function. However, much work remains in understanding the unique susceptibility of the optic nerves in NMO, in developing animal models of NMO optic neuritis, and in improving therapies to preserve vision. PMID:23545439

  4. Brain Abnormalities in Neuromyelitis Optica Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Woojun Kim

    2012-01-01

    Full Text Available Neuromyelitis optica (NMO is an idiopathic inflammatory syndrome of the central nervous system that is characterized by severe attacks of optic neuritis (ON and myelitis. Until recently, NMO was considered a disease without brain involvement. However, since the discovery of NMO-IgG/antiaqaporin-4 antibody, the concept of NMO was broadened to NMO spectrum disorder (NMOSD, and brain lesions are commonly recognized. Furthermore, some patients present with brain symptoms as their first manifestation and develop recurrent brain symptoms without ON or myelitis. Brain lesions with characteristic locations and configurations can be helpful in the diagnosis of NMOSD. Due to the growing recognition of brain abnormalities in NMOSD, these have been included in the NMO and NMOSD diagnostic criteria or guidelines. Recent technical developments such as diffusion tensor imaging, MR spectroscopy, and voxel-based morphometry reveal new findings related to brain abnormalities in NMOSD that were not identified using conventional MRI. This paper focuses on the incidence and characteristics of the brain lesions found in NMOSD and the symptoms that they cause. Recent studies using advanced imaging techniques are also introduced.

  5. Monoclonal antibody therapy for neuromyelitis optica spectrum disorder: current and future.

    Science.gov (United States)

    Lin, Jie; Xue, Binbin; Li, Xiang; Xia, Junhui

    2017-08-01

    Monoclonal-antibody has been used for patients with autoimmune disorders for several years, and efficacy and safety were appreciated for these patients. Neuromyelitis optica specturm disorder (NMOSD) has been defined as an autoimmune demyelination disorder of the central nervous system (CNS) with a course of relapse-remission. Treatment of prevention is important for patients with NMOSD because of the increased disability after several attacks. Multiple factors were involved in the pathogenesis of NMOSD. Currently, targeting specific factor was favored in the research into the treatment for NMOSD. Previous studies reported the efficacy and tolerance in NMOSD for drugs such as rituximab, tocilizumab, and eculizumab. The aim of this article is to review the current monoclonal therapies for NMOSD patients, and also future alternative options.

  6. Quantitative Susceptibility Mapping Indicates a Disturbed Brain Iron Homeostasis in Neuromyelitis Optica ? A Pilot Study

    OpenAIRE

    Doring, Thomas Martin; Granado, Vanessa; Rueda, Fernanda; Deistung, Andreas; Reichenbach, Juergen R.; Tukamoto, Gustavo; Gasparetto, Emerson Leandro; Schweser, Ferdinand

    2016-01-01

    Dysregulation of brain iron homeostasis is a hallmark of many neurodegenerative diseases and can be associated with oxidative stress. The objective of this study was to investigate brain iron in patients with Neuromyelitis Optica (NMO) using quantitative susceptibility mapping (QSM), a quantitative iron-sensitive MRI technique. 12 clinically confirmed NMO patients (6 female and 6 male; age 35.4y±14.2y) and 12 age- and sex-matched healthy controls (7 female and 5 male; age 33.9±11.3y) underwen...

  7. Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

    DEFF Research Database (Denmark)

    Kremer, S.; Renard, F.; Achard, S.

    2015-01-01

    Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder but the specific morphological and temporal patterns distinguishing them uneqtaivcally from lesions caused by other disorders have...... not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR voltametry, and ultrahigh...... diffusion-weighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MR I techniques may further our understanding of the pathogenic processes hi NMO spectrum disorders and may...

  8. Seronegative Neuromyelitis Optica Spectrum - The challenges on disease definition and pathogenesis

    Directory of Open Access Journals (Sweden)

    Douglas Kazutoshi Sato

    2014-06-01

    Full Text Available Neuromyelitis optica spectrum disorders (NMOSD are characterized by severe optic neuritis and/or longitudinally extensive transverse myelitis, and some brain lesions are also unique to NMOSD. Serum autoantibodies against aquaporin-4 (AQP4 are detected in most cases of NMOSD. However, some patients with NMOSD remain seronegative despite repetitive testing during attacks with highly sensitive cell-based assays. The differential diagnosis of NMOSD is not restricted to multiple sclerosis and it includes many diseases that can produce longitudinally extensive myelitis and/or optic neuritis. We review the clinical features, imaging, and laboratory findings that can be helpful on the diagnostic work-up, discuss the differences between AQP4 antibody positive and negative patients with NMOSD, including features of NMOSD with antibodies against myelin oligodendrocyte glycoprotein.

  9. MRI characteristics of neuromyelitis optica spectrum disorder

    Science.gov (United States)

    Paul, Friedemann; Lana-Peixoto, Marco A.; Tenembaum, Silvia; Asgari, Nasrin; Palace, Jacqueline; Klawiter, Eric C.; Sato, Douglas K.; de Seze, Jérôme; Wuerfel, Jens; Banwell, Brenda L.; Villoslada, Pablo; Saiz, Albert; Fujihara, Kazuo; Kim, Su-Hyun

    2015-01-01

    Since its initial reports in the 19th century, neuromyelitis optica (NMO) had been thought to involve only the optic nerves and spinal cord. However, the discovery of highly specific anti–aquaporin-4 antibody diagnostic biomarker for NMO enabled recognition of more diverse clinical spectrum of manifestations. Brain MRI abnormalities in patients seropositive for anti–aquaporin-4 antibody are common and some may be relatively unique by virtue of localization and configuration. Some seropositive patients present with brain involvement during their first attack and/or continue to relapse in the same location without optic nerve and spinal cord involvement. Thus, characteristics of brain abnormalities in such patients have become of increased interest. In this regard, MRI has an increasingly important role in the differential diagnosis of NMO and its spectrum disorder (NMOSD), particularly from multiple sclerosis. Differentiating these conditions is of prime importance because early initiation of effective immunosuppressive therapy is the key to preventing attack-related disability in NMOSD, whereas some disease-modifying drugs for multiple sclerosis may exacerbate the disease. Therefore, identifying the MRI features suggestive of NMOSD has diagnostic and prognostic implications. We herein review the brain, optic nerve, and spinal cord MRI findings of NMOSD. PMID:25695963

  10. Immunopathogenesis in Myasthenia Gravis and Neuromyelitis Optica

    Science.gov (United States)

    Wang, Zhen; Yan, Yaping

    2017-01-01

    Myasthenia gravis (MG) and neuromyelitis optica (NMO) are autoimmune channelopathies of the peripheral neuromuscular junction (NMJ) and central nervous system (CNS) that are mainly mediated by humoral immunity against the acetylcholine receptor (AChR) and aquaporin-4 (AQP4), respectively. The diseases share some common features, including genetic predispositions, environmental factors, the breakdown of tolerance, the collaboration of T cells and B cells, imbalances in T helper 1 (Th1)/Th2/Th17/regulatory T cells, aberrant cytokine and antibody secretion, and complement system activation. However, some aspects of the immune mechanisms are unique. Both targets (AChR and AQP4) are expressed in the periphery and CNS, but MG mainly affects the NMJ in the periphery outside of CNS, whereas NMO preferentially involves the CNS. Inflammatory cells, including B cells and macrophages, often infiltrate the thymus but not the target—muscle in MG, whereas the infiltration of inflammatory cells, mainly polymorphonuclear leukocytes and macrophages, in NMO, is always observed in the target organ—the spinal cord. A review of the common and discrepant characteristics of these two autoimmune channelopathies may expand our understanding of the pathogenic mechanism of both disorders and assist in the development of proper treatments in the future. PMID:29312313

  11. Anti-C1q autoantibodies in patients with neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Yoshikura, Nobuaki; Kimura, Akio; Hayashi, Yuichi; Inuzuka, Takashi

    2017-09-15

    We examined anti-complement C1q (C1q) autoantibody levels in serum and cerebrospinal fluid (CSF) samples of patients with neuromyelitis optica spectrum disorders (NMOSD). We analyzed the correlations between anti-C1q autoantibody levels and the clinical and other CSF characteristics of NMOSD. Serum and CSF anti-C1q autoantibody levels increased during the acute phase of NMOSD, reverting to the same levels as controls during remission. CSF anti-C1q autoantibody levels during the acute phase correlated with several markers reflecting disease severity, Expanded Disability Status Scale worsening, spinal cord lesion length in cases with myelitis, CSF protein and interleukin-6 levels, and CSF/serum albumin ratios. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Experimental Neuromyelitis Optica Induces a Type I Interferon Signature in the Spinal Cord

    Science.gov (United States)

    Kaufmann, Nathalie; Zeka, Bleranda; Schanda, Kathrin; Fujihara, Kazuo; Illes, Zsolt; Dahle, Charlotte; Reindl, Markus; Lassmann, Hans; Bradl, Monika

    2016-01-01

    Neuromyelitis optica (NMO) is an acute inflammatory disease of the central nervous system (CNS) which predominantly affects spinal cord and optic nerves. Most patients harbor pathogenic autoantibodies, the so-called NMO-IgGs, which are directed against the water channel aquaporin 4 (AQP4) on astrocytes. When these antibodies gain access to the CNS, they mediate astrocyte destruction by complement-dependent and by antibody-dependent cellular cytotoxicity. In contrast to multiple sclerosis (MS) patients who benefit from therapies involving type I interferons (I-IFN), NMO patients typically do not profit from such treatments. How is I-IFN involved in NMO pathogenesis? To address this question, we made gene expression profiles of spinal cords from Lewis rat models of experimental neuromyelitis optica (ENMO) and experimental autoimmune encephalomyelitis (EAE). We found an upregulation of I-IFN signature genes in EAE spinal cords, and a further upregulation of these genes in ENMO. To learn whether the local I-IFN signature is harmful or beneficial, we induced ENMO by transfer of CNS antigen-specific T cells and NMO-IgG, and treated the animals with I-IFN at the very onset of clinical symptoms, when the blood-brain barrier was open. With this treatment regimen, we could amplify possible effects of the I-IFN induced genes on the transmigration of infiltrating cells through the blood brain barrier, and on lesion formation and expansion, but could avoid effects of I-IFN on the differentiation of pathogenic T and B cells in the lymph nodes. We observed that I-IFN treated ENMO rats had spinal cord lesions with fewer T cells, macrophages/activated microglia and activated neutrophils, and less astrocyte damage than their vehicle treated counterparts, suggesting beneficial effects of I-IFN. PMID:26990978

  13. Serial quantitative MR assessment of optic neuritis in a case of neuromyelitis optica, using gadolinium-'enhanced' STIR imaging

    International Nuclear Information System (INIS)

    Barkhof, F.; Scheltens, P.; Valk, J.; Waalewijn, C.; Uitdehaag, B.M.J.; Polman, C.H.

    1991-01-01

    A patient is presented with neuromyelitis optica. MR imaging, using a short inversion time inversion recovery (STIR) technique, clearly depicted the lesion in the left optic nerve. Subsequent serial STIR imaging, with and without Gadolinium-DTPA, allowed quantitative assessment of changes parallel to improved optic nerve function. STIR imaging is a sensitive technique to demonstrate optic nerve lesions, and enables quantitative assessment to be made of the effect of (steroid) medication. (orig.)

  14. Treatment of neuromyelitis optica: an evidence based review

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2012-01-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS, and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

  15. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders

    Science.gov (United States)

    Banwell, Brenda; Bennett, Jeffrey L.; Cabre, Philippe; Carroll, William; Chitnis, Tanuja; de Seze, Jérôme; Fujihara, Kazuo; Greenberg, Benjamin; Jacob, Anu; Jarius, Sven; Lana-Peixoto, Marco; Levy, Michael; Simon, Jack H.; Tenembaum, Silvia; Traboulsee, Anthony L.; Waters, Patrick; Wellik, Kay E.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory CNS syndrome distinct from multiple sclerosis (MS) that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Prior NMO diagnostic criteria required optic nerve and spinal cord involvement but more restricted or more extensive CNS involvement may occur. The International Panel for NMO Diagnosis (IPND) was convened to develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. The new nomenclature defines the unifying term NMO spectrum disorders (NMOSD), which is stratified further by serologic testing (NMOSD with or without AQP4-IgG). The core clinical characteristics required for patients with NMOSD with AQP4-IgG include clinical syndromes or MRI findings related to optic nerve, spinal cord, area postrema, other brainstem, diencephalic, or cerebral presentations. More stringent clinical criteria, with additional neuroimaging findings, are required for diagnosis of NMOSD without AQP4-IgG or when serologic testing is unavailable. The IPND also proposed validation strategies and achieved consensus on pediatric NMOSD diagnosis and the concepts of monophasic NMOSD and opticospinal MS. PMID:26092914

  16. Differential diagnosis of neuromyelitis optica spectrum disorders

    Science.gov (United States)

    Kim, Sung-Min; Kim, Seong-Joon; Lee, Haeng Jin; Kuroda, Hiroshi; Palace, Jacqueline; Fujihara, Kazuo

    2017-01-01

    Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients. Despite some similarity in their phenotypes, these NMOSD and NMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment. Understanding the detailed clinical, serological, radiological, and prognostic differences of these diseases will improve the proper management as well as diagnosis of patients. PMID:28670343

  17. Magnetic Resonance Imaging Features of Neuromyelitis Optica

    Energy Technology Data Exchange (ETDEWEB)

    You, Sun Kyung; Song, Chang June; Park, Woon Ju; Lee, In Ho; Son, Eun Hee [Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2013-03-15

    To report the magnetic resonance (MR) imaging features of the spinal cord and brain in patients of neuromyelitis optica (NMO). Between January 2001 and March 2010, the MR images (spinal cord, brain, and orbit) and the clinical and serologic findings of 11 NMO patients were retrospectively reviewed. The contrast-enhancement of the spinal cord was performed (20/23). The presence and pattern of the contrast-enhancement in the spinal cord were classified into 5 types. Acute myelitis was monophasic in 8 patients (8/11, 72.7%); and optic neuritis preceded acute myelitis in most patients. Longitudinally extensive cord lesion (average, 7.3 vertebral segments) was involved. The most common type was the diffuse and subtle enhancement of the spinal cord with a multifocal nodular, linear or segmental intense enhancement (45%). Most of the brain lesions (5/11, 10 lesions) were located in the brain stem, thalamus and callososeptal interphase. Anti-Ro autoantibody was positive in 2 patients, and they showed a high relapse rate of acute myelitis. Anti-NMO IgG was positive in 4 patients (4/7, 66.7%). The imaging findings of acute myelitis in NMO may helpful in making an early diagnosis of NMO which can result in a severe damage to the spinal cord, and to make a differential diagnosis of multiple sclerosis and inflammatory diseases of the spinal cord such as toxocariasis.

  18. Magnetic Resonance Imaging Features of Neuromyelitis Optica

    International Nuclear Information System (INIS)

    You, Sun Kyung; Song, Chang June; Park, Woon Ju; Lee, In Ho; Son, Eun Hee

    2013-01-01

    To report the magnetic resonance (MR) imaging features of the spinal cord and brain in patients of neuromyelitis optica (NMO). Between January 2001 and March 2010, the MR images (spinal cord, brain, and orbit) and the clinical and serologic findings of 11 NMO patients were retrospectively reviewed. The contrast-enhancement of the spinal cord was performed (20/23). The presence and pattern of the contrast-enhancement in the spinal cord were classified into 5 types. Acute myelitis was monophasic in 8 patients (8/11, 72.7%); and optic neuritis preceded acute myelitis in most patients. Longitudinally extensive cord lesion (average, 7.3 vertebral segments) was involved. The most common type was the diffuse and subtle enhancement of the spinal cord with a multifocal nodular, linear or segmental intense enhancement (45%). Most of the brain lesions (5/11, 10 lesions) were located in the brain stem, thalamus and callososeptal interphase. Anti-Ro autoantibody was positive in 2 patients, and they showed a high relapse rate of acute myelitis. Anti-NMO IgG was positive in 4 patients (4/7, 66.7%). The imaging findings of acute myelitis in NMO may helpful in making an early diagnosis of NMO which can result in a severe damage to the spinal cord, and to make a differential diagnosis of multiple sclerosis and inflammatory diseases of the spinal cord such as toxocariasis.

  19. Neuromyelitis optica immunoglobulin G in Chinese patients detected by immunofluorescence assay on a monkey brain substrate.

    Science.gov (United States)

    Long, Youming; Hu, Xueqiang; Peng, Fuhua; Lu, Zhengqi; Wang, Yuge; Yang, Yu; Qiu, Wei

    2012-01-01

    Serum neuromyelitis optica immunoglobulin G (NMO-IgG) is used as a biomarker to differentiate between neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the original assay is expensive and complex and shows low sensitivity. Here, we investigated the potential of NMO-IgG detection using an indirect immunofluorescence (IIF) assay on monkey brains. NMO-IgG seroprevalence was determined in 168 samples by an IIF assay on a monkey brain substrate. The data were compared with those from a standard mouse brain IIF assay using McNemar and kappa tests. Thirty-one of 50 (62%) NMO patients, 7 of 18 (38.9%) longitudinally extensive transverse myelitis patients, 6 of 57 (10.5%) MS patients, and 5 of 10 (50%) optic neuritis patients were seropositive for NMO-IgG. None of the acute partial transverse myelitis patients (n = 3) or healthy controls (n = 20) was positive. Thus, the sensitivity of the test was 62% for the patients with clinically definite NMO. The specificity was 89.5%, considering the 57 MS patients as the control group. The modified IIF assay on monkey brains and the standard IIF assay based on mouse brains were not significantly different (McNemar test; p = 1.000). The two assays were concordant in 39 seropositive samples and 100 seronegative samples (kappa test; kappa = 0.592, p monkey brain assay was no better than the standard mouse brain IIF assay, we affirmed that NMO-IgG is a sensitive and specific biomarker to differentiate between NMO and MS. Copyright © 2011 S. Karger AG, Basel.

  20. Quantitative MRI analysis of the brain after twenty-two years of neuromyelitis optica indicates focal tissue damage

    DEFF Research Database (Denmark)

    Aradi, Mihaly; Koszegi, Edit; Orsi, Gergely

    2013-01-01

    ). In such abnormal NAWM regions, biexponential diffusion analysis and quantitative spectroscopy indicated extracellular edema and axonal loss, respectively. Repeated analysis 6 months later identified the same alterations. Such patchy alterations were not detectable in the NAWM of the 3 cases with short-term NMO......BACKGROUND: The long-term effect of neuromyelitis optica (NMO) on the brain is not well established. METHODS: After 22 years of NMO, a patient's brain was examined by quantitative T1- and T2-weighted mono- and biexponential diffusion and proton spectroscopy. It was compared to 3 cases with short...

  1. Clinical analysis of neuromyelitis optica presenting as intractable nausea, vomiting and hiccups.

    Science.gov (United States)

    Jin, Xuehong; Pei, Shaofang; Liu, Yi; Li, Xia

    2017-10-01

    Vomiting and hiccups can be the manifestations of numerous systemic and neurological illnesses. Intractable nausea, vomiting and hiccups (INH) are reported as possible initial manifestations of neuromyelitis optica (NMO), but not correctly identified. Awareness of these atypical presentations is conducive to NMO early diagnosis and proper treatment to prevent further disability. In this paper, 12 NMO were reported, whose intractable vomiting and hiccups were the sole manifestations of the first attack and other attacks involving spinal cord and optic nerves developed later. All the patients were women and serum aquaporin 4 antibody (AQP4-Ab) of 83% patients was positive. MRI of 50% patients showed T2-weighted imaging/fluid attenuated inversion recovery hyperintensity which were longitudinally extensive transverse myelitis or linear signal changes. Sixty-seven percent of patients had medulla lesions, in which dorsomedial and area postrema were involved.

  2. Unexpected exacerbations following initiation of disease-modifying drugs in neuromyelitis optica spectrum disorder: Which factor is responsible, anti-aquaporin 4 antibodies, B cells, Th1 cells, Th2 cells, Th17 cells, or others?

    Science.gov (United States)

    Kira, Jun-Ichi

    2017-08-01

    Some disease-modifying drugs for multiple sclerosis, which mainly act on T cells, are ineffective for neuromyelitis optica spectrum disorder and induce unexpected relapses. These include interferon beta, glatiramer acetate, fingolimod, natalizumab, and alemtuzumab. The cases reported here suggest that dimethyl fumarate, which reduces the number of Th1 and Th17 cells and induces IL-4-producing Th2 cells, is also unsuitable for neuromyelitis optica spectrum disorder, irrespective of anti-aquaporin 4 IgG serostatus. Although oral dimethyl fumarate with manageable adverse effects is easy to initiate in the early course of multiple sclerosis, special attention should be paid for atypical demyelinating cases.

  3. Serial quantitative MR assessment of optic neuritis in a case of neuromyelitis optica, using gadolinium-'enhanced' STIR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Barkhof, F.; Scheltens, P.; Valk, J. (Vrije Univ., Amsterdam (Netherlands). Dept. of Diagnostic Radiology); Waalewijn, C.; Uitdehaag, B.M.J.; Polman, C.H. (Vrije Univ., Amsterdam (Netherlands). Dept. of Neurology)

    1991-02-01

    A patient is presented with neuromyelitis optica. MR imaging, using a short inversion time inversion recovery (STIR) technique, clearly depicted the lesion in the left optic nerve. Subsequent serial STIR imaging, with and without Gadolinium-DTPA, allowed quantitative assessment of changes parallel to improved optic nerve function. STIR imaging is a sensitive technique to demonstrate optic nerve lesions, and enables quantitative assessment to be made of the effect of (steroid) medication. (orig.).

  4. The expanded spectrum of neuromyelitis optica: evidences for a new definition

    Directory of Open Access Journals (Sweden)

    Marco A Lana-Peixoto

    2012-10-01

    Full Text Available Neuromyelitis optica (NMO has been traditionally described as the association of recurrent or bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM. Identification of aquaporin-4 antibody (AQP4-IgG has deeply changed the concept of NMO. A spectrum of NMO disorders (NMOSD has been formulated comprising conditions which include both AQP4-IgG seropositivity and one of the index events of the disease (recurrent or bilateral optic neuritis and LETM. Most NMO patients harbor asymptomatic brain MRI lesions, some of them considered as typical of NMO. Some patients with aquaporin-4 autoimmunity present brainstem, hypothalamic or encephalopathy symptoms either preceding an index event or occurring isolatedly with no evidence of optic nerve or spinal involvement. On the opposite way, other patients have optic neuritis or LETM in association with typical lesions of NMO on brain MRI and yet are AQP4-IgG seronegative. An expanded spectrum of NMO disorders is proposed to include these cases.

  5. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography

    Science.gov (United States)

    Bennett, JL; de Seze, J; Lana-Peixoto, M; Palace, J; Waldman, A; Schippling, S; Tenembaum, S; Banwell, B; Greenberg, B; Levy, M; Fujihara, K; Chan, KH; Kim, HJ; Asgari, N; Sato, DK; Saiz, A; Wuerfel, J; Zimmermann, H; Green, A; Villoslada, P

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber layer (RNFL) and ganglion cell layer thinning and more frequent development of microcystic macular edema than in MS. Furthermore, while patients’ RNFL thinning also occurs in the absence of optic neuritis in MS, subclinical damage seems to be rare in NMO. Thus, OCT might be useful in differentiating NMO from MS and serve as an outcome parameter in clinical studies. PMID:25662342

  6. Detection and clinical value of NMO-IgG in neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    De-hui HUANG

    2014-09-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory demyelinating disease of the central nervous system (CNS of autoimmune etiology which predominantly affects the optic nerves and spinal cord. In 2004, a highly specific serum antibody, NMO-IgG, was found in the sera of NMO patients. Subsequently, the target antigen of NMO-IgG was identified as aquaporin 4 (AQP4, a water channel densely expressed in optic nerves, spinal cord and area around cerebral ventricles. NMO-IgG/AQP4 antibody has demonstrated extreme importance for the diagnosis and differential diagnosis, the evaluation of disease activity, therapeutic effect and prognosis of NMO. In recent years, different techniques have been used to examine NMO-IgG in serum and cerebrospinal fluid, including tissue-based, cell-based and protein-based assays. In this review, the authors give an overview of the tests currently available for the detection of NMO-IgG and their clinical significance. doi: 10.3969/j.issn.1672-6731.2014.09.003

  7. Neuromyelitis optica accompanied by nephrotic syndrome and autoimmune-related pancytopenia.

    Science.gov (United States)

    ZhangBao, Jingzi; Zhou, Lei; Lu, Jiahong; Xi, Jianying; Zhao, Chongbo; Quan, Chao

    2016-05-01

    Neuromyelitis optica (NMO) associated with nephrotic syndrome and autoimmune-related pancytopenia has not been reported previously. We report herein a young woman who initially presented with bilateral blurring of vision and numbness in her hands. MRI disclosed multiple white matter lesions and a long cervical spinal cord lesion extending to the medulla oblongata. Serum aquaporin-4 antibody was positive and the patient was diagnosed with NMO. While in the hospital, she presented with hypoproteinemia and heavy proteinuria, meeting the diagnostic criteria of nephrotic syndrome. After high-dose methylprednisolone treatment, her vision improved significantly and urine protein quantity decreased. However, the patient subsequently developed severe pancytopenia with a positive Coombs' test. Thrombocytopenia finally led to uncontrollable gastrointestinal bleeding as the direct cause of the patient's death. This case illustrates the extremely rare condition of concurrence of NMO, nephrotic syndrome, and autoimmune pancytopenia in one patient, which suggests the involvement of organs beyond the central nervous system in NMO spectrum disorders. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica.

    Science.gov (United States)

    Berger, Joseph R; Neltner, Janna; Smith, Charles; Cambi, Franca

    2014-11-01

    Both progressive multifocal leukoencephalopathy (PML) and posterior reversible encephalopathy syndrome (PRES) have been reported as complications of rituximab therapy. These disorders may appear indistinguishable on magnetic resonance imaging (MRI). We report on a 42 year old woman with neuromyelitis optica (NMO) of 10 years duration who developed extensive white matter disease affecting chiefly both parietal lobes 6 months after her first and only dose of rituximab. The MRI findings suggested the diagnosis of PML, but her history was more consistent with PRES. Ultimately, a brain biopsy was performed which was consistent with the diagnosis of PRES. PRES and PML may have overlapping symptomatology and be indistinguishable on MRI. An approach to distinguishing between these two disorders is addressed. Copyright © 2014. Published by Elsevier B.V.

  9. Endocrinopathies in paediatric-onset neuromyelitis optica spectrum disorder with aquaporin 4 (AQP4) antibody.

    Science.gov (United States)

    Hacohen, Yael; Messina, Silvia; Gan, Hoong-Wei; Wright, Sukhvir; Chandratre, Saleel; Leite, Maria Isabel; Fallon, Penny; Vincent, Angela; Ciccarelli, Olga; Wassmer, Evangeline; Lim, Ming; Palace, Jacqueline; Hemingway, Cheryl

    2018-04-01

    The involvement of the diencephalic regions in neuromyelitis optica spectrum disorder (NMOSD) may lead to endocrinopathies. In this study, we identified the following endocrinopathies in 60% (15/25) of young people with paediatric-onset aquaporin 4-Antibody (AQP4-Ab) NMOSD: morbid obesity ( n = 8), hyperinsulinaemia ( n = 5), hyperandrogenism ( n = 5), amenorrhoea ( n = 5), hyponatraemia ( n = 4), short stature ( n = 3) and central hypothyroidism ( n = 2) irrespective of hypothalamic lesions. Morbid obesity was seen in 88% (7/8) of children of Caribbean origin. As endocrinopathies were prevalent in the majority of paediatric-onset AQP4-Ab NMOSD, endocrine surveillance and in particular early aggressive weight management is required for patients with AQP4-Ab NMOSD.

  10. Estudio Te\\'orico del espectro de emisi\\'on para un sistema microcavidad-punto cu\\'antico en una aproximaci\\'on de campo medio (Theoretical study of emission spectrum for a quantum dot-microcavity system in a mean field approximation)

    OpenAIRE

    Rojas-Arias, Juan S.; Rodriguez, B.; Vinck-Posada, Herbert

    2015-01-01

    En este trabajo, se obtiene una expresi\\'on num\\'erica para calcular el espectro de emisi\\'on de un sistema microcavidad-punto cu\\'antico usando una teor\\'ia de campo medio en el formalismo de la matriz densidad. El sistema modelado es un micropilar semiconductor que contiene un \\'unico punto cu\\'antico en el interior de la microcavidad, este sistema presenta p\\'erdida de fotones a trav\\'es de los espejos de la cavidad y bombeo de excitones al punto cu\\'antico. Obtenemos una ecuaci\\'on maestr...

  11. NMO-IgG: A Specific Biomarker for Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Brian G. Weinshenker

    2006-01-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory demyelinating disease that principally targets the optic nerves and spinal cord and often leads to severe disability and occasionally life threatening respiratory failure. Although its clinical manifestations overlap with those of multiple sclerosis (MS, in established cases these two conditions can be distinguished on the basis of clinical, radiological, and routine spinal fluid studies. The diagnosis in early cases or limited forms of NMO is difficult. We recently discovered a unique IgG autoantibody (NMO-IgG that is highly specific to patients with NMO and thus a valuable diagnostic aid. Its antigen, aquaporin-4 (AQP4, is the central nervous system’s predominant water channel protein. This antibody has not yet been proven to be pathogenic, but several facts suggest that it might be, including the similarity of the immunohistochemical pattern of NMO-(AQP4 IgG binding to mouse CNS tissues to the pattern of immune complex deposition in autopsied patients’ spinal cord tissue. The spectrum of diseases identified by NMO-IgG is broader than has previously been recognized clinically and includes incomplete forms of NMO, such as recurrent transverse myelitis without optic neuritis and recurrent optic neuritis without myelitis.

  12. Ovarian Reserve in Women With Neuromyelitis Optica Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Jan Thöne

    2018-06-01

    Full Text Available Neuromyelitis optica spectrum disorder (NMOSD is a neuroinflammatory disease. The majority of NMOSD patients is seropositive for aquaporin-4 (AQP4 antibodies. AQP4 is the main water channel protein in the central nervous system, but has also been identified in the female reproductive system. Fertility issues and ovarian reserve has not yet been studied in females with NMOSD. The purpose of this study was to measure serum Anti-Müllerian hormone (AMH in females with NMOSD compared to healthy controls (HC, in combination with other lifestyle and reproduction parameters. AMH is independent from the menstrual cycle and a reliable indicator of both ovarian reserve and ovarian function. We included a total of 32 reproductive-age females, 18 HC and 14 with NMOSD. We used an enzymatically amplified two-site immunoassay to determine serum AMH level. In comparison to HC, mean AMH value was reduced in NMOSD. Apart from that significantly more women with NMOSD showed low AMH levels (< 0.8 ng/ml. Low AMH was associated with disease activity. In contrast, none of the immunotherapies for NMOSD, neither any reproductive life style parameter was associated with a decreased AMH. Our results contribute to understanding of hindered fertility in females with NMOSD and enables neurologists to better counsel female patients.

  13. Neuromyelitis optica in pregnancy complicated by posterior reversible encephalopathy syndrome, eclampsia and fetal death.

    Science.gov (United States)

    Igel, Catherine; Garretto, Diana; Robbins, Matthew S; Swerdlow, Michael; Judge, Nancy; Dayal, Ashlesha

    2015-03-01

    Neuromyelitis optica (NMO) is a demyelinating syndrome characterized by optic neuritis and acute myelitis with poor recovery and a progressive course. We report a poor outcome complicated by posterior reversible encephalopathy syndrome (PRES) and eclampsia and review available literature and current evidence for anticipation of adverse fetal and maternal effects. After a pregnancy complicated by multiple admissions for painful NMO exacerbations, a primiparous patient with seropositive NMO presented at 31 + 3/7 weeks with eclampsia, HELLP and subsequent fetal death. MRI confirmed PRES. NMO may be associated with eclampsia and leads to adverse maternal and fetal outcomes. Posited mechanisms include antibody-mediated placental damage and a heightened risk of eclampsia-associated PRES. Further characterization of the course of NMO and its relationship with pregnancy outcomes in larger series would be invaluable.

  14. Default-mode network and deep gray-matter analysis in neuromyelitis optica patients.

    Science.gov (United States)

    Rueda-Lopes, Fernanda C; Pessôa, Fernanda M C; Tukamoto, Gustavo; Malfetano, Fabíola Rachid; Scherpenhuijzen, Simone Batista; Alves-Leon, Soniza; Gasparetto, Emerson L

    2018-02-20

    The aim of our study was to detect functional changes in default-mode network of neuromyelitis optica (NMO) patients using resting-state functional magnetic resonance images and the evaluation of subcortical gray-matter structures volumes. NMO patients (n=28) and controls patients (n=19) were enrolled. We used the integrated registration and segmentation tool, part of FMRIB's Software Library (FSL) to segment subcortical structures including the thalamus, caudate nucleus, putamen, hippocampus and amygdalae. Resting-state functional magnetic resonance images were post-processed using the Multivariate Exploratory Linear Optimized Decomposition into Independent Components, also part of FSL. Average Z-values extracted from the default-mode network were compared between patients and controls using t-tests (P values default-mode network of patients compared to controls, notably in the precuneus and right hippocampus (corrected Pdefault-mode network. The hyperactivity of certain default-mode network areas may reflect cortical compensation for subtle structural damage in NMO patients. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  15. Neuromyelitis optica spectrum disorder in patient with systemic lupus erythematosus - our experience

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    Božić Ksenija

    2018-01-01

    Full Text Available Introduction. Neuromyelitis optica spectrum disorder (NMOSD is a rare demyelinating immune-mediated central nervous system disease. It is extremely rare to occur in patients with systemic lupus erythematosus (SLE, and it represents a diagnostic and therapeutic challenge. Case report. A 38-year-old Caucasian woman with medical history of SLE and new onset of flaccid paraparesis, fecal and urinary incontinence, persistent nausea and vomiting was admitted to our hospital. Based on the clinical presentation, magnetic resonance imaging findings and positive aquaporin 4 (AQP4 antibodies, a NMOSD with coexisting SLE were diagnosed. Pulse-doses of cyclophosphamide and glucocorticoids were efficient in patient treatment. Conclusion. In a patient with SLE and symptoms of longitudinal extensive transverse myelitis and/or optic neuritis and area postrema syndrome, assessment of AQP4 antibodies is neccessary for diagnosing NMOSD. Accurate diagnosis, and timely and long-term administration of immunosuppressive therapy are crucial for favorable outcome of these two coexisting diseases.

  16. The Contribution of Optical Coherence Tomography in Neuromyelitis Optica Spectrum Disorders

    Science.gov (United States)

    Mateo, Javier; Esteban, Olivia; Martínez, Mireya; Grzybowski, Andrzej; Ascaso, Francisco Javier

    2017-01-01

    Neuromyelitis optica spectrum disorders (NMOSD) comprises a group of central nervous system disorders of inflammatory autoimmune origin that mainly affect the optic nerves and the spinal cord and can cause severe visual and general disability. The clinical signs are similar to those of multiple sclerosis (MS), with the result that it is often difficult to differentiate between the two, thus leading to misdiagnosis. As the treatment and prognosis of NMOSD and MS are different, it is important to make an accurate and early diagnosis of NMOSD. Optical coherence tomography (OCT) is a non-invasive technique that enables a quantitative study of the changes that the optic nerve and the macula undergo in several neurodegenerative diseases. Many studies have shown that some of these changes, such as retinal nerve fiber layer thinning or microcystic macular edema, can be related to alterations in the brain due to neurodegenerative disorders. The purpose of this mini-review is to show how OCT can be useful for the diagnosis of NMOSD and follow-up of affected patients, as well as for the differential diagnosis with MS. PMID:29085325

  17. Neuromyelitis optica-IgG testing in an Indian cohort with neuromyelitis optica and related demyelinating disorders: Our experience

    Directory of Open Access Journals (Sweden)

    Narayanan Unni

    2013-01-01

    Full Text Available Background: Neuromyelitis optica (NMO is an immune-mediated inflammatory demyelinating disorder of the central nervous system with a predilection for the optic nerves and the spinal cord. Immunopathological evidence suggests that the target antigen of the disease is aquaporin-4. An IgG antibody against this protein has been explored as a molecular marker for the disease and as a diagnostic tool due to its high sensitivity and specificity in various populations. Objective: To assess the value of NMO-IgG testing in Indian patients with clinical and magnetic resonance imaging features consistent with NMO and longitudinally extensive transverse myelitis (LETM. Materials and Methods: Forty-five patients with clinical and magnetic resonance imaging features consistent with NMO, LETM, and MS were tested for serum NMO-IgG. Of these patients, 22 patients satisfied revised (2006 Wingerchuk criteria for NMO (excluding NMO-IgG status and 11 patients had LETM. Twelve patients satisfied the revised (2010 McDonald criteria for multiple sclerosis (MS. Results: Of the 21 patients, satisfying the criteria for NMO and for whom the test results were available, 17 were positive for NMO-IgG (80.9%, and of the 11 patients having LETM, 6 (54.5% were positive for NMO-IgG. In one patient with NMO, the test result was not available. None of the 12 patients satisfying McDonald criteria for MS showed NMO-IgG seropositivity. Conclusion: Our study suggests that it is worthwhile to pursue NMO-IgG testing as a diagnostic tool for patients with clinical and Magnetic Resonance Imaging (MRI features consistent with NMO and LETM in the Indian population.

  18. Neuromyelitis optica: a positive appraisal of seronegative cases.

    Science.gov (United States)

    Bernard-Valnet, R; Liblau, R S; Vukusic, S; Marignier, R

    2015-12-01

    Neuromyelitis optica (NMO) is a rare inflammatory disorder of the central nervous system. The hallmark of NMO is the presence of specific autoantibodies directed against aquaporin 4 (AQP4-IgG). AQP4-IgG, included in diagnostic criteria, has enlarged the clinical spectrum of NMO and serves to predict relapses. Moreover AQP4-IgG has provided unprecedented insight in the immunopathology of NMO, representing a rationale for therapeutic intervention with relevant novel treatment strategies specific for NMO. However, some patients remain seronegative for AQP4-IgG despite a definite diagnosis of NMO and the use of the finest methods for antibody detection. Interestingly, seronegative NMO (NMO(neg)) patients exhibit different demographic and disease-related characteristics in comparison to seropositive patients. The recent association with autoantibodies specific for myelin oligodendrocyte glycoprotein (MOG) is the main indication that disease mechanisms might differ in NMO(pos) and NMO(neg), challenging the position of NMO(neg) patients in the spectrum of demyelinating diseases and therapeutic strategies to be adopted. Thus, a reappraisal of the NMO(neg) population is needed to improve NMO care. Here the current knowledge regarding NMO(neg) is reviewed and hypotheses on its pathogenesis are made including a comprehensive description of detection methods and the prevalence of AQP4-IgG and a review of the epidemiological, clinical and paraclinical characteristics of NMO(neg); finally an integrated view of the general pathophysiological mechanisms underlying NMO(neg) is provided. © 2015 EAN.

  19. Is pruritus an indicator of aquaporin-positive neuromyelitis optica?

    Science.gov (United States)

    Netravathi, Manjunath; Saini, Jitender; Mahadevan, Anita; Hari-Krishna, Bollampalli; Yadav, Ravi; Pal, Pramod Kumar; Satishchandra, Parthasarathy

    2017-05-01

    Recently, pruritus has been recognised as an important association with neuromyelitis optica spectrum disorders (NMOSD). To determine the clinical and radiological characteristics of patients with NMOSD and pruritus. Among 57 consecutive patients with NMOSD, 15 (26.3% women) reported pruritus. All had aquaporin-4 (AQP4) antibodies. The mean age was 34.5 ± 9.1 years, age at onset was 31.3 ± 11.0 years and the duration of illness was 3.9 ± 3.1 years. Pruritus preceded the neurological disturbances in all the patients. Predominant patients experienced pruritus in the cervical dermatome (66.7%) followed by cervicothoracic region (13.3%), trigeminal nerve (13.3%) and lumbar region (6.7%). Lesions extending from cervicomedullary junction up to the thoracic segment was the most common site of affection (40%) followed by cervicothoracic (26.7%), cervicomedullary junction to cervical cord (13.3%), cervical cord (6.7%) and thoracic segment (6.7%). This report is one of the largest series reporting the close association of pruritus with onset of neurological symptoms in NMOSD. It highlights the importance of recognising this rare symptom which may help in making a correct diagnosis in a patient with suspected demyelinating disorder. In a patient with NMOSD, early treatment with immunomodulation during pruritus may prevent or minimise occurrence of neurological dysfunction.

  20. Qualitative and quantitative autoradiographic investigations on DNA-repair in the pars optica retinae of the rabbit

    International Nuclear Information System (INIS)

    Kellner, G.; Reindl, E.; Pichler, L.; Hofer, H.

    1974-01-01

    In vitro and in vivo investigations into the incorporation of 3 H-thymidine into the nuclei of pars optica retinae of rabbits after β-irradiation with 60 krad were performed. The results of the in vitro and in vivo experiments are comparable with the in vitro data showing smaller statistical deviations. The rate comparable with the in vitro data showing smaller statistical deviations. The rate of incorporation of 3 H-thymidine into the nuclei of Ggl. opticum and Ggl. retinae is about the same, but it is significantly lower in the nuclei of photoreceptor cells by one order of magnitude. The in vitro experiment demonstrates that ganglion cells are capable of DNA repair even after circulation has been stopped for 15 or more minutes. (author)

  1. Contribution of spinal cord biopsy to diagnosis of aquaporin-4 antibody positive neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Ringelstein, M; Metz, I; Ruprecht, K; Koch, A; Rappold, J; Ingwersen, J; Mathys, C; Jarius, S; Brück, W; Hartung, H-P; Paul, F; Aktas, O

    2014-06-01

    Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not guide the diagnostic process to anti-aquaporin-4 (AQP4)-seropositive NMOSD. Serious postoperative complications occurred in 5/7 patients and persisted during follow-up in 2/7 patients (29%). Considering these sequelae, AQP4-antibody testing should be mandatory in patients with inconclusive longitudinally extensive spinal cord lesions prior to biopsy. © The Author(s) 2013.

  2. Presentation of Neuromyelitis Optica with Recurrent Severe Myelitis and Acute Respiratory Failure in an Old Woman

    Directory of Open Access Journals (Sweden)

    Saeed Razmeh

    2017-06-01

    Full Text Available Neuromyelitis Optica (NMO is a rare disease of the central nervous system that causes optic nerve and spinal cord involvement. The our patient first developed acute paraplegia that was treated with intravenous methylprednisolone with diagnosis of acute thoracic myelitis according to magnetic resonance imaging (MRI finding , concurrently with tapering of oral prednisolone, again affected by quadriplegia and respiratory failure. She was seropositivity for NMO-IgG that was negative in first admission and MRI of spine shows hyperintense lesion in whole cervical and upper thoracic MRI. With considering the findings, NMO was diagnosed and the plasmapheresis starts for her. We report a case of this syndrome because it can increase the physician’s awareness of the unusual manifestations of this syndrome.

  3. Challenges and opportunities in designing clinical trials for neuromyelitis optica

    Science.gov (United States)

    Barron, Gerard; Behne, Jacinta M.; Bennett, Jeffery L.; Chin, Peter S.; Cree, Bruce A.C.; de Seze, Jerome; Flor, Armando; Fujihara, Kazuo; Greenberg, Benjamin; Higashi, Sayumi; Holt, William; Khan, Omar; Knappertz, Volker; Levy, Michael; Melia, Angela T.; Palace, Jacqueline; Smith, Terry J.; Sormani, Maria Pia; Van Herle, Katja; VanMeter, Susan; Villoslada, Pablo; Walton, Marc K.; Wasiewski, Warren; Wingerchuk, Dean M.; Yeaman, Michael R.

    2015-01-01

    Current management of neuromyelitis optica (NMO) is noncurative and only partially effective. Immunosuppressive or immunomodulatory agents are the mainstays of maintenance treatment. Safer, better-tolerated, and proven effective treatments are needed. The perceived rarity of NMO has impeded clinical trials for this disease. However, a diagnostic biomarker and recognition of a wider spectrum of NMO presentations has expanded the patient population from which study candidates might be recruited. Emerging insights into the pathogenesis of NMO have provided rationale for exploring new therapeutic targets. Academic, pharmaceutical, and regulatory communities are increasingly interested in meeting the unmet needs of patients with NMO. Clinical trials powered to yield unambiguous outcomes and designed to facilitate rapid evaluation of an expanding pipeline of experimental agents are needed. NMO-related disability occurs incrementally as a result of attacks; thus, limiting attack frequency and severity are critical treatment goals. Yet, the severity of NMO and perception that currently available agents are effective pose challenges to study design. We propose strategies for NMO clinical trials to evaluate agents targeting recovery from acute attacks and prevention of relapses, the 2 primary goals of NMO treatment. Aligning the interests of all stakeholders is an essential step to this end. PMID:25841026

  4. Pruritus may be a common symptom related to neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    He, Zhiyong; Ren, Ming; Wang, Xiaofeng; Guo, Qifeng; Qi, Xiaokun

    2017-04-01

    To evaluate pruritus in patients with neuromyelitis optica spectrum disorders (NMOSD) and to characterize the relationship between pruritus and lesions of NMOSD. 61 patients with NMOSD were included in the study and their medical records were reviewed for pruritus, neurological symptoms and magnetic resonance imaging (MRI) images. We focused on the patients' history of pruritus, especially the severity, duration, region, and the relationship of pruritus with other symptoms of NMOSD. Of the 61 patients with NMOSD, 59 had longitudinally extensive transverse myelitis (LETM). 38 of these patients (64.4%) reported pruritus during the course of their illness, with 16 patients reporting pruritus as the initial symptoms followed by limb weakness. In 35 of 38 patients (92.1%), pruritus was located within the dermatomes innervated by the spinal nerves from the involved spinal cord. Our results show that pruritus is a common symptom of NMOSD and relates to the lesions in the spinal cord. Pruritus may indicate a new episode of myelitis in patients with NMOSD. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

    Science.gov (United States)

    Kremer, Stephane; Renard, Felix; Achard, Sophie; Lana-Peixoto, Marco A.; Palace, Jacqueline; Asgari, Nasrin; Klawiter, Eric C.; Tenembaum, Silvia N.; Banwell, Brenda; Greenberg, Benjamin M.; Bennett, Jeffrey L.; Levy, Michael; Villoslada, Pablo; Saiz, Albert; Fujihara, Kazuo; Chan, Koon Ho; Schippling, Sven; Paul, Friedemann; Kim, Ho Jin; de Seze, Jerome; Wuerfel, Jens T.

    2016-01-01

    Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other disorders have not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR volumetry, and ultrahigh-field strength MRI. It was undertaken to consider the advanced MRI techniques used for patients with NMO by different specialists in the field. Although quantitative measures such as proton MR spectroscopy or magnetization transfer imaging have not reproducibly revealed diffuse brain injury, preliminary data from diffusion-weighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MRI techniques may further our understanding of the pathogenic processes in NMO spectrum disorders and may help us identify the distinct radiographic features corresponding to specific phenotypic manifestations of this disease. PMID:26010909

  6. Cognitive impairment differs between neuromyelitis optica spectrum disorder and multiple sclerosis.

    Science.gov (United States)

    Kim, Su-Hyun; Kwak, Kichang; Jeong, In Hye; Hyun, Jae-Won; Jo, Hyo-Jin; Joung, AeRan; Yu, Eun-Seung; Kim, Ji-Hee; Lee, Sang Hyun; Yun, Sooin; Joo, Jungnam; Lee, Dong-Kyun; Lee, Jong-Min; Kim, Ho Jin

    2016-12-01

    To compare the frequency and pattern of cognitive impairment (CI) between patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). A total of 82 NMOSD patients, 58 MS patients, and 45 healthy controls (HCs) underwent a neuropsychological assessment. CI was observed in 29% of NMOSD and 50% of MS patients (p < 0.001); CI was considered present if a patient scored lower than the fifth percentile compared with HCs in at least three domains. A lower frequency of CI was consistently found when CI was indicated by at least two failed tests (p < 0.001). MS patients performed worse than did NMOSD patients on verbal learning and verbal and visual memory tests. Levels of education and depression and the interval from disease onset to treatment were associated with a negative influence on cognition in patients with NMOSD. CI in patients with NMOSD may be not as common as in patients with MS. MS patients exhibited severe impairment, particularly on learning and memory tests, compared with NMOSD patients. Differential prevalence and patterns of CI between NMOSD and MS patients suggest that the two diseases have different mechanisms of brain injury. © The Author(s), 2016.

  7. The Contribution of Optical Coherence Tomography in Neuromyelitis Optica Spectrum Disorders

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    Javier Mateo

    2017-09-01

    Full Text Available Neuromyelitis optica spectrum disorders (NMOSD comprises a group of central nervous system disorders of inflammatory autoimmune origin that mainly affect the optic nerves and the spinal cord and can cause severe visual and general disability. The clinical signs are similar to those of multiple sclerosis (MS, with the result that it is often difficult to differentiate between the two, thus leading to misdiagnosis. As the treatment and prognosis of NMOSD and MS are different, it is important to make an accurate and early diagnosis of NMOSD. Optical coherence tomography (OCT is a non-invasive technique that enables a quantitative study of the changes that the optic nerve and the macula undergo in several neurodegenerative diseases. Many studies have shown that some of these changes, such as retinal nerve fiber layer thinning or microcystic macular edema, can be related to alterations in the brain due to neurodegenerative disorders. The purpose of this mini-review is to show how OCT can be useful for the diagnosis of NMOSD and follow-up of affected patients, as well as for the differential diagnosis with MS.

  8. Autoimmune AQP4 channelopathies and neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Hinson, Shannon R; Lennon, Vanda A; Pittock, Sean J

    2016-01-01

    Neuromyelitis optica (NMO) spectrum disorders (SD) represent an evolving group of central nervous system (CNS)-inflammatory autoimmune demyelinating diseases unified by a pathogenic autoantibody specific for the aquaporin-4 (AQP4) water channel. It was historically misdiagnosed as multiple sclerosis (MS), which lacks a distinguishing biomarker. The discovery of AQP4-IgG moved the focus of CNS demyelinating disease research from emphasis on the oligodendrocyte and myelin to the astrocyte. NMO is recognized today as a relapsing disease, extending beyond the optic nerves and spinal cord to include brain (especially in children) and skeletal muscle. Brain magnetic resonance imaging abnormalities, identifiable in 60% of patients at the second attack, are consistent with MS in 10% of cases. NMOSD-typical lesions (another 10%) occur in AQP4-enriched regions: circumventricular organs (causing intractable nausea and vomiting) and the diencephalon (causing sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Advances in understanding the immunobiology of AQP4 autoimmunity have necessitated continuing revision of NMOSD clinical diagnostic criteria. Assays that selectively detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 are promising prognostically. When referring to AQP4 autoimmunity, we suggest substituting the term "autoimmune aquaporin-4 channelopathy" for the term "NMO spectrum disorders." Randomized clinical trials are currently assessing the efficacy and safety of newer immunotherapies. Increasing therapeutic options based on understanding the molecular pathogenesis is anticipated to improve the outcome for patients with AQP4 channelopathy. © 2016 Elsevier B.V. All rights reserved.

  9. Actions in the electrical sector to propitiate the environmental protection; Acciones en el sector electrico para propiciar la proteccion ambiental

    Energy Technology Data Exchange (ETDEWEB)

    Trevino Gaspari, Mateo [Fideicomiso de Ahorro de Energia (FIDE) (Mexico)

    1997-07-01

    The saving of electrical energy is one of the most efficient means to propitiate the environmental protection in the surroundings of the facilities used in the production of electrical energy. The emission of polluting agents associated with the electric power generation is analyzed, among them, CO{sub 2}, SO{sub 2} and NO{sub 2}, along with the particulate emission of ash or soot. In addition, an analysis is made of the contribution of the electrical energy saving to the environmental protection and the actions that the Comision Federal de Electricidad of Mexico will undertake on the electric energy saving for the 1995 to the 2000 period. [Spanish] El ahorro de energia electrica es uno de los medios mas eficientes para propiciar la proteccion ambiental en el entorno de las instalaciones usadas en la produccion de energia electrica. Se analiza la emision de contaminantes asociados con la generacion electrica, entre ellos, el CO{sub 2}, el SO{sub 2} y NO{sub 2}, junto con la emision de particulas de ceniza o de hollin. Ademas se analiza la contribucion del ahorro de energia electrica a la proteccion ambiental y las acciones que emprendera la Comision Federal de Electricidad de Mexico sobre ahorro de energia electrica para el periodo 1995 al 2000.

  10. Seronegative Neuromyelitis Optica: A Case Report of a Hispanic Male

    Directory of Open Access Journals (Sweden)

    Nabeel Badri

    2016-05-01

    Full Text Available Neuromyelitis optica (NMO is a rare disease, common in white females and rarely reported in Hispanic males. It is usually associated with recurrent demyelinating spectrum that is autoimmune in nature. The diagnosis is usually confirmed by antibody biomarkers; however, they can be negative and lead to more dilemma in diagnosis. Furthermore, the course of disease and prognosis are different in seronegative as compared to seropositive NMO. Treatment is similar in both subgroups with new approaches under investigation for seronegative NMO patients. We present an interesting case of a 37-year-old Hispanic male who presented with sudden onset of lower extremity weakness, numbness, blurry vision, and urinary retention. Magnetic resonance imaging (MRI of the thoracic spine showed multiphasic demyelinating process involving the thoracic spinal cord. His brain MRI also revealed changes suggesting optic neuritis. The patient met the criteria for diagnosis of NMO by having optic neuritis and myelitis by imaging studies despite having negative aquaporin-4 antibodies (AQP4-Ab. His condition improved after plasma exchange. NMO can be difficult to distinguish from acute multiple sclerosis in the early stages of the disease. Having AQP4-Ab testing is important for diagnosis with imaging studies; however, negative antibody results cannot exclude the diagnosis, but rather group it in seronegative subtype. Ongoing studies and research suggest that seronegative NMO might have a different pathophysiology, manifestation, and prognosis.

  11. Complexity and wide range of neuromyelitis optica spectrum disorders: more than typical manifestations

    Science.gov (United States)

    Han, Jinming; Yang, Meng-ge; Zhu, Jie; Jin, Tao

    2017-01-01

    Neuromyelitis optica (NMO), considered to be mediated by autoantibodies, often cause severely disabling disorders of the central nervous system, and predominantly cause optic nerve damage and longitudinally extensive transverse myelitis. Remarkable progress has been made in deciphering NMO pathogenesis during the past decade. In 2015, the International Panel for NMO Diagnosis proposed the unifying term “NMO spectrum disorders” (NMOSD) and the updated NMOSD criteria reflects a wide range of disease and maintains reasonable specificity. Moreover, cumulative findings have indicated that NMOSD are frequently associated with multiple autoimmune diseases, thereby presenting complex clinical symptoms that make this disease more difficult to recognize. Notably, most neurologists do not heed these symptoms or comorbid conditions in patients with NMOSD. Whereas previous reviews have focused on pathogenesis, treatment, and prognosis in NMOSD, we summarize the present knowledge with particular emphasis on atypical manifestations and autoimmune comorbidities in patients with NMOSD. Furthermore, we emphasized the identification of these atypical characteristics to enable a broader and better understanding of NMOSD, and improve early accurate diagnosis and therapeutic decision making. PMID:29118581

  12. Plasma complement biomarkers distinguish multiple sclerosis and neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Hakobyan, Svetlana; Luppe, Sebastian; Evans, David Rs; Harding, Katharine; Loveless, Samantha; Robertson, Neil P; Morgan, B Paul

    2017-06-01

    Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are autoimmune inflammatory demyelinating diseases of the central nervous system. Although distinguished by clinicoradiological and demographic features, early manifestations can be similar complicating management. Antibodies against aquaporin-4 support the diagnosis of NMOSD but are negative in some patients. Therefore, there is unmet need for biomarkers that enable early diagnosis and disease-specific intervention. We investigated whether plasma complement proteins are altered in MS and NMOSD and provide biomarkers that distinguish these diseases. Plasma from 54 NMOSD, 40 MS and 69 control donors was tested in multiplex assays measuring complement activation products and proteins. Using logistic regression, we tested whether combinations of complement analytes distinguished NMOSD from controls and MS. All activation products were elevated in NMOSD compared to either control or MS. Four complement proteins (C1inh, C1s, C5 and FH) were higher in NMOSD compared to MS or controls. A model comprising C1inh and terminal complement complex (TCC) distinguished NMOSD from MS (area under the curve (AUC): 0.98), while C1inh and C5 distinguished NMOSD from controls (AUC: 0.94). NMOSD is distinguished from MS by plasma complement biomarkers. Selected complement analytes enable differential diagnosis. Findings support trials of anti-complement therapies in NMOSD.

  13. Short segment myelitis as a first manifestation of neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Huh, So-Young; Kim, Su-Hyun; Hyun, Jae-Won; Jeong, In Hye; Park, Min Su; Lee, Sang-Hyun; Kim, Ho Jin

    2017-03-01

    Some patients with neuromyelitis optica spectrum disorders (NMOSD) present with spinal cord lesions extending fewer than three vertebral segments (short transverse myelitis, STM), hindering an early diagnosis. We investigated the frequency and imaging characteristics of STM lesions in patients presenting with myelitis as an initial manifestation of NMOSD. Patients seen at three referral hospitals in Korea between June 2005 and March 2015 who met the following inclusion criteria were recruited for review: seropositivity for aquaporin-4 antibody, initial presentation with myelitis and spinal cord magnetic resonance imaging (MRI) performed within 1 month of initial myelitis onset. Of the 76 enrolled patients, 65 (85.5%) collectively had 69 longitudinally extensive transverse myelitis lesions, while the remaining 11 (14.5%) had a total of 15 STM lesions. Of the 15 STM lesions, 5 spanned 2.5 vertebral segments, 6 were continuous over two segments, 3 showed a length of 1.5 segments and 1 was confined to a single segment. On axial imaging, all of the STM lesions involved the central grey matter. These MRI findings suggested that STM does not preclude the possibility of an NMOSD diagnosis.

  14. Systematic review of the published data on the worldwide prevalence of John Cunningham virus in patients with multiple sclerosis and neuromyelitis optica.

    Science.gov (United States)

    Paz, Sonia Patricia Castedo; Branco, Luciana; Pereira, Marina Alves de Camargo; Spessotto, Caroline; Fragoso, Yara Dadalti

    2018-01-01

    John Cunningham virus (JCV) is a polyoma virus that infects humans, mainly in childhood or adolescence, and presents no symptomatic manifestations. JCV can cause progressive multifocal leukoencephalopathy (PML) in immunosuppressed individuals, including those undergoing treatment for multiple sclerosis (MS) and neuromyelitis optica (NMO). PML is a severe and potentially fatal disease of the brain. The prevalence of JCV antibodies in human serum has been reported to be between 50.0 and 90.0%. The aim of the present study was to review worldwide data on populations of patients with MS and NMO in order to establish the rates of JCV seropositivity in these individuals. The present review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used the following search terms: "JCV" OR "JC virus" AND "multiple sclerosis" OR "MS" OR "NMO" OR "neuromyelitis optica" AND "prevalence." These terms were searched for both in smaller and in larger clusters of words. The databases searched included PubMed, MEDLINE, SciELO, LILACS, Google Scholar, and Embase. After the initial selection, 18 papers were included in the review. These articles reported the prevalence of JCV antibodies in the serum of patients with MS or NMO living in 26 countries. The systematic review identified data on 29,319 patients with MS/NMO and found that 57.1% of them (16,730 individuals) were seropositive for the anti-JCV antibody (range, 40.0 to 69.0%). The median worldwide prevalence of JCV among adults with MS or NMO was found to be 57.1%.

  15. Tonic spasms are a common clinical manifestation in patients with neuromyelitis optica Espasmos tônicos são manifestações clínicas frequentes em pacientes com neuromielite óptica

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    Luz Abaroa

    2013-05-01

    Full Text Available Tonic spasms have been most commonly associated with multiple sclerosis. To date, few reports of series of patients with neuromyelitis optica and tonic spasms have been published. Methods: We analyzed the characteristics and frequency of tonic spasms in 19 subjects with neuromyelitis optica. Data was collected using a semi-structured questionnaire for tonic spasms, by both retrospectively reviewing medical records and performing clinical assessment. Results: All patients except one developed this symptom. The main triggering factors were sudden movements and emotional factors. Spasms were commonly associated to sensory disturbances and worsened during the acute phases of the disease. Carbamazepine was most commonly used to treat the symptom and patients showed good response to the drug. Conclusions: Tonic spasms are a common clinical manifestation in patients with neuromyelitis optica.Espasmos tônicos têm sido mais frequentemente associados com esclerose múltipla. Foram publicados até agora poucos relatos de série de pacientes com neuromielite óptica e espasmos tônicos. Métodos: Foram analisadas as características e a frequência de espasmos tônicos em 19 indivíduos com neuromielite óptica. Os dados foram coletados por meio de um questionário semiestruturado para espasmos tônicos, mediante a avaliação retrospectiva dos prontuários e a análise dos dados clínicos Resultados: Todos os pacientes com neuromielite óptica exceto um apresentaram espasmos tônicos. Os principais fatores desencadeantes foram movimentos bruscos e fatores emocionais. Espasmos foram frequentemente associados a perturbações sensoriais e se agravaram durante a fase aguda da doença. A carbamazepina foi utilizada frequentemente para tratar os sintomas, com boa resposta. Conclusões: Os espasmos tônicos são manifestações clínicas frequentes em pacientes com neuromielite óptica.

  16. Anti-N-methyl-d-aspartate receptor encephalitis in a patient with neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Luo, Jing-Jing; Lv, He; Sun, Wei; Zhao, Juan; Hao, Hong-Jun; Gao, Feng; Huang, Yi-Ning

    2016-07-01

    We described a female patient with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis occurring sequentially with neuromyelitis optica spectrum disorders (NMOSD). The 19-year-old patient initially presented a diencephalic syndrome with aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) and brain lesions which involving bilateral medial temporal lobes and periependymal surfaces of the third ventricle on magnetic resonance imaging (MRI). Ten months later, the patient developed cognitive impairment, psychiatric symptoms and dyskinesia with left basal ganglia lesions on brain MRI. Meanwhile, the anti-NMDAR antibodies were positive in the patient's serum and cerebrospinal fluid, while the screening tests for an ovarian teratoma and other tumors were all negative. Hence, the patient was diagnosed NMOSD and anti-NMDAR encephalitis followed by low-dose rituximab treatment with a good response. This case was another evidence for demyelinating syndromes overlapping anti-NMDAR encephalitis in Chinese patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Neuromyelitis optica: association with paroxysmal painful tonic spasms.

    Science.gov (United States)

    Carnero Contentti, E; Leguizamón, F; Hryb, J P; Celso, J; Pace, J L Di; Ferrari, J; Knorre, E; Perassolo, M B

    2016-10-01

    Paroxysmal painful tonic spasms (PPTS) were initially described in multiple sclerosis (MS) but they are more frequent in neuromyelitis optica (NMO). The objective is to report their presence in a series of cases of NMO and NMO spectrum disorders (NMOSD), as well as to determine their frequency and clinical features. We conducted a retrospective assessment of medical histories of NMO/NMOSD patients treated in 2 hospitals in Buenos Aires (Hospital Durand and Hospital Álvarez) between 2009 and 2013. Out of 15 patients with NMOSD (7 with definite NMO and 8 with limited NMO), 4 presented PPTS (26.66%). PPTS frequency in the definite NMO group was 57.14% (4/7). Of the 9 patients with longitudinally extensive transverse myelitis (LETM), 44.44% (9/15) presented PPTS. Mean age was 35 years (range, 22-38 years) and all patients were women. Mean time between NMO diagnosis and PPTS onset was 7 months (range, 1-29 months) and mean time from last relapse of LETM was 30 days (range 23-40 days). LETM (75% cervicothoracic and 25% thoracic) was observed by magnetic resonance imaging (MRI) in all patients. Control over spasms and pain was achieved in all patients with carbamazepine (associated with gabapentin in one case). No favourable responses to pregabalin, gabapentin, or phenytoin were reported. PPTS are frequent in NMO. Mean time of PPTS onset is approximately one month after an LETM relapse, with extensive cervicothoracic lesions appearing on the MRI scan. They show an excellent response to carbamazepine but little or no response to pregabalin and gabapentin. Prospective studies with larger numbers of patients are necessary in order to confirm these results. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Widespread cortical thinning in patients with neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Kim, S-H; Kwak, K; Hyun, J-W; Jeong, I H; Jo, H-J; Joung, A; Kim, J-H; Lee, S H; Yun, S; Joo, J; Lee, J-M; Kim, H J

    2016-07-01

    Studies on cortical involvement and its relationship with cognitive function in patients with neuromyelitis optica spectrum disorder (NMOSD) remain scarce. The objective of this study was to compare cortical thickness on magnetic resonance imaging (MRI) between patients with NMOSD and multiple sclerosis (MS) and to investigate its relationship with clinical features and cognitive function. This observational clinical imaging study of 91 patients with NMOSD, 52 patients with MS and 44 healthy controls was conducted from 1 December 2013 to 30 April 2015 at the institutional referral center. Three tesla MRI of the brain and neuropsychological tests were performed. Cortical thickness was measured using three-dimensional surface-based analysis. Both sets of patients exhibited cortical thinning throughout the entire brain cortex. Patients with MS showed a significantly greater reduction in cortical thickness over broad regions of the bilateral frontal and parieto-temporal cortices and the left precuneus compared to those with NMOSD. Memory functions in patients with MS were correlated with broad regional cortical thinning, whereas no significant associations were observed between cortical thickness and cognitive function in patients with NMOSD. Widespread cortical thinning was observed in patients with NMOSD and MS, but the extent of cortical thinning was greater in patients with MS. The more severe cortical atrophy may contribute to memory impairment in patients with MS but not in those with NMOSD. These results provide in vivo evidence that the severity and clinical relevance of cortical thinning differ between NMOSD and MS. © 2016 EAN.

  19. 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.

  20. Factors associated with the effectiveness of plasma exchange for the treatment of NMO-IgG-positive neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Lim, Young-Min; Pyun, So Young; Kang, Bong-Hui; Kim, Jimin; Kim, Kwang-Kuk

    2013-08-01

    To identify factors associated with plasma exchange response in neuromyelitis optica (NMO) spectrum disorders, the clinical and magnetic resonance imaging (MRI) features of 31 NMO-IgG-positive patients receiving plasma exchange for steroid-resistant exacerbations were analyzed. Functional improvement was observed in 65% of the patients. A lower baseline Expanded Disability Status Scale score was associated with favorable response (p = 0.040). Patients without cord atrophy had a higher success rate than patients with atrophy (p = 0.016). Levels of NMO-IgG did not differ between responders and non-responders before and after plasma exchange. In conclusion, a minimal pre-existing disability is the primary determinant of the effectiveness of plasma exchange.

  1. Treatment of neuromyelitis optica: state-of-the-art and emerging therapies

    Science.gov (United States)

    Papadopoulos, Marios C.; Bennett, Jeffrey L.; Verkman, Alan S.

    2014-01-01

    Neuromyelitis optica (NMO) is an autoimmune disease of the CNS that is characterized by inflammatory demyelinating lesions in the spinal cord and optic nerve, potentially leading to paralysis and blindness. NMO can usually be distinguished from multiple sclerosis (MS) on the basis of seropositivity for IgG antibodies against the astrocytic water channel aquaporin-4 (AQP4). Differentiation from MS is crucial, because some MS treatments can exacerbate NMO. NMO pathogenesis involves AQP4-IgG antibody binding to astrocytic AQP4, which causes complement-dependent cytotoxicity and secondary inflammation with granulocyte and macrophage infiltration, blood–brain barrier disruption and oligodendrocyte injury. Current NMO treatments include general immunosuppressive agents, B-cell depletion, and plasma exchange. Therapeutic strategies targeting complement proteins, the IL-6 receptor, neutrophils, eosinophils and CD19—all initially developed for other indications—are under clinical evaluation for repurposing for NMO. Therapies in the preclinical phase include AQP4-blocking antibodies and AQP4-IgG enzymatic inactivation. Additional, albeit currently theoretical, treatment options include reduction of AQP4 expression, disruption of AQP4 orthogonal arrays, enhancement of complement inhibitor expression, restoration of the blood–brain barrier, and induction of immune tolerance. Despite the many therapeutic options in NMO, no controlled clinical trials in patients with this condition have been conducted to date. PMID:25112508

  2. Risk of venous thromboembolism in neuromyelitis optica patients hospitalized for acute relapse.

    Science.gov (United States)

    Farber, Rebecca Straus; Gross, Robert; Zakin, Elina; Fabian, Michelle

    2017-06-01

    Neuromyelitis optica spectrum disorder (NMOSD) patients may be at increased risk of venous thromboembolism (VTE) not only due to ambulatory disability but also due to systemic autoimmune and inflammatory mechanisms altering the hemostatic balance. To compare the risk of VTE in NMOSD versus multiple sclerosis (MS) patients hospitalized for acute relapses. Hospital admissions for MS or NMOSD exacerbations were retrospectively identified. Demographics and medical history were recorded. The relationship between visit diagnosis and presence of VTE within 6 weeks of relapse onset was assessed by univariate logistic regression. A multivariate model evaluated the relationship between diagnosis, age, race, gender, body mass index (BMI), disease modifying therapy use, oral corticosteroid use, oral contraceptive use, smoking, length of stay (LOS), and ambulatory status on VTE risk. A total of 30 NMOSD patients had 55 hospitalizations; 179 MS patients had 264 hospitalizations. Six NMOSD patients and one MS patient had VTE. NMOSD visits compared to MS visits had an odds ratio (OR) of VTE of 32.2 ( p = 0.002). NMOSD was more likely to be associated with VTE (OR = 17.4; p = 0.01) controlling for age, LOS, and ambulatory disability. NMOSD may be a risk factor for VTE. Larger prospective studies are required to confirm this risk and determine implications for prophylaxis.

  3. Brain parenchymal damage in neuromyelitis optica spectrum disorder - A multimodal MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Pache, F.; Paul, F. [Max Delbrueck Center for Molecular Medicine and Charite Universitaetsmedizin Berlin, NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Berlin (Germany); Charite Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Zimmermann, H.; Lacheta, A.; Papazoglou, S.; Kuchling, J.; Wuerfel, J.; Brandt, A.U. [Max Delbrueck Center for Molecular Medicine and Charite Universitaetsmedizin Berlin, NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Berlin (Germany); Finke, C. [Charite Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Humboldt-Universitaet zu Berlin, Berlin School of Mind and Brain, Berlin (Germany); Hamm, B. [Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Ruprecht, K. [Charite Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Scheel, M. [Max Delbrueck Center for Molecular Medicine and Charite Universitaetsmedizin Berlin, NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Berlin (Germany); Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany)

    2016-12-15

    To investigate different brain regions for grey (GM) and white matter (WM) damage in a well-defined cohort of neuromyelitis optica spectrum disorder (NMOSD) patients and compare advanced MRI techniques (VBM, Subcortical and cortical analyses (Freesurfer), and DTI) for their ability to detect damage in NMOSD. We analyzed 21 NMOSD patients and 21 age and gender matched control subjects. VBM (GW/WM) and DTI whole brain (TBSS) analyses were performed at different statistical thresholds to reflect different statistical approaches in previous studies. In an automated atlas-based approach, Freesurfer and DTI results were compared between NMOSD and controls. DTI TBSS and DTI atlas based analysis demonstrated microstructural impairment only within the optic radiation or in regions associated with the optic radiation (posterior thalamic radiation p < 0.001, 6.9 % reduction of fractional anisotropy). VBM demonstrated widespread brain GM and WM reduction, but only at exploratory statistical thresholds, with no differences remaining after correction for multiple comparisons. Freesurfer analysis demonstrated no group differences. NMOSD specific parenchymal brain damage is predominantly located in the optic radiation, likely due to a secondary degeneration caused by ON. In comparison, DTI appears to be the most reliable and sensitive technique for brain damage detection in NMOSD. (orig.)

  4. Gender effect on neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G.

    Science.gov (United States)

    Kim, Sung-Min; Waters, Patrick; Woodhall, Mark; Kim, Yoo-Jin; Kim, Jin-Ah; Cheon, So Young; Lee, Sehoon; Jo, Seong Rae; Kim, Dong Gun; Jung, Kyeong Cheon; Lee, Kwang-Woo; Sung, Jung-Joon; Park, Kyung Seok

    2017-07-01

    Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated. The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4. The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed. Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset. In NMOSD-AQP4 patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4 patients with limited manifestations as well as in predicting their clinical courses.

  5. Brain parenchymal damage in neuromyelitis optica spectrum disorder - A multimodal MRI study

    International Nuclear Information System (INIS)

    Pache, F.; Paul, F.; Zimmermann, H.; Lacheta, A.; Papazoglou, S.; Kuchling, J.; Wuerfel, J.; Brandt, A.U.; Finke, C.; Hamm, B.; Ruprecht, K.; Scheel, M.

    2016-01-01

    To investigate different brain regions for grey (GM) and white matter (WM) damage in a well-defined cohort of neuromyelitis optica spectrum disorder (NMOSD) patients and compare advanced MRI techniques (VBM, Subcortical and cortical analyses (Freesurfer), and DTI) for their ability to detect damage in NMOSD. We analyzed 21 NMOSD patients and 21 age and gender matched control subjects. VBM (GW/WM) and DTI whole brain (TBSS) analyses were performed at different statistical thresholds to reflect different statistical approaches in previous studies. In an automated atlas-based approach, Freesurfer and DTI results were compared between NMOSD and controls. DTI TBSS and DTI atlas based analysis demonstrated microstructural impairment only within the optic radiation or in regions associated with the optic radiation (posterior thalamic radiation p < 0.001, 6.9 % reduction of fractional anisotropy). VBM demonstrated widespread brain GM and WM reduction, but only at exploratory statistical thresholds, with no differences remaining after correction for multiple comparisons. Freesurfer analysis demonstrated no group differences. NMOSD specific parenchymal brain damage is predominantly located in the optic radiation, likely due to a secondary degeneration caused by ON. In comparison, DTI appears to be the most reliable and sensitive technique for brain damage detection in NMOSD. (orig.)

  6. Combination Treatment of C16 Peptide and Angiopoietin-1 Alleviates Neuromyelitis Optica in an Experimental Model

    Directory of Open Access Journals (Sweden)

    Yuanyuan Zhang

    2018-01-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune inflammatory demyelinating disease that mainly affects the spinal cord and optic nerve, causing blindness and paralysis in some individuals. Moreover, NMO may cause secondary complement-dependent cytotoxicity (CDC, leading to oligodendrocyte and neuronal damage. In this study, a rodent NMO model, showing typical NMO pathogenesis, was induced with NMO-IgG from patient serum and human complement. We then tested whether the combination of C16, an αvβ3 integrin-binding peptide, and angiopoietin-1 (Ang1, a member of the endothelial growth factor family, could alleviate NMO in the model. Our results demonstrated that this combination therapy significantly decreased disease severity, inflammatory cell infiltration, secondary demyelination, and axonal loss, thus reducing neural death. In conclusion, our study suggests a possible treatment that can relieve progressive blindness and paralysis in an animal model of NMO through improvement of the inflammatory milieu.

  7. MOG-IgG-Associated Optic Neuritis, Encephalitis, and Myelitis: Lessons Learned From Neuromyelitis Optica Spectrum Disorder

    Science.gov (United States)

    dos Passos, Giordani Rodrigues; Oliveira, Luana Michelli; da Costa, Bruna Klein; Apostolos-Pereira, Samira Luisa; Callegaro, Dagoberto; Fujihara, Kazuo; Sato, Douglas Kazutoshi

    2018-01-01

    Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been found in some cases diagnosed as seronegative neuromyelitis optica spectrum disorder (NMOSD). MOG-IgG allowed the identification of a subgroup with a clinical course distinct from that of NMOSD patients who are seropositive for aquaporin-4-IgG antibodies. MOG-IgG is associated with a wider clinical phenotype, not limited to NMOSD, with the majority of cases presenting with optic neuritis (ON), encephalitis with brain demyelinating lesions, and/or myelitis. Therefore, we propose the term MOG-IgG-associated Optic Neuritis, Encephalitis, and Myelitis (MONEM). Depending on the clinical characteristics, these patients may currently be diagnosed with NMOSD, acute disseminated encephalomyelitis, pediatric multiple sclerosis, transverse myelitis, or ON. With specific cell-based assays, MOG-IgG is emerging as a potential biomarker of inflammatory disorders of the central nervous system. We review the growing body of evidence on MONEM, focusing on its clinical aspects. PMID:29670575

  8. A case of seropositive Neuromyelitis Optica in a paediatric patient with co-existing acute nephrotic syndrome.

    Science.gov (United States)

    Volkman, Thomas; Hemingway, Cheryl

    2017-11-01

    Neuromyelitis optica (NMO) and NMO spectrum disorder (NMOSD) is a rare relapsing autoimmune disease of the central nervous system constituting less than 1% of demyelinating diseases (Jeffery and Buncic, 1996). It preferentially affects the optic nerves and spinal cord, with the brain parenchyma generally spared. Demyelinating lesions are characterised by longitudinally extensive transverse myelitis (LETM) and often longitudinally extensive optic neuritis. Following the discovery of a novel pathogenic antibody, Aquaporin 4 in 2004 (Lennon et al., 2004) this disease has been seen as a separate entity from Multiple Sclerosis (MS). We report the case of a severe AQP4 IgG case of NMO in a 10 year old child. This case unusually had a coexisting diagnosis of acute nephrotic syndrome which has only been reported once previously in the literature 2 . This article will examine some of the treatment challenges and the spectrum of co-existing autoimmune disease in NMOSD. Copyright © 2017. Published by Elsevier B.V.

  9. Cognitive impairment in neuromyelitis optica spectrum disorders: A comparison of the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale Revised with the Rao Brief Repeatable Neuropsychological Battery

    OpenAIRE

    Fujimori, Juichi; Nakashima, Ichiro; Baba, Toru; Meguro, Yuko; Ogawa, Ryo; Fujihara, Kazuo

    2017-01-01

    Background: Approximately 55% of patients with neuromyelitis optica spectrum disorder (NMOSD) show cognitive impairment as evaluated using the Rao Brief Repeatable Neuropsychological Battery (BRBN), but this frequency appears to be higher than the frequency of specific brain lesions in NMOSD. Objective: We studied whether cognitive impairment could be observed in NMOSD patients with no or minor non-specific brain lesions. Methods: We evaluated cognitive function in 12 NMOSD and 14 MS patients...

  10. Serum 25-hydroxyvitamin D3 is associated with disease status in patients with neuromyelitis optica spectrum disorders in south China.

    Science.gov (United States)

    Shan, Yilong; Tan, Sha; Zhang, Lei; Huang, Jianhua; Sun, Xiaobo; Wang, Yuge; Cai, Wei; Qiu, Wei; Hu, Xueqiang; Lu, Zhengqi

    2016-10-15

    Here, we investigated the relationship between serum 25-hydroxyvitamin D 3 (25[OH]D 3 ) levels and neuromyelitis optica spectrum disorder (NMOSD). Patients with NMOSD had lower 25(OH)D 3 levels than healthy people, with lower levels in patients in the acute phase than those in remission. An inverse correlation was found between 25(OH)D 3 and Expanded Disability Status Scale scores of patients during attacks. Higher serum 25(OH)D 3 levels were associated with greater amelioration of symptoms during corticosteroid therapy. These results indicate that decreased vitamin D may be involved in NMOSD pathogenesis, and that 25(OH)D 3 serum levels may reflect the severity of NMOSD in the acute phase. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Comparative molecular dynamics study of neuromyelitis optica-immunoglobulin G binding to aquaporin-4 extracellular domains.

    Science.gov (United States)

    Alberga, Domenico; Trisciuzzi, Daniela; Lattanzi, Gianluca; Bennett, Jeffrey L; Verkman, Alan S; Mangiatordi, Giuseppe Felice; Nicolotti, Orazio

    2017-08-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system in which most patients have serum autoantibodies (called NMO-IgG) that bind to astrocyte water channel aquaporin-4 (AQP4). A potential therapeutic strategy in NMO is to block the interaction of NMO-IgG with AQP4. Building on recent observation that some single-point and compound mutations of the AQP4 extracellular loop C prevent NMO-IgG binding, we carried out comparative Molecular Dynamics (MD) investigations on three AQP4 mutants, TP 137-138 AA, N 153 Q and V 150 G, whose 295-ns long trajectories were compared to that of wild type human AQP4. A robust conclusion of our modeling is that loop C mutations affect the conformation of neighboring extracellular loop A, thereby interfering with NMO-IgG binding. Analysis of individual mutations suggested specific hydrogen bonding and other molecular interactions involved in AQP4-IgG binding to AQP4. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Serological markers associated with neuromyelitis optica spectrum disorders in South India

    Directory of Open Access Journals (Sweden)

    Lekha Pandit

    2016-01-01

    Full Text Available Background: Neuromyelitis optica spectrum disorders (NMOSDs represent 20% of all demyelinating disorders in South India. No studies have determined the seroprevalence to both antibodies against aquaporin-4FNx01 and antimyelin oligodendrocyte glycoprotein antibody (anti-MOG+ in this population. Objective: To identify and characterize seropositive patients for anti-aquaporin-4 antibody (anti-AQP4+ and anti-MOG+ in South India. Materials and Methods: We included 125 consecutive patients (15 children who were serologically characterized using live transfected cells to human M23-AQP4 or full-length MOG. Results: Among a total of 125 patients, 30.4% of patients were anti-AQP4+, 20% were anti-MOG+, and 49.6% were seronegative. No patient was positive for both. Anti-MOG+ patients represented 28.7% (25/87 of seronegative NMOSD. In comparison to anti-AQP4+ patients, anti-MOG+ patients were commonly male, had less frequent attacks and milder disability on expanded disability status score scale. Seronegative patients were also predominantly male, 36% (9/25 had monophasic longitudinally extensive transverse myelitis and disability was comparable with anti-AQP4+ patients. Lumbar cord involvement was common in anti-MOG+ and seronegatives, whereas anti-AQP4+ patients had more cervical lesions. Conclusion: Anti-AQP4+/anti-MOG + patients accounted for nearly half of the patients suspected of having NMOSD in South India, indicating that antibody testing may be useful on the management of subgroups with different prognosis.

  13. White matter atrophy and cognitive dysfunctions in neuromyelitis optica.

    Directory of Open Access Journals (Sweden)

    Frederic Blanc

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of central nervous system characterized by optic neuritis and longitudinally extensive acute transverse myelitis. NMO patients have cognitive dysfunctions but other clinical symptoms of brain origin are rare. In the present study, we aimed to investigate cognitive functions and brain volume in NMO. The study population consisted of 28 patients with NMO and 28 healthy control subjects matched for age, sex and educational level. We applied a French translation of the Brief Repeatable Battery (BRB-N to the NMO patients. Using SIENAx for global brain volume (Grey Matter, GM; White Matter, WM; and whole brain and VBM for focal brain volume (GM and WM, NMO patients and controls were compared. Voxel-level correlations between diminished brain concentration and cognitive performance for each tests were performed. Focal and global brain volume of NMO patients with and without cognitive impairment were also compared. Fifteen NMO patients (54% had cognitive impairment with memory, executive function, attention and speed of information processing deficits. Global and focal brain atrophy of WM but not Grey Matter (GM was found in the NMO patients group. The focal WM atrophy included the optic chiasm, pons, cerebellum, the corpus callosum and parts of the frontal, temporal and parietal lobes, including superior longitudinal fascicle. Visual memory, verbal memory, speed of information processing, short-term memory and executive functions were correlated to focal WM volumes. The comparison of patients with, to patients without cognitive impairment showed a clear decrease of global and focal WM, including brainstem, corticospinal tracts, corpus callosum but also superior and inferior longitudinal fascicles. Cognitive impairment in NMO patients is correlated to the decreased of global and focal WM volume of the brain. Further studies are needed to better understand the precise origin of cognitive impairment in

  14. European ancestry predominates in neuromyelitis optica and multiple sclerosis patients from Brazil.

    Directory of Open Access Journals (Sweden)

    Doralina Guimarães Brum

    Full Text Available BACKGROUND: Neuromyelitis optica (NMO is considered relatively more common in non-Whites, whereas multiple sclerosis (MS presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs to estimate the genetic ancestry contribution to NMO patients. METHODS: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP, Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP. PRINCIPAL FINDINGS: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7% patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5% patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. CONCLUSIONS: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil.

  15. Burner redesign for the reduction of the unburned particulate emission in thermal power stations of Comision Federal de Electricidad; Rediseno de quemadores para la reduccion de la emision de particulas inquemadas en centrales termicas de la Comisionon Federal de Electricidad

    Energy Technology Data Exchange (ETDEWEB)

    Huerta Espino, Mario; Espipnoza Garza, Jesus; Mani Gonzalez, Alejandro; Giles Alarcon, Armando; Pena Garcia, Adriana; Albarran Sanchez, Irma L; Mendez Aranda, Angel [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

    2001-07-01

    In the presence of the increasing demand for reaching higher efficiencies and a smaller production of polluting emissions in combustion systems, studies focused to the optimization of the present designs of burners are required. The Comision Federal de Electricidad (CFE) and the Instituto de Investigaciones Electricas (IIE) have established a project that contemplates the redesign of burners in ten of its units of thermoelectric generation. In this work the redesign of the flame stabilizer or diffuser for the reduction of the unburned particulate emission is explained. The results of the modeling of a burner of rotational flow of steam generators of the CFE are shown, as well as the graphs of the contours of the recirculation zone generated by each diffuser without combustion and a figure of the velocity profile that is generated in front of the diffuser. In agreement with the results obtained in the aerodynamic evaluation of frontal burners of rotational flow, it is possible to established that the characteristics of the recirculation zone, generated by this type of burners, are related to geometric parameters of the diffuser that identify with the number of turns and the pressure drop, where it is necessary to look for designs that improve the conditions of the mixing process and combustion in the burner. [Spanish] Ante la creciente demanda por alcanzar mayores eficiencias y una menor produccion de emisiones contaminantes en sistemas de combustion, se requieren estudios enfocados a la optimizacion de los disenos actuales de quemadores. La Comision Federal de Electricidad (CFE) y el Instituto de Investigaciones Electricas (IIE) han establecido un proyecto que contempla el rediseno de quemadores en diez de sus unidades de generacion termoelectrica. En este trabajo se explica el rediseno del estabilizador de flama o difusor para la reduccion de la emision de particulas inquemadas. Se muestran los resultados de la modelacion de un quemador de flujo rotacional de

  16. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-03-02

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  17. MR imaging findings of the corpus callosum region in the differentiation between multiple sclerosis and neuromyelitis optica

    International Nuclear Information System (INIS)

    Chen, Zhiye; Feng, Feng; Yang, Yang; Li, Jinfeng; Ma, Lin

    2012-01-01

    Purpose: To evaluate MR imaging findings in corpus callosum region for the discrimination between opticospinal multiple sclerosis (OSMS) and neuromyelitis optica (NMO). Materials and methods: Forty-two definite OSMS with seronegative NMO-IgG and 23 NMO with seropositive NMO-IgG, and 27 age-matched normal controls (NC) were recruited. Sagittal T2-FLAIR images with 2-mm slice thickness were obtained. Subcallosal dot-dash (SCDD) sign and subcallosal striations (SCS) sign were reviewed. Results: SCDD was more commonly detected in OSMS (28 of 42 patients) than in NMO (5 of 23 patients) (P 0.05). For comparing ROC analysis among SCDD, SCS, and SCDD + SCS for predicted probability through binary logistic regression analysis, SCDD + SCS had the largest area under ROC curve (0.777) than SCDD (0.725) and SCS (0.608). Conclusion: SCDD may be helpful in distinguishing OSMS from NMO. The regression equation may also be a simple and effective method of choice for the differentiation between OSMS and NMO.

  18. CFHR1-Modified Neural Stem Cells Ameliorated Brain Injury in a Mouse Model of Neuromyelitis Optica Spectrum Disorders.

    Science.gov (United States)

    Shi, Kaibin; Wang, Zhen; Liu, Yuanchu; Gong, Ye; Fu, Ying; Li, Shaowu; Wood, Kristofer; Hao, Junwei; Zhang, Guang-Xian; Shi, Fu-Dong; Yan, Yaping

    2016-11-01

    A major hurdle for effective stem cell therapy is ongoing inflammation in the target organ. Reconditioning the lesion microenvironment may be an effective way to promote stem cell therapy. In this study, we showed that engineered neural stem cells (NSCs) with complement factor H-related protein 1, a complement inhibitor protein, can attenuate inflammatory infiltration and immune-mediated damage of astrocytes, an important pathogenic progress in patients with neuromyelitis optica spectrum disorders. Furthermore, we demonstrated that transplantation of the complement factor H-related protein 1-modified NSCs effectively blocked the complement activation cascade and inhibited formation of the membrane attack complex, thus contributing to the protection of endogenous and transplanted NSC-differentiated astrocytes. Therefore, manipulation of the lesion microenvironment contributes to a more effective cell replacement therapeutic strategy for autoimmune diseases of the CNS. Copyright © 2016 by The American Association of Immunologists, Inc.

  19. Diagnosis of neuromyelitis optica (NMO) spectrum disorders: is MRI obsolete?

    International Nuclear Information System (INIS)

    Downer, Jonathan James; Carter, Ranjana; Kueker, Wilhelm; Quaghebeur, Gerardine; Leite, Maria Isabel; Palace, Jacqueline

    2012-01-01

    Neuromyelitis optica (NMO) is a severe demyelinating disease that preferentially involves spinal cord and optic nerve. It is part of a spectrum of neurological conditions associated with antibodies to aquaporin-4 (AQP4). This study investigates the role of MRI where novel, more sensitive AQP4 antibody immunoassay techniques are being used. Retrospective review of neuroimaging in 69 patients (25 antibody positive, 44 antibody negative), investigated in the context of suspected NMO or NMO spectrum disorder, was performed independently by two consultant neuroradiologists. Longitudinally extensive, central spinal cord lesions were more frequent in AQP4 positive patients (95.2% vs 35.5%, p < 0.0001; 85.7% vs 45.2%, p = 0.015). Multiple sclerosis diagnostic criteria were less frequently fulfilled on brain MRI in antibody positive patients (5.6% vs 33.3%, p = 0.035). Juxtacortical and corpus callosal lesions were also less common in this group (16.7% vs 46.7%, p = 0.063; 5.6% vs 46.7%, p = 0.0034). Hypothalamic and periependymal disease related to the aqueduct was not seen in antibody negative patients. T1 hypointensity was more common in cord lesions of antibody positive patients (75.0% vs 35.3%, p = 0.037). However, this characteristic did not discriminate antibody positive and negative longitudinally extensive cord lesions (73.3% vs 62.5%, p = 0.66). The NMO spectrum of diseases are among an increasing number of neurological conditions defined by serological tests. However, despite improved immunoassay techniques, MRI of the brain and spinal cord continues to be among the first-line investigations in these patients, providing valuable diagnostic information that will help guide patient management. (orig.)

  20. Gender differences among Chinese patients with neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Sun, Hui; Sun, Xuan; Li, Jie; Huo, Yunyun; Wu, Lei; Huang, Dehui; Yu, Shengyuan; Wu, Weiping

    2017-10-01

    Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune, inflammatory demyelinating diseases of the central nervous system, which have established variations in prevalence across different ethnicities and genders. The objective of this study was to investigate differences in clinical features among men and women with NMOSD, according to the 2015 diagnostic criteria. A total of 97 patients with NMOSD were recruited from inpatient neurology clinics in this retrospective study. Demographic and clinical data were extracted from the various databases. Data on epidemiology, clinical signs, initial symptoms, and laboratory indices of men and women with NMOSD were compared. The cohort of this study had a female/male ratio of 5.47:1, with annualized relapse rates of 0.72 in female and 0.56 in male patients. Among female patients, 29.2% and 53.6% initially experienced acute optic neuritis and acute myelitis, respectively, while the prevalence of these symptoms was 46.6% and 53.3% among male patients. A total of 14.6% and 2.4% of female patients had area postrema symptoms and other brainstem signs, respectively on study enrollment. The prevalence of anti-AQP4-autoantibodies and anti-thyroid peroxidase autoantibodies/anti-thyroglobulin autoantibodies (TPO/TG-Ab) was significantly higher among women (77% and 45.7%) than among men (46.1% and 13.3%) (P < 0.05 for both comparisons). A total of 11 women with NMOSD (11.3% of the cohort) also had autoimmune diseases. Women with NMOSD have higher morbidity levels than men with this disease and are more likely to have autoimmune diseases and brainstem lesions, especially in the area postrema. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Diagnosis of neuromyelitis optica (NMO) spectrum disorders: is MRI obsolete?

    Energy Technology Data Exchange (ETDEWEB)

    Downer, Jonathan James; Carter, Ranjana; Kueker, Wilhelm; Quaghebeur, Gerardine [John Radcliffe Hospital, Department of Neuroradiology, Oxford (United Kingdom); Leite, Maria Isabel; Palace, Jacqueline [Oxford University, Department of Clinical Neurology, Oxford (United Kingdom)

    2012-04-15

    Neuromyelitis optica (NMO) is a severe demyelinating disease that preferentially involves spinal cord and optic nerve. It is part of a spectrum of neurological conditions associated with antibodies to aquaporin-4 (AQP4). This study investigates the role of MRI where novel, more sensitive AQP4 antibody immunoassay techniques are being used. Retrospective review of neuroimaging in 69 patients (25 antibody positive, 44 antibody negative), investigated in the context of suspected NMO or NMO spectrum disorder, was performed independently by two consultant neuroradiologists. Longitudinally extensive, central spinal cord lesions were more frequent in AQP4 positive patients (95.2% vs 35.5%, p < 0.0001; 85.7% vs 45.2%, p = 0.015). Multiple sclerosis diagnostic criteria were less frequently fulfilled on brain MRI in antibody positive patients (5.6% vs 33.3%, p = 0.035). Juxtacortical and corpus callosal lesions were also less common in this group (16.7% vs 46.7%, p = 0.063; 5.6% vs 46.7%, p = 0.0034). Hypothalamic and periependymal disease related to the aqueduct was not seen in antibody negative patients. T1 hypointensity was more common in cord lesions of antibody positive patients (75.0% vs 35.3%, p = 0.037). However, this characteristic did not discriminate antibody positive and negative longitudinally extensive cord lesions (73.3% vs 62.5%, p = 0.66). The NMO spectrum of diseases are among an increasing number of neurological conditions defined by serological tests. However, despite improved immunoassay techniques, MRI of the brain and spinal cord continues to be among the first-line investigations in these patients, providing valuable diagnostic information that will help guide patient management. (orig.)

  2. Ellipsometry and electronic microscopy of ashes swept of the Popocatepetl volcano; Elipsometria y microscopia electronica de barrido de las cenizas del volcan Popocatepetl

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Aaron; Munoz, Rafel; Falcon, Nelson [Universidad de Carabobo, Valencia (Venezuela); Chavira, Enrique [Instituto Nacional de Astrofisica Optica y Electronica, Puebla (Mexico)

    2001-12-01

    The ellipsometry and the scanning electronic microscopy is applied to the study of the optic properties of Popocatepetl volcano ash in connection with the form, ruggedness and elemental chemical composition of the microparticles, also to argue about the relation with atmospheric conditions. [Spanish] Se aplica la eliposometria y la microscopia electronica de barrido al estudio de las propiedades opticas de las cenizas de volcan Popocatepetl en relacion con la forma, rugosidad y composicion quimica elemental de las microparticulas, destacandose su vinculacion con las condiciones de visibilidad.

  3. Sjögren syndrome and neuromyelitis optica spectrum disorder co-exist in a common autoimmune milieu

    Directory of Open Access Journals (Sweden)

    Diogo C. Carvalho

    2014-06-01

    Full Text Available The relationship between Sjögren’s syndrome (SS and neuromyelitis optica spectrum disorder (NMOSD is not completely understood. We report two patients with both conditions and review 47 other previously reported cases meeting currently accepted diagnostic criteria, from 17 articles extracted from PubMed. Out of 44 patients whose gender was informed, 42 were females. Mean age at onset of neurological manifestation was 36.2 years (10-74. Serum anti-AQP4-IgG was positive in 32 patients, borderline in 1, and negative in 4. Our Case 1 was seronegative for AQP4-IgG and had no non-organ-specific autoantibodies other than anti-SSB antibodies. Our Case 2 had serum anti-AQP4, anti-SSA/SSB, anti-thyreoglobulin and anti-acethylcholine-receptor antibodies, as well as clinical hypothyreoidism, but no evidence of myasthenia gravis. Our Cases and others, as previously reported in literature, with similar heterogeneous autoimmune response to aquaporin-4, suggest that SS and NMO co-exist in a common autoimmune milieu which is not dependent on aquaporin-4 autoimmunity.

  4. Long-term MRI findings in neuromyelitis optica: seropositive versus seronegative patients.

    Science.gov (United States)

    Kıyat-Atamer, A; Ekizoğlu, E; Tüzün, E; Kürtüncü, M; Shugaiv, E; Akman-Demir, G; Eraksoy, M

    2013-05-01

    Neuromyelitis optica (NMO) is a severe demyelinating inflammatory disorder associated with serum antibodies against aquaporin 4 (AQP4-Ab). A significant number of patients with NMO remain seronegative over time. Long-term observational magnetic resonance imaging (MRI) studies of the CNS in patients with NMO are rare or of limited duration. The objective of this study is to determine long-term MRI characteristics of seropositive and seronegative patients, and assess possible overlap with multiple sclerosis (MS). Clinical and radiological characteristics of 28 patients with NMO at onset and of 17 patients after an average follow-up time of 9 years were recorded. Fifty percent of patients were seropositive for AQP4-Ab. Onset and final brain/spinal MRI scans were retrospectively analysed and compared. Significantly more patients in the seronegative group had brain lesions at onset. Spinal lesions of seropositive patients were longer and showed increased cord swelling at onset MRI scans. After the follow-up time the differences between both groups disappeared. Patients in the seropositive group tended to develop brain lesions over time. No patient fulfilled Barkhof's or McDonald's radiological criteria for MS at onset or over time. Brain MRI features show differences between seropositive and seronegative patients at time of onset in NMO, but differences between groups vanish over time. None of the AQP4-negative patients fulfill radiological MS criteria on a long-term basis, suggesting that seronegative NMO constitutes an independent entity. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  5. Manufacture of amorphous and poly-crystalline materials with the sol-gel process; Fabricacion de materiales amorfos y policristalinos con la ruta sol-gel

    Energy Technology Data Exchange (ETDEWEB)

    Castaneda-Contreras, J. [Centro Universitario de Los Lagos, Universidad de Guadalajara, Guadalajara, Jalisco (Mexico)

    2006-01-15

    The sun-gel process is a chemical route that allows the manufacture of amorphous and poly-crystalline materials in a relatively simple way. New materials can be obtained, materials that through the traditional manufacture methods, are very difficult to obtain, such as oxide combinations (SiO{sub 2}, TiO{sub 2}, ZrO{sub 2}, etc.), and that, when being produced by traditional methods, they run the risk of being contaminated with rare earth ions or organic dyes. The unique structures, micro- structures and compounds that can be made with the sun-gel process open many possibilities for practical applications, to name a few: the manufacture of optical components, preforms for optical fibers, dielectric coatings, superconductors, waveguides, nanoparticles, solar cells, etc. [Spanish] El proceso sol-gel es una ruta quimica que permite fabricar materiales amorfos y policristalinos de forma relativamente sencilla. Se pueden obtener nuevos materiales que a traves de los metodos tradicionales de fabricacion son muy dificiles de obtener, tales como combinaciones de oxidos (SiO{sub 2}, TiO{sub 2}, ZrO{sub 2}, etc.), y que, de ser producidos por metodos tradicionales corren el riesgo de contaminarse con iones de tierras raras o colorantes organicos. Las estructuras unicas, micro estructuras y compuestos que pueden hacerse con el proceso sol-gel abren muchas posibilidades para aplicaciones practicas, por nombrar algunas, la fabricacion de componentes opticos, preformas para fibras opticas, recubrimientos dielectricos, superconductores, guias de onda, nanoparticulas, celdas solares, etc.

  6. Neuromyelitis optica IgG stimulates an immunological response in rat astrocyte cultures.

    Science.gov (United States)

    Howe, Charles L; Kaptzan, Tatiana; Magaña, Setty M; Ayers-Ringler, Jennifer R; LaFrance-Corey, Reghann G; Lucchinetti, Claudia F

    2014-05-01

    Neuromyelitis optica (NMO) is a primary astrocyte disease associated with central nervous system inflammation, demyelination, and tissue injury. Brain lesions are frequently observed in regions enriched in expression of the aquaporin-4 (AQP4) water channel, an antigenic target of the NMO IgG serologic marker. Based on observations of disease reversibility and careful characterization of NMO lesion development, we propose that the NMO IgG may induce a dynamic immunological response in astrocytes. Using primary rat astrocyte-enriched cultures and treatment with NMO patient-derived serum or purified IgG, we observed a robust pattern of gene expression changes consistent with the induction of a reactive and inflammatory phenotype in astrocytes. The reactive astrocyte factor lipocalin-2 and a broad spectrum of chemokines, cytokines, and stress response factors were induced by either NMO patient serum or purified IgG. Treatment with IgG from healthy controls had no effect. The effect is disease-specific, as serum from patients with relapsing-remitting multiple sclerosis, Sjögren's, or systemic lupus erythematosus did not induce a response in the cultures. We hypothesize that binding of the NMO IgG to AQP4 induces a cellular response that results in transcriptional and translational events within the astrocyte that are consistent with a reactive and inflammatory phenotype. Strategies aimed at reducing the inflammatory response of astrocytes may short circuit an amplification loop associated with NMO lesion development. Copyright © 2014 Wiley Periodicals, Inc.

  7. Neuromyelitis optica spectrum disorder: 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography findings--case report.

    Science.gov (United States)

    Oyama, Hirofumi; Miwa, Shigeru; Noda, Tomoyuki; Sobajima, Atsuhiro; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Wada, Kentaro

    2012-01-01

    A 51-year-old female with a history of rheumatoid arthritis rapidly developed anterior neck pain and paresis in the left upper and lower extremities and right lower extremity, sensory disturbance in the left upper and lower extremities, and bladder and rectal disorder. Adduction of the left eye and abduction of the right eye were also disturbed. Spinal magnetic resonance imaging demonstrated severe edema in the C1-T5 levels, which then deteriorated rapidly over 3 days, and lesions enhanced with gadolinium in the C1-C3 and C5-T3 levels. 2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography study demonstrated the inflammatory sites as segmental enhanced accumulation in the C1-C3, C5-C6, and T1 levels. The serum anti-aquaporin 4 antibody level was positive and she was diagnosed with neuromyelitis optica spectrum disorder. Marked improvement in the neurological conditions, concomitant with reduced spinal cord edema, was obtained by steroid pulse therapy.

  8. Clinical characteristics of disabling attacks at onset in patients with neuromyelitis optica spectrum disorder.

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    Seok, Jin Myoung; Cho, Eun Bin; Lee, Hye Lim; Cho, Hye-Jin; Min, Ju-Hong; Lee, Kwang Ho; Kim, Byoung Joon

    2016-09-15

    Individual attacks of neuromyelitis optica (NMO) are generally severe enough to cause disability even after the onset attack. We aimed to elucidate the clinical characteristics of disabling attacks at the onset of NMO. We investigated the clinical characteristics at onset and at first relapse in patients with NMO or NMO spectrum disorder with seropositive for the anti-aquaporin-4 antibody. A disabling attack at onset (DAO) was defined as an onset attack in which, at best recovery (allowing up to one year), patients were unable to walk without assistance or were left functionally blind in at least one affected eye. Fifty-seven patients were enrolled (53 females; onset age, 41.9±14.8years). Ten patients (17.5%) had a DAO; four had become unable to walk without assistance following myelitis, and six had severe visual impairment following optic neuritis despite rescue treatments. Attack severity at nadir was the only clinical factor predicting a DAO (odds ratio, 2.120; 95% CI, 1.162-3.869; P=0.014). The use of immunosuppressants delayed the interval to the first relapse (P=0.003). Our study showed characteristics of NMO onset attacks that caused severe disability. However, no clinically modifiable factors predicted disabling attacks, except attack severity. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Cognitive dysfunction in adult patients with neuromyelitis optica: a systematic review and meta-analysis.

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    Meng, Hao; Xu, Jun; Pan, Chenling; Cheng, Jiaxing; Hu, Yue; Hong, Yin; Shen, Yuehai; Dai, Hua

    2017-08-01

    The objective of this study was to investigate cognitive dysfunction in 24-60-year-old neuromyelitis optica (NMO) patients, demographically matched healthy subjects, and MS patients. We conducted a comprehensive literature review of the PubMed, Medline, EMBASE, CNKI, Wan Fang Date, Web of Science, and Cochrane Library databases from inception to May 2016 for case-control studies that reported cognitive test scores in NMO patients, healthy subjects, and MS patients. Outcome measures were cognitive function evaluations, including performance on attention, language, memory, information processing speed, and executive function tests. The meta-analysis included eight studies. NMO patients performed significantly worse on attention (P < 0.00001), language (P = 0.00008), memory (P = 0.00004), information processing speed (P < 0.00001), and executive function tests (P = 0.00009) than healthy subjects. There were no significant differences in performance between NMO patients and MS patients on these tests. This meta-analysis indicates that NMO patients aged 24-60 years have significantly worse cognitive performance than demographically matched healthy subjects. However, this was comparable to the performance of demographically matched MS patients. There is a need for further rigorous randomized controlled trials with focus on elucidating the underlying mechanism of cognitive dysfunction in NMO patients.

  10. Altered topological organization of white matter structural networks in patients with neuromyelitis optica.

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    Yaou Liu

    Full Text Available OBJECTIVE: To investigate the topological alterations of the whole-brain white-matter (WM structural networks in patients with neuromyelitis optica (NMO. METHODS: The present study involved 26 NMO patients and 26 age- and sex-matched healthy controls. WM structural connectivity in each participant was imaged with diffusion-weighted MRI and represented in terms of a connectivity matrix using deterministic tractography method. Graph theory-based analyses were then performed for the characterization of brain network properties. A multiple linear regression analysis was performed on each network metric between the NMO and control groups. RESULTS: The NMO patients exhibited abnormal small-world network properties, as indicated by increased normalized characteristic path length, increased normalized clustering and increased small-worldness. Furthermore, largely similar hub distributions of the WM structural networks were observed between NMO patients and healthy controls. However, regional efficiency in several brain areas of NMO patients was significantly reduced, which were mainly distributed in the default-mode, sensorimotor and visual systems. Furthermore, we have observed increased regional efficiency in a few brain regions such as the orbital parts of the superior and middle frontal and fusiform gyri. CONCLUSION: Although the NMO patients in this study had no discernible white matter T2 lesions in the brain, we hypothesize that the disrupted topological organization of WM networks provides additional evidence for subtle, widespread cerebral WM pathology in NMO.

  11. Evaluation of Clinical Interest of Anti-Aquaporin-4 Autoantibody Followup in Neuromyelitis Optica

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    Jean-Baptiste Chanson

    2013-01-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune disease in which a specific biomarker named NMO-IgG and directed against aquaporin-4 (AQP4 has been found. A correlation between disease activity and anti-AQP4 antibody (Ab serum concentration or complement-mediated cytotoxicity has been reported, but the usefulness of longitudinal evaluation of these parameters remains to be evaluated in actual clinical practice. Thirty serum samples from 10 NMO patients positive for NMO-IgG were collected from 2006 to 2011. Anti-AQP4 Ab serum concentration and complement-mediated cytotoxicity were measured by flow cytometry using two quantitative cell-based assays (CBA and compared with clinical parameters. We found a strong correlation between serum anti-AQP4 Ab concentration and complement-mediated cytotoxicity (P<0.0001. Nevertheless, neither relapse nor worsening of impairment level was closely associated with a significant increase in serum Ab concentration or cytotoxicity. These results suggest that complement-mediated serum cytotoxicity assessment does not provide extra insight compared to anti-AQP4 Ab serum concentration. Furthermore, none of these parameters appears closely related to disease activity and/or severity. Therefore, in clinical practice, serum anti-AQP4 reactivity seems not helpful as a predictive biomarker in the followup of NMO patients as a means of predicting the onset of a relapse and adapting the treatment accordingly.

  12. Complement-independent retinal pathology produced by intravitreal injection of neuromyelitis optica immunoglobulin G

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    Christian M. Felix

    2016-10-01

    Full Text Available Abstract Background Neuromyelitis optica (NMO, an autoimmune inflammatory disease of the central nervous system, is often associated with retinal abnormalities including thinning of the retinal nerve fiber layer and microcystic changes. Here, we demonstrate that passive transfer of an anti-aquaporin-4 autoantibody (AQP4-IgG produces primary retinal pathology. Methods AQP4-IgG was delivered to adult rat retinas by intravitreal injection. Rat retinas and retinal explant cultures were assessed by immunofluorescence. Results Immunofluorescence showed AQP4-IgG deposition on retinal Müller cells, with greatly reduced AQP4 expression and increased glial fibrillary acidic protein by 5 days. There was mild retinal inflammation with microglial activation but little leukocyte infiltration and loss of retinal ganglion cells by 30 days with thinning of the ganglion cell complex. Interestingly, the loss of AQP4 was complement independent as seen in cobra venom factor-treated rats and in normal rats administered a mutated AQP4-IgG lacking complement effector function. Exposure of ex vivo retinal cultures to AQP4-IgG produced a marked reduction in AQP4 expression by 24 h, which was largely prevented by inhibitors of endocytosis or lysosomal acidification. Conclusions Passive transfer of AQP4-IgG results in primary, complement-independent retinal pathology, which might contribute to retinal abnormalities seen in NMO patients.

  13. Abnormal brain function in neuromyelitis optica: A fMRI investigation of mPASAT.

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    Wang, Fei; Liu, Yaou; Li, Jianjun; Sondag, Matthew; Law, Meng; Zee, Chi-Shing; Dong, Huiqing; Li, Kuncheng

    2017-10-01

    Cognitive impairment with the Neuromyelitis Optica (NMO) patients is debated. The present study is to study patterns of brain activation in NMO patients during a pair of task-related fMRI. We studied 20 patients with NMO and 20 control subjects matched for age, gender, education and handedness. All patients with NMO met the 2006 Wingerchuk diagnostic criteria. The fMRI paradigm included an auditory attention monitoring task and a modified version of the Paced Auditory Serial Addition Task (mPASAT). Both tasks were temporally and spatially balanced, with the exception of task difficulty. In mPASAT, Activation regions in control subjects included bilateral superior temporal gyri (BA22), left inferior frontal gyrus (BA45), bilateral inferior parietal lobule (BA7), left cingulate gyrus (BA32), left insula (BA13), and cerebellum. Activation regions in NMO patients included bilateral superior temporal gyri (BA22), left inferior frontal gyrus (BA9), right cingulate gyrus (BA32), right inferior parietal gyrus (BA40), left insula (BA13) and cerebellum. Some dispersed cognition related regions are greater in the patients. The present study showed altered cerebral activation during mPASAT in patients with NMO relative to healthy controls. These results are speculated to provide further evidence for brain plasticity in patients with NMO. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. STAT4 Polymorphisms are Associated with Neuromyelitis Optica Spectrum Disorders.

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    Shi, Ziyan; Zhang, Qin; Chen, Hongxi; Lian, Zhiyun; Liu, Ju; Feng, Huiru; Miao, Xiaohui; Du, Qin; Zhou, Hongyu

    2017-12-01

    STAT4 plays a crucial role in the functioning of the innate and adaptive immune cells and has been identified as a susceptibility gene in numerous autoimmune disorders. However, its association with neuromyelitis optica spectrum disorders (NMOSD) remains uncertain. Here, we performed a case-control study to determine whether STAT4 contributed to the risk of NMOSD. We tested five STAT4 SNPs in 233 patients with established NMOSD and 492 healthy controls. Chi-square tests and logistic regression analyses were performed with four genetic models, including allelic, additive, dominant, and recessive models, to identify associations with NMOSD. The results of multiple test comparisons were corrected using the Benjamini and Hochberg false discovery rate (FDR-BH). After correcting for multiple test comparisons, the minor alleles of four STAT4 SNPs exhibited significant association with increased risk of NMOSD (rs7574865 T, odds ratio [OR] = 1.66, 95% confidence interval [CI] 1.32-2.08, P corr  = 0.000; rs10181656 G, OR = 1.62, 95% CI 1.29-2.03, P corr  = 0.000; rs10168266 T, OR = 1.59, 95% CI 1.27-2.00, P corr  = 0.001; and rs13426947 A, OR = 1.51, 95% CI 1.21-1.90, P corr  = 0.004). Identical results were observed in the dominant, recessive, and additive models. In contrast, the G allele of rs7601754 displayed a protective effect against NMOSD (OR = 0.53, 95% CI 0.36-0.76, P corr  = 0.006). Our study indicates that STAT4 polymorphisms are associated with the risk of NMOSD, which provides novel insights into the underlying mechanisms of this disease.

  15. Cognitive impairment in neuromyelitis optica spectrum disorders: A comparison of the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale Revised with the Rao Brief Repeatable Neuropsychological Battery

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    Juichi Fujimori

    2017-12-01

    Full Text Available Background: Approximately 55% of patients with neuromyelitis optica spectrum disorder (NMOSD show cognitive impairment as evaluated using the Rao Brief Repeatable Neuropsychological Battery (BRBN, but this frequency appears to be higher than the frequency of specific brain lesions in NMOSD. Objective: We studied whether cognitive impairment could be observed in NMOSD patients with no or minor non-specific brain lesions. Methods: We evaluated cognitive function in 12 NMOSD and 14 MS patients using the Wechsler Adult Intelligence Scale-III (WAIS-III, the Wechsler Memory Scale-Revised (WMS-R, and the BRBN. We judged as cognitively impaired patients whose scores were below the average by 2 standard deviations or greater in 2 or more cognitive domains. Results: Cognitive impairment was observed in 5 MS patients (35.7% and in the only NMOSD patient (8.3% with symptomatic brain lesions, but not in the other NMOSD patients who had no or minor non-specific brain lesions. Meanwhile, 5 NMOSD (41.7% and 4 MS (28.6% patients who had normal cognition according to the WAIS-III and WMS-R were assessed as cognitively impaired by the BRBN (which is not standardized for age. Conclusions: Cognitive function in NMOSD patients with no or mild non-specific brain lesions was preserved according to the WAIS-III and WMS-R. Keywords: Neuromyelitis Optica, Cognitive impairment, Wechsler Adult Intelligence Scale-III, Wechsler Memory Scale-Revised, Rao Brief Repeatable Neuropsychological Battery, Multiple sclerosis

  16. MR imaging findings of the corpus callosum region in the differentiation between multiple sclerosis and neuromyelitis optica

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    Chen, Zhiye, E-mail: yyqf@hotmail.com [Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Feng, Feng, E-mail: cjr.fengfeng@vip.163.com [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Wangfujing, Beijing 100730 (China); Yang, Yang, E-mail: whitean0584@sina.com.cn [Department of Neurology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Li, Jinfeng, E-mail: lijf_301@163.com [Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Ma, Lin, E-mail: cjr.malin@vip.163.com [Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2012-11-15

    Purpose: To evaluate MR imaging findings in corpus callosum region for the discrimination between opticospinal multiple sclerosis (OSMS) and neuromyelitis optica (NMO). Materials and methods: Forty-two definite OSMS with seronegative NMO-IgG and 23 NMO with seropositive NMO-IgG, and 27 age-matched normal controls (NC) were recruited. Sagittal T2-FLAIR images with 2-mm slice thickness were obtained. Subcallosal dot-dash (SCDD) sign and subcallosal striations (SCS) sign were reviewed. Results: SCDD was more commonly detected in OSMS (28 of 42 patients) than in NMO (5 of 23 patients) (P < 0.05). SCS showed no difference between OSMS (31 of 42 patients) and NMO (12 of 23 patients) (P > 0.05). For comparing ROC analysis among SCDD, SCS, and SCDD + SCS for predicted probability through binary logistic regression analysis, SCDD + SCS had the largest area under ROC curve (0.777) than SCDD (0.725) and SCS (0.608). Conclusion: SCDD may be helpful in distinguishing OSMS from NMO. The regression equation may also be a simple and effective method of choice for the differentiation between OSMS and NMO.

  17. Soluble CD40 ligand contributes to blood-brain barrier breakdown and central nervous system inflammation in multiple sclerosis and neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Masuda, Hiroki; Mori, Masahiro; Uchida, Tomohiko; Uzawa, Akiyuki; Ohtani, Ryohei; Kuwabara, Satoshi

    2017-04-15

    Soluble CD40 ligand (sCD40L) is reported to disrupt the blood-brain barrier (BBB). Cerebrospinal fluid (CSF) and serum sCD40L levels were measured in 29 multiple sclerosis (MS), 29 neuromyelitis optica spectrum disorder (NMOSD), and 27 disease control (DC) patients. In MS, serum sCD40L levels were higher than in DCs and positively correlated with the CSF/serum albumin ratio (Qalb). In NMOSD, CSF sCD40L levels were significantly increased compared to DCs, and were correlated to Qalb, CSF cell counts, protein concentrations, and interleukin-6 levels. sCD40L could be involved in BBB disruption in MS, whereas it may contribute to CNS inflammation in NMOSD. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Disruption of the leptomeningeal blood barrier in neuromyelitis optica spectrum disorder

    Science.gov (United States)

    Flanagan, Eoin P.; Fujihara, Kazuo; Kim, Ho Jin; Skejoe, Hanne P.; Wuerfel, Jens; Kuroda, Hiroshi; Kim, Su Hyun; Maillart, Elisabeth; Marignier, Romain; Pittock, Sean J.; Paul, Friedemann; Weinshenker, Brian G.

    2017-01-01

    Objective: To describe leptomeningeal blood-barrier impairment reflected by MRI gadolinium-enhanced lesions in patients with aquaporin-4 immunoglobulin G (AQP4-IgG)–positive neuromyelitis optica spectrum disorder (NMOSD). Methods: A retrospective case series of 11 AQP4-IgG–positive NMOSD patients with leptomeningeal enhancement (LME) were collected from 5 centers. External neuroradiologists, blinded to the clinical details, evaluated MRIs. Results: LME was demonstrated on postcontrast T1-weighted and fluid-attenuated inversion recovery images as a sign of leptomeningeal blood-barrier disruption and transient leakage of contrast agent into the subarachnoid space in 11 patients, 6 in the brain and 6 in the spinal cord. The patterns of LME were linear or extensive and were accompanied by periependymal enhancement in 5 cases and intraparenchymal enhancement in all cases. The location of LME in the spinal cord was adjacent to intraparenchymal contrast enhancement with involvement of a median number of 12 (range 5–17) vertebral segments. At the time of LME on MRI, all patients had a clinical attack such as encephalopathy (36%) and/or myelopathy (70%) with median interval between symptom onset and LME of 12 days (range 2–30). LME occurred in association with an initial area postrema attack (44%), signs of systemic infection (33%), or AQP4-IgG in CSF (22%) followed by clinical progression. LME was found at initial clinical presentation in 5 cases and at clinical relapses leading to a diagnosis of NMOSD in 6 cases. Conclusion: This study suggests that altered leptomeningeal blood barrier may be accompanied by intraparenchymal blood-brain barrier breakdown in patients with AQP4-IgG–positive NMOSD during relapses. PMID:28451627

  19. Frequency of autoimmune disorders and autoantibodies in patients with neuromyelitis optica.

    Science.gov (United States)

    Pereira, Wildéa Lice de Carvalho Jennings; Reiche, Edna Maria Vissoci; Kallaur, Ana Paula; Oliveira, Sayonara Rangel; Simão, Andréa Name Colado; Lozovoy, Marcell Alysson Batisti; Schiavão, Lucas José Vaz; Rodrigues, Paula Raquel do Vale Pascoal; Alfieri, Daniela Frizon; Flauzino, Tamires; Kaimen-Maciel, Damacio Ramón

    2017-06-01

    The aim of this study was to report the frequency of autoimmune disorders and autoantibodies in 22 patients with neuromyelitis optica (NMO), as well as whether the seropositivity for autoantibodies differs between anti-aquaporin 4 (AQP4) positive and AQP4 negative NMO patients. Demographic, medical records, and a profile of autoantibodies were evaluated in 22 NMO patients, including AQP4, anti-thyroid-stimulating hormone receptor, antinuclear antibodies (ANA), anti-thyroperoxidase (anti-TPO), anti-thyroglobulin (anti-Tg), anti-double-stranded DNA, anti-neutrophil cytoplasmic, anti-cyclic citrullinate peptide, rheumatoid factor, anti-SSA/Ro, anti-SSB/La, anti-Smith antibodies (anti-Sm), anti-ribonucleoprotein, anti-nucleosome, and anti-Scl70. Thyroid-stimulating hormone and free thyroxin were measured. The frequency of women was higher than men (95.5% vs. 4.5%) and 68.2% were Afro-Brazilians. Six (27.3%) patients presented other autoimmune disorders, such as Hashimoto thyroiditis (n=2), Graves' disease (n=1), juvenile idiopathic arthritis (n=1), systemic lupus erythematosus and systemic sclerosis (n=1), and Raynaud's phenomenon (n=1). The most frequent autoantibodies were anti-AQP4 (54.5%), anti-nucleosome (31.8%), ANA (27.3%), anti-TPO (22.7%), and anti-Tg (22.7%). Difference was not observed in the frequency of autoimmune disorders when the patients were compared according to their anti-AQP4 status. The results of the present study underscored that the NMO patients present high frequency of autoantibodies against cellular antigens and the presence of autoimmune disorders. Further studies with large number of NMO patients may contribute to advances in the understanding of NMO disease mechanisms.

  20. Non-linear absorption for concentrated solar energy transport

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    Jaramillo, O. A; Del Rio, J.A; Huelsz, G [Centro de Investigacion de Energia, UNAM, Temixco, Morelos (Mexico)

    2000-07-01

    In order to determine the maximum solar energy that can be transported using SiO{sub 2} optical fibers, analysis of non-linear absorption is required. In this work, we model the interaction between solar radiation and the SiO{sub 2} optical fiber core to determine the dependence of the absorption of the radioactive intensity. Using Maxwell's equations we obtain the relation between the refractive index and the electric susceptibility up to second order in terms of the electric field intensity. This is not enough to obtain an explicit expression for the non-linear absorption. Thus, to obtain the non-linear optical response, we develop a microscopic model of an harmonic driven oscillators with damp ing, based on the Drude-Lorentz theory. We solve this model using experimental information for the SiO{sub 2} optical fiber, and we determine the frequency-dependence of the non-linear absorption and the non-linear extinction of SiO{sub 2} optical fibers. Our results estimate that the average value over the solar spectrum for the non-linear extinction coefficient for SiO{sub 2} is k{sub 2}=10{sup -}29m{sup 2}V{sup -}2. With this result we conclude that the non-linear part of the absorption coefficient of SiO{sub 2} optical fibers during the transport of concentrated solar energy achieved by a circular concentrator is negligible, and therefore the use of optical fibers for solar applications is an actual option. [Spanish] Con el objeto de determinar la maxima energia solar que puede transportarse usando fibras opticas de SiO{sub 2} se requiere el analisis de absorcion no linear. En este trabajo modelamos la interaccion entre la radiacion solar y el nucleo de la fibra optica de SiO{sub 2} para determinar la dependencia de la absorcion de la intensidad radioactiva. Mediante el uso de las ecuaciones de Maxwell obtenemos la relacion entre el indice de refraccion y la susceptibilidad electrica hasta el segundo orden en terminos de intensidad del campo electrico. Esto no es

  1. Clinical and imaging characteristics and autoantibody analysis of neuromyelitis optica spectrum disorders

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    Nan LIU

    2014-09-01

    Full Text Available Objective To observe the clinical and imaging characteristics and the changes of autoimmune antibodies in the serum and cerebrospinal fluid (CSF of patients with neuromyelitis optica spectrum disorders (NMOSDs.  Methods The data of 10 patients with NMOSDs in Aviation General Hospital of China Medical University from January 2011 to June 2014 were collected. The clinical and imaging features were retrospectively reviewed, and NMO-IgG in serum and CSF, anti-nuclear antibody (ANA, homocysteine (Hcy and thyroid function were analyzed.  Results Cranial and spinal MRI of these patients showed that brain stem was involved in 3 cases, cervical cord in 3 cases, thoracic cord in 6 cases, and cervical-thoracic cord in one case. Serum NMO-IgG were tested in 8 cases, among whom 3 patients were positive (3/8 and 5 were negative (5/8. ANA was positive in one case (1/3, and thyroglobulin (TG antibody and thyroid peroxidase (TPO antibody were positive in 2 cases (2/3. Hypothyroidism occured in 2 cases, hyperthyroidism occured in one case, and Hcy rised in 2 cases.  Conclusions NMOSDs frequently occur in young and middle-aged women. Patients who were highly suspected with NMOSDs should receive tests of autoimmune antibodies in the serum and CSF, and cranial and spinal MRI examination, in order to make a definite diagnosis and receive appropriate treatment. Retesting the autoimmune antibodies should be done in catabasis, in order to identify the relationship between autoimmune antibodies and NMOSDs. doi: 10.3969/j.issn.1672-6731.2014.09.010

  2. Imbalance in multiple sclerosis and neuromyelitis optica: association with deep sensation disturbance.

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    Demura, Yutaka; Kinoshita, Masako; Fukuda, Osamu; Nose, Shouzou; Nakano, Hitoshi; Juzu, Akira; Murase, Nagako; Yamamoto, Kenji

    2016-12-01

    Abnormality in balance is one of the most important causes of gait disturbance which has a direct impact to disability and medical cost in multiple sclerosis (MS) and neuromyelitis optica (NMO). However, characteristics of imbalance in these two diseases have not been fully elucidated. The aim of this study was to evaluate the degree and features of imbalance using stabilography, the degree of deep sensation disturbance using tibial nerve somatosensory evoked potentials (SEP), and their association with clinical impairment, in patients with MS and NMO. Seven NMO patients and seven MS patients with balance disturbance were examined. The relationship among stabilography measurements representing the degree and features of imbalance, height-adjusted P38 peak latency of SEP, and neurological functional disability, were analyzed. Stabilography evaluation showed a significantly severer degree of imbalance in NMO than in MS. Romberg quotient of the patients with brainstem lesions was significantly larger than those without them. In all patients, length of excursion per second significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. In all patients and in NMO, P38 peak latency adjusted by height significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. These findings suggest that the degree of imbalance of MS and NMO possibly correlate with deep sensation disturbance, which could be evaluated by anterio-posterior-axis power spectra at intermediate frequency band by stabilography. Severer imbalance in NMO than MS may be associated with the severe longitudinally extensive spinal cord lesions.

  3. Circulating regulatory B cell subsets in patients with neuromyelitis optica spectrum disorders.

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    Han, Jinming; Sun, Li; Wang, Zhongkun; Fan, Xueli; Wang, Lifang; Song, Yang-Yang; Zhu, Jie; Jin, Tao

    2017-07-01

    This study analyzed the populations of three different subsets of regulatory B cells (Bregs) in the peripheral blood mononuclear cells (PBMCs) of patients with neuromyelitis optica spectrum disorders (NMOSDs) and explored the relationship between the changes in these subsets of Bregs and the severity of NMOSD. A total of 22 patients with relapsed NMOSDs before treatment were recruited in our study, along with 20 age and gender-matched healthy controls, from May 2015 to March 2016. The percentages and numbers for three different subsets of Bregs including the CD19 + CD24 hi CD38 hi , CD19 + CD24 hi CD27 + , and CD19 + CD5 + CD1d hi populations were evaluated in parallel by flow cytometry. Afterwards, correlations between the change of three different subsets of Bregs and disease severity were analyzed. We found significantly lower percentages of CD19 + CD24 hi CD38 hi and CD19 + CD5 + CD1d hi Bregs in NMOSDs patients than in healthy individuals. In contrast, the CD19 + CD24 hi CD27 + Bregs population was significantly higher in NMOSDs patients than in healthy individuals. However, the three different Bregs subsets showed no significant correlation with expanded disability status scale (EDSS) or annualized relapse rate (ARR). Our findings suggest that the subsets of Bregs may play complex roles in the pathogenesis of NMOSDs and are not correlated with clinical disease severity. Further insights into the potential role of subsets of Bregs could increase our basic knowledge of NMOSDs pathogenesis.

  4. Assessment of Optic Nerve Impairment in Patients with Neuromyelitis Optica by MR Diffusion Tensor Imaging.

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    Zhiye Chen

    Full Text Available Diffusion tensor imaging (DTI has been used for the evaluation of the white matter integrity. In this study, we evaluated optic nerve impairment in patients with neuromyelitis optica (NMO using DTI.Optic nerve DTI were performed on 28 NMO patients and 38 normal controls. Fractional anisotropy (FA values were measured in the anterior, middle, and posterior parts of the intraorbital optic nerve segment. For the posterior intraorbital optic nerve, FA values of BI (0.20±0.07, MI (0.24±0.16, and NA (0.25±0.14 decreased significantly compared with that of NC (0.43±0.07 (P<0.05, and ROC analysis demonstrated that the area under the curve (AUC measurements for BI vs. NC, MI vs. NC, NA vs. NC, and NMO (including BI, MI, and NA vs. NC were 0.99, 0.93, 0.88, and 0.96, respectively. The corresponding diagnostic sensitivities of ROC analysis were 100%, 80%, 80%, and 91%; and the specificities were 93%, 97%, 91%, and 93%.Decreased FA value in the intraorbital optic nerve, especially in the posterior part of the nerve, was demonstrated as a characteristic MR feature for NMO-related optic nerve impairment.

  5. Multifrequency magnetic resonance elastography of the brain reveals tissue degeneration in neuromyelitis optica spectrum disorder

    International Nuclear Information System (INIS)

    Streitberger, Kaspar-Josche; Fehlner, Andreas; Sack, Ingolf; Pache, Florence; Lacheta, Anna; Papazoglou, Sebastian; Brandt, Alexander; Bellmann-Strobl, Judith; Ruprecht, Klemens; Braun, Juergen; Paul, Friedemann; Wuerfel, Jens

    2017-01-01

    Application of multifrequency magnetic resonance elastography (MMRE) of the brain parenchyma in patients with neuromyelitis optica spectrum disorder (NMOSD) compared to age matched healthy controls (HC). 15 NMOSD patients and 17 age- and gender-matched HC were examined using MMRE. Two three-dimensional viscoelastic parameter maps, the magnitude G* and phase angle φ of the complex shear modulus were reconstructed by simultaneous inversion of full wave-field data in 1.9-mm isotropic resolution at 7 harmonic drive frequencies from 30 to 60 Hz. In NMOSD patients, a significant reduction of G* was observed within the white matter fraction (p = 0.017), predominantly within the thalamic regions (p = 0.003), compared to HC. These parameters exceeded the reduction in brain volume measured in patients versus HC (p = 0.02 whole-brain volume reduction). Volumetric differences in white matter fraction and the thalami were not detectable between patients and HC. However, phase angle φ was decreased in patients within the white matter (p = 0.03) and both thalamic regions (p = 0.044). MMRE reveals global tissue degeneration with accelerated softening of the brain parenchyma in patients with NMOSD. The predominant reduction of stiffness is found within the thalamic region and related white matter tracts, presumably reflecting Wallerian degeneration. (orig.)

  6. Multifrequency magnetic resonance elastography of the brain reveals tissue degeneration in neuromyelitis optica spectrum disorder

    Energy Technology Data Exchange (ETDEWEB)

    Streitberger, Kaspar-Josche [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Neurology with Experimental Neurology, Berlin (Germany); Fehlner, Andreas; Sack, Ingolf [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Pache, Florence [Charite - Universitaetsmedizin Berlin, Department of Neurology with Experimental Neurology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Lacheta, Anna; Papazoglou, Sebastian; Brandt, Alexander [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Bellmann-Strobl, Judith [Max Delbrueck Center for Molecular Medicine and Charite - Universitaetsmedizin Berlin, Experimental and Clinical Research Center, Berlin (Germany); Ruprecht, Klemens [Charite - Universitaetsmedizin Berlin, Department of Neurology with Experimental Neurology, Berlin (Germany); Braun, Juergen [Charite - Universitaetsmedizin Berlin, Institute of Medical Informatics, Berlin (Germany); Paul, Friedemann [Charite - Universitaetsmedizin Berlin, Department of Neurology with Experimental Neurology, Berlin (Germany); Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Max Delbrueck Center for Molecular Medicine and Charite - Universitaetsmedizin Berlin, Experimental and Clinical Research Center, Berlin (Germany); Wuerfel, Jens [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Max Delbrueck Center for Molecular Medicine and Charite - Universitaetsmedizin Berlin, Experimental and Clinical Research Center, Berlin (Germany); Medical Image Analysis Center (MIAC AG), Basel (Switzerland)

    2017-05-15

    Application of multifrequency magnetic resonance elastography (MMRE) of the brain parenchyma in patients with neuromyelitis optica spectrum disorder (NMOSD) compared to age matched healthy controls (HC). 15 NMOSD patients and 17 age- and gender-matched HC were examined using MMRE. Two three-dimensional viscoelastic parameter maps, the magnitude G* and phase angle φ of the complex shear modulus were reconstructed by simultaneous inversion of full wave-field data in 1.9-mm isotropic resolution at 7 harmonic drive frequencies from 30 to 60 Hz. In NMOSD patients, a significant reduction of G* was observed within the white matter fraction (p = 0.017), predominantly within the thalamic regions (p = 0.003), compared to HC. These parameters exceeded the reduction in brain volume measured in patients versus HC (p = 0.02 whole-brain volume reduction). Volumetric differences in white matter fraction and the thalami were not detectable between patients and HC. However, phase angle φ was decreased in patients within the white matter (p = 0.03) and both thalamic regions (p = 0.044). MMRE reveals global tissue degeneration with accelerated softening of the brain parenchyma in patients with NMOSD. The predominant reduction of stiffness is found within the thalamic region and related white matter tracts, presumably reflecting Wallerian degeneration. (orig.)

  7. Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later

    Science.gov (United States)

    Pittock, Sean J.; Lucchinetti, Claudia F.

    2015-01-01

    The discovery of AQP4-IgG (a pathogenic antibody that targets the astrocytic water channel aquaporin-4) as the first sensitive and specific biomarker for any inflammatory central nervous system demyelinating disease, has shifted emphasis from the oligodendrocyte and myelin to the astrocyte as a central immunopathogenic player. Neuromyelitis optica (NMO) spectrum disorders (SD) represent an evolving spectrum of IDDs extending beyond the optic nerves and spinal cord to include the brain (especially in children) and, rarely, muscle. NMOSD typical brain lesions are located in areas that highly express the target antigen, AQP4, including the circumventricular organs (accounting for intractable nausea and vomiting) and the diencephalon (accounting for sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Magnetic resonance imaging (MRI) brain abnormalities fulfill Barkoff criteria for multiple sclerosis in up to 10% of patients. As the spectrum broadens, the importance of highly specific assays that detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 cannot be overemphasized. The rapid evolution of our understanding of the immunobiology of AQP4 autoimmunity necessitates continuing revision of NMOSD diagnostic criteria. Here, we describe scientific advances that have occurred since the discovery of NMO-IgG in 2004 and review novel targeted immunotherapies. We also suggest that NMOSDs should now be considered under the umbrella term autoimmune aquaporin-4 channelopathy. PMID:26096370

  8. Lesions of the posterior limb of the internal capsule in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Long, Youming; Wu, Linzhan; Zhong, Rong; Ouyang, Xiaoming; Liang, Junyan; Gao, Cong; Chen, Xiaohui; Qiu, Wei; Chang, Yanyu; Wang, Zhanhang; Ye, Jinlong

    2017-05-01

    Posterior limb of the internal capsule lesions (PLICL) are one of the MRI features of neuromyelitis optica spectrum disorder (NMOSD). However, there is no evidence that such lesions are pathogenically related to NMOSD. We retrospectively analyzed features of PLICL in NMOSD, and other central nervous system inflammatory disorders, in 561 patients. We also examined the pathological samples of six patients. Of the 561 patients investigated, PLICL were found in 65 patients (11.6%). Lesions were bilateral in 26 cases (40%) and unilateral in 39 cases (60%). Unilateral lesions were mainly located on the left side (74.3%, 29/39). Of the 65 patients with PLICL, 46 patients had NMOSD (70.8%) and were positive for anti-aquaporin (AQP4-IgG), four had NMOSD (6.2%) and were AQP4-IgG negative, 10 patients had multiple sclerosis (MS), three patients had NMDAR encephalitis, and two had autoimmune meningoencephalitis. Of the six patients whose pathological samples were evaluated, all had PLICL and were negative for AQP4-IgG, and none had pathological NMOSD lesion features. These cases included three patients with multiple sclerosis, one with anti-N-methyl-D-aspartate receptor encephalitis, and two with autoimmune meningoencephalitis. In conclusion, PLICL are found not only in patients with NMOSD, but also in MS and other disorders.

  9. Neuromyelitis optica spectrum disorders: long-term safety and efficacy of rituximab in Caucasian patients.

    Science.gov (United States)

    Radaelli, M; Moiola, L; Sangalli, F; Esposito, F; Barcella, V; Ferrè, L; Rodegher, M; Colombo, B; Fazio, R; Martinelli, V; Comi, G

    2016-04-01

    To assess the long-term benefit-risk profile of repeated courses of rituximab in Caucasian patients affected by neuromyelitis optica (NMO) and related disorders, in everyday clinical practice. This is a prospective observational study performed at San Raffaele Hospital, Milan, Italy. From February 2006, we recruited 21 patients affected by NMO and NMO spectrum of disorders (NMOSD) whom underwent at least one cycle of intravenous (i.v.) rituximab and then were followed for at least 2 years. At a mean follow-up time of 48 months, we observed a significant reduction of the annualized relapse rate (ARR), from 2.0 to 0.16 (p < 0.01); and of the median Expanded Disability Status Scale (EDSS), from 5.5 to 4.0 (p < 0.013). There were 12 patients (57%) who remained disease free during the follow-up period. Five patients (24%) reported mild hematological adverse events. Serious infectious adverse events were reported by another four patients: These were all wheelchair bound at the beginning of their rituximab treatment. A fixed treatment scheme of rituximab, with re-treatment every 6 months, was efficacious for NMO and NMOSD, with a good safety profile; however, to obtain an even better benefit-risk ratio, close monitoring of CD19(+) B cells should be performed before the re-treatment of patients with high-level disability, concomitant leukopenia and hypogammaglobulinemia. © The Author(s), 2015.

  10. MRI abnormalities and related risk factors of the brain in patients with neuromyelitis optica

    International Nuclear Information System (INIS)

    Xiao Hui; Ma Lin; Lou Xin; Cai Youquan; Wang Yulin; Wang Yan; Wu Lei; Wu Weiping

    2011-01-01

    Objective: To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors. Methods: Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signal features of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results: Twenty-four NMO patients (44.4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43.3%). Typical lesion locations included corpus callosum, subependyma of ventricles, hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Post-contrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting autoimmune disease or infection. history had correlations with abnormalities of the brain on MRI (OR=3.519, P<0.05). Conclusions: There was a high incidence of brain abnormalities in NMO. Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO. NMO patients with coexisting autoimmune disease and infection history had higher risk of brain abnormalities. (authors)

  11. Metal pollution (Pb, Zn, Ni and Cr) in air, road and soil sediment in a high traffic area; Contaminacion por metales (Pb, Zn, Ni y Cr) en aire, sedimentos viales y suelo en una zona de alto trafico vehicular

    Energy Technology Data Exchange (ETDEWEB)

    Manchado, Anali; Garcia, Neyma; Garcia, Cezar; Acosta, Lorena; Cordova, Alberto; Linares, Maria; Giraldoth, Debora [Centro de Investigaciones CEDEGAS, Facultad de Ingenieria, Universidad del Zulia, Maracaibo (Venezuela)]. E-mail: analimachado@yahoo.com; amachadop@luz.edu.ve; Velasquez, Harvi [Facultad Experimental de Ciencias, Universidad del Zulia, Maracaibo (Venezuela)

    2008-11-15

    sequia y de lluvia, empleando un muestreador de bajo volumen con filtros de fibra de cuarzo -para las muestras de PM10- con una frecuencia de una muestra cada tres dias para un total de 26; para los sedimentos viales y suelo fueron colectadas tres muestras con una frecuencia de 15 dias para un periodo de medicion de mes y medio en epoca seca. Todas las muestras fueron sometidas a un proceso de digestion y analizadas por espectrometria de absorcion atomica. Las concentraciones de las PM10 resultaron 2 veces mas altas en la zona de emision que en la zona de dispersion durante ambas epocas climatologicas, presentando una mejor correlacion entre las zonas para epoca de sequia. Todos los metales analizados presentaron diferencias estadisticamente significativas entre las zonas de muestreo. Por otra parte, para el periodo global existen diferencias significativas entre las zonas y las epocas climatologicas tanto para PM10 como para la totalidad de los metales. El Pb no excedio el estandar de calidad del aire establecido para Venezuela, pero su concentracion promedio en la zona de emision fue de 1.13 {mu}g/m{sup 3}, muy cercano al limite diario permitido en Venezuela y por la EPA; por su parte, tanto Pb como Ni sobrepasaron el limite permisible de la Organizacion Mundial de la Salud (OMS) en ambas zonas durante todo el periodo de muestreo. Para las muestras de sedimento y de suelo se encontraron concentraciones significativamente elevadas de Pb, Zn, Ni y Cr en comparacion con la muestra testigo. Los niveles hallados de Pb y Zn estan por encima de los limites permitidos por el decreto 2635 de la normativa venezolana y la EPA, clasificandose la zona como suelo con alta contaminacion por metales pesados. Adicionalmente, el analisis estadistico demostro la adecuada seleccion de la zona de monitoreo, confirmando que la principal fuente de emision de los contaminantes es el parque automotor.

  12. Linear lesions may assist early diagnosis of neuromyelitis optica and longitudinally extensive transverse myelitis, two subtypes of NMOSD.

    Science.gov (United States)

    Cai, Wei; Tan, Sha; Zhang, Lei; Shan, Yilong; Wang, Yanqiang; Lin, Yinyao; Zhou, Fangjing; Zhang, Bingjun; Chen, Xiaoyu; Zhou, Li; Wang, Yuge; Huang, Xuehong; Men, Xuejiao; Li, Haiyan; Qiu, Wei; Hu, Xueqiang; Lu, Zhengqi

    2016-01-15

    To investigate the relationship between linear lesions (LL) and the development of longitudinally extensive spinal cord lesions (LESCL) in Chinese patients with neuromyelitis optica or longitudinally extensive transverse myelitis. The clinical records of 143 patients with these conditions were reviewed. Forty-one patients with LL were divided into three groups according to the order of appearance of LL and LESCL (simultaneously [n=10], LL first [n=26], or LESCL first [n=5]). The remaining 102 patients without LL were used as a control group. Patients who developed LL first demonstrated a lower annualized relapse rate than those in the simultaneous group (1.00 [0.23-10.00] vs. 4.38 [0.60-6.67], p=0.017) and the control group (1.00 [0.23-10.00] vs. 2.00 [0.24-10.00], p=0.007). Among all patients with LL, there were significantly more who developed them before LESCL than those who developed them after LESCL (poptica and longitudinally extensive transverse myelitis. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. The Pathology of an Autoimmune Astrocytopathy: Lessons Learned from Neuromyelitis Optica

    Science.gov (United States)

    Lucchinetti, Claudia F.; Guo, Yong; Popescu, Bogdan F. Gh.; Fujihara, Kazuo; Itoyama, Yasuto; Misu, Tatsuro

    2014-01-01

    Neuromyelitis optica (NMO) is a disabling autoimmune astrocytopathy characterized by typically severe and recurrent attacks of optic neuritis and longitudinally-extensive myelitis. Until recently, NMO was considered an acute aggressive variant of multiple sclerosis (MS), despite the fact that early studies postulated that NMO and MS may be two distinct diseases with a common clinical picture. With the discovery of a highly specific serum autoantibody (NMO-IgG), Lennon and colleagues provided the first unequivocal evidence distinguishing NMO from MS and other CNS inflammatory demyelinating disorders. The target antigen of NMO-IgG was confirmed to be aquaporin-4 (AQP4), the most abundant water channel protein in the central nervous system (CNS), mainly expressed on astrocytic foot processes at the blood brain barrier, subpial and subependymal regions. Pathological studies demonstrated that astrocytes were selectively targeted in NMO as evidenced by the extensive loss of immunoreactivities for the astrocytic proteins, AQP4 and glial fibrillary acidic protein (GFAP), as well as perivascular deposition of immunoglobulins and activation of complement even within lesions with a relative preservation of myelin. In support of these pathological findings, GFAP levels in the cerebrospinal fluid (CSF) during acute NMO exacerbations were found to be remarkably elevated in contrast to MS where CSF-GFAP levels did not substantially differ from controls. Additionally, recent experimental studies showed that AQP4 antibody is pathogenic, resulting in selective astrocyte destruction and dysfunction in vitro, ex vivo, and in vivo. These findings strongly suggest that NMO is an autoimmune astrocytopathy where damage to astrocytes exceeds both myelin and neuronal damage. This chapter will review recent neuropathological studies that have provided novel insights into the pathogenic mechanisms, cellular targets, as well as the spectrum of tissue damage in NMO. PMID:24345222

  14. Anti-thyroid antibodies and thyroid function in neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Wang, Xuan; Yi, Huan; Liu, Jia; Li, Min; Mao, Zhi-Feng; Xu, Li; Peng, Fu-Hua

    2016-07-15

    Neuromyelitis optica spectrum disorders (NMOSD) are complicated neuroautoimmune disorders which can coexist with other organ-specific autoimmune disorders. The most frequently specific organ is the thyroid. The aim of this study is to evaluate the thyroid function of NMOSD patients and detect the difference between anti-thyroid antibodies (ATAbs) seropositive and seronegative NMOSD patients. 88 patients diagnosed with NMOSD were enrolled and their thyroid functions were evaluated. They were divided into two groups by ATAbs abnormalities. In addition, demographic characteristics, clinical symptoms and MRI scan results of brain and spinal cord were assessed. Anti-thyroid peroxidase antibodies (TPOAbs) and anti-thyroglobulin antibodies (TGAbs) seropositivities were detected more frequently in patients with NMOSDs when compared with healthy controls (37.5% vs 14.9%, P=0.01, Diff22.6%, 95CI[9.0%, 34.9%]; 31.8% vs 16.2%, P=0.022, Diff15.6%, 95CI[2.27%, 27.9%]). In NMOSD patients, the Expanded disability status scale score (EDSS) score was significantly higher in ATAbs seropositive group than that in ATAbs seronegative group (median 6.5 vs 3.75, P=0.012). However, there is no significant difference for demographic characteristics and other clinical symptoms. Moreover, NMOSD patients with ATAbs abnormalities had more brain and cervical cord lesions when compared with ATAbs negative NMOSD patients (83.8% vs 61.4%, P=0.029, Diff22.4%, 95CI[0.9%, 40.9%]; 93.9% vs 59.6%, P=0.001, Diff34.3%, 95CI[13.6%, 50.4%]). NMOSD patients have a higher frequency of ATAbs abnormalities. ATAbs may be associated with disability status, brain abnormalities and cervical cord lesions. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Efficacy and safety of rituximab in neuromyelitis optica: Review of evidence

    Directory of Open Access Journals (Sweden)

    Masoud Etemadifar

    2017-01-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune inflammatory disease of the central nervous system with preferential involvement in the optic nerve and spinal cord with a widespread spectrum of clinical features; multiple therapeutic agents have been used with different results. Recent evidence points to B-cell-mediated humoral immunity in the pathogenesis of NMO. Rituximab targets the CD20 antigen on B-cells. Treatment leads to profound B-cell depletion, principally over an antibody-dependent cell cytotoxicity mechanism. The aim of our study was to review clinical trials to elucidate the impact of rituximab on the relapse rate, Expanded Disability Status Scale (EDSS, and progression of disability in NMO. We performed a comprehensive review of all studies that evaluated clinical and paraclinical effects of rituximab on NMO. MEDLINE-PubMed, Web of Sciences, EMBASE, and Cochrane databases up to June 2016 included in our searches. In addition, reference lists from articles identified by search as well as a key review article to identify additional articles included in the study. Rituximab targets the CD20 antigen on B-cells and decreases attack frequency and severity in patients with NMO; however, it does not remove attacks, even when modifying treatment to achieve B-cell depletion. Most of the investigations revealed that EDSS significantly in all patients with rituximab treatment will be decreased after treatment with rituximab. No new or enlarged lesions or pathological gadolinium enhancement was observed in serial brain and spinal cord magnetic resonance imaging, except for those observed concomitantly with clinical relapses and the median length of spinal cord lesions was significantly reduced after therapy. Rituximab targets the CD20 antigen and decreases attack frequency and severity in patients with NMO.

  16. Proceedings CORENDE: Regional congress on nondestructive and structural evaluation; Actas CORENDE: Congreso regional de ensayos no destructivos y estructurales

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    Works are presented at the CORENDE: Regional Congress on Nondestructive and Structural Evaluation organized by the National Atomic Energy Commission and the National Technological University (Mendoza). This congress wants to be the forum where people from research, industry and marketing might meet and discuss ideas towards the fostering of these new cultural habits. Papers covering all disciplines contributing to the evaluation of components, systems and structures are welcome: nondestructive evaluation methods and techniques (ultrasound, eddy currents and other electromagnetic methods, acoustic emission, radiography, thermography, leak testing, dye-penetrants, visual inspection, etc.), personnel certification, welding inspection, nondestructive metallography, optics and lasers, fluid-structure interaction, vibrations, extensometry, modelling of structures refs., ills. [Espanol] Se presentan trabajos de CORENDE: Congreso Regional de Ensayos no Destructivos y Estructurales organizado por la Comision Nacional de Energia Atomica y la Universidad Tecnologica Nacional (Mendoza). Este congreso se propone como un foro de discusion, donde, desde la investigacion hasta la produccion y comercializacion, se intercambien y discutan ideas que sirvan de guia para fomentar ese necesario cambio cultural. Los topicos de discusion incluyen a todas las disciplinas presentes en la evaluacion de componentes, sistemas y estructuras: tecnicas no destructivas (ultrasonido, corrientes inducidas, radiografia industrial, emision acustica, particulas magnetizables, termografia, liquidos penetrantes, ensayos de perdidas, inspeccion visual, etc.), certificacion de personal, inspeccion en soldaduras, replicas metalograficas, tecnicas opticas y laser, interaccion fluido-estructura, vibraciones, extensometria, modelado de estructuras

  17. Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging

    Science.gov (United States)

    Pekcevik, Yeliz; Mitchell, Charles H; Mealy, Maureen A; Orman, Gunes; Lee, In H; Newsome, Scott D; Thompson, Carol B; Pardo, Carlos A; Calabresi, Peter A; Levy, Michael; Izbudak, Izlem

    2016-01-01

    Background Although spinal magnetic resonance imaging (MRI) findings of neuromyelitis optica (NMO) have been described, there is limited data available that help differentiate NMO from other causes of longitudinally extensive transverse myelitis (LETM). Objective To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM. Methods We enrolled 94 patients with LETM into our study. Bright spotty lesions (BSL), the lesion distribution and location were evaluated on axial T2-weighted images. Brainstem extension, cord expansion, T1 darkness and lesion enhancement were noted. We also reviewed the brain MRI of the patients during LETM. Results Patients with NMO had a greater amount of BSL and T1 dark lesions (p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord’s cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO. Conclusions Certain spinal cord MRI features are more commonly seen in NMO patients and so obtaining brain MRI during LETM may support diagnosis. PMID:26209588

  18. Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Krampla, Wolfgang; Hruby, Walter [SMZ-Ost Donauspital, Department of Radiology, Vienna (Austria); Aboul-Enein, Fahmy; Jecel, Julia; Kristoferitsch, Wolfgang [SMZ-Ost Donauspital, Department of Neurology, Vienna (Austria); Lang, Wilfried [Hospital of Barmherzige Brueder, Department of Neurology, Vienna (Austria); Fertl, Elisabeth [Krankenanstalt Rudolfstiftung, Department of Neurology, Vienna (Austria)

    2009-10-15

    Neuromyelitis optica (NMO) is characterised by a particular pattern of the optic nerves and the spinal cord. Long-term MRI follow-up studies of spinal NMO lesions are rare, or limited by short observation periods. In nine patients with definite NMO or recurrent longitudinally extensive transverse myelitis (LETM) with NMO-IgG serum antibodies, repeated MRI examinations of the spine were carried out over a period of up to 11 years and evaluated regarding the changes over time in this retrospective study. In eight patients spinal cord lesions were located centrally, involving the grey and white matter. In the first examination after clinical onset changes resembled a stroke of the anterior spinal artery in two patients. Symmetrical signal alterations within the grey matter were observed. In one patient this pattern was transient, but it remained in the other. During the chronic stage, either a variable degree of spinal cord atrophy and high signal alterations, or almost complete remission of the lesions, was observed. Spinal MRI of patients with NMO myelitis can resemble a stroke. MRI of acute NMO stages did not allow a prediction of the clinical outcome. To a variable degree, NMO left behind typical defects which correlated with the clinical outcome. (orig.)

  19. Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

    International Nuclear Information System (INIS)

    Krampla, Wolfgang; Hruby, Walter; Aboul-Enein, Fahmy; Jecel, Julia; Kristoferitsch, Wolfgang; Lang, Wilfried; Fertl, Elisabeth

    2009-01-01

    Neuromyelitis optica (NMO) is characterised by a particular pattern of the optic nerves and the spinal cord. Long-term MRI follow-up studies of spinal NMO lesions are rare, or limited by short observation periods. In nine patients with definite NMO or recurrent longitudinally extensive transverse myelitis (LETM) with NMO-IgG serum antibodies, repeated MRI examinations of the spine were carried out over a period of up to 11 years and evaluated regarding the changes over time in this retrospective study. In eight patients spinal cord lesions were located centrally, involving the grey and white matter. In the first examination after clinical onset changes resembled a stroke of the anterior spinal artery in two patients. Symmetrical signal alterations within the grey matter were observed. In one patient this pattern was transient, but it remained in the other. During the chronic stage, either a variable degree of spinal cord atrophy and high signal alterations, or almost complete remission of the lesions, was observed. Spinal MRI of patients with NMO myelitis can resemble a stroke. MRI of acute NMO stages did not allow a prediction of the clinical outcome. To a variable degree, NMO left behind typical defects which correlated with the clinical outcome. (orig.)

  20. Anti-N-methyl-D-aspartate receptor(NMDAR) antibody encephalitis presents in atypical types and coexists with neuromyelitis optica spectrum disorder or neurosyphilis.

    Science.gov (United States)

    Qin, Kaiyu; Wu, Wenqing; Huang, Yuming; Xu, Dongmei; Zhang, Lei; Zheng, Bowen; Jiang, Meijuan; Kou, Cheng; Gao, Junhua; Li, Wurong; Zhang, Jinglin; Wang, Sumei; Luan, Yanfei; Yan, Chaoling; Xu, Dan; Zheng, Xinmei

    2017-01-05

    Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a clinically heterogeneous disorder characterized by epileptic seizures, psychosis, dyskinesia, consciousness impairments, and autonomic instability. Symptoms are always various. Sometimes it presents in milder or incomplete forms. We report 4 cases of anti-NMDAR encephalitis with incomplete forms, 3 cases of which were accompanied by neuromyelitis optica spectrum disorder or neurosyphilis respectively. A 33-year-old man presented with dysarthria, movement disorder and occasional seizures. He had 6 relapses in 28 years. When suffered from upper respiratory tract syndrome, he developed behavioral and consciousness impairment. Cranial MRI was normal. Viral PCR studies and oncologic work-up were negative. Anti-NMDAR antibody was detected in CSF and serum. A 21-year-old female manifested dizziness and diplopia ten months and six months before, respectively. Both responded to steroid therapy and improved completely. This time she presented with progressive left limb and facial anesthesia, walking and holding unsteadily. Spinal cord MRI follow-up showed abnormality of medulla oblongata and cervical cord(C1). Anti-AQP4 and anti-NMDAR were positive in CSF. Steroid-pulse therapy ameliorated her symptoms. A 37-year-old male experienced worsening vision. He was confirmed neurosyphilis since the CSF tests for syphilis were positive. Protein was elevated and the oligoclonal IgG bands(OB) and anti-NMDAR was positive in CSF. Anti-aquaporin 4(AQP4) antibodies and NMO-IgG were negative. Cranial MRI showed high FLAIR signal on frontal lobe and low T2 signal adjacent to the right cornu posterious ventriculi lateralis. Treatment for neurosyphlis was commenced with gradual improvement. A 39-year-old male, developed serious behavioral and psychiatric symptoms. Examination showed abnormal pupils and unsteady gait. He was confirmed neurosyphilis according to the CSF tests for syphilis. Anti-NMDAR was positive in CSF and serum

  1. Anti-Aquaporin-4 Antibody-Positive Neuromyelitis Optica Presenting with Syndrome of Inappropriate Antidiuretic Hormone Secretion as an Initial Manifestation

    Directory of Open Access Journals (Sweden)

    H. Nakajima

    2011-10-01

    Full Text Available The distribution of neuromyelitis optica (NMO-characteristic brain lesions corresponds to sites of high aquaporin-4 (AQP4 expression, and the brainstem and hypothalamus lesions that express high levels of AQP4 protein are relatively characteristic of NMO. The syndrome of inappropriate antidiuretic hormone secretion (SIADH is one of the important causes of hyponatremia and results from an abnormal production or sustained secretion of antidiuretic hormone (ADH. SIADH has been associated with many clinical states or syndromes, and the hypothalamic-neurohypophyseal system regulates the feedback control system for ADH secretion. We report the case of a 63-year-old man with NMO, whose initial manifestation was hyponatremia caused by SIADH. Retrospective analysis revealed that the serum anti-AQP4 antibody was positive, and an MRI scan showed a unilateral lesion in the hypothalamus. SIADH recovered completely with regression of the hypothalamic lesion. As such, NMO should even be considered in patients who develop SIADH and have no optic nerve or spinal cord lesions but have MRI-documented hypothalamic lesions.

  2. A voxel-based morphometry study of brain volume changes in patients with neuromyelitis optica

    International Nuclear Information System (INIS)

    Duan Yunyun; Liu Yaou; Liang Peipeng; Huang Jing; Ren Zhuoqiong; Ye Jing; Dong Huiqing; Chen Hai; Li Kuncheng

    2012-01-01

    Objective: To detect changes of regional grey matter and white matter volume in patients of neuromyelitis optica (NMO) by voxel-based morphometry (VBM), and investigate its relationship with clinical variables. Methods: Conventional magnetic resonance imaging (MRI) and structural three-dimensional MRI were obtained from 20 NMO and 20 sex-and age-matched healthy volunteers. The comparison of grey matter and white matter volume between the two groups was analyzed by VBM tools of statistical parametric mapping (SPM) 5. Pearson correlation analysis was used to assess correlations between regional volume decrease and disease duration and expanded disability status scale (EDSS) scores in NMO patients. Results: Compared with normal controls, NMO patients had grey matter atrophy in several cortical regions, such as right inferior frontal gyrus (cluster size 514), left superior temporal gyrus (282), right middle temporal gyrus (229) and right insula (211) (t=3.58-5.11, AlphaSim corrected, P<0.05). White matter atrophy was found in several subcortical regions in NMO patients, such as right precentral and postcentral gyrus (cluster size 457, 110), left middle frontal gyrus (285), and right inferior parietal lobule (231) (t=2.90-4.25, AlphaSim corrected, P<0.05). Grey matter and white matter volume loss were not significantly correlated with clinical duration or EDSS score in NMO. Conclusion: By means of VBM, regional atrophy of grey matter and white matter is found in NMO patients, which may provide evidence for brain structural abnormality in NMO. (authors)

  3. preescolares desnutridos con madres con obesidad y sin obesidad

    Directory of Open Access Journals (Sweden)

    Viridiana Vanessa Conzuelo-González

    2009-01-01

    Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

  4. Variants of Interferon Regulatory Factor 5 are Associated with Neither Neuromyelitis Optica Nor Multiple Sclerosis in the Southeastern Han Chinese Population

    Institute of Scientific and Technical Information of China (English)

    Qi-Bing Liu; Lei Wu; Gui-Xian Zhao; Ping-Ping Cai; Zhen-Xin Li; Zhi-Ying Wu

    2015-01-01

    Background:Neuromyelitis optica (NMO) and multiple sclerosis (MS) are demyelinating disorders of the central nervous system.Interferon regulatory factor 5 (IRF5) is a common susceptibility gene to different autoimmune disorders.However,the association of IRF5 variants with NMO and MS patients has not been well studied.Therefore,we aimed to evaluate whether IRF5 variants were associated with NMO and MS in the Southeastern Han Chinese population.Methods:Four single nucleotide polymorphisms (SNPs) were selected and genotyped by matrix-assisted laser desorption/ionization time of flight mass spectrometry in 111 NMO patients,145 MS patients and 300 controls from Southeastern China.Results:None of these 4 SNPs was associated with NMO or MS patients.Conclusions:Our preliminary study indicates that genetic variants in IRF5 may affect neither NMO nor MS in the Southeastern Han Chinese population.Further studies with a large sample size and diverse ancestry populations are needed to clarify this issue.

  5. Fiber-optic components for optical communicatios and sensing =

    Science.gov (United States)

    Marques, Carlos Alberto Ferreira

    Nos ultimos anos, a Optoelectronica tem sido estabelecida como um campo de investigacao capaz de conduzir a novas solucoes tecnologicas. As conquistas abundantes no campo da optica e lasers, bem como em comunicacoes opticas tem sido de grande importancia e desencadearam uma serie de inovacoes. Entre o grande numero de componentes opticos existentes, os componentes baseados em fibra optica sao principalmente relevantes devido a sua simplicidade e a elevada de transporte de dados da fibra optica. Neste trabalho foi focado um destes componentes opticos: as redes de difraccao em fibra optica, as quais tem propriedades opticas de processamento unicas. Esta classe de componentes opticos e extremamente atraente para o desenvolvimento de dispositivos de comunicacoes opticas e sensores. O trabalho comecou com uma analise teorica aplicada a redes em fibra e foram focados os metodos de fabricacao de redes em fibra mais utilizados. A inscricao de redes em fibra tambem foi abordado neste trabalho, onde um sistema de inscricao automatizada foi implementada para a fibra optica de silica, e os resultados experimentais mostraram uma boa aproximacao ao estudo de simulacao. Tambem foi desenvolvido um sistema de inscricao de redes de Bragg em fibra optica de plastico. Foi apresentado um estudo detalhado da modulacao acustico-optica em redes em fibra optica de silica e de plastico. Por meio de uma analise detalhada dos modos de excitacao mecanica aplicadas ao modulador acustico-optico, destacou-se que dois modos predominantes de excitacao acustica pode ser estabelecidos na fibra optica, dependendo da frequencia acustica aplicada. Atraves dessa caracterizacao, foi possivel desenvolver novas aplicacoes para comunicacoes opticas. Estudos e implementacao de diferentes dispositivos baseados em redes em fibra foram realizados, usando o efeito acustico-optico e o processo de regeneracao em fibra optica para varias aplicacoes tais como rapido multiplexador optico add-drop, atraso de grupo

  6. La reforma del Estado de Bienestar: Derechos, deberes e igualdad de oportunidades

    Directory of Open Access Journals (Sweden)

    RICARDO MONTORO ROMERO

    1997-01-01

    Full Text Available partiendo de la situacion de crisis del estado de bienestar y basandose en los postulados defendidos por la optica de welfare mix, en este articulo se examinan la situacion de derechos y deberes propia del estado de bienestar, la necesidad de vincular la politica social con la politica economica, los limites entre la privacidad y la publicidad, y la estrecha vinculacion entre bienestar individual y bienestar publico. en este marco,

  7. Aplicación de la técnica PIXE (Particle Induced X-Ray Emision a la caracterización no destructiva de una pieza de ajuar funerario (siglo I d.c. procedente de una excavación arqueológica (antiguo Hospital de las Cinco Llagas, Sevilla

    Directory of Open Access Journals (Sweden)

    Enrique Magariño, M. E.

    2002-12-01

    performed directly on the object, which is very interesting in studies on glass and ceramics samples of the Cultural Heritage.

    En el presente trabajo se ha realizado la caracterización de una pieza de ajuar funerario del Siglo I d.C. (anillo con pieza incrustada y grabada, encontrado en una excavación arqueológica en el antiguo Hospital de las Cinco Llagas de Sevilla, de la que inicialmente se desconocía su naturaleza cerámica o vítrea, utilizando las posibilidades que brindan una serie de técnicas instrumentales no destructivas ampliamente conocidas, como son microscopía óptica convencional, MEB-EDX, DRX y FRX. En este caso concreto se ha aplicado, además, la técnica de Emisión de Rayos X inducidos por partículas (Particle Induced X-ray Emision, PIXE. Dicha técnica permite extraer información de la composición química de una muestra para un análisis rápido de múltiples elementos traza. El estudio de esta interesante pieza pone de manifiesto la extrema calidad y precisión de la talla de las figuras o motivos, en particular algunos de ellos (garza y palma a pesar del tamaño reducido de la misma, con efectos de relieve en el tallado del material aprovechando su propia constitución. El análisis de fases por DRX indica que la única fase cristalina constituyente del material es cuarzo y puede considerarse la pieza estudiada como una gema: cuarzo azul. La composición química de la gema determinada por FRX ha permitido comprobar que además de los elementos mayoritarios (Si y O, existen otros minoritarios, como son Ca y Fe (< 1,5 %, Na y Al (próximos al 0,3 %; otros elementos como Cl, K y P aparecen en porcentajes similares (0.2-0,25 %, además de Mg y S en porcentajes inferiores (ca. 0,08 %. Sin embargo, la aplicación de la técnica PIXE basada en haces de iones ha permitido determinar la presencia de Ti y V en la gema, lo que explicaría su coloración azul. Estos elementos deben encontrarse en forma iónica formando parte de la estructura

  8. Frequency of brain MRI abnormalities in neuromyelitis optica spectrum disorder at presentation: A cohort of Latin American patients.

    Science.gov (United States)

    Carnero Contentti, Edgar; Daccach Marques, Vanessa; Soto de Castillo, Ibis; Tkachuk, Veronica; Antunes Barreira, Amilton; Armas, Elizabeth; Chiganer, Edson; de Aquino Cruz, Camila; Di Pace, José Luis; Hryb, Javier Pablo; Lavigne Moreira, Carolina; Lessa, Carmen; Molina, Omaira; Perassolo, Monica; Soto, Arnoldo; Caride, Alejandro

    2018-01-01

    Brain magnetic resonance imaging (BMRI) lesions were classically not reported in neuromyelitis optica (NMO). However, BMRI lesions are not uncommon in NMO spectrum disorder (NMOSD) patients. To report BMRI characteristic abnormalities (location and configuration) in NMOSD patients at presentation. Medical records and BMRI characteristics of 79 patients with NMOSD (during the first documented attack) in Argentina, Brazil and Venezuela were reviewed retrospectively. BMRI abnormalities were observed in 81.02% of NMOSD patients at presentation. Forty-two patients (53.1%) showed typical-NMOSD abnormalities. We found BMRI abnormalities at presentation in the brainstem/cerebellum (n = 26; 32.9%), optic chiasm (n = 16; 20.2%), area postrema (n = 13; 16.4%), thalamus/hypothalamus (n = 11; 13.9%), corpus callosum (n = 11; 13.9%), periependymal-third ventricle (n = 9; 11.3%), corticospinal tract (n = 7; 8.8%), hemispheric white matter (n = 1; 1.2%) and nonspecific areas (n = 49; 62.03%). Asymptomatic BMRI lesions were more common. The frequency of brain MRI abnormalities did not differ between patients who were positive and negative for aquaporin 4 antibodies at presentation. Typical brain MRI abnormalities are frequent in NMOSD at disease onset. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. The Comparative Accuracy of the 4 {pi} Liquid Scintillation Counting Method of Radioisotope Standardization; L'exactitude comparee de la methode de comptage 4 {pi} a scintillateurs liquides pour l'etalonnage des radioisotopes; Sravnitel'naya tochnost' 4 {pi} zhidkogo stsintillatsionnogo metoda podscheta standartiziruemykh radioizotopov; Exactitud del metodo de recuento con centelleador liquido 4 {pi} para normalizar radioisotopos, comparada con la de otros metodos

    Energy Technology Data Exchange (ETDEWEB)

    Steyn, J [National Physical Research Laboratory, Pretoria (South Africa)

    1960-06-15

    The accuracy of the 4 {pi} liquid scintillation counting method of standardizing {beta} emitters was compared to 4 l{pi} {beta}-{gamma} coincidence counting for the nuclides Co{sup 60}, I{sup 131} and Au{sup 198}. For P{sup 32} the liquid counting results were compared to 4 {pi} proportional counting. The efficiency of the liquid scintillation counting method was found to be energy dependent, dropping to about 97.5% for Co{sup 60} which was the lowest energy {beta} emitter investigated. (author) [French] La precision de la methode de comptage 4 {pi} a scintillateurs liquides pour l'etalonnage des emetteurs {beta} a ete comparee au comptage par coincidences 4 {pi} {beta}-{gamma} pour le So{sup 60}, le I{sup 131} et le Au{sup 198}. Dans le cas du P{sup 32}, les resultats du comptage au liquide ont ete compares a ceux du comptage 4 {pi} proportionnel. On a constate que le rendement de la methode de comptage a scintillateurs liquides variait en fonction de l'energie emise et qu'il descendait a environ 97.5% pour le Co{sup 60} qui, de tous les emetteurs {beta} etudies, emet l'energie la plus faible. (author) [Spanish] El autor compara la precision del metodo de recuento con centelleador iquido 4 {pi} para normalizar emisores {beta} con la del metodo de coincidencias {beta}-{gamma} 4 {pi}, para los siguientes nuclidos: So{sup 60}, I{sup 131} y Au{sup 198}. En el caso del P{sup 32}, confronta los resultados del primer metodo con los obtenidos mediante el recuento proporcional 4 {pi}. Comprueba que la eficacia del metodo de recuento con centelleador liquido depende de la energia y desciende al 97.5%, aproximadamente, para el Co{sup 60}, que fue el emisor {beta} mas debil que se investigo. (author) [Russian] Tochnost' 4 {pi} zhidkogo stsintillyatsionnog o metoda podscheta standartiziruemogo {beta}-izluchatelya sravnivalas' s 4 {pi} {beta}-{gamma} metodom podscheta na sovpadeniyakh dlya izotopov So{sup 60}, I{sup 131} i Au{sup 198}. Dlya R{sup 32} rezultaty zhidkogo

  10. Early and extensive spinal white matter involvement in neuromyelitis optica.

    Science.gov (United States)

    Hayashida, Shotaro; Masaki, Katsuhisa; Yonekawa, Tomomi; Suzuki, Satoshi O; Hiwatashi, Akio; Matsushita, Takuya; Watanabe, Mitsuru; Yamasaki, Ryo; Suenaga, Toshihiko; Iwaki, Toru; Murai, Hiroyuki; Kira, Jun-Ichi

    2017-05-01

    Studies of longitudinally extensive spinal cord lesions (LESCLs) in neuromyelitis optica (NMO) have focused on gray matter, where the relevant antigen, aquaporin-4 (AQP4), is abundant. Because spinal white matter pathology in NMO is not well characterized, we aimed to clarify spinal white matter pathology of LESCLs in NMO. We analyzed 50 spinal cord lesions from eleven autopsied NMO/NMO spectrum disorder (NMOSD) cases. We also evaluated LESCLs with three or fewer spinal cord attacks by 3-tesla MRI in 15 AQP4 antibody-positive NMO/NMOSD patients and in 15 AQP4 antibody-negative multiple sclerosis (MS) patients. Pathological analysis revealed seven cases of AQP4 loss and four predominantly demyelinating cases. Forty-four lesions from AQP4 loss cases involved significantly more frequently posterior columns (PC) and lateral columns (LC) than anterior columns (AC) (59.1%, 63.6%, and 34.1%, respectively). The posterior horn (PH), central portion (CP), and anterior horn (AH) were similarly affected (38.6%, 36.4% and 31.8%, respectively). Isolated perivascular inflammatory lesions with selective loss of astrocyte endfoot proteins, AQP4 and connexin 43, were present only in white matter and were more frequent in PC and LC than in AC (22.7%, 29.5% and 2.3%, P corr  = 0.020, and P corr  = 0.004, respectively). MRI indicated LESCLs more frequently affected PC and LC than AC in anti-AQP4 antibody-seropositive NMO/NMOSD (86.7%, 60.0% and 20.0%, P corr  = 0.005, and P corr  = 0.043, respectively) and AQP4 antibody-seronegative MS patients (86.7%, 73.3% and 33.3%, P corr  = 0.063, and P corr  = 0.043, respectively). PH, CP and AH were involved in 93.3%, 86.7% and 73.3% of seropositive patients, respectively, and in 53.3%, 60.0% and 40.0% of seronegative patients, respectively. NMO frequently and extensively affects spinal white matter in addition to central gray matter, especially in PC and LC, where isolated perivascular lesions with astrocyte endfoot

  11. Ring-enhancing spinal cord lesions in neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Zalewski, Nicholas L; Morris, Padraig P; Weinshenker, Brian G; Lucchinetti, Claudia F; Guo, Yong; Pittock, Sean J; Krecke, Karl N; Kaufmann, Timothy J; Wingerchuk, Dean M; Kumar, Neeraj; Flanagan, Eoin P

    2017-03-01

    We assessed the frequency and characteristics of ring-enhancing spinal cord lesions in neuromyelitis optica spectrum disorder (NMOSD) myelitis and myelitis of other cause. We reviewed spinal cord MRIs for ring-enhancing lesions from 284 aquaporin-4 (AQP4)-IgG seropositive patients at Mayo Clinic from 1996 to 2014. Inclusion criteria were as follows: (1) AQP4-IgG seropositivity, (2) myelitis attack and (3) MRI spinal cord demonstrating ring-enhancement. We identified two groups of control patients with: (1) longitudinally extensive myelopathy of other cause (n=66) and (2) myelitis in the context of a concurrent or subsequent diagnosis of multiple sclerosis (MS) from a population-based cohort (n=30). Ring-enhancement was detected in 50 of 156 (32%) myelitis episodes in 41 patients (83% single; 17% multiple attacks). Ring-enhancement was noted on sagittal and axial images in 36 of 43 (84%) ring enhancing myelitis episodes and extended a median of two vertebral segments (range, 1-12); in 21 of 48 (44%) ring enhancing myelitis episodes, the ring extended greater than or equal to three vertebrae. Ring-enhancement was accompanied by longitudinally extensive (greater than or equal to three vertebral segments) T2-hyperintensity in 44 of 50 (88%) ring enhancing myelitis episodes. One case of a spinal cord biopsy during ring-enhancing myelitis revealed tissue vacuolation and loss of AQP4 immunoreactivity with preserved axons. The clinical characteristics of ring-enhancing myelitis episodes did not differ from non-ring-enhancing episodes. Ring-enhancing spinal cord lesions were more common in NMOSD than other causes of longitudinally extensive myelopathy (50/156 (32%) vs 0/66 (0%); p≤0.001) but did not differ between NMOSD and MS (50/156 (32%) vs 6/30 (20%); p=0.20). Spinal cord ring-enhancement accompanies one-third of NMOSD myelitis episodes and distinguishes NMOSD from other causes of longitudinally extensive myelopathies but not from MS. Published by the BMJ Publishing

  12. Application of diffusional kurtosis imaging to detect occult brain damage in multiple sclerosis and neuromyelitis optica.

    Science.gov (United States)

    Qian, Wenshu; Chan, Koon Ho; Hui, Edward S; Lee, Chi Yan; Hu, Yong; Mak, Henry Ka-Fung

    2016-11-01

    Multiple sclerosis (MS) and neuromyelitis optica (NMO) are two common types of inflammatory demyelinating disease of the central nervous system. Early distinction of NMO from MS is crucial but quite challenging. In this study, 13 NMO spectrum disorder patients (Expanded Disability Status Scale (EDSS) of 3.0 ± 1.7, ranging from 2 to 6.5; disease duration of 5.3 ± 4.7 years), 17 relapsing-remitting MS patients (EDSS of 2.6 ± 1.4, ranging from 1 to 5.5; disease duration of 7.9 ± 7.8 years) and 18 healthy volunteers were recruited. Diffusional kurtosis imaging was employed to discriminate NMO and MS patients at the early or stable stage from each other, and from healthy volunteers. The presence of alterations in diffusion and diffusional kurtosis metrics in normal-appearing white matter (NAWM) and diffusely increased mean diffusivity (MD) in the cortical normal-appearing gray matter (NAGM) favors the diagnosis of MS rather than NMO. Meanwhile, normal diffusivities and kurtosis metrics in all NAWM as well as increases in MD in the frontal and temporal NAGM suggest NMO. Our results suggest that diffusion and diffusional kurtosis metrics may well aid in discriminating the two diseases. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Painful tonic spasm in neuromyelitis optica spectrum disorders: Prevalence, clinical implications and treatment options.

    Science.gov (United States)

    Liu, Ju; Zhang, Qin; Lian, Zhiyun; Chen, Hongxi; Shi, Ziyan; Feng, Huiru; Miao, Xiaohui; Du, Qin; Zhou, Hongyu

    2017-10-01

    Painful tonic spasm (PTS) is a common symptom in patients with neuromyelitis optica spectrum disorders (NMOSD). This study aimed to obtain further insights into the prevalence, characteristics, and treatment of PTS in patients with NMOSD, and to systematically investigate and compare the clinical features and prognosis of NMOSD with and without PTS. We reviewed the medical records and prospectively interviewed patients with NMOSD who attended the West China Hospital of Sichuan University in Chengdu, China between September 2014 and December 2016. In total, 52 of the 230 patients with NMOSD experienced PTS (22.61%). Patients with NMOSD and PTS were characterized by a higher age at onset (P = 0.017), higher annual relapse rate (ARR) (P = 0.003), higher ARR of myelitis (P = 0.011), and a tendency to experience pruritus (P = 0.025). Sodium channel blocking antiepileptic drugs (carbamazepine or oxcarbazepine) had higher efficacy than gabapentin in the treatment of PTS (P = 0.001). Although the progression index was higher in patients with PTS, this difference did not reach statistical significance (P = 0.05). Our study suggested that immunosuppressors for the prevention of relapse should be administered without delay in patients with NMOSD and PTS. Owing to the side effects of carbamazepine, we recommend oxcarbazepine as the first-line of treatment for PTS in patients with NMOSD. Whether PTS is a marker of disease severity in NMOSD remains to be determined, requiring a long-term prospective observational study. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Tecnicas de etiquetado de senales opticas en redes de conmutacion de rafagas

    NARCIS (Netherlands)

    Vegas Olmos, J.J.; Tafur Monroy, I.; Koonen, A.M.J.

    2003-01-01

    En este artículo presentamos una revision de los asuntos mas importantes relacionados con las redes de conmutacion de ráfagas de señales ópticas etiquetadas (LOBS – Labeled optical burst switched) y las En este artículo presentamos una revision de los asuntos mas importantes relacionados con las

  15. Design and construction of a new furnace combustion pilot in IIE; Diseno y construccion de un nuevo horno experimental de combustion en el IIE

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Flores, Marco Antonio; Tamayo Flores, G. A. [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)]. E-mail: mamf@iie.org.mx; gatamayo@iie.org.mx

    2010-11-15

    To expand the scope of studies and technological developments in the Laboratory of Combustion of the Thermal Process Management a new experimental furnace with a capacity of 1.5 MWt was designed and built. Spray design studies with real operational evaluation (comparison of emission of Combustion products and thermal behavior) as well as information on the behavior of the NO{sub x} emissions will be produced. An automatic control system using a water cooling jacket provides the cooling of the furnace. The furnace design is modular, consisting of six sections. Currently three trials to its maximum load of operation have been performed. The results show that the global energy balance of the furnace matches the design. The flue gas residence time and temperature also match those at the exit of steam generators of big capacity. [Spanish] Para ampliar las posibilidades de estudios y desarrollos tecnologicos del laboratorio de combustion de la Gerencia de Procesos Termicos, se diseno y construyo un nuevo horno experimental con capacidad maxima de 1.5 MegaWatts termicos (MWt). Este horno permitira realizar estudios de diseno de atomizadores con evaluacion de operacion real (comparacion de emision de productos de combustion y comportamiento termico), asi como ampliar la informacion que se tiene en el comportamiento de la emision de los oxidos de nitrogeno (NO{sub x}) que se producen en el horno. El diseno del horno es modular, compuesto por seis secciones, las cuales se enfrian de forma independiente a traves de un sistema de control automatico, empleando una chaqueta de enfriamiento por la cual circula agua. Actualmente se han realizado tres encendidos hasta alcanzar su carga maxima de operacion, los resultados obtenidos muestran que el balance de energia global del horno experimental es practicamente el de diseno y cumple con las caracteristicas de tiempo de residencia y temperatura de gases a la salida del horno de Generadores de Vapor de gran capacidad.

  16. Comparison of spontaneous brain activity revealed by regional homogeneity in AQP4-IgG neuromyelitis optica-optic neuritis versus MOG-IgG optic neuritis patients: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Wang J

    2017-10-01

    Full Text Available Junqing Wang,1,* Yuan Tian,2,* Yi Shao,3,* Hui Feng,1 Limin Qin,1 Weiwei Xu,1 Hongjuan Liu,1 Quangang Xu,1 Shihui Wei,1 Lin Ma2 1Department of Ophthalmology, 2Department of Radiology, Chinese PLA General Hospital, Beijing, 3Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China *These authors contributed equally to this work Objective: Many previous studies have demonstrated that neuromyelitis optica (NMO patients have abnormalities of brain anatomy and function. However, differences in spontaneous brain activity between myelin oligodendrocyte glycoprotein (MOG-IgG ON and aquaporin 4(AQP4-neuromyelitis optica-optic neuritis (ON remain unknown. In the current study, we investigated the brain neural homogeneity in MOG-IgG ON versus AQP4-IgG NMO-ON subjects by regional homogeneity (ReHo method using magnetic resonance imaging (MRI. Patients and methods: A total of 32 NMO-ON and ON subjects (21 with AQP4-IgG+NMO-ON and 11 with MOG-IgG+ON and 34 healthy controls (HCs closely matched for age were recruited, and scans were performed for all subjects. A one-way analysis of variance (ANOVA was performed to determine the regions in which the ReHo was different across the three groups. NMO-ON and ON subjects were distinguished from HCs by a receiver operating characteristic (ROC curve. The relationship between the mean ReHo in many brain regions and clinical features in NMO subjects was calculated by Pearson correlation analysis. Results: Compared with HCs, MOG-IgG+ON subjects had significantly decreased ReHo values in the posterior lobe of the left cerebellum and increased ReHo values in the left inferior frontal gyrus, right prefrontal gyrus, and left precentral/postcentral gyrus. AQP4-IgG+NMO-ON subjects showed higher ReHo values in the left inferior frontal gyrus and right middle temporal/occipital gyrus. Compared with MOG-IgG+ON subjects, AQP4-IgG+NMO-ON subjects had lower Re

  17. The cervical spinal cord in neuromyelitis optica patients: A comparative study with multiple sclerosis using diffusion tensor imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pessôa, Fernanda Miraldi Clemente, E-mail: fernandamiraldi@hotmail.com [Federal University of Rio de Janeiro, Medical Student, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Lopes, Fernanda Cristina Rueda, E-mail: frueda81@hotmail.com [Department of Radiology, Federal University of Rio de Janeiro, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); Costa, João Victor Altamiro, E-mail: victoraltamiro@gmail.com [Department of Radiology, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Leon, Soniza Vieira Alves, E-mail: sonizavleon@globo.com [Department of Neurology, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco, 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ (Brazil); Domingues, Romeu Côrtes, E-mail: romeu@CDPi.com.br [CDPI – Clínica de Diagnóstico Por Imagem, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); Gasparetto, Emerson Leandro, E-mail: egasparetto@gmail.com [Department of Radiology, Federal University of Rio de Janeiro, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); CDPI – Clínica de Diagnóstico Por Imagem, Avenida das Américas, 4666 sl 325, Barra da Tijuca, Rio de Janeiro, RJ (Brazil)

    2012-10-15

    Introduction: This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord in patients with neuromyelitis optica (NMO), using diffusion tensor MR imaging, comparing to controls and patients with multiple sclerosis (MS). Materials and methods: We studied 8 patients with NMO and 17 without any neurologic disorder. Also, 32 MS patients were selected. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results: At C2, the FA value was decreased in NMO patients compared to MS and controls in the anterior column. Also in this column, RD value showed increase in NMO compared to MS and to controls. The FA value of the posterior column was decreased in NMO in comparison to controls. At C7, AD value was higher in NMO than in MS in the right column. At the same column, MD values were increased in NMO compared to MS and to controls. Conclusions: There is extensive NASC damage in NMO patients, including peripheral areas of the cervical spinal cord, affecting the white matter, mainly caused by demyelination. This suggests a new spinal cord lesion pattern in NMO in comparison to MS.

  18. The cervical spinal cord in neuromyelitis optica patients: A comparative study with multiple sclerosis using diffusion tensor imaging

    International Nuclear Information System (INIS)

    Pessôa, Fernanda Miraldi Clemente; Lopes, Fernanda Cristina Rueda; Costa, João Victor Altamiro; Leon, Soniza Vieira Alves; Domingues, Romeu Côrtes; Gasparetto, Emerson Leandro

    2012-01-01

    Introduction: This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord in patients with neuromyelitis optica (NMO), using diffusion tensor MR imaging, comparing to controls and patients with multiple sclerosis (MS). Materials and methods: We studied 8 patients with NMO and 17 without any neurologic disorder. Also, 32 MS patients were selected. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results: At C2, the FA value was decreased in NMO patients compared to MS and controls in the anterior column. Also in this column, RD value showed increase in NMO compared to MS and to controls. The FA value of the posterior column was decreased in NMO in comparison to controls. At C7, AD value was higher in NMO than in MS in the right column. At the same column, MD values were increased in NMO compared to MS and to controls. Conclusions: There is extensive NASC damage in NMO patients, including peripheral areas of the cervical spinal cord, affecting the white matter, mainly caused by demyelination. This suggests a new spinal cord lesion pattern in NMO in comparison to MS

  19. Dynamic simulation of an office with windows with solar control filter: cases in Mexico and Canada; Simulacion dinamica de una oficina con una ventana con filtro de control solar: casos en Mexico y Canada

    Energy Technology Data Exchange (ETDEWEB)

    Gijon Rivera, M. A.; Alvarez Garcia, G.; Xaman Villasenor, J. [Centro Nacional de Investigacion y Desarrollo Tecnologico, CENIDET-DGEST-SEP, Cuernavaca, Morelos (Mexico)]. E-mail: gaby@cenidet.edu.mx; I. Beausoleil-Morrison [Department of Mechanical and Aerospace Engineering, Carleton University, Ottawa (Canada)]. E-mail: ibeausol@mae.carleton.ca

    2010-11-15

    The use of solar passive strategies in buildings with large glazed areas such as new solar control coatings in windows are becoming more important and helpful recently, mainly because those developments can help to reduce heat gains and/or losses through transparent materials, reduce energy consumption, and improving the environment inside buildings. This paper presents an assessment of thermal performance in an office building with a SnS-Cu{sub x}S solar control coating and its influence on indoor conditions. The simulations consider climates of Mexico city and Ottawa as a good representation of two extremely conditions to asses the thermal behaviour inside offices, energy consumption, costs for air conditioning, and the influence of interior heat transfer coefficient correlations on energy consumption. The results are shown with and without the solar control coating adhered in a clear glass and in a double window configuration. The case of the system glass-film is the worst configuration as result of the high temperatures in the internal surface impacting the air point temperature and increasing the energy consumption. In general, the double glass configuration presents the best conditions, showing higher benefits for the case in Mexico City than the case of Ottawa. [Spanish] Resulta importante implementar estrategias pasivas en estudios de edificaciones con grandes areas de ventanas, como es la implementacion de nuevos materiales de control solar en vidrios que ayudan a reducir las ganancias y/o perdidas de calor a traves de los materiales transparentes, y asi reducir el consumo de energia y mejorar las condiciones del confort interior de los edificios. Este estudio realiza una evaluacion del funcionamiento termico de una pelicula selectiva de SnS-Cu{sub x}S que permite algunas ventajas termicas y opticas en el ambiente interno. Las simulaciones dinamicas consideran climas de la Ciudad de Mexico y Ottawa , con resultados que muestran las condiciones de confort

  20. Optical Coherence Tomography and Magnetic Resonance Imaging in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder.

    Science.gov (United States)

    Manogaran, Praveena; Hanson, James V M; Olbert, Elisabeth D; Egger, Christine; Wicki, Carla; Gerth-Kahlert, Christina; Landau, Klara; Schippling, Sven

    2016-11-15

    Irreversible disability in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) is largely attributed to neuronal and axonal degeneration, which, along with inflammation, is one of the major pathological hallmarks of these diseases. Optical coherence tomography (OCT) is a non-invasive imaging tool that has been used in MS, NMOSD, and other diseases to quantify damage to the retina, including the ganglion cells and their axons. The fact that these are the only unmyelinated axons within the central nervous system (CNS) renders the afferent visual pathway an ideal model for studying axonal and neuronal degeneration in neurodegenerative diseases. Structural magnetic resonance imaging (MRI) can be used to obtain anatomical information about the CNS and to quantify evolving pathology in MS and NMOSD, both globally and in specific regions of the visual pathway including the optic nerve, optic radiations and visual cortex. Therefore, correlations between brain or optic nerve abnormalities on MRI, and retinal pathology using OCT, may shed light on how damage to one part of the CNS can affect others. In addition, these imaging techniques can help identify important differences between MS and NMOSD such as disease-specific damage to the visual pathway, trans-synaptic degeneration, or pathological changes independent of the underlying disease process. This review focuses on the current knowledge of the role of the visual pathway using OCT and MRI in patients with MS and NMOSD. Emphasis is placed on studies that employ both MRI and OCT to investigate damage to the visual system in these diseases.

  1. Fatigue in patients with neuromyelitis optica spectrum disorder and its impact on quality of life.

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    Jin Myoung Seok

    Full Text Available Fatigue is a prevalent symptom and major burden in neuroimmunological diseases. In neuromyelitis optica spectrum disorder (NMOSD, a severe autoimmune central nervous system (CNS inflammatory disease with autoantibodies reactive to aquaporin-4, there are few reports about fatigue and quality of life (QOL. We aimed to evaluate the severity of fatigue and its relationship with QOL in patients with NMOSD. We prospectively studied patients with NMOSD who were in remission and seropositive for anti-aquaporin-4 antibody, and they were divided into 2 groups based on the presence of fatigue assessed using the Functional Assessment of Chronic Illness Therapy-fatigue score. Sleep quality, depression, pain, and QOL were also evaluated. A total of 35 patients were enrolled (mean age, 46.5 ± 14.1 years; female: male = 29:6, and the median Expanded Disability Status Scale (EDSS score was 2.0 (range, 0 to 8.0. The patients with fatigue (N = 25, 71.4% had poorer sleep quality and more severe depression than those without fatigue (p = 0.009 and p = 0.001. Both the physical and mental QOL scores were lower in patients with fatigue than in those without fatigue (p = 0.033 and p = 0.004. Multiple linear regression analyses showed that the degree of fatigue with EDSS score and pain were independent predictors of physical aspects of QOL (B = 0.382, p = 0.001, whereas depression was the only predictor of the mental components of QOL (B = -0.845, p = <0.001. Fatigue is a common symptom and an important predictor of QOL in patients with NMOSD.

  2. Abnormal baseline brain activity in patients with neuromyelitis optica: A resting-state fMRI study

    International Nuclear Information System (INIS)

    Liu Yaou; Liang Peipeng; Duan Yunyun; Jia Xiuqin; Wang Fei; Yu Chunshui; Qin Wen; Dong Huiqing; Ye Jing; Li Kuncheng

    2011-01-01

    Purpose: Recent immunopathologic and MRI findings suggest that tissue damage in neuromyelitis optica (NMO) is not limited to spinal cord and optic nerve, but also in brain. Baseline brain activity can reveal the brain functional changes to the tissue damages and give clues to the pathophysiology of NMO, however, it has never been explored by resting-state functional MRI (fMRI). We used regional amplitude of low frequency fluctuation (ALFF) as an index in resting-state fMRI to investigate how baseline brain activity changes in patients with NMO. Methods: Resting-state fMRIs collected from seventeen NMO patients and seventeen age- and sex-matched normal controls were compared to investigate the ALFF difference between the two groups. The relationships between ALFF in regions with significant group differences and the EDSS (Expanded Disability Status Scale), disease duration were further explored. Results: Our results showed that NMO patients had significantly decreased ALFF in precuneus, posterior cingulate cortex (PCC) and lingual gyrus; and increased ALFF in middle frontal gyrus, caudate nucleus and thalamus, compared to normal controls. Moderate negative correlations were found between the EDSS and ALFF in the left middle frontal gyrus (r = -0.436, p = 0.040) and the left caudate (r = -0.542, p = 0.012). Conclusion: The abnormal baseline brain activity shown by resting-state fMRI in NMO is relevant to cognition, visual and motor systems. It implicates a complex baseline brain status of both functional impairments and adaptations caused by tissue damages in these systems, which gives clues to the pathophysiology of NMO.

  3. Abnormal baseline brain activity in patients with neuromyelitis optica: A resting-state fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Liu Yaou [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Liang Peipeng [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); International WIC institute, Beijing University of Technology, Beijing 100024 (China); Duan Yunyun; Jia Xiuqin; Wang Fei; Yu Chunshui; Qin Wen [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Dong Huiqing; Ye Jing [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Li Kuncheng, E-mail: likuncheng1955@yahoo.com.cn [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China)

    2011-11-15

    Purpose: Recent immunopathologic and MRI findings suggest that tissue damage in neuromyelitis optica (NMO) is not limited to spinal cord and optic nerve, but also in brain. Baseline brain activity can reveal the brain functional changes to the tissue damages and give clues to the pathophysiology of NMO, however, it has never been explored by resting-state functional MRI (fMRI). We used regional amplitude of low frequency fluctuation (ALFF) as an index in resting-state fMRI to investigate how baseline brain activity changes in patients with NMO. Methods: Resting-state fMRIs collected from seventeen NMO patients and seventeen age- and sex-matched normal controls were compared to investigate the ALFF difference between the two groups. The relationships between ALFF in regions with significant group differences and the EDSS (Expanded Disability Status Scale), disease duration were further explored. Results: Our results showed that NMO patients had significantly decreased ALFF in precuneus, posterior cingulate cortex (PCC) and lingual gyrus; and increased ALFF in middle frontal gyrus, caudate nucleus and thalamus, compared to normal controls. Moderate negative correlations were found between the EDSS and ALFF in the left middle frontal gyrus (r = -0.436, p = 0.040) and the left caudate (r = -0.542, p = 0.012). Conclusion: The abnormal baseline brain activity shown by resting-state fMRI in NMO is relevant to cognition, visual and motor systems. It implicates a complex baseline brain status of both functional impairments and adaptations caused by tissue damages in these systems, which gives clues to the pathophysiology of NMO.

  4. Connexin 43 astrocytopathy linked to rapidly progressive multiple sclerosis and neuromyelitis optica.

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    Katsuhisa Masaki

    Full Text Available BACKGROUND: Multiple sclerosis (MS and neuromyelitis optica (NMO occasionally have an extremely aggressive and debilitating disease course; however, its molecular basis is unknown. This study aimed to determine a relationship between connexin (Cx pathology and disease aggressiveness in Asian patients with MS and NMO. METHODS/PRINCIPAL FINDINGS: Samples included 11 autopsied cases with NMO and NMO spectrum disorder (NMOSD, six with MS, and 20 with other neurological diseases (OND. Methods of analysis included immunohistochemical expression of astrocytic Cx43/Cx30, oligodendrocytic Cx47/Cx32 relative to AQP4 and other astrocytic and oligodendrocytic proteins, extent of demyelination, the vasculocentric deposition of complement and immunoglobulin, and lesion staging by CD68 staining for macrophages. Lesions were classified as actively demyelinating (n=59, chronic active (n=58 and chronic inactive (n=23. Sera from 120 subjects including 30 MS, 30 NMO, 40 OND and 20 healthy controls were examined for anti-Cx43 antibody by cell-based assay. Six NMO/NMOSD and three MS cases showed preferential loss of astrocytic Cx43 beyond the demyelinated areas in actively demyelinating and chronic active lesions, where heterotypic Cx43/Cx47 astrocyte oligodendrocyte gap junctions were extensively lost. Cx43 loss was significantly associated with a rapidly progressive disease course as six of nine cases with Cx43 loss, but none of eight cases without Cx43 loss regardless of disease phenotype, died within two years after disease onset (66.7% vs. 0%, P=0.0090. Overall, five of nine cases with Cx43 loss and none of eight cases without Cx43 loss had distal oligodendrogliopathy characterized by selective myelin associated glycoprotein loss (55.6% vs. 0.0%, P=0.0296. Loss of oligodendrocytic Cx32 and Cx47 expression was observed in most active and chronic lesions from all MS and NMO/NMOSD cases. Cx43-specific antibodies were absent in NMO/NMOSD and MS patients. CONCLUSIONS

  5. Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica.

    Science.gov (United States)

    Hu, Sai-Jing; Lu, Pei-Rong

    2018-01-01

    To determine the thickness of the retinal ganglion cell-inner plexiform layer (GCIPL) and the retinal nerve fiber layer (RNFL) in patients with neuromyelitis optica (NMO). We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis (ON), subjects were divided into either the NMO-ON group (30 eyes) or the NMO-ON contra group (10 eyes). A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using high-definition optical coherence tomography (OCT). In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 µm, the minimum GCIPL thickness was 66.02±10.02 µm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 µm, the minimum GCIPL thickness was 25.39±25.1 µm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 µm, the minimum GCIPL thickness was 85.28±10.75 µm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 µm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group ( P deviation (MD) and corrected pattern standard deviation (PSD) in the NMO-ON group ( P <0.05). The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.

  6. Adult methylmalonic acidemia presented as neuromyelitis optica: one case report

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    Sheng-de LI

    2015-10-01

    Full Text Available A 26-year-old male was admitted to our department, complaining of cognitive impairment, urine incontinence for 3 months, blurred vision for one month and numbness of bilateral lower limbs for 20 days. Presumed as “depression” and “viral encephalitis”, antidepressant and dexamethasone had been given but had no response. Neurological examination demonstrated impaired orientation to time and place; hearing impairment of right ear; normal muscle force in upper limbs, proximal lower muscle force was 2 and distal was 0; normal tendon reflex in both upper limbs; diminished tendon reflex in both lower limbs; left palmomental reflex (+; bilateral Babinski sign (+. Below T10: diminished superficial, deep sensation and cortical sensory. Cranial MRI on admission revealed widened sulci in bilateral cleft and frontal, temporal and insular lobes, indicating brain atrophy. Spinal MRI revealed high-intensity signals of C3-7 level and T1-12 level. The patient was diagnosed as “neuromyelitis optica (NMO” at first, but cognitive impairment is really rare in NMO. It finally turned out to be “inherited metabolic diseases” with the negative results of aquaporin 4 (AQP4, NMO-IgG, GM1, voltage-gated potassium channel (VGKC from serum and cerebrospinal fluid (CSF. The elevated level of plasm homocysteine [30.79 mmol/L (5-20 mmol/L] and urine methylmalonic acid [0.40 mmol/L (0.001 mmol/L] ascertained the diagnosis of methylmalonic acidemia. The patient was given oral treatment of folate 5 mg (3 times a day, 13 days and levocarnitine 1 g (3 times a day, 8 days and intramuscular injection of mecobalamine 1mg (once a day, 4 days or 0.50 mg (once a day, 8 days and adenosylcobalamine 0.50 mg (once a day, 8 days. Sixteen days on discharge, the patient’s neurological examination revealed no obvious recovery of vision; lower muscle force: about Ⅳ, right sensory level: T12-L1, and left sensory level lowered to L3. Reexamination of MRI revealed brain atrophy

  7. Cognitive performance of neuromyelitis optica patients: comparison with multiple sclerosis

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    Sandra Vanotti

    2013-06-01

    Full Text Available The aim of the present research was to investigate cognitive pattern of patients with neuromyelitis optica (NMO and to compare it with multiple sclerosis (MS patients' performance. Methods: Fourteen NMO, 14 relapsing remitting multiple sclerosis (RRMS, and 14 healthy control patients participated in the investigation. Neuropsychological functions were evaluated with the Brief Repeatable Neuropsychological Battery for MS; Symbol Digit Modalities Test; Digit Span; and Semantic Fluency. Results: Fifty-seven percent of NMO patients and 42.85% of the MS ones had abnormal performance in at least two cognitive tests. The NMO Group showed abnormal performance in verbal fluency, verbal and visual memories, with greater attention deficits. NMO patients outperformed healthy control in the paced auditory serial addition test (PASAT. However, no difference was found between NMO and RRMS patients. Conclusions: The NMO Group showed more dysfunction in attention and verbal fluencies than in verbal and visual memories. When compared with the MS patients, a similar dysfunction pattern was found. O objetivo da presente pesquisa foi investigar o padrão cognitivo de pacientes com neuromielite óptica (NMO e compará-lo com o desempenho de pacientes com esclerose múltipla (EM. Métodos: Quatorze pacientes com NMO, 14 com esclerose múltipla recorrente remitente (EMRR e 14 participantes do Controle saudáveis participaram da presente investigação. As funções neuropsicológicas foram avaliadas com a Bateria Breve de Testes Neuropsicológicos de Rao, Teste Símbolo Digit e a Fluência Semântica. Resultados: Cinquenta e sete por cento dos pacientes com NMO e 42,85% daqueles com EM apresentaram desempenho anormal em pelo menos dois testes cognitivos. O Grupo NMO apresentarou desempenho anormal na fluência verbal e nas memórias visual e verbal, com maiores déficits de atenção. Pacientes com NMO superaram os controles saudáveis em PASAT. No entanto, não foi

  8. Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response.

    Science.gov (United States)

    Stellmann, Jan-Patrick; Krumbholz, Markus; Friede, Tim; Gahlen, Anna; Borisow, Nadja; Fischer, Katrin; Hellwig, Kerstin; Pache, Florence; Ruprecht, Klemens; Havla, Joachim; Kümpfel, Tania; Aktas, Orhan; Hartung, Hans-Peter; Ringelstein, Marius; Geis, Christian; Kleinschnitz, Christoph; Berthele, Achim; Hemmer, Bernhard; Angstwurm, Klemens; Young, Kim Lea; Schuster, Simon; Stangel, Martin; Lauda, Florian; Tumani, Hayrettin; Mayer, Christoph; Zeltner, Lena; Ziemann, Ulf; Linker, Ralf Andreas; Schwab, Matthias; Marziniak, Martin; Then Bergh, Florian; Hofstadt-van Oy, Ulrich; Neuhaus, Oliver; Zettl, Uwe; Faiss, Jürgen; Wildemann, Brigitte; Paul, Friedemann; Jarius, Sven; Trebst, Corinna; Kleiter, Ingo

    2017-08-01

    To analyse predictors for relapses and number of attacks under different immunotherapies in patients with neuromyelitis optica spectrum disorder (NMOSD). This is a retrospective cohort study conducted in neurology departments at 21 regional and university hospitals in Germany. Eligible participants were patients with aquaporin-4-antibody-positive or aquaporin-4-antibody-negative NMOSD. Main outcome measures were HRs from Cox proportional hazard regression models adjusted for centre effects, important prognostic factors and repeated treatment episodes. 265 treatment episodes with a mean duration of 442 days (total of 321 treatment years) in 144 patients (mean age at first attack: 40.9 years, 82.6% female, 86.1% aquaporin-4-antibody-positive) were analysed. 191 attacks occurred during any of the treatments (annual relapse rate=0.60). The most common treatments were rituximab (n=77, 111 patient-years), azathioprine (n=52, 68 patient-years), interferon-β (n=32, 61 patient-years), mitoxantrone (n=34, 32.1 patient-years) and glatiramer acetate (n=17, 10 patient-years). Azathioprine (HR=0.4, 95% CI 0.3 to 0.7, p=0.001) and rituximab (HR=0.6, 95% CI 0.4 to 1.0, p=0.034) reduced the attack risk compared with interferon-β, whereas mitoxantrone and glatiramer acetate did not. Patients who were aquaporin-4-antibody-positive had a higher risk of attacks (HR=2.5, 95% CI 1.3 to 5.1, p=0.009). Every decade of age was associated with a lower risk for attacks (HR=0.8, 95% CI 0.7 to 1.0, p=0.039). A previous attack under the same treatment tended to be predictive for further attacks (HR=1.5, 95% CI 1.0 to 2.4, p=0.065). Age, antibody status and possibly previous attacks predict further attacks in patients treated for NMOSD. Azathioprine and rituximab are superior to interferon-β. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Diffusion-weighted imaging helps differentiate multiple sclerosis and neuromyelitis optica-related acute optic neuritis.

    Science.gov (United States)

    Wan, Hailin; He, Huijin; Zhang, Fang; Sha, Yan; Tian, Guohong

    2017-06-01

    To evaluate the apparent diffusion coefficient (ADC) values between multiple sclerosis (MS) and neuromyelitis optica (NMO)-related acute optic neuritis (ON) patients and predict their optic nerve atrophy of optic coherence tomography (OCT) parameters. Nineteen MS and 15 NMO-related acute ON patients who underwent a diffusion-weighted imaging sequence in 3.0 Tesla MR scanner and a follow-up OCT examination after 6 months were included. The ADC values, thickness of the retinal nerve fiber layer (RNFL) and the macular ganglion cell complex (GCC) between MS and NMO related ON were assessed. The mean ADC value of the NMO-ON, (0.691 ± 0.195[SD]) × 10 -3 mm 2 /s, was significantly smaller (P = 0.0133) than that of MS-ON. The mean ADC value of MS-ON, (0.879 ± 0.144) × 10 -3 mm 2 /s, was significantly smaller (P < 0.0001) than that of control group, (1.025 ± 0.067) × 10 -3 mm 2 /s. Using an ADC value smaller than 0.830 × 10 -3 mm 2 /s as the threshold value for differentiating MS-ON from NMO-ON patients, the highest accuracy of 76.7%, with 75.0% sensitivity and 78.3% specificity, was obtained. The ADC value measured at the acute stage of ON was correlated with the thickness of the RNFL (r = 0.441; P = 0.006) and the GCC (r = 0.526; P < 0.0001) after 6 months. The ADC value might be helpful for differentiating MS-ON from NMO-ON patients. The decreased ADC value was correlated with optic nerve atrophy on OCT. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1780-1785. © 2016 International Society for Magnetic Resonance in Medicine.

  10. con dietas suplementadas con Cromo-L-metionina

    Directory of Open Access Journals (Sweden)

    Ram\\u00F3n Garc\\u00EDa-Castillo

    2006-01-01

    Full Text Available Un total de 48 cerdos (Sus scrofa domesticus; 24 machos castrados y 24 hembras cruzados (Yorkshire, Hampshire, Duroc y Landrace de 3,5 a 4,0 meses de edad y 60,0 ± 5,0 kg PV en finalización. Se alimentaron con dietas isoproteícas (14,5 % PC e isoenergéticas (3.400 kcal EM/kg de MS, adicionadas con Cr-L-metionina (MiCroPlex® (0, 200, 400 y 600 ppb. El experimento tuvo una duración de 45 días y se realizó de agosto a noviembre del 2002 en las instalaciones de la Universidad Autónoma Agraria Antonio Narro, localizada en Saltillo, Coahuila, México. Al tener los animales aproximadamente 95 kg PV, se tomó muestra de 15 ml de sangre por cada animal para determinar la concentración de glucosa, ácido úrico, creatinina, urea, proteinas totales y colesterol. Se aplicó un diseño completamente al azar con arreglo factorial 2 x 4; dos para el factor sexo y cuatro para nivel de cromo. Los metabolitos en suero no fueron afectados (P>0,05 por el factor sexo. La glucosa en suero disminuyó (P<0,05 y el colesterol incrementó (P<0,05 con cromo en la dieta. Se concluye que el Cr incrementa el metabolismo de glucosa y disminuye el de colesterol, con lo cual puede haber energía disponible para síntesis de proteína la cual es necesaria para el crecimiento de los animales

  11. Quantitative Susceptibility Mapping Indicates a Disturbed Brain Iron Homeostasis in Neuromyelitis Optica - A Pilot Study.

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    Thomas Martin Doring

    Full Text Available Dysregulation of brain iron homeostasis is a hallmark of many neurodegenerative diseases and can be associated with oxidative stress. The objective of this study was to investigate brain iron in patients with Neuromyelitis Optica (NMO using quantitative susceptibility mapping (QSM, a quantitative iron-sensitive MRI technique. 12 clinically confirmed NMO patients (6 female and 6 male; age 35.4y±14.2y and 12 age- and sex-matched healthy controls (7 female and 5 male; age 33.9±11.3y underwent MRI of the brain at 3 Tesla. Quantitative maps of the effective transverse relaxation rate (R2* and magnetic susceptibility were calculated and a blinded ROI-based group comparison analysis was performed. Normality of the data and differences between patients and controls were tested by Kolmogorov-Smirnov and t-test, respectively. Correlation with age was studied using Spearman's rank correlation and an ANCOVA-like analysis. Magnetic susceptibility values were decreased in the red nucleus (p0.95; between -15 and -22 ppb depending on reference region with a trend toward increasing differences with age. R2* revealed significantly decreased relaxation in the optic radiations of five of the 12 patients (p<0.0001; -3.136±0.567 s-1. Decreased relaxation in the optic radiation is indicative for demyelination, which is in line with previous findings. Decreased magnetic susceptibility in the red nucleus is indicative for a lower brain iron concentration, a chemical redistribution of iron into less magnetic forms, or both. Further investigations are necessary to elucidate the pathological cause or consequence of this finding.

  12. Diffusion tensor imaging of brain in relapsing neuromyelitis optica

    International Nuclear Information System (INIS)

    Yu Chunshui; Li Kuncheng; Qin Wen; Lin Fuchun; Jiang Tianzi

    2007-01-01

    Objective: To investigate the presence of occult brain tissue damage in patients with relapsing neuromyelitis optica (RNMO) and its possible mechanism by using diffusion tensor imaging (DTI). Methods: DTI scans were performed in 16 patients with RNMO and 16 sex- and age-matched healthy controls. Histogram analysis of mean diffusivity (MD) and fractional anisotropy (FA) was performed in brain tissue (BT), white matter (WM) and gray matter (GM) to detect the presence of occult brain tissue damage in RNMO patients. Region of interest (ROI) analysis of MD and FA was also performed in 6 dedicated regions with or without direct connection with spinal cord or optic nerve to determine the relationship between occult brain tissue damage and the damage of spinal cord and optic nerve. Results Patients with RNMO had a significantly higher average MD of the BT [RNMO (0.95 ± 0.02) x 10 -3 mm 2 /s, controls (0.91 ± 0.03) x 10 -3 mm 2 /s, t=3.940, P -3 mm 2 /s, controls(0.80 ± 0.02) x 10 -3 mm 2 /s, t=3.117, P=0.004] an.d GM [RNMO (1.06 ± 0.04) x 10 -3 mm 2 /s, controls (0.88 ± 0.05) x 10 -3 mm 2 /s, t=4.031, P -3 mm 2 /s, controls (0.81 ± 0.02) x 10 -3 mm 2 /s, t=4.373, P -3 mm 2 /s, controls (1.11 ± 0.10) x 10 -3 mm 2 /s, t=4.260, P -3 mm 2 /s, controls (0.87 ± 0.05) x 10 -3 mm 2 /s, t4.391, P -3 mm 2 /s, controls (0.72 ± O.01) x 10 -3 mm 2 /s, t=4.683, P -3 mm 2 /s, controls (0.82+0.03) x 10-3 mm2/s, t = 4. 619, P -3 mm 2 /s, controls (0.73±0.03) x 10 -3 mm 2 /s, t =2.804, P=0.009 and splenium of corpus callosum: RNMO(0.77 ± 0.05) x 10 -3 mm 2 /s, controls (0.73 ± 0.04) x 10 -3 mm 2 /s, t=2.234, P=0.033] and FA [genu of corpus callosum: RNMO 0.82± 0.03 ,controls 0.82 ± 0.03, t=0.196, P=0.846 and splenium of corpus caltosum: RNMO 0.83±0.03, controls 0.83 ± 0.02, t=0.333, P=0.741] between RNMO patients and controls. Conclusion: RNMO patients have occult brain tissue damage, which might be related to the antegrade and retrograde degeneration secondary to lesions in

  13. Study of optic nerve in patients with neuromyelitis optica using diffusion tensor imaging

    International Nuclear Information System (INIS)

    Chen Zhiye; Zhu Lijun; Lou Xin; Li Jinfeng; Yang Yang; Ma Lin

    2012-01-01

    Objective: To explore the diagnostic value of optic diffusion tensor imaging (DTI) in detecting the impairment of optic nerve in neuromyelitis optica (NMO) patients. Methods: Conventional MRI and optic DTI were performed in 28 NMO patients and 38 normal controls (NC). Fractional anisotropy (FA) values were measured in the anterior part, middle part and posterior part of intraorbital segment of optic nerve. The patients were classified into 3 groups based on the impairment of vision and visual evoked potential (VEP): monocular impairment (MI) group, 10 eyes; biocular impairment (BI) group, 36 eyes; and normal-appearing (NA) group, 10 eyes. All patients were performed with the evaluation of expanded disability status scale (EDSS). One-way analysis of variance (ANOVA), receiver operating characteristic (ROC) curve, and Spearman correlation analysis were performed among the subgroups of NMO and normal controls. Results: There was significantly statistical difference between the four groups (F=43.54, P<0.01). Decreased FA values were demonstrated in the MI group (0.29 ±0.08), BI group (0.27 ±0.08), and NA group (0.35 ±0.13) compared with NC (0.45 ±0.07) (P<0.01). FA value in BI group was significantly lower than that of NA group (P<0.01). Area under curve by ROC analysis in NC vs MI, NC vs BI, NC vs NA, and NC vs NMO was 0.92, 0.95, 0.74, and 0.91, respectively. The diagnostic sensitivity of ROC was 80%, 86%, 50%, and 79%, respectively. The diagnostic specificity of ROC was 95% for the each compared groups. FA value showed no correlation with EDSS for each NMO groups, and showed negative correlation with disease duration for BI group (r=-0.371, P<0.05). Conclusions: Various degrees of optic nerve injuries, indicated by decreased FA value,are present in NMO patients, and optic DTI may be a simple and effective tool for the quantitative evaluation of optic nerve in NMO patients. (authors)

  14. The photo refractive polymers, physics and photonic applications of these new materials; Los polimeros fotorrefractivos, fisica y aplicaciones fotonicas de estos nuevos materiales

    Energy Technology Data Exchange (ETDEWEB)

    Maldonado, J. L. [Centro de Investigacion en Optica, Leon, Guanajuato (Mexico); Garcia M, J. [Universidad Nacional Autonoma de Mexico, Mexico, D.F. (Mexico)

    2001-12-01

    This paper is a review about the new photo refractive organic materials and their potential photonic applications, the photo refractive polymers. The physical properties required for observing photo refractivity, including charge generation, transport, and nonlinear optical properties are discussed for amorphous polymers. The nonlinear optical properties on a macroscopic level are related to the microscopic properties by using the Oriented Gas model. Four Wave Mixing (FWM) and Two Beam Coupling (TBC) experiments, to investigate the photo refractive properties of the material by measuring the diffraction efficiency {eta} of the polymeric gratings, and the optical gain coefficient {eta} are described. Kogelnik's Coupled Wave model to describe the photo refractive polymeric gratings is reviewed. Finally some applications of these new polymers are presented. [Spanish] Este articulo es una revision sobre los nuevos materiales organicos fotorrrefractivos y sus potenciales aplicaciones fotonicas: los polimeros fotorrefractivos. Se discuten las propiedades fisicas requeridas para observar fotorrefractividad, incluyendo la generacion de cargas, el transporte y las propiedades opticas no lineales en polimeros amorfos. Usando el modelo de gas orientado, se muestra como se relacionan las propiedades opticas no lineales a nivel marcoscopico con las propiedades microscopicas. Se describen los experimentos de mezcla de cuatro ondas (FWM) y dos ondas (TBC) para investigar las propiedades fotorrefractivas del material, midiendo la eficiencia de difraccion {eta} de las rejillas polimericas y el coeficiente de ganancia optica {eta}. Se revisa el modelo de ondas acopladas de Kogelnik para describir las rejillas polimericas fotorrefractivas. Finalmente se presentan algunas aplicaciones de estos nuevos polimeros.

  15. Estudio espectroscópico de la radiación electromagnética ultravioleta, visible e infrarroja cercana sobre la obra pictórica.

    OpenAIRE

    D'ANTONI, PABLO LUIS

    2013-01-01

    La Tesis "Estudio Espectroscópico de la Radiación Electromagnética, Ultravioleta Visible e Infrarroja cercana sobre la Obra Pictórica" de Pablo D'Antoni desarrolla un método no invasivo para caracterizar, medir y predecir daños a los pigmentos y aglutinantes en obras pictóricas, probablemente por la radiación electromagnética (REM). Usando 3 formas de Espectroscopia: 1) Irradiancia, 2) FORS(Espectroscopía de Reflectancia (y Absorbancia) con Fibra Optica, se analizan los efectos producidos por...

  16. Extended emission-line regions in active galaxies

    International Nuclear Information System (INIS)

    Hutchings, J.B.; Hickson, P.

    1988-01-01

    Long-slit spectra of four active galaxies in the redshift range 0.06-0.10 are presented. Two have interacting companions. Spectra of the galaxies show extended narrow emission lines in all cases. Continuum color changes, emision-line ratio changes, and velocity changes with 1 arcsec resolution can be detected. Relative velocities between AGN and companion galaxies are also given. These objects appear to lie in galaxies in which there is considerable star-formation activity, and very extended line emision. 20 references

  17. Tratamiento con implantes Leader-Nano en paciente con oligodoncia

    Directory of Open Access Journals (Sweden)

    Salvador Javier Santos Medina

    2015-03-01

    Full Text Available Los implantes dentales de titanio han revolucionado el mundo de la rehabilitación desde su surgimiento. De manera particular, el empleo de implantes de carga inmediata acorta el tiempo quirúrgico y protésico, con el consiguiente bienestar estético. Se presenta el caso de una paciente femenina de 32 años de edad, con antecedentes de oligodoncia de ambos incisivos laterales superiores y portadora de prótesis parcial acrílica. Fue atendida por el equipo multidisciplinario de implantes en la Clínica Estomatológica Docente “3 de Octubre” y se le realizó tratamiento de rehabilitación integral con implantes Leader-Nano y prótesis fija con corona acrílica sobre dichos implantes. La implantología fue satisfactoria en la paciente; la mejoría estética y funcional, así como la satisfacción de la paciente, fueron los principales logros obtenidos

  18. Development of a patient-centred conceptual framework of health-related quality of life in neuromyelitis optica: a qualitative study.

    Science.gov (United States)

    Methley, Abigail M; Mutch, Kerry; Moore, Perry; Jacob, Anu

    2017-02-01

    Neuromyelitis optica (NMO) is an auto-immune disease that can cause severe visual and mobility impairments. Research on health-related quality of life (HRQoL) in NMO is scarce, limiting knowledge on factors influencing HRQoL and support needs. This study provides the first qualitative exploration of HRQoL in NMO, conducted to provide a conceptual framework for the development of an NMO patient-reported outcome measure. Fifteen people with NMO (aged 18-74; 11 women, 4 men) participated in semi-structured interviews; data were analysed using constant comparative analysis. HRQoL in NMO is a multifaceted concept incorporating highly subjective perceptions of normality and meaning. Four major themes were identified: impact of physical symptoms on daily living, utilizing support to achieve independence, expectations for life and meaningful roles in life and purpose. Themes highlighted the importance of perceived normality, and its relationship to attaining life goals comparable to peers, as underpinning evaluations of HRQoL. Many people with severe disability reported a high HRQoL, suggesting the inappropriateness of assuming a negative HRQoL on the basis of an individual's neurological impairment. These findings further the conceptual understanding of HRQoL in NMO, informing patient-care approaches and the development of an NMO-specific patient-reported outcome measure. © 2015 The Authors. Health Expectation published by John Wiley & Sons Ltd.

  19. Experiencias de haber crecido con un padre/madre con trastorno mental severo (TMS)

    OpenAIRE

    Vivanco B, Gabriela; Grandón F, Pamela

    2016-01-01

    Introducción. La experiencia de vivir con personas que presentan un Trastorno Mental Severo (TMS) es difícil para las familias, en especial para los hijos quienes han sido poco estudiados. El objetivo de la investigación fue conocer cómo la experiencia de haber vivido con un padre o madre con un trastorno mental severo influyó en la infancia, adolescencia y adultez joven de sus hijos e hijas. Método. Se analizan las experiencias de convivencia con un padre/madre con TMS en 10 hijos (6 hombres...

  20. Aquaporin-4 antibody in neuromyelitis optica: re-testing study in a large population from China.

    Science.gov (United States)

    Long, Youming; Liang, Junyan; Zhong, Rong; Wu, Linzhan; Qiu, Wei; Lin, Shaopeng; Gao, Cong; Chen, Xiaohui; Zheng, Xueping; Yang, Ning; Gao, Min; Wang, Zhanhang

    2017-09-01

    Aquaporin-4 (AQP4) antibody sero-positivity is critically important in neuromyelitis optica (NMO). However, the sensitivity of different assays is highly variable. Repeating detection with a highly sensitive assay in a large population is necessary in the case of so-called negative NMO. Retrospective analysis where AQP4 antibodies were detected by commercial cell-based assay (CBA), in-house M23-CBA and in-house M1-CBA. Of the 1011 serum samples, 206 (20.4%) were sero-positive by primary commercial CBA. In the retest, all 206 participants positive by primary commercial CBA also yielded positive results by in-house M23-CBA and the second commercial CBA again, but only 124 positive in in-house M1-CBA. Among the 805 participants negative by primary commercial CBA, 71 participants were positive for in-house M23-CBA, of which 20 participants were positive for the second commercial CBA, and none were positive by in-house M1-CBA. Of the 171 cerebral spinal fluid samples, 75 (43.9%) were positive by primary commercial CBA. All 75 participants positive by primary commercial CBA also yielded positive results by in-house M23-CBA and the second commercial CBA. Forty-nine (65.3%) of these 75 participants were positive by in-house M1-CBA. Among the 96 participants negative by primary commercial CBA, 15 participants were positive for in-house M23-CBA and none were positive by in-house M1-CBA and the second commercial CBA. Different AQP4 isoforms in CBA result in different detection effects, and in-house M23-CBA is the most sensitive method. Some AQP4 antibody-negative NMO may be subject to diagnostic uncertainty due to limitations of the assays.

  1. Low T3 syndrome in neuromyelitis optica spectrum disorder: Associations with disease activity and disability.

    Science.gov (United States)

    Cho, Eun Bin; Min, Ju-Hong; Cho, Hye-Jin; Seok, Jin Myoung; Lee, Hye Lim; Shin, Hee Young; Lee, Kwang-Ho; Kim, Byoung Joon

    2016-11-15

    Neuromyelitis optica (NMO) sometimes coexists with serological marker-positive, non-organ-specific autoimmune disorders. We evaluated the prevalence of thyroid dysfunction and anti-thyroid antibodies in patients with NMO spectrum disorder (NMOSD) and investigated the associations between thyroid dysfunction/autoimmunity and clinical features of NMOSD. Forty-nine NMOSD patients with anti-aquaporin-4 antibody and 392 age- and sex-matched healthy controls were included. We measured the levels of thyroid hormones and anti-thyroid antibodies. The prevalence of clinical hypothyroidism, subclinical hyperthyroidism, and low T3 syndrome were higher in patients with NMOSD (4.1%, 12.2%, and 20.4%, respectively) compared with healthy controls (0.3%, 2.8%, and 0.5%, respectively; p=0.034, p=0.001, and p<0.001, respectively). However, anti-thyroperoxidase antibody (anti-TPO)-positivity did not significantly differ between NMOSD patients (20.4%) and controls (11.5%). Low T3 syndrome was more prevalent among patients during an attack (N=10/19, 52.6%) than those in remission (N=1/30, 3.3%). In addition, patients with low T 3 syndrome had significantly higher EDSS scores at the last visits as well as at sampling compared to those without low T3 syndrome. T3 levels were inversely correlated with EDSS score at the last visit after adjustment for age, sex, disease duration, clinical status (attack vs. remission), oral prednisolone use, iv methylprednisolone use, other immunosuppressive agents use, and the location of lesion (ρ=-0.416, p=0.010). Our study suggests that thyroid dysfunction is frequent in patients with NMOSD; particularly, serum T3 levels may be a useful indicator of disease activity and disability in NMOSD. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Experimental mouse model of optic neuritis with inflammatory demyelination produced by passive transfer of neuromyelitis optica-immunoglobulin G

    Science.gov (United States)

    2014-01-01

    Background Although optic neuritis (ON) is a defining feature of neuromyelitis optica (NMO), appropriate animal models of NMO ON are lacking. Most NMO patients are seropositive for immunoglobulin G autoantibodies (NMO-IgG) against the astrocyte water channel aquaporin-4 (AQP4). Methods Several approaches were tested to develop a robust, passive-transfer mouse model of NMO ON, including NMO-IgG and complement delivery by: (i) retrobulbar infusion; (ii) intravitreal injection; (iii) a single intracranial injection near the optic chiasm; and (iv) 3-days continuous intracranial infusion near the optic chiasm. Results Little ON or retinal pathology was seen using approaches (i) to (iii). Using approach (iv), however, optic nerves showed characteristic NMO pathology, with loss of AQP4 and glial fibrillary acidic protein immunoreactivity, granulocyte and macrophage infiltration, deposition of activated complement, demyelination and axonal injury. Even more extensive pathology was created in mice lacking complement inhibitor protein CD59, or using a genetically modified NMO-IgG with enhanced complement effector function, including significant loss of retinal ganglion cells. In control studies, optic nerve pathology was absent in treated AQP4-deficient mice, or in wild-type mice receiving control (non-NMO) IgG and complement. Conclusion Passive transfer of NMO-IgG and complement by continuous infusion near the optic chiasm in mice is sufficient to produce ON with characteristic NMO pathology. The mouse model of NMO ON should be useful in further studies of NMO pathogenesis mechanisms and therapeutics. PMID:24468108

  3. Development of an Aquaporin-4 Orthogonal Array of Particle-Based ELISA for Neuromyelitis Optica Autoantibodies Detection.

    Directory of Open Access Journals (Sweden)

    Francesco Pisani

    Full Text Available Serological markers of Nuromyelitis Optica (NMO, an autoimmune disorder of the central nervous system, are autoantibodies targeting the astrocytic water channel aquaporin-4 (AQP4. We have previously demonstrated that the main epitopes for these autoantibodies (AQP4-IgG are generated by the supramolecular arrangement of AQP4 tetramers into an Orthogonal Array of Particles (OAPs. Many tests have been developed to detect AQP4-IgG in patient sera but several procedural issues affect OAP assembly and consequently test sensitivity. To date, the protein based ELISA test shows the lowest sensitivity while representing a valid alternative to the more sensitive cell based assay (CBA, which, however, shows economic, technical and interpretation problems. Here we have developed a high perfomance ELISA in which native OAPs are used as the molecular target. To this aim a native size exclusion chromatography method has been developed to isolate integral, highly pure and AQP4-IgG-recognized OAPs from rat brain. These OAPs were immobilized and oriented on a plastic plate by a sandwich approach and 139 human sera were tested, including 67 sera from NMO patients. The OAP-ELISA showed a 99% specificity and a higher sensitivity (91% compared to the CBA test. A comparative analysis revealed an end-point titer three orders of magnitude higher than the commercial ELISA and six times higher than our in-house CBA test. We show that CNS-extracted OAPs are crucial elements in order to perform an efficient AQP4-IgG test and the OAP-ELISA developed represents a valid alternative to the CBA currently used.

  4. A treatable cause of myelopathy and vision loss mimicking neuromyelitis optica spectrum disorder: late-onset biotinidase deficiency.

    Science.gov (United States)

    Yilmaz, Sanem; Serin, Mine; Canda, Ebru; Eraslan, Cenk; Tekin, Hande; Ucar, Sema Kalkan; Gokben, Sarenur; Tekgul, Hasan; Serdaroglu, Gul

    2017-06-01

    Biotinidase deficiency is characterized by severe neurological manifestations as hypotonia, lethargy, ataxia, hearing loss, seizures and developmental retardation in its classical form. Late-onset biotinidase deficiency presents distinctly from the classical form such as limb weakness and vision problems. A 14-year-old boy presented with progressive vision loss and upper limb weakness. The patient was initiated steroid therapy with a preliminary diagnosis of neuromyelitis optica spectrum disorder due to the craniospinal imaging findings demonstrating optic nerve, brainstem and longitudinally extensive spinal cord involvement. Although the patient exhibited partial clinical improvement after pulse steroid therapy, craniocervical imaging performed one month after the initiation of steroid therapy did not show any regression. The CSF IgG index was <0.8 (normal: <0.8), oligoclonal band and aquaporin-4 antibodies were negative. Metabolic investigations revealed a low biotinidase enzyme activity 8% (0.58 nmoL/min/mL; normal range: 4.4 to 12). Genetic testing showed c.98-104delinsTCC and p.V457 M mutations in biotinidase (BTD) gene. At the third month of biotin replacement therapy, control craniospinal MRI demonstrated a complete regression of the lesions. The muscle strength of the case returned to normal. His visual acuity was 7/10 in the left eye and 9/10 in the right. The late-onset form of the biotinidase deficiency should be kept in mind in all patients with myelopathy with or without vision loss, particularly in those with inadequate response to steroid therapy. The family screening is important to identify asymptomatic individuals and timely treatment.

  5. Longitudinally extensive transverse myelitis in neuromyelitis optica: a prospective study of 13 Caucasian patients and literature review.

    Science.gov (United States)

    Bălaşa, Rodica; Maier, Smaranda; Bajko, Zoltan; Motataianu, Anca; Crişan, Alexandra; Bălaşa, Adrian

    2015-12-01

    Neuromyelitis optica (NMO) is a homogenous disease that can be diagnosed by an association of clinical, neuroimaging and serological aspects. We analysed our 4 years NMO series with longitudinally extensive transverse myelitis (LETM) during the disease course. We included consecutive adult Caucasian patients who were diagnosed with definite NMO, or cases of NMO-IgG seropositive LETM considered as limited forms of NMO. Patients included were negative for other diseases (autoimmune, infectious, etc.). We report the Expanded Disability Status Scale (EDSS), brain and spine MRI, CSF, NMO-IgG, treatment, motor and visual outcome. Thirteen cases fulfilled the inclusion criteria, and the mean follow-up period was 3.74 ± 1.8 years. The initial motor deficit was severe with the mean value of motor functional parameter of 4.46 ± 1 and improved at discharge to 2.53 ± 1.4 (p < 0.001). With treatment, the outcome after LETM attack was good in 10 patients, with a significant improvement of the EDSS mainly upon motor deficit, while visual function had a very slight amelioration. The CSF analysis was normal in 8 cases; spinal MRI showed evidence of LETM in all patients while brain MRI was normal in 7. NMO-IgG is a biomarker for NMO that is of diagnostic value in cases of isolated LETM. LETM has a better outcome than ON in NMO Caucasians. Spinal MRI is essential for NMO diagnosis in the presence of LETM and the absence of multiple brain MRI lesions. Maintenance immunosuppressive therapy reduces the frequency of attacks.

  6. Aspectos Psicosociales Relacionados con el TEPT en Pacientes con Cáncer de Mama

    OpenAIRE

    Hernández Moreno, Fresia Paloma; Landero Hernández, René

    2015-01-01

    El objetivo del estudio fue analizar la relación del estrés, la depresión y las estrategias de afrontamiento con el Trastorno de Estrés Postraumático (TEPT) en una muestra de pacientes con cáncer de mama. Se realizó con una muestra no probabilística de 52 mujeres con cáncer de mama. Se encontró una relación entre TEPT y estrés (r= .344, p= .014), TEPT y depresión (rs=.346, p= .013). El TEPT correlacionó con evitación cognitiva (r= .437, p= .001), TEPT y desesperanza (rs= .437, p= .001) y TEPT...

  7. Greenhouse gases emissions inventory in 2005 by the Mexican energy sector; Inventario de emisiones en 2005 de gases de efecto invernadero por el sector energetico mexicano

    Energy Technology Data Exchange (ETDEWEB)

    Flores Velazquez, R.; Munoz Lerdo Carranza, R.; Villalba Valle, D. [Instituto de Investigaciones Electricas, Cuernavaca, Morelos (Mexico)]. E-mail: rfv@iie.org.mx; rml@iie.org.mx; danviva17@yahoo.com.mx

    2010-01-15

    In the present work, it is estimated the greenhouse gases (GHG, GEI in this paper) emissions in 2005 by the consumption and/or transformation of energy in Mexico. This document is not official, and it is used as reference the fuel consumption reported in the Balance National de Energia 2005 published by the Secretaria de Energia. In this way, it is standardized the emission source that will be used in the near future to estimated the official 2005 GHG Emissions Inventory. In order to solve the absence of own emission factors in Mexico, it is used the default global emission factors proposed by the Intergovernmental Panel for Climate Change. The Sectorial Method was used to estimate the GHG emissions taking in account the fuel consumption in each subsector considered in the energy sector. It was found that the transport and energy industries sector had the most GHG emissions, and that Mexico as a non-industrialized country had lower per capita emissions that developed countries. [Spanish] En este trabajo se calcularon las emisiones de Gases de Efecto de inventario (GEI's) del 2005 por la seccion de consumo y/o transformacion de energia en Mexico. El documento obtenido no es oficial, y como referencia, se utiliza el consumo de combustible que refiere el Balance Nacional de Energia 2005, publicado por la Secretaria de Energia. Con esto, se estandarizan las fuentes de emision que en algun momento usara el Inventario Nacional de Emisiones de GEI's 2005. Para resolver la falta de factores de emision propios de Mexico, se recurre a los factores globales de emision propuestos como valores por omision por el Panel Intergubernamental de Cambio Climatico. Para la estimacion de las emisiones de GEI's se utilizo el Metodo Sectorial tomando en consideracion el consumo de combustible de cada uno de los subsectores en que se encuentra dividido el sector energetico. Se encontro que los sectores transporte y de la industria de la transformacion de energia son los que

  8. Eleven episodes of recurrent optic neuritis of the same eye for 22 years eventually diagnosed as neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Yew, Yih Chian; Hor, Jyh Yung; Lim, Thien Thien; Kanesalingam, Ruban; Ching, Yee Ming; Arip, Masita; Easaw, P E Samuel; Eow, Gaik Bee

    2016-11-01

    It is difficult to predict whether a particular attack of neuromyelitis optica spectrum disorder (NMOSD) will affect the optic nerve [optic neuritis (ON): unilateral or bilateral], spinal cord (myelitis), brain or brainstem, or a combination of the above. We report an interesting case of recurrent ON of the same eye for a total of 11 episodes in a Chinese woman. Over a period of 22 years, the attacks only involved the left eye, and never the right eye and also no myelitis. For a prolonged duration, she was diagnosed as recurrent idiopathic ON. Only until she was tested positive for aquaporin 4 antibody that her diagnosis was revised to NMOSD. Optical coherence tomography revealed thinning of the retinal nerve fibre layer (RNFL) for the affected left eye, while the RNFL thickness was within normal range for the unaffected right eye. The disability accrual in NMOSD is generally considered to be attack-related - without a clinical attack of ON, there shall be no visual impairment, and no significant subclinical thinning of RNFL. Our case is in agreement with this notion. This is in contrast to multiple sclerosis where subclinical RNFL thinning does occur. This case highlights the importance of revisiting and questioning a diagnosis of recurrent idiopathic ON particularly when new diagnostic tools are available. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Paciente con esquizofrenia tratado con ziprasidona + clozapina

    Directory of Open Access Journals (Sweden)

    Pol Yanguas E.

    2013-05-01

    Full Text Available P es un paciente diagnosticado de esquizofrenia, sigue en un piso tutelado un programa de rehabilitación, está medicado con clozapina 500 mg/día y ziprasidona 280 mg/ día. Padece hipercolesterolemia, tabaquismo y sus hábitos alimenticios no son buenos. La medicación que utiliza desde 2007 hasta ahora se refleja en la tabla 1. El último tratamiento se le introdujo el 7 de agosto de 2012, habiendo presentado un electro cardiograma (ECG normal, pero con ligera taquicardia ventricular y prolactinemia de 44,8 ng/ml (valores normales: 2-18 ng/ml.

  10. Riesgo familiar total en familias con mujeres diagnosticadas con neoplasia de mama

    Directory of Open Access Journals (Sweden)

    Nancy Cecilia Charrys-Bravo

    2017-07-01

    Full Text Available Objetivo: Determinar el riesgo familiar total de las familias con mujeres diagnosticadas con cáncer de mama, que asisten a un centro de salud oncológico en la ciudad de Barranquilla. Materiales y Métodos: El estudio fue de tipo descriptivo, transversal con abordaje cuantitativo. Se utilizó el instrumento Riesgo Familiar Total RFT 5-33. El universo estuvo conformado por familias con mujeres diagnosticadas con cáncer en mama. La muestra fue de 41 familias que integraron a 154 miembros; se abordó el estudio de manera censal, y no por medio de una muestra, porque el acceso a la información de la totalidad de las familia fue viable. Resultados: Los resultados mostraron que las familias, en su mayoría, son de tipo 2. El 68 % de las pacientes categorizan sus familias como amenazadas, el 5 % como familias de alto riesgo y un 27 % de las familias con un bajo riesgo. Conclusiones: Los hallazgos encontrados en esta investigación son importantes para las familias, lo cual permitirá establecer acciones y actividades que logren orientar e implementar procesos de atención específicos con el propósito de cuidar a las familias para que se mantengan sanos en un nivel de bajo riesgo; además, desarrollar controles y seguimiento a aquellas familias que se encuentran en un riesgo alto de amenazas, mediante acciones de promoción y prevención de la enfermedad de una manera amplia. Por lo anterior, se deben emprender programas más agresivos de prevención y promoción, especialmente con las familias que asisten en busca de apoyo médico para este padecimiento; de esta forma, se podrán diagnosticar los casos de forma temprana y proceder al respectivo tratamiento.

  11. REDUCCIÓN DE ÓXIDOSDE NITROGENO CON CATALIZADORES ZEOLÍTICOS INTERCAMBIADOS CON COBALTO

    Directory of Open Access Journals (Sweden)

    Enrique Alexis García Moya

    2012-10-01

    Full Text Available Se presenta un estudio sobre la reducción catalítica selectiva (RCS de NOx con metano en presencia de oxígeno en exceso con varios catalizadores a base de las zeolitas mordenita, ferrierita y ZSM-5 intercambiadas con diferentes cargas de cobalto y con las correspondientes zeolitas en forma acida. Cuando la mezcla reactiva contenía mayormente NO2 en lugar de NO, los catalizadores ácidos mostraron las más altas velocidades de formación de N2 en condiciones secas. Las mayores actividades se obtuvieron con los catalizadores Co-mordenita, siguiendo en orden de actividad los catalizadores Co-Ferrierita y Co-ZSM-5. El catalizador Co-Mordenita más activo se ensayó con una mezcla reactiva donde predominó el NO en lugar del NO2 bajo condiciones secas e hidrotérmicas y en presencia de SO2. Con la adición de 8% de agua a la mezcla de reacción se observó desactivación reversible, especialmente a bajas temperaturas. La adición de 60 ppm de SO2 disminuyó la velocidad de reacción aproximadamente a la mitad debido posiblemente al envenenamiento de algunos sitios activos.

  12. Efficacy of Polyvalent Human Immunoglobulins in an Animal Model of Neuromyelitis Optica Evoked by Intrathecal Anti-Aquaporin 4 Antibodies

    Directory of Open Access Journals (Sweden)

    Benedikt Grünewald

    2016-08-01

    Full Text Available Neuromyelitis Optica Spectrum Disorders (NMOSD are associated with autoantibodies (ABs targeting the astrocytic aquaporin-4 water channels (AQP4-ABs. These ABs have a direct pathogenic role by initiating a variety of immunological and inflammatory processes in the course of disease. In a recently-established animal model, chronic intrathecal passive-transfer of immunoglobulin G from NMOSD patients (NMO-IgG, or of recombinant human AQP4-ABs (rAB-AQP4, provided evidence for complementary and immune-cell independent effects of AQP4-ABs. Utilizing this animal model, we here tested the effects of systemically and intrathecally applied pooled human immunoglobulins (IVIg using a preventive and a therapeutic paradigm. In NMO-IgG animals, prophylactic application of systemic IVIg led to a reduced median disease score of 2.4 on a 0–10 scale, in comparison to 4.1 with sham treatment. Therapeutic IVIg, applied systemically after the 10th intrathecal NMO-IgG injection, significantly reduced the disease score by 0.8. Intrathecal IVIg application induced a beneficial effect in animals with NMO-IgG (median score IVIg 1.6 vs. sham 3.7 or with rAB-AQP4 (median score IVIg 2.0 vs. sham 3.7. We here provide evidence that treatment with IVIg ameliorates disease symptoms in this passive-transfer model, in analogy to former studies investigating passive-transfer animal models of other antibody-mediated disorders.

  13. Terapias alternativas con animales para niños con necesidades especiales

    OpenAIRE

    Cea-Chueca, Aihnoa

    2014-01-01

    El presente trabajo de fin de grado consiste en la realización de un análisis y descripción de la literatura acerca de las distintas terapias animales, destinadas a niños con necesidades especiales: cómo y por qué surgieron, en qué consisten las terapias, cómo podemos utilizarlas, etc. Las terapias alternativas con animales se conocen como una alternativa terapéutica, donde se utiliza a un animal como co-terapeuta para poder desarrollar diferentes capacidades de los niños con necesidades espe...

  14. Comparison study of imaging features of multiple sclerosis and neuromyelitis optica

    International Nuclear Information System (INIS)

    Liu Jianguo; Zhang Hailing; Zheng Kuihong; Zhang Wenluo; Dong Qinwen; Qi Xiaokun

    2012-01-01

    Objective: To compare the imaging characteristics of multiple sclerosis (MS) and neuromyelitis optica (NMO) for better diagnosis and differential diagnosis. Methods: The brain and spinal MRI images of 60 MS and 48 NMO cases were retrospectively reviewed. The imaging characteristics including the predilection site, morphological features, enhancement manifestations were summarized. All data was analyzed by using t test and Chi square test with SPSS 13.0. Results: (1) The three top predilection sites of brain in head MRI of MS patients were periventricular white matter (34 cases in 60), subcortical white matter (27 cases in 60), brain stem (23 cases in 60). MS lesions also were found in basal ganglia, cerebellum, corpus callosum and thalamus,as well as cortex (9 cases in 60). By contrast, brain lesions were observed in 59.4% (19/32) of NMO patients, and the three top predilection sites of NMO by turns were brain stem (13 cases in 19), periventricular white matter (12 cases in 19), subcortical white matter (7 cases in 19). Furthermore, the lesions surrounding third ventricle (6 cases in 19) and the tegmentum of brain stem near peri-aqueduct (8 cases in 19) in NMO were not found in patients of MS. The involvement of brain stem and thalamus was more frequent in NMO than in MS (χ 2 =5.267, 6.004, P<0.05, respectively). (2) The lesions of spinal cord in MS patients were typically oval, peripheral, and asymmetric, but in NMO patients they were longitudinally extensive and centrally located. The mean number of involved vertebral segments in NMO patients was significantly more than that in MS patients (7.3 vs 2.2, t=-9.288, P<0.01). Furthermore, the number of spinal cord lesions in MS patients was remarkably more than that in NMO (2.0 vs 1.3, t=4.565, P<0.01). The ratios of occurrence of spinal cord swelling and distension of NMO patients was 58.3% (28/48), which was significantly higher than 21.9% in MS (7/32, χ 2 =10.370, P<0.01). (3) The enhancement pattern in MS was

  15. Comparisons of presentations and outcomes of neuromyelitis optica patients with and without Sjögren's syndrome.

    Science.gov (United States)

    Zhong, Yu Hua; Zhong, Zhi Gang; Zhou, Zhou; Ma, Zhen Yu; Qiu, Meng Yao; Peng, Fu Hua; Zhang, Wei Xi

    2017-02-01

    Patients with neuromyelitis optica (NMO) often have an accompanying autoimmune disease, most commonly, but not limited to Sjögren's syndrome (SS). The aim of this study was to compare clinical and laboratory features between NMO patients with and without SS and to investigate the prognosis of NMO in patients with and without SS. Twenty-three NMO patients with SS and 42 NMO patients without SS were included. Clinical and laboratory profiles were compared, including annual relapse rate and time from onset of NMO to Expanded Disability Status Scale (EDSS) scores of 4.0 and 6.0. More NMO patients with SS than those without SS had anti-nuclear antibody, anti-SS-A/Ro and anti-SS-B/La antibodies (91.3 vs. 35.7%, p < 0.001, 87.0 vs. 2.3%, p < 0.001, and 34.8 vs. 0.0%, p < 0.001, respectively). Serum immunoglobulins (IgA, IgM and IgG) were markedly increased in NMO patients with SS in comparison with those without SS. Annual relapse rate and the time from disease onset to an EDSS score of 4.0 and 6.0 were not significantly different between the two groups. No differences between the two groups were found for the other parameters, including AQP-4 antibody status, length of spinal cord lesion and brain lesions. These results imply that NMO in SS more likely represents coexistence with SS rather than representing the result of direct central nervous system involvement in SS. Autoimmune response appears to be more intense in the NMO group with SS, but did not cause a more severe prognosis in comparison with the group without SS, indicating that we should pay attention to the potential benefit of the antinuclear antibodies in NMO.

  16. Elevated Plasma Chemokines for Eosinophils in Neuromyelitis Optica Spectrum Disorders during Remission

    Directory of Open Access Journals (Sweden)

    Yanping Tong

    2018-02-01

    Full Text Available BackgroundA prominent pathological feature of neuromyelitis optica spectrum disorders (NMOSD is markedly greater eosinophilic infiltration than that seen in other demyelinating diseases, like multiple sclerosis (MS. Eosinophils express the chemokine receptor CCR3, which is activated by eotaxins (CCL11/eotaxin-1, CCL24/eotaxin-2, CCL26/eotaxin-3 and CCL13 [monocyte chemoattractant protein (MCP-4]. Moreover, CCL13 is part of the chemokine set that activates CCR2. The present study aimed to evaluate plasma levels of eotaxins (CCL11, CCL24, and CCL26 and MCPs (CCL13, CCL2, CCL8, and CCL7 in patients with NMOSD during remission.MethodsHealthy controls (HC; n = 30 and patients with MS (n = 47 and NMOSD (n = 58 in remission were consecutively enrolled in this study between January 2016 and August 2017. Plasma CCL11, CCL24, CCL26, CCL2, CCL8, CCL7, CCL13, tumor necrosis factor (TNF-α, and interleukin (IL-1β levels were detected using the human cytokine multiplex assay.ResultsPlasma CCL13, CCL11, and CCL26 levels were all significantly higher in patients with NMOSD than in HC and patients with MS. No significant differences were found in the CCL13, CCL11, or CCL26 levels between patients with NMOSD receiving and not receiving immunosuppressive therapy. The plasma levels of TNF-α and IL-1β, which stimulate the above chemokines, were higher in patients with NMOSD than in HC. There was no difference in CCL24 levels among the three groups. In most cases, the CCL7 levels were below the threshold value of the human cytokine multiplex assay, which is in line with other studies. Adjusted multiple regression analyses showed a positive association of CCL13 levels with the number of relapses after controlling gender, age, body mass index, and disease duration in patients with NMOSD.ConclusionThe study indicates that in NMOSD, the overproduction of cytokines such as IL-1β and TNF-α during remission stimulates eosinophilic chemoattractants such as

  17. Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Sai-Jing Hu

    2018-01-01

    Full Text Available AIM: To determine the thickness of the retinal ganglion cell-inner plexiform layer (GCIPL and the retinal nerve fiber layer (RNFL in patients with neuromyelitis optica (NMO. METHODS: We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis (ON, subjects were divided into either the NMO-ON group (30 eyes or the NMO-ON contra group (10 eyes. A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using high-definition optical coherence tomography (OCT. RESULTS: In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 μm, the minimum GCIPL thickness was 66.02±10.02 μm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 μm, the minimum GCIPL thickness was 25.39±25.1 μm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 μm, the minimum GCIPL thickness was 85.28±10.75 μm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 μm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group (P<0.05; additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group (P<0.05. Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation (MD and corrected pattern standard deviation (PSD in the NMO-ON group (P<0.05. CONCLUSION: The thickness of the GCIPL

  18. Comparison of grey matter atrophy between patients with neuromyelitis optica and multiple sclerosis: A voxel-based morphometry study

    International Nuclear Information System (INIS)

    Duan Yunyun; Liu Yaou; Liang Peipeng; Jia Xiuqin; Yu Chunshui; Qin Wen; Sun Hui; Liao Zhangyuan; Ye Jing; Li Kuncheng

    2012-01-01

    Purpose: Previous studies have established regional grey matter (GM) loss in multiple sclerosis (MS). However, whether there is any regional GM atrophy in neuromyelitis optica (NMO) and the difference between NMO and MS is unclear. The present study addresses this issue by voxel-based morphometry (VBM). Methods: Conventional magnetic resonance imaging (MRI) and T1-weighted three-dimensional MRI were obtained from 26 NMO patients, 26 relapsing–remitting MS (RRMS) patients, and 26 normal controls. An analysis of covariance model assessed with cluster size inference was used to compare GM volume among three groups. The correlations of GM volume changes with disease duration, expanded disability status scale (EDSS) and brain T2 lesion volume (LV) were analyzed. Results: GM atrophy was found in NMO patients in several regions of frontal, temporal, parietal lobes and insula (uncorrected, p < 0.001). While extensive GM atrophy was found in RRMS patients, including most cortical regions and the deep grey matter (corrected for multiple comparisons, p < 0.01). Compared with NMO, those with RRMS had significant GM loss in bilateral thalami, caudate, left parahippocampal gyrus, right hippocampus and insula (corrected, p < 0.01). In RRMS group, regional GM loss in right caudate and bilateral thalami were strongly correlated with brain T2LV. Conclusions: Our study found the difference of GM atrophy between NMO and RRMS patients mainly in deep grey matter. The correlational results suggested axonal degeneration from lesions on T2WI may be a key pathogenesis of atrophy in deep grey matter in RRMS.

  19. Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad

    Directory of Open Access Journals (Sweden)

    Conzuelo González, Viridiana Vanessa

    2009-01-01

    Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

  20. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Directory of Open Access Journals (Sweden)

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  1. Terapia regenerativa con plasma rico en plaquetas en pacientes con quemaduras

    Directory of Open Access Journals (Sweden)

    María del Carmen Franco Mora

    2015-10-01

    Full Text Available Se realizó un estudio comparativo, longitudinal y prospectivo de 60 adultos con quemaduras profundas, atendidos en el Hospital General docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde febrero de 2013 hasta igual mes de 2014, para evaluar la efectividad de la terapia regenerativa con plasma rico en plaquetas para la cicatrización de estas lesiones. La muestra fue dividida en 2 grupos de 30 integrantes cada uno: a los del primero se les aplicó plasma rico en plaquetas y a los del segundo sulfadiazina de plata. Se utilizaron las frecuencias absolutas y el porcentaje como medidas de resumen para variables cualitativos, así como la media aritmética y la desviación estándar para las cuantitativas. Con el proceder aplicado la cicatrización se completó en un tiempo menor, de manera que se demostró la efectividad de esta alternativa terapéutica en relación con el tratamiento convencional

  2. RadConEd: A Graphical Data Editor for the Radiological Consequences Model, RadCon

    International Nuclear Information System (INIS)

    Crawford, J.; Domel, R.U.

    2000-05-01

    This document describes the application, RadConEd, which has been designed and implemented to enable users of the RadCon system to update these parameter files. The RadCon system is written in the Java programming language, and as such provides portability across computer platforms. The software described in this report was developed in line with the portability requirements of RadCon, thus providing a uniform user interface across computer platforms and bypassing the need of using system editors. In addition a number of data integrity measures were implemented

  3. Calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA

    OpenAIRE

    Granado Casas, Minerva

    2014-01-01

    Introducción: La calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes mellitus están relacionados con el control metabólico, las complicaciones y algunas variables socioeconómicas. Actualmente, no existe ningún estudio científico que analice la calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA. Objetivos: Los objetivos principales fueron conocer la calidad de vida, satisfacción con el tratamient...

  4. Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Zhengqi Lu

    Full Text Available BACKGROUND: Brain stem lesions are common in patients with acute disseminated encephalomyelitis (ADEM, neuromyelitis optica (NMO, and multiple sclerosis (MS. OBJECTIVES: To investigate comparative brain stem lesions on magnetic resonance imaging (MRI among adult patients with ADEM, NMO, and MS. METHODS: Sixty-five adult patients with ADEM (n = 17, NMO (n = 23, and MS (n = 25 who had brain stem lesions on MRI were enrolled. Morphological features of brain stem lesions among these diseases were assessed. RESULTS: Patients with ADEM had a higher frequency of midbrain lesions than did patients with NMO (94.1% vs. 17.4%, P<0.001 and MS (94.1% vs. 40.0%, P<0.001; patients with NMO had a lower frequency of pons lesions than did patients with MS (34.8% vs. 84.0%, P<0.001 and ADEM (34.8% vs. 70.6%, P = 0.025; and patients with NMO had a higher frequency of medulla oblongata lesions than did patients with ADEM (91.3% vs. 35.3%, P<0.001 and MS (91.3% vs. 36.0%, P<0.001. On the axial section of the brain stem, the majority (82.4% of patients with ADEM showed lesions on the ventral part; the brain stem lesions in patients with NMO were typically located in the dorsal part (91.3%; and lesions in patients with MS were found in both the ventral (44.0% and dorsal (56.0% parts. The lesions in patients with ADEM (100% and NMO (91.3% had poorly defined margins, while lesions of patients with MS (76.0% had well defined margins. Brain stem lesions in patients with ADEM were usually bilateral and symmetrical (82.4%, while lesions in patients with NMO (87.0% and MS (92.0% were asymmetrical or unilateral. CONCLUSIONS: Brain stem lesions showed various morphological features among adult patients with ADEM, NMO, and MS. The different lesion locations may be helpful in distinguishing these diseases.

  5. Patient with neuromyelitis optica and inflammatory demyelinating lesions comprising whole spinal cord from C2 level till conus: case report

    Directory of Open Access Journals (Sweden)

    Pavlisa Goran

    2009-10-01

    Full Text Available Abstract Background Neuromyelitis optica (NMO is an idiopathic, severe, inflammatory demyelinating disease of the central nervous system, that causes severe optic neuritis and myelitis attacks. Early discrimination between multiple sclerosis (MS and NMO is important, as optimum treatment for both diseases may differ considerably. Case Presentation We report a case of a patient who initially presented as longitudinally extensive transverse myelitis (LETM, having spastic upper extremities diparesis and spastic paraplegia, C2/C3 sensory level and urinary incontinence, as well as extensive inflammatory spinal cord lesions from C2 level to conus. After 5 months the patient had another attack of transverse myelitis, had electrophysiological findings consistent with optic neuritis, was seropositive for NMO-IgG (aquaporin-4 IgG and thus fulfilled NMO diagnostic criteria. Following treatment of disease attacks with pulse corticosteroid therapy and intravenous immunoglobulins, we included oral azathioprine in a combination with oral prednisone in the therapy. Since there was no significant clinical improvement, we decided to use cyclophosphamide therapy, which resulted in good clinical improvement and gradual decrease of cord swelling. Conclusion In this NMO case report we wanted to emphasize the extensiveness of inflammatory spinal cord changes in our patient, from C2 level to conus. In the conclusion it is important to say that accurate, early diagnosis and distinction from MS is critical to facilitate initiation of immunosuppressive therapy for attack prevention.

  6. Mastopexia con prótesis: técnica triplanar con colgajo en cola de pez para mamas con pobre calidad de cobertura

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    M. Berrocal-Revueltas

    2013-12-01

    Full Text Available La mastopexia con implantes de silicona, es uno de los procedimientos más frecuentes en la práctica diaria en Cirugía Plástica. Sin embargo, la pobre calidad de la cobertura de las mamas, relacionada con piel estriada, escaso tejido subcutáneo y pérdida del parénquima mamario secundarios a la lactancia prolongada y a la pérdida masiva de peso, son causa del incremento progresivo de resultados insatisfactorios a medio y largo plazo que han sido evaluados, analizados y discutidos por los especialistas. Los resultados insatisfactorios más frecuentes en mastopexia con implantes en posición retromuscular son: doble contorno mamario, asimetrías y desplazamiento de los implantes. Los objetivos del presente estudio son: describir el nuevo método triplanar como alternativa útil para lograr mejores resultados en pacientes con mala calidad de cobertura y analizar los resultados obtenidos con el mismo. Realizamos un estudio observacional, descriptivo, prospectivo, en un grupo de 268 pacientes con diagnóstico de ptosis mamaria con hipotrofia y mala calidad de cobertura por piel estriada, escaso tejido celular subcutáneo y pérdida del parénquima mamario, secundarios a lactancia prolongada y pérdida masiva de peso, entre otros, a las que se les practicó mamoplastia de aumento con implantes de silicona mediante la aplicación del método triplanar descrito por la autora, entre enero del 2004 y enero del 2013 en el Hospital de Bocagrande de Cartagena, Colombia. El diseño de la técnica se basa en los principios de cicatriz vertical descrita por Lassus o Lejour o mediante cicatriz en "J", descrita por la autora. El método triplanar se basa en tres planos de cobertura del implante. Plano I: submuscular, para cubrir los dos tercios superiores del implante. Plano II: colgajo dermoglandular con dos prolongaciones distales triangulares de tejido adiposo, en forma de pez, para cubrir el tercio inferior del implante y el borde libre del m

  7. Prevalence of neuromyelitis optica spectrum disorder in the multi-ethnic Penang Island, Malaysia, and a review of worldwide prevalence.

    Science.gov (United States)

    Hor, Jyh Yung; Lim, Thien Thien; Chia, Yuen Kang; Ching, Yee Ming; Cheah, Chun Fai; Tan, Kenny; Chow, Han Bing; Arip, Masita; Eow, Gaik Bee; Easaw, P E Samuel; Leite, M Isabel

    2018-01-01

    Neuromyelitis optica spectrum disorder (NMOSD) occurs worldwide in all ethnicities. Recently, population-based studies have shown that NMOSD is more common among non-White populations. There is scarce data about NMOSD prevalence in South East Asian populations. (1) A population-based study was undertaken to estimate NMOSD prevalence in the multi-ethnic Penang Island, Malaysia, comprising Chinese, Malays, and Indians. Medical records of NMOSD patients followed up at the Penang General Hospital (the neurology referral centre in Penang Island) were reviewed. The 2015 diagnostic criteria of the International Panel for NMO Diagnosis were used for case ascertainment. (2) A review of population-based prevalence studies of NMOSD worldwide was carried out. PubMed and conference proceedings were searched for such studies. Of the 28 NMOSD patients, 14 were residents of Penang Island on prevalence day [13 (93%) Chinese and one (7%) Malay]. All 14 patients were females and aquaporin 4 seropositive. The prevalence of NMOSD in Penang Island was 1.99/100,000 population; according to ethnicities, the prevalence in Chinese was significantly higher than in Malays (3.31/100,000 vs 0.43/100,000, respectively, p = 0.0195). Based on our and other population-based studies, among Asians, East Asian origin populations (Chinese and Japanese) appear to have higher NMOSD prevalence than other Asian ethnic groups. Worldwide, Blacks seem to have the highest NMOSD prevalence. More studies in different geographical regions and ethnic groups will be useful to further inform about potential factors in NMOSD pathogenesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Estudio comparativo del efecto del cepillado con una crema dental con propóleos rojos y de un gel con clorofila

    OpenAIRE

    Estela Gispert Abreu; Elena Cantillo Estrada; Aracelys Rivero López; Berta Oramas Rodríguez

    1998-01-01

    Se analiza comparativamente el efecto de un gel dental de clorofila y de una crema dental con propóleos rojos sobre varios parámetros relacionados con la caries dental, en escolares que se cepillaron durante 21 días con dichos productos. Se obtuvieron resultados favorables principalmente en la disminución del grado de infección por Streptococcus mutans y la elevación de la capacidad individual de remineralización; salvo en este último no hubo diferencias estadísticamente significativas.Author...

  9. The major brain endocannabinoid 2-AG controls neuropathic pain and mechanical hyperalgesia in patients with neuromyelitis optica.

    Directory of Open Access Journals (Sweden)

    Hannah L Pellkofer

    Full Text Available Recurrent myelitis is one of the predominant characteristics in patients with neuromyelitis optica (NMO. While paresis, visual loss, sensory deficits, and bladder dysfunction are well known symptoms in NMO patients, pain has been recognized only recently as another key symptom of the disease. Although spinal cord inflammation is a defining aspect of neuromyelitis, there is an almost complete lack of data on altered somatosensory function, including pain. Therefore, eleven consecutive patients with NMO were investigated regarding the presence and clinical characteristics of pain. All patients were examined clinically as well as by Quantitative Sensory Testing (QST following the protocol of the German Research Network on Neuropathic Pain (DFNS. Additionally, plasma endocannabinoid levels and signs of chronic stress and depression were determined. Almost all patients (10/11 suffered from NMO-associated neuropathic pain for the last three months, and 8 out of 11 patients indicated relevant pain at the time of examination. Symptoms of neuropathic pain were reported in the vast majority of patients with NMO. Psychological testing revealed signs of marked depression. Compared to age and gender-matched healthy controls, QST revealed pronounced mechanical and thermal sensory loss, strongly correlated to ongoing pain suggesting the presence of deafferentation-induced neuropathic pain. Thermal hyperalgesia correlated to MRI-verified signs of spinal cord lesion. Heat hyperalgesia was highly correlated to the time since last relapse of NMO. Patients with NMO exhibited significant mechanical and thermal dysesthesia, namely dynamic mechanical allodynia and paradoxical heat sensation. Moreover, they presented frequently with either abnormal mechanical hypoalgesia or hyperalgesia, which depended significantly on plasma levels of the endogenous cannabinoid 2-arachidonoylglycerole (2-AG. These data emphasize the high prevalence of neuropathic pain and hyperalgesia

  10. The Urine Proteome Profile Is Different in Neuromyelitis Optica Compared to Multiple Sclerosis: A Clinical Proteome Study.

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    Helle H Nielsen

    Full Text Available Inflammatory demyelinating diseases of the CNS comprise a broad spectrum of diseases like neuromyelitis optica (NMO, NMO spectrum disorders (NMO-SD and multiple sclerosis (MS. Despite clear classification criteria, differentiation can be difficult. We hypothesized that the urine proteome may differentiate NMO from MS.The proteins in urine samples from anti-aquaporin 4 (AQP4 seropositive NMO/NMO-SD patients (n = 32, patients with MS (n = 46 and healthy subjects (HS, n = 31 were examined by quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS after trypsin digestion and iTRAQ labelling. Immunoglobulins (Ig in the urine were validated by nephelometry in an independent cohort (n = 9-10 pr. groups.The analysis identified a total of 1112 different proteins of which 333 were shared by all 109 subjects. Cluster analysis revealed differences in the urine proteome of NMO/NMO-SD compared to HS and MS. Principal component analysis also suggested that the NMO/NMO-SD proteome profile was useful for classification. Multivariate regression analysis revealed a 3-protein profile for the NMO/NMO-SD versus HS discrimination, a 6-protein profile for NMO/NMO-SD versus MS discrimination and an 11-protein profile for MS versus HS discrimination. All protein panels yielded highly significant ROC curves (AUC in all cases >0.85, p≤0.0002. Nephelometry confirmed the presence of increased Ig-light chains in the urine of patients with NMO/NMO-SD.The urine proteome profile of patients with NMO/NMO-SD is different from MS and HS. This may reflect differences in the pathogenesis of NMO/NMO-SD versus MS and suggests that urine may be a potential source of biomarkers differentiating NMO/NMO-SD from MS.

  11. Programs in Fortran language for reporting the results of the analyses by ICP emission spectroscopy; Programas en lenguaje Fortran para la informacion de los resultados de los analisis efectuados mediante Espectroscopia Optica de emision con fuente de plasma

    Energy Technology Data Exchange (ETDEWEB)

    Roca, M

    1985-07-01

    Three programs, written in FORTRAN IV language, for reporting the results of the analyses by ICP emission spectroscopy from data stored in files on floppy disks have been developed. They are intended, respectively, for the analyses of: 1) waters, 2) granites and slates, and 3) different kinds of geological materials. (Author) 8 refs.

  12. "Estudio tribologico de aceros para moldes. Aplicacion al moldeo por inyeccion de polibutilentereftalato reforzado con fibra de vidrio"

    Science.gov (United States)

    Martinez Mateo, Isidoro Jose

    fabricacion del molde, tienen una gran influencia sobre su comportamiento en servicio a lo largo de la vida util del molde. En la primera parte del presente estudio, a partir de ensayos punzon sobre disco, se ha determinado la relacion entre la resistencia al desgaste y la dureza de aceros para moldes obtenidos a partir de bloques de gran espesor, estudiando los principales mecanismos de desgaste que tienen lugar. A continuacion, con el fin de determinar el dano superficial que sufren los aceros para moldes en condiciones reales de inyeccion, se han estudiado distintos tipos de aceros utilizados comercialmente en moldes de inyeccion de polimeros y materiales compuestos, seleccionando las condiciones de operacion para determinar la variacion de la rugosidad superficial del acero en funcion del material inyectado, del numero de operaciones sucesivas de inyeccion y de la orientacion del flujo de inyeccion, mediante tecnicas de perfilometria optica y microscopia electronica de barrido. Ademas del dano superficial sufrido por el acero con el numero de piezas inyectadas, tambien se ha determinado la evolucion de la rugosidad superficial de los materiales inyectados, polibutilentereftalato (PBT) puro y materiales compuestos derivados de PBT por adicion de un 20 o un 50% en peso de fibra de vidrio. En el caso de las piezas inyectadas, se ha caracterizado su microestructura en funcion del flujo de inyeccion y de la densidad de fibra, se han determinado sus propiedades termicas y dinamico-mecanicas, asi como la variacion de la rugosidad superficial de las piezas inyectadas con el numero de operaciones de inyeccion y con la geometria de las distintas secciones de las piezas. Finalmente, se ha evaluado la resistencia a la abrasion de PBT reforzado con un 50% de fibra, en funcion del numero de piezas inyectadas y de la direccion de rayado con respecto a la orientacion del flujo de inyeccion.

  13. Severe structural and functional visual system damage leads to profound loss of vision-related quality of life in patients with neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Schmidt, Felix; Zimmermann, Hanna; Mikolajczak, Janine; Oertel, Frederike C; Pache, Florence; Weinhold, Maria; Schinzel, Johann; Bellmann-Strobl, Judith; Ruprecht, Klemens; Paul, Friedemann; Brandt, Alexander U

    2017-01-01

    Neuromyelitis optica spectrum disorders (NMOSD) are characterized by devastating optic neuritis attacks causing more structural damage and visual impairment than in multiple sclerosis (MS). The objective of this study was to compare vision-related quality of life in NMOSD and MS patients and correlate it to structural retinal damage and visual function. Thirty-one NMOSD and 31 matched MS patients were included. Vision-related quality of life was assessed with the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). All patients underwent retinal optical coherence tomography and visual acuity and contrast sensitivity measurements. Vision-related quality of life was reduced in NMOSD compared to MS patients. This difference was driven by a higher incidence of bilateral and more severe optic neuritis in the NMOSD group. Retinal thinning and visual impairment were significantly greater in the NMOSD cohort. Lower vision-related quality of life was associated with more retinal damage and reduced visual function as assessed by visual acuity and contrast sensitivity. NMOSD-related bilateral ON-attacks cause severe structural damage and visual impairment that lead to severe loss of vision-related quality of life. The NEI-VFQ is a helpful tool to monitor vision-related quality of life in NMOSD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Associated Myelopathy (HAM) Neuromyelitis Optica (NMO) Schilder's Disease Transverse Myelitis d Symptoms & Diagnosis d Diagnosing MS d ... Overview (.pdf) Download Document Pediatric MS Learn More Transverse Myelitis Learn More Neuromyelitis Optica (NMO) Learn More ...

  15. Investigando con personas con dificultades de aprendizaje

    Directory of Open Access Journals (Sweden)

    Borja González Luna

    2013-12-01

    Full Text Available El artículo muestra los orígenes de lo que Walmsley (2008 denomina «investigación inclusiva». Para comprender qué se entiende por investigación inclusiva tenemos que remontarnos a los debates epistemológicos sobre las metodologías cuantitativas y cualitativas, acontecidos en la década de los 90, en torno a la revista Disability & Society. A partir de una síntesis de dichos debates, focalizados en el ámbito de la «discapacidad intelectual y del desarrollo», se exponen dos estrategias de colaboración con dicha población: a una aproximación etnográfica (de trabajo grupal, y b una aproximación biográfica (de trabajo individual. A continuación se esboza un posible diseño de trabajo de campo que intenta superar el paradigma cualitativo «clásico» con el objetivo de incluir a dicho colectivo más allá del rol de «sujetos de la investigación». Para finalizar se recoge el debate sobre la accesibilidad de los resultados de la investigación a los participantes en dichas investigaciones, y con ello la necesaria innovación en el ámbito de las «devoluciones» de los resultados, cuando se trata de incluir a personas que presentan limitaciones para la comprensión del lenguaje abstracto oral y/o escrito.

  16. MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

    OpenAIRE

    Johanna Stella Castellanos Arias; Leonardo Enrique Solaque Guzmán

    2010-01-01

    En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF), con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED), específicamente Redes de Petri (RdP), y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proces...

  17. Thermal study by conduction and convection in an elongated tilted cavity with a semitransparent cover; Estudio termico por conveccion y conduccion en una cavidad alargada inclinada con una cubierta semitransparente

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Rosas, Tannia Renee; Alvarez Garcia, Gabriela del S.; Xaman Villasenor, Jesus Perfecto [Centro Nacional de Investigacion y Desarrollo Tecnologico (CENIDET), Departamento de Mecanica, Cuernavaca, Morelos (Mexico)]. E-mail:Tann1a@live.com.mx; gaby@cenidet.edu.mx; jxaman@cenidet.edu.mx

    2010-11-15

    In this paper a two dimensional numerical study on heat transfer by conduction and convection in a shallow inclined cavity with a semi-transparent wall is presented, where the region between the glass cover (GC) and the absorber plate resembles a cavity. The absorber plate is considered an isothermal surface at hot temperature; whereas the vertical walls were considered adiabatic. The thermal physical and optical properties of the glass cover (GC) were taken into account for the analysis. Inclination angles from 15 degrees to 35 degrees, aspect ratios (A) of 8 and 12 and Rayleigh numbers 10 4, 10 5 and 10 6 were combined to construct the cases. The governing equations of mass, moment and energy were discretized by the use of the Finite Volume method solving the algebraic equations with the SIMPLE algorithm. Results displayed include isotherms and streamlines inside the cavity, as well as temperature distribution on the inside surface of the glass cover (GC) and Nusselt number variations regarding the inclination angle for the two aspect ratios. The results show that the heat transfer increases while the inclination angle rise up, except for the cases where A=8,12, Ra=10 4 and {lambda}=30 where a transition of the flow pattern occurs, and the heat transfer diminishes with the aspect ratio for a fixed Rayleigh. [Spanish] Se presenta el estudio numerico bidimensional de la transferencia de calor por conduccion y conveccion en una cavidad alargada inclinada con pared semitransparente, simulando como una cavidad, la region comprendida entre la cubierta de vidrio (GC) y la placa absorbedora, de un captador solar, con aire en su interior. La placa absorbedora se considero isoterma a una temperatura caliente, se tomo en cuenta las propiedades termofisicas y opticas de la cubierta de vidrio (GC), mientras las paredes verticales se consideraron adiabaticas. Las ecuaciones de conservacion de masa, momentum y energia se resolvieron usando el metodo de Volumen Finito mediante

  18. con mala calidad de vida

    Directory of Open Access Journals (Sweden)

    Agustín Martín-Rodríguez

    2007-01-01

    Full Text Available En este estudio ex post facto se ha analizado si los familiares de pacientes con mala calidad de vida presentan diferencias en las variables clínicas de personalidad y relaciones familiares en función de que el paciente haya estado o no ingresado en una Unidad de Cuidados Intensivos. Seleccionamos dos grupos: 29 familiares de pacientes traumatizados graves transcurridos cuatro años de su ingreso en una UCI de Traumatología y con mala calidad de vida (debido a secuelas físicas y/o psicológicas tras el ingreso, tales como traumatismos craneoencefálicos, politraumatismos y tetraplejias traumáticas y 32 familiares de pacientes con mala calidad de vida con cuatro años de evolución de su enfermedad física (hipertensión, diabetes, artritis reumatoide y síndrome de intestino irritable que no han estado ingresados en la UCI. Para alcanzar nuestro objetivo empleamos una Encuesta Psicosocial y los siguientes instrumentos: Cuestionario de Análisis Clínico, Escala de Clima Social en la Familia y Escala de Adaptación Psicosocial de la Enfermedad. Los resultados mostraron que los familiares de pacientes con mala calidad de vida que estuvieron ingresados en la UCI hace cuatro años, presentan diferencias significativas en las variables agitación y expresividad comparados con los familiares de pacientes con mala calidad de vida que no han estado ingresados en la UCI.

  19. Characteristic cerebrospinal fluid cytokine/chemokine profiles in neuromyelitis optica, relapsing remitting or primary progressive multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Takuya Matsushita

    Full Text Available BACKGROUND: Differences in cytokine/chemokine profiles among patients with neuromyelitis optica (NMO, relapsing remitting multiple sclerosis (RRMS, and primary progressive MS (PPMS, and the relationships of these profiles with clinical and neuroimaging features are unclear. A greater understanding of these profiles may help in differential diagnosis. METHODS/PRINCIPAL FINDINGS: We measured 27 cytokines/chemokines and growth factors in CSF collected from 20 patients with NMO, 26 with RRMS, nine with PPMS, and 18 with other non-inflammatory neurological diseases (OND by multiplexed fluorescent bead-based immunoassay. Interleukin (IL-17A, IL-6, CXCL8 and CXCL10 levels were significantly higher in NMO patients than in OND and RRMS patients at relapse, while granulocyte-colony stimulating factor (G-CSF and CCL4 levels were significantly higher in NMO patients than in OND patients. In NMO patients, IL-6 and CXCL8 levels were positively correlated with disability and CSF protein concentration while IL-6, CXCL8, G-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF and IFN-γ were positively correlated with CSF neutrophil counts at the time of sample collection. In RRMS patients, IL-6 levels were significantly higher than in OND patients at the relapse phase while CSF cell counts were negatively correlated with the levels of CCL2. Correlation coefficients of cytokines/chemokines in the relapse phase were significantly different in three combinations, IL-6 and GM-CSF, G-CSF and GM-CSF, and GM-CSF and IFN-γ, between RRMS and NMO/NMOSD patients. In PPMS patients, CCL4 and CXCL10 levels were significantly higher than in OND patients. CONCLUSIONS: Our findings suggest distinct cytokine/chemokine alterations in CSF exist among NMO, RRMS and PPMS. In NMO, over-expression of a cluster of Th17- and Th1-related proinflammatory cytokines/chemokines is characteristic, while in PPMS, increased CCL4 and CXCL10 levels may reflect on-going low grade T cell

  20. Calidad de vida relacionada con la salud del niño y del adolescente con obesidad

    OpenAIRE

    Hurtado-Valenzuela, Jaime Gabriel; Álvarez-Hernández, Gerardo

    2014-01-01

    Objetivo Estimar la calidad de vida relacionada con la salud (CVRS) en un grupo de niños y adolescentes con obesidad de la ciudad de Hermosillo, Sonora, México. Métodos Se realizó un estudio transversal utilizando el cuestionario PedsQL® para comparar la CVRS de 200 niños y adolescentes con obesidad al igual que a sus padres, con dos grupos de control, uno de la comunidad (n=400) y otro grupo de usuarios (n=200) del Hospital Infantil del Estado de Sonora. Las diferencias en la CVRS fueron eva...

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... ADEM) Balo’s Disease HTLV-I Associated Myelopathy (HAM) Neuromyelitis Optica (NMO) Schilder's Disease Transverse Myelitis d Symptoms & Diagnosis ... Other Conditions to Rule Out Lyme Disease Lupus Neuromyelitis Optica Acute Disseminated Encephalomyelitis (ADEM) d For Clinicians d ...

  2. Pulpotomía con electrocauterio en pacientes con hemofilia A

    OpenAIRE

    Carbonell Rodriguez, Rosario

    2017-01-01

    Rehabilita la salud oral de un niños con Hemofilia A, empleando el Electrocauterio como una alternativa en la terapia pulpar, específicamente en la pulpotomía, para lo cual se realiza un minucioso examen clínico y anamnesis, que respaldados con exámenes complementarios, permite determinar el plan de tratamiento. La rehabilitación integral se llevó a cabo, previo consentimiento informado del padre, en sala de operaciones bajo anestesia general, debido a la condición sistémica del niño. Incl...

  3. Intervención con menores con adicciones desde Proyecto Hombre

    OpenAIRE

    Pardo-Esteban, Belén; Escalza-González, Amaia

    2015-01-01

    En el citado seminario informaremos del programa de atención y prevención de las toxicomanías y otras adicciones, llevado a cabo por la Asociación Proyecto hombre. A continuación, trataremos la formación en adicciones y toxicomanía con los estudiantes, mediante charla, cuestionarios sobre conocimientos básicos en prevención de toxicomanía en menores y los diferentes programas de intervención posibles aducados a los perfiles de los usuarios. Terminaremos con un debate sobre los temas tra...

  4. NARRATIVAS CONVERSACIONALES CON FAMILIAS Y DOCENTES DE NIÑOS Y NIÑAS CON DISCAPACIDAD: UN APORTE METODOLÓGICO

    Directory of Open Access Journals (Sweden)

    NORA ANETH PAVA-RIPOLL

    2015-01-01

    Full Text Available Se presentan algunas ventajas y limitaciones de las narrativas conversacionales como estrategia de investigación para el trabajo con familias y docentes de niños con discapacidad. La narración realizada por muchas voces, como sucede en una conversación, privilegia la relación y el discurso entre las personas como fuente de construcción consensuada de significados. La interacción triádica entre familia, inclusión educativa y salud orientó los encuentros conversacionales con padres, acudientes y profesores de estos niños en la ciudad de Manizales (Colombia. Los participantes conformaron equipos conversacionales y equipos reflexivos y conversaron sobre preguntas propuestas, previamente elaboradas. Con este ejercicio investigativo se resalta el valor interaccional de esta estrategia desde tres ámbitos: entre los par ticipantes, con el investigador y con el contexto situacional. Se argumenta que la reflexividad está más relacionada con el hacer que con el ser y el sentir de las personas, las cuales no necesariamente se transforman en la narrativa...

  5. MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

    Directory of Open Access Journals (Sweden)

    Johanna Stella Castellanos Arias

    2010-01-01

    Full Text Available En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF, con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED, específicamente Redes de Petri (RdP, y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proceso modelado mediante una RdP, el cual constituye la base para hallar la mejor secuencia posible del sistema modelado. Por último, se realizó una implementación en el Laboratorio de Automatización de la Universidad Militar Nueva Granada, que simula el funcionamiento del SMF modelado por un montaje electrohidroneumático controlado con GRAFCET mediante PLC.

  6. Relación del perfil salival con el grado de inmunosupresión en pacientes infectados con VIH con y sin tratamiento antirretroviral

    OpenAIRE

    Vera Cruz, Moisés; Cornejo Salaza, José; Chiyong, Teresa Evaristo; Arevalo Abanto, Jorge A.; Villanueva Vílchez, Hugo G.

    2014-01-01

    El objetivo del estudio fue evaluar el perfil salival de pacientes con infección por VIH con y sin Tratamiento Antirretroviral de Gran Actividad (TARGA), por medio de la evaluación de los síntomas de hipofunción salival (Xerostomía, Disgeusia, Disfagia y Susceptibilidad de desarrollar úlceras orales), la Tasa de Flujo salival no estimulado, el pH salival y la viscosidad salival; estableciendo su relación con el Grado de Inmunosupresión, evaluado por medio del Recuento de Linfocitos CD4/μl. Se...

  7. SATISFACCIÓN CON EL TRATAMIENTO EN PACIENTES DE ATENCIÓN PRIMARIA CON ARTROSIS

    Directory of Open Access Journals (Sweden)

    Carmen Llanos Val Jiménez

    2017-01-01

    Full Text Available Fundamentos: Al igual que en otros problemas crónicos, en el abor - daje del paciente con artrosis se tiende a un modelo de toma de decisiones compartidas, en el que el punto de vista del paciente debe ser considerado en la elección del tratamiento. El objetivo de este trabajo fue evaluar la sa - tisfacción con el tratamiento en pacientes diagnosticados de osteoartrosis y comprobar si existen diferencias entre diferentes opciones farmacológicas, así como determinar si existe asociación con el estado funcional y las carac - terísticas clínicas y sociodemográficas. Métodos: Se realizó un estudio observacional transversal en una muestra de 487 pacientes seleccionados mediante muestreo consecutivo. La variable principal fue el nivel de satisfacción con el tratamiento (cuestionario ARTS. El estado funcional de los pacientes fue evaluado mediante la escala WO - MAC. Otras variables fueron: características del tratamiento, adherencia te - rapéutica, eventos adversos, y variables clínicas y sociodemográficas. Resultados: En el cuestionario ARTS los pacientes, en un rango entre 28 y 87, obtuvieron una puntuación media de 65,3 (DE: 9,9. La puntuación no fue significativamente diferente en consumidores de 1, 2 o más fármacos. Entre quienes consumían un solo fármaco, no hubo diferencias entre los di - ferentes tipos de fármacos. En el estado funcional se obtuvo una puntuación media de 30,2 puntos (DE: 20,8 y se observó una débil correlación negativa con el nivel de satisfacción (r= - 0,252; p<0,001. Mediante regresión lineal múltiple, se observó mayor puntuación en la escala ARTS (p<0,05 en pa - cientes con menor puntuación en la escala WOMAC, mayor edad y ausencia de eventos adversos. Conclusión : En pacientes con osteoartritis se observa un nivel mode - rado de satisfacción con el tratamiento farmacológico, condicionado por su situación funcional, sus características sociodemográficas y por la presencia de eventos

  8. Disease: H01717 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available . Many cases of optic neuritis are associated with multiple sclerosis or neuromyelitis optica or can occur i...feron beta [DR:D04554 D00746] Glatiramer acetate [DR:D04318] See also H01490 Multiple sclerosis and H01491 Neuromyelitis optica

  9. Hidroxilación de fenol con catalizadores ZSM-5 modificado con cobre

    Directory of Open Access Journals (Sweden)

    César Augusto Caro

    2005-01-01

    Full Text Available Se sintetizaron varios catalizadores Cu-ZSM-5 con diferentes relaciones Si/Al y Si/Cu. Usando metilamina o hidróxido de sodio como agente mineralizante. Los catalizadores se caracterizaron por DRX, IR, análisis BET, UV-VIS y análisis elemental. El desempeño catalítico de los catalizadores sintetizados se evaluó en la hidroxilación de fenol con H2O2. Se encontró que la relación catecol (CAT/(hidroquinona (HQ + p-benzoquinona (PBQ aumentó con el contenido de agua, presentó un máximo cuando la relación en peso de agua/fenol fue de 53/1 y se favoreció a altas temperaturas, con el aumento del contenido de aluminio o con la disminución en el contenido de catalizador. El contenido de cobre no fue un factor determinante para la conversión ni para la selectividad en la hidroxilación de fenol. La producción de la p-benzoquinona (PBQ, producto de oxidación de la hidroquinona, fue mínimo cuando se usaron las siguientes condiciones: 80 ºC, fenol: 1 mmol, relación molar fenol/H2O2 de 3/1, catalizador: 20 mg, agua: 5 g, tiempo de reacción: 4 h.

  10. ESTUDIO DE LA DIGESTION HUMANA CON ALUMNOS CON DIFICULTADES DE APRENDIZAJE

    Directory of Open Access Journals (Sweden)

    Mª Begoña Carretero Gómez

    2009-01-01

    Full Text Available En esta experiencia se han seleccionado una serie de actividades relacionadas con la digestión con el fin de lograr una reestructuración de ideas y cambios conceptuales, y así con la conseguir que el alumnado aprenda a construir sus propios conocimientos acerca de cómo y donde se dan los procesos de digestión necesarios para la nutrición del organismo. El trabajo se ha llevado a cabo con alumnos de 3º de Educación Secundaria Obligatoria, pertenecientesal programa de diversificación curricular. Hemos querido hacer la ciencia más cercana para que comprendan que algunos procesos tienen su explicación científica y que la ciencia forma parte de nuestro día a día, fomentando el interés del estudiante así como su implicación en el proceso de enseñanza-aprendizaje. Por ello hemos trabajado a base de pequeñas investigaciones, donde es el alumno el que marca su ritmo de trabajo, investiga y hace sus aportaciones. Han aprendido a trabajar de una forma meticulosa donde el rigor esfundamental, contagiándose del afán investigador de manera que al realizar las experiencias se han aproximado al trabajo científico a la vez que aclaran y reestructuran conocimientos.

  11. Esporotricosis cutánea diseminada con compromiso articular en una mujer con diabetes tipo 2

    Directory of Open Access Journals (Sweden)

    Sendy Solorzano

    Full Text Available La esporotricosis diseminada es una presentación infrecuente de esta micosis. Aunque ha sido descrita en sujetos inmunocompetentes, con frecuencia existe compromiso de la inmunidad mediada por células T. Reportamos el caso de una mujer con diabetes tipo 2 no controlada que desarrolló esporotricosis cutánea diseminada. El curso de la enfermedad presentó varias complicaciones que incluyeron hepatitis secundaria a itraconazol y artritis de la rodilla con cultivo positivo para Sporothrix schenckii durante el tratamiento con solución saturada de ioduro de potasio. La discusión del caso incluye aspectos de la patogénesis de la esporotricosis diseminada y el manejo de la infección y sus complicaciones.

  12. Comparison of brain and spinal cord magnetic resonance imaging features in neuromyelitis optica spectrum disorders patients with or without aquaporin-4 antibody.

    Science.gov (United States)

    Fan, Moli; Fu, Ying; Su, Lei; Shen, Yi; Wood, Kristofer; Yang, Li; Liu, Yaou; Shi, Fu-Dong

    2017-04-01

    The spinal cord and brain measurements are rarely investigated in neuromyelitis optica (NMO) patients with and without antibodies to aquaporin-4 (AQP4), directly compared to multiple sclerosis (MS) patients. To investigate magnetic resonance imaging (MRI) features of both brain and spinal cord in NMO patients with and without antibodies to AQP4, compared with MS patients and healthy controls (HC). We recruited 55 NMO including 30 AQP4 (+) and 25 AQP4 (-), 25 MS and 25 HC. Brain and spinal cord MRIs were obtained for each participant. Brain lesions (BL), whole brain and deep grey matter volumes (DGMV), white matter diffusion metrics and spinal cord lesions were measured and compared among groups. The incidence of BL was lower in the AQP4 (+) group than in the AQP4 (-) and MS groups (p<0.05). In the AQP4 (+) group, there was a lower incidence of infratentorial lesions (ITL) and higher spinal cord lesions length than in the MS group (p<0.05). The thalamic and hippocampal volumes were smaller in the AQP4 (-) group and MS group than in the HC group (p<0.05). The NMO patients with AQP4 (-) showed higher prevalence of BL, ITL, and similar spinal cord lesion length, compared to AQP4 (+), and demonstrated deep grey matter atrophy, suggesting an intermediate phenotype between that of typical MS and NMO. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Recombinant IgG1 Fc hexamers block cytotoxicity and pathological changes in experimental in vitro and rat models of neuromyelitis optica.

    Science.gov (United States)

    Tradtrantip, Lukmanee; Felix, Christian M; Spirig, Rolf; Morelli, Adriana Baz; Verkman, A S

    2018-05-01

    Intravenous human immunoglobulin G (IVIG) may have therapeutic benefit in neuromyelitis optica spectrum disorders (herein called NMO), in part because of the anti-inflammatory properties of the IgG Fc region. Here, we evaluated recombinant Fc hexamers consisting of the IgM μ-tailpiece fused with the Fc region of human IgG1. In vitro, the Fc hexamers prevented cytotoxicity in aquaporin-4 (AQP4) expressing cells and in rat spinal cord slice cultures exposed to NMO anti-AQP4 autoantibody (AQP4-IgG) and complement, with >500-fold greater potency than IVIG or monomeric Fc fragments. Fc hexamers at low concentration also prevented antibody-dependent cellular cytotoxicity produced by AQP4-IgG and natural killer cells. Serum from rats administered a single intravenous dose of Fc hexamers at 50 mg/kg taken at 8 h did not produce complement-dependent cytotoxicity when added to AQP4-IgG-treated AQP4-expressing cell cultures. In an experimental rat model of NMO produced by intracerebral injection of AQP4-IgG, Fc hexamers at 50 mg/kg administered before and at 12 h after AQP4-IgG fully prevented astrocyte injury, complement activation, inflammation and demyelination. These results support the potential therapeutic utility of recombinant IgG1 Fc hexamers in AQP4-IgG seropositive NMO. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Neuromyelitis optica study model based on chronic infusion of autoantibodies in rat cerebrospinal fluid.

    Science.gov (United States)

    Marignier, R; Ruiz, A; Cavagna, S; Nicole, A; Watrin, C; Touret, M; Parrot, S; Malleret, G; Peyron, C; Benetollo, C; Auvergnon, N; Vukusic, S; Giraudon, P

    2016-05-18

    Devic's neuromyelitis optica (NMO) is an autoimmune astrocytopathy, associated with central nervous system inflammation, demyelination, and neuronal injury. Several studies confirmed that autoantibodies directed against aquaporin-4 (AQP4-IgG) are relevant in the pathogenesis of NMO, mainly through complement-dependent toxicity leading to astrocyte death. However, the effect of the autoantibody per se and the exact role of intrathecal AQP4-IgG are still controversial. To explore the intrinsic effect of intrathecal AQP4-IgG, independent from additional inflammatory effector mechanisms, and to evaluate its clinical impact, we developed a new animal model, based on a prolonged infusion of purified immunoglobulins from NMO patient (IgG(AQP4+), NMO-rat) and healthy individual as control (Control-rat) in the cerebrospinal fluid (CSF) of live rats. We showed that CSF infusion of purified immunoglobulins led to diffusion in the brain, spinal cord, and optic nerves, the targeted structures in NMO. This was associated with astrocyte alteration in NMO-rats characterized by loss of aquaporin-4 expression in the spinal cord and the optic nerves compared to the Control-rats (p = 0.001 and p = 0.02, respectively). In addition, glutamate uptake tested on vigil rats was dramatically reduced in NMO-rats (p = 0.001) suggesting that astrocytopathy occurred in response to AQP4-IgG diffusion. In parallel, myelin was altered, as shown by the decrease of myelin basic protein staining by up to 46 and 22 % in the gray and white matter of the NMO-rats spinal cord, respectively (p = 0.03). Loss of neurofilament positive axons in NMO-rats (p = 0.003) revealed alteration of axonal integrity. Then, we investigated the clinical consequences of such alterations on the motor behavior of the NMO-rats. In a rotarod test, NMO-rats performance was lower compared to the controls (p = 0.0182). AQP4 expression, and myelin and axonal integrity were preserved in AQP4-Ig

  15. Efectos del tratamiento con litio sobre las funciones neurosicológicas de pacientes con trastorno bipolar de tipo I

    Directory of Open Access Journals (Sweden)

    Anabel Martínez Aran

    2008-11-01

    Full Text Available OBJETIVO: determinar si el tratamiento continuo con litio influye en el desempeño cognitivo de un grupo de pacientes eutímicos con trastorno afectivo bipolar I. MÉTODO: se evaluó el desempeño cognitivo usando pruebas neurosicológicas de atención, memoria y función ejecutiva en 20 pacientes eutímicos con trastorno afectivo bipolar I que no tomaban medicación, 20 pacientes eutímicos con trastorno afectivo bipolar I quienes continuaban regularmente el tratamiento con carbonato de litio, y un tercer grupo de 20 pacientes control. RESULTADOS: no se encontraron diferencias estadísticamente significativas entre los dos grupos de pacientes con trastorno afectivo bipolar. Sin embargo, al compararlos con el grupo control, su desempeño en términos de memoria verbal, viso-verbal y asociación semántica medida fue menor. DISCUSIÓN: los pacientes con trastorno afectivo bipolar I muestran deficiencias en términos de memoria verbal y viso-verbal que no pueden ser atribuidos al tratamiento regular con carbonato de litio. Por el contrario, estas deficiencias podrían ser consideradas como características de rasgo de este trastorno.

  16. Volumetric properties of room temperature ionic liquid 1. The system of {1-methyl-3-ethylimidazolium ethyl sulfate+water} at temperature in the range (278.15 to 333.15) K

    International Nuclear Information System (INIS)

    Lu Xingmei; Xu Weiguo; Gui Jinsong; Li Huawei; Yang Jiazhen

    2005-01-01

    This paper reports densities of aqueous solutions of ionic liquid (IL) 1-methyl-3-ethylimidazolium ethyl sulfate (EMISE) that were measured gravimetrically at temperatures (278.15 to 333.15) K. The values of the apparent molar volume, φ V B and partial molar volume, V-bar B, were determined and apparent molar expansibilities φ E=((∂φ B )/∂T)) p of EMISE and the coefficients of thermal expansion of the solutions, α, were calculated. The values of the apparent molar volume, φ V B , were fitted by the method of least-squares to a Pitzer's equation to determine the parameters, β MX (0)V , β MX (1)V , and C MX V

  17. Acne polimorfo: tratamiento con Implacen

    Directory of Open Access Journals (Sweden)

    Rubén Pérez Armas

    1995-06-01

    Full Text Available Se realiza el estudio de 40 pacientes con acné polimorfo, los que fueron atendidos en la Consulta de Dermatología del Hospital Provincial Clinicoquirúrgico Docente "Celia Sánchez Manduley", en el período comprendido de enero de 1988 a diciembre de 1989. Se revisa la literatura médica sobre los diversos métodos y medicamentos utilizados en la terapéutica de esta dermatosis. Se describe el esquema de tratamiento empleado con implacén en 30 pacientes; los 10 restantes se trataron con placebo; se compara dicho esquema con los tradicionales y se observan mejores resultados con nuestro estudio. Se destaca la ausencia de recaídas, así como el resultado del tratamiento de acuerdo con el sexo.A study was performed in 40 patients presenting with polymorphic acne who were attended in the Dermatology Department of "Celia Sánchez Manduley" Clinicosurgical and Teaching Hospital from January, 1988 to December, 1989. A review of the literature was made seeking for the different methods and drugs used for the treatment of this dermatosis. The treatment schedule with the use of implacen in 30 patients is described. Such therapeutic schedule was compared with traditional ones and better results were observed with the use of implacen. The fact that there were no relapses is highlighted, as well as the result of treatment according to sex.

  18. Reducción de color con cloruro de magnesio en soluciones con colorantes comerciales

    Directory of Open Access Journals (Sweden)

    Mercedes Lucero Chávez

    2017-01-01

    Full Text Available Se experimentó con diferentes concentraciones de cloruro de magnesio (MgCl2 como coagulante para reducir el color en soluciones con colorantes comerciales: negro, azul y café. Los parámetros analizados fueron pH, color, demanda química de oxígeno ( dqo y sólidos suspendidos totales (sst de acuerdo con las Normas Mexicanas. Como prueba complementaria se agregó carbón activado a las muestras para reducir el color residual después de la coagulación-floculación. La reducción de los valores de color y dqo fue mayor cuando se adicionó más cantidad de MgCl2 (1.8 g/L. Los porcentajes de reducción fueron ≥90% para el color y >50% para la dqo. Los sst aumentaron con la adición de MgCl2. El carbón activado eliminó el color residual.

  19. Aprende Ajedrez con Rey - Parte 2

    OpenAIRE

    ESTÉVEZ MONTERO, RAÚL; Lloret Mauri, Jaime

    2016-01-01

    Es una pieza audiovisual creada con el objeto de atraer la atención de los niños de muy corta edad con el ajedrez y familiarizarlos con todas sus piezas y movimientos. Es una animación dirigida a un público infantil presentada por dibujos animados en 2D, en la que se ha intentado respetar en todo momento el argot de la comunidad ajedredística. En este video se presenta la segunda parte. Estévez Montero, R.; Lloret Mauri, J. (2016). Aprende Ajedrez con Rey - Parte 2. http://hdl.handle.net/1...

  20. Aprende Ajedrez con Rey - Parte 1

    OpenAIRE

    ESTÉVEZ MONTERO, RAÚL; Lloret Mauri, Jaime

    2016-01-01

    Es una pieza audiovisual creada con el objeto de atraer la atención de los niños de muy corta edad con el ajedrez y familiarizarlos con todas sus piezas y movimientos. Es una animación dirigida a un público infantil presentada por dibujos animados en 2D, en la que se ha intentado respetar en todo momento el argot de la comunidad ajedredística. En este video se presenta la primera parte. Estévez Montero, R.; Lloret Mauri, J. (2016). Aprende Ajedrez con Rey - Parte 1. http://hdl.handle.net/1...

  1. Autologous mesenchymal stem cells applied on the pressure ulcers had produced a surprising outcome in a severe case of neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Adriana Octaviana Dulamea

    2015-01-01

    Full Text Available Recent studies provided evidence that mesenchymal stem cells (MSCs have regenerative potential in cutaneous repair and profound immunomodulatory properties making them a candidate for therapy of neuroimmunologic diseases. Neuromyelitis optica (NMO is an autoimmune, demyelinating central nervous system disorder characterized by a longitudinally extensive spinal cord lesion. A 46-year-old male diagnosed with NMO had relapses with paraplegia despite treatment and developed two stage IV pressure ulcers (PUs on his legs. The patient consented for local application of autologous MSCs on PUs. MSCs isolated from the patient′s bone marrow aspirate were multiplied in vitro during three passages and embedded in a tridimensional collagen-rich matrix which was applied on the PUs. Eight days after MSCs application the patient showed a progressive healing of PUs and improvement of disability. Two months later the patient was able to walk 20 m with bilateral assistance and one year later he started to walk without assistance. For 76 months the patient had no relapse and no adverse event was reported. The original method of local application of autologous BM-MSCs contributed to healing of PUs. For 6 years the patient was free of relapses and showed an improvement of disability. The association of cutaneous repair, sustained remission of NMO and improvement of disability might be explained by a promotion/optimization of recovery mechanisms in the central nervous system even if alternative hypothesis should be considered. Further studies are needed to assess the safety and efficacy of mesenchymal stem cells in NMO treatment.

  2. Measuring system of partial discharges with optical links and interphase for PC; Sistema de medicion de descargas parciales con enlaces opticos e interfase para PC

    Energy Technology Data Exchange (ETDEWEB)

    Pacheco Arteaga, Maria Jojutla Olimpia

    1999-07-01

    In this work a measuring system of partial discharges based on the traditional electrical detection technique is presented, but that unlike the existing systems it uses an optical link of communication. On one hand, the optical fiber avoids that the electromagnetic interference of the area affects the measurement and on the other hand, allows to make measurements online. With a personal computer and an application program the system is controlled, besides storing and displaying graphically the acquired data. As a result of this thesis the developed system obtains the magnitude and the phase of every partial discharge occurred during a time interval fixed or selected by the user, as well as the total number of discharges. In a graphical form it presents the magnitude and the phase of each discharge, in addition to the corresponding histogram of frequencies. [Spanish] En este trabajo se presenta un sistema de medicion de descargas parciales basado en la tecnica de deteccion electrica tradicional, pero que a diferencia de los sistemas existentes utiliza un enlace de comunicacion optico. Por un lado, la fibra optica evita que la interferencia electromagnetica del medio afecte la medicion y por otro, permite hacer mediciones en linea. Con una computadora personal y un programa de aplicacion se controla el sistema, ademas de almacenar y presentar graficamente la informacion adquirida. Como resultado de esta tesis el sistema desarrollado obtiene la magnitud y la fase de cada descarga parcial ocurrida durante un intervalo de tiempo fijo o seleccionado por el usuario, asi como el numero total de descargas. En forma grafica presenta la magnitud y la fase de cada descarga, ademas del histograma de frecuencias correspondiente.

  3. Multicentre comparison of a diagnostic assay

    DEFF Research Database (Denmark)

    Waters, Patrick; Reindl, Markus; Saiz, Albert

    2016-01-01

    ) assays in neuromyelitis optica spectrum disorders (NMOSD). METHODS: Coded samples from patients with neuromyelitis optica (NMO) or NMOSD (101) and controls (92) were tested at 15 European diagnostic centres using 21 assays including live (n=3) or fixed cell-based assays (n=10), flow cytometry (n=4...

  4. Videojuego con Realidad Virtual

    OpenAIRE

    González Mora, César

    2017-01-01

    El objetivo del proyecto es el desarrollo de un videojuego deportivo que utilice realidad mixta. El videojuego se podrá utilizar con dispositivos de tipo cardboard, y utilizará realidad aumentada para la interacción del jugador con el videojuego. En el desarrollo se utilizará el motor Unity para conseguir una aplicación multiplataforma, y la librería Vuforia para implementar realidad mixta.

  5. Factores psicosociales relacionados con la rehospitalización de pacientes con psicosis orgánica

    Directory of Open Access Journals (Sweden)

    Cortés-Padilla María Teresa

    2001-01-01

    Full Text Available Objetivo. Conocer los factores psicosociales relacionados con la frecuente rehospitalización de pacientes con psicosis orgánica. Material y métodos. Estudio de tipo observacional descriptivo, de corte transversal. La muestra estuvo formada por 33 pacientes del Hospital Psiquiátrico Guillermo Dávila, con Unidad de Medicina Familiar Número 10 del Instituto Mexicano del Seguro Social de la Ciudad de México, con psicosis orgánica y quienes durante los años de 1993-1994 presentaron más de dos rehospitalizaciones. Instrumentos: Entrevista grabada, o muestra de conversación de cinco minutos, para la emoción expresada (EE, cuestionarios mixtos para la Concepción de Enfermedad y la Relación médico-paciente. La validez y confiabilidad de los datos se establecieron con las pruebas de Kappa y Alpha de Cronbach y se efectuó análisis estadístico descriptivo e inferencial. Resultados. El 60.9% de los familiares presentan alto nivel de EE, es decir, expresan crítica, hostilidad o sobreinvolucramiento emocional; el 64.3% de los sujetos de la muestra conviven más de 35 horas a la semana con familiares que presentan Alta EE. Conclusiones. Altos niveles de EE estuvieron asociados con los frecuentes reingresos a hospitalización. Existe mayor conocimiento de las características de la enfermedad por parte del familiar que del paciente. La relación médico-paciente es satisfactoria pero no forma conciencia de enfermedad ni propicia apego al tratamiento terapeútico. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

  6. Astrocytic autoantibody of neuromyelitis optica (NMO-IgG) binds to aquaporin-4 extracellular loops, monomers, tetramers and high order arrays

    Science.gov (United States)

    Iorio, Raffaele; Fryer, James P.; Hinson, Shannon R.; Fallier-Becker, Petra; Wolburg, Hartwig; Pittock, Sean J.; Lennon, Vanda A.

    2012-01-01

    The principal central nervous system (CNS) water channel, aquaporin-4 (AQP4), is confined to astrocytic and ependymal membranes and is the target of a pathogenic autoantibody, neuromyelitis optica (NMO)-IgG. This disease-specific autoantibody unifies a spectrum of relapsing CNS autoimmune inflammatory disorders of which NMO exemplifies the classic phenotype. Multiple sclerosis and other immune-mediated demyelinating disorders of the CNS lack a distinctive biomarker. Two AQP4 isoforms, M1 and M23, exist as homotetrameric and heterotetrameric intramembranous particles (IMPs). Orthogonal arrays of predominantly M23 particles (OAPs) are an ultrastructural characteristic of astrocytic membranes. We used high-titered serum from 32 AQP4-IgG-seropositive patients and 85 controls to investigate the nature and molecular location of AQP4 epitopes that bind NMO-IgG, and the influence of supramolecular structure. NMO-IgG bound to denatured AQP4 monomers (68% of cases), to native tetramers and high order arrays (90% of cases), and to AQP4 in live cell membranes (100% of cases). Disease-specific epitopes reside in extracellular loop C more than in loops A or E. IgG binding to intracellular epitopes lacks disease specificity. These observations predict greater disease specificity and sensitivity for tissue-based and cell-based serological assays employing “native” AQP4 than assays employing denatured AQP4 and fragments. NMO-IgG binds most avidly to plasma membrane surface AQP4 epitopes formed by loop interactions within tetramers and by intermolecular interactions within high order structures. The relative abundance and localization of AQP4 high order arrays in distinct CNS regions may explain the variability in clinical phenotype of NMO spectrum disorders. PMID:22906356

  7. Análisis probabilista con caminata al azar del número de personas viviendo con VIH mundialmente

    Directory of Open Access Journals (Sweden)

    Javier Oswaldo Rodríguez-Velásquez

    2018-01-01

    Full Text Available Introducción: El estudio de la dinámica anual de la epidemia de VIH a partir de la caminata al azar ha mostrado ser de utilidad para llevar este fenómeno altamente variable a un comportamiento predecible Objetivo: Predecir el comportamiento de la dinámica del número de personas viviendo con VIH mediante la caminata al azar probabilista. Metodología: Se analizaron los valores anuales de personas que a nivel global viven con VIH desde el año 1990 hasta el 2009, a partir de los espacios de probabilidad generados con la caminata al azar probabilista, para posteriormente desarrollar la predicción del valor anual de personas viviendo con VIH para los años 2010, 2011 y 2012. Resultados: Se predijeron los valores anuales de personas viviendo con VIH con un porcentaje de acierto de 98,95% para el año 2010, de 98,82% para el año 2011 y de 98,99% para la predicción realizada para el año 2012. Conclusiones: Se establecieron órdenes matemáticos a partir de la caminata al azar probabilista, estableciendo predicciones prácticamente deterministas del número de personas viviendo con VIH, lo que podría ser útil para las decisiones en Salud Pública y para la evaluación de intervenciones.

  8. Fuerza manual de adultos con discapacidad intelectual

    Directory of Open Access Journals (Sweden)

    Ruth Cabeza Ruiz

    2017-09-01

    Full Text Available Objetivo. Presentar una descripción de la fuerza de prensión manual de hombres y mujeres con discapacidad intelectual (DI y comparar los resultados con valores de referencia de otras personas con y sin discapacidad intelectual. Método. El presente trabajo es un estudio transversal observacional, financiado por la Fundación SAMU, en el que se evaluaron a 122 personas con DI (86 hombres y 36 mujeres durante el desarrollo de unas jornadas de carácter recreativo en las que participaron varias asociaciones de atención a este colectivo. La batería de test utilizada fue el Alpaha-Fit Test Battery for Adults. Resultados. Se presentan los resultados relacionados con las variables de fuerza del miembro superior (Hand Grip Strength por grupos de edad (20-24, 25- 29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59 años. Los datos muestran valores que oscilan desde los 31 kg en los hombres más jóvenes con DI hasta los 13.3 kg del grupo más maduro de mujeres. Estos hallazgos son similares a los valores de referencia de población con DI española. Sin embargo, son muy inferiores a los obtenidos por la población sin discapacidad de la misma edad. Conclusión. Los resultados evidencian el menor rendimiento de las personas con DI en pruebas de fuerza de prensión manual por lo que se hace evidente la necesidad de llevar a cabo programas de ejercicio físico o deporte con las personas con DI.

  9. Sistemas integrados con Arduino

    OpenAIRE

    EL YAKOUTI, MOHAMMED

    2017-01-01

    Design of a robot prototype remotely controllable from Bluetooth using Arduino. Control and testing of sensors and events interacting with Arduino and Bluetooth. Diseño de un prototipo de robot controlable remotamente con Bluetooth utilizando Arduino. Control y verificación de los sensores y eventos que interactúan mediante el Arduino y el Bluetooth. El Yakouti, M. (2017). Sistemas integrados con Arduino. http://hdl.handle.net/10251/89274. TFGM

  10. Developments in the technology for the combustion of water emulsions in Mexican fuel oil; Desarrollos en la tecnologia para la combustion de emulsiones agua en combustoleo mexicano

    Energy Technology Data Exchange (ETDEWEB)

    Diego, Antonio Marin; Martinez Flores, Marco A.; Tamayo Flores, Gustavo; Alarcon Quiroz, Ernesto; Melendez Cervantes, Carlos [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

    2001-07-01

    sulfurico que, al emitirse, tambien afecta la visibilidad de la pluma y puede condensarse, originado corrosion e incrementar la acumulacion de depositos de las calderas. La investigacion experimental se realizo en una base comparativa, entre pruebas de combustion de combustoleo , con emulsiones en donde se vario la concentracion de agua y el tamano de la gota de esta. Se muestra un diagrama de alimentacion de combustible y de preparacion de emulsiones en horno piloto. Y se da una grafica del efecto de la concentracion de agua de las emulsiones en la emision de particulas.El articulo contiene figuras de las cenosferas producidas por la combustion de combustoleo (500x) y las producidas por la combustion con 5% de agua (500x). Tambien muestra graficas del efecto del tamano de gota de agua de emulsiones en la emision de particulas, de la reduccion del trioxido de azufre con productos de magnesio soluble en el agua de emulsiones, y de la acidez libre de particulas con neutralizadores de magnesio soluble en el agua de emulsiones.

  11. fertilizada con diferentes abonos

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Elizondo-Salazar

    2007-01-01

    Full Text Available Producción y calidad de la biomasa de morera (Morus alba fertilizada con diferentes abonos. Se llevó a cabo un experimento en la Estación Experimental “Alfredo Volio Mata” de la Universidad de Costa Rica con el fi n de evaluar la aplicación de 150 kg de N/ha/año proveniente de dos abonos orgánicos: lombriabono y compostaje; y de un fertilizante químico, sobre la producción y calidad de la biomasa de morera. El periodo experimental comprendió un ciclo de 12 meses, iniciando en julio del 2003 y fi nalizando en julio del 2004. Se utilizó una plantación de morera de 12 años de establecida con una densidad de siembra de 27.777 plantas/ ha. Se empleó un diseño de bloques completos al azar con cuatro tratamientos: dos abonos orgánicos, nitrato de amonio (33,5% N y un control. Las plantas se podaron a 0,6 m sobre el nivel del suelo al inicio del ensayo. Durante el periodo experimental, las plantas fueron podadas consecutivamente cada 90 días. Las hojas y los tallos fueron separados y analizados para determinar el contenido de materia seca y proteína cruda. La producción de materia seca fue 23% superior y el contenido de proteína cruda fue signifi cativamente mayor con el nitrógeno químico, mientras que el contenido de materia seca fue menor. No se encontraron diferencias signifi cativas entre el tratamiento control y los tratamientos orgánicos.

  12. Estudio observacional prospectivo con insulina detemir en pacientes con diabetes mellitus tipo 2 mal controlados que inician por primer vez tratamiento con insulina (estudio SOLVE

    Directory of Open Access Journals (Sweden)

    Domingo Orozco-Beltrán

    2016-02-01

    Conclusiones: En esta cohorte de pacientes con diabetes mellitus tipo 2 recientemente insulinizados, la insulina detemir (una vez al día mejoró el control glucémico, con baja incidencia de hipoglucemia y una reducción significativa del peso.

  13. Eficacia del tratamiento tópico con Vimang® en pacientes con estomatitis subprótesis

    Directory of Open Access Journals (Sweden)

    Laritza Coureaux Rojas

    2013-10-01

    Full Text Available Se efectuó un ensayo clínico terapéutico controlado de fase III en 120 pacientes con estomatitis subprótesis, atendidos en la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba, desde junio de 2010 hasta mayo de 2011, con vistas a evaluar la eficacia del tratamiento tópico con té de Vimang® en dichos pacientes. Se conformaron 2 grupos de 60 integrantes cada uno (de estudio y de control. Los primeros fueron tratados con enjuagatorios fríos de dicho té 4 veces al día y los segundos con el mismo tratamiento más vitaminas. Se utilizaron el porcentaje para variables cualitativas, así como la media aritmética y la desviación estándar para variables cuantitativas. Todos los integrantes del grupo de estudio se curaron y disminuyó el gasto de material, pero el costo-efectividad fue mayor por ser menor el tiempo de curación. El té de Vimang® resultó eficaz para eliminar las manifestaciones clínicas de esa lesión y no hubo reacciones adversas, de manera que se logró la curación de los afectados con ahorro de tiempo y recursos.

  14. Tolerogenic Dendritic Cells as a Promising Antigen-Specific Therapy in the Treatment of Multiple Sclerosis and Neuromyelitis Optica From Preclinical to Clinical Trials

    Directory of Open Access Journals (Sweden)

    Georgina Flórez-Grau

    2018-05-01

    Full Text Available The identification of activated T-lymphocytes restricted to myelin-derived immunogenic peptides in multiple sclerosis (MS and aquaporin-4 water channel in neuromyelitis optica (NMO in the blood of patients opened the possibility for developing highly selective and disease-specific therapeutic approaches. Antigen presenting cells and in particular dendritic cells (DCs represent a strategy to inhibit pro-inflammatory T helper cells. DCs are located in peripheral and lymphoid tissues and are essential for homeostasis of T cell-dependent immune responses. The expression of a particular set of receptors involved in pathogen recognition confers to DCs the property to initiate immune responses. However, in the absence of danger signals different DC subsets have been revealed to induce active tolerance by inducing regulatory T cells, inhibiting pro-inflammatory T helper cells responses or both. Interestingly, several protocols to generate clinical-grade tolerogenic DC (Tol-DC in vitro have been described, offering the possibility to restore the homeostasis to central nervous system-related antigens. In this review, we discuss about different DC subsets and their role in tolerance induction, the different protocols to generate Tol-DCs and preclinical studies in animal models as well as describe recent characterization of Tol-DCs for clinical application in autoimmune diseases and in particular in MS and NMO patients. In addition, we discuss the clinical trials ongoing based on Tol-DCs to treat different autoimmune diseases.

  15. Trastornos temporomandibulares en pacientes con maloclusiones

    Directory of Open Access Journals (Sweden)

    Luis Soto Cantero

    Full Text Available Introducción: existe una prevalencia de trastornos oclusales en gran medida relacionados con la presencia de disfunción temporomandibular. Objetivo: determinar el grado de disfunción temporomandibular según el Índice de Maglione en correspondencia con la prevalencia de maloclusiones en el área de salud del policlínico "Turcios Lima". Métodos: se realizó un estudio observacional descriptivo, de corte transversal, en la consulta de ortodoncia, de junio del 2008 a junio del 2009. De un universo constituido por los 280 pacientes que acudieron al servicio de ortodoncia en el período señalado con presencia de maloclusiones, se seleccionó una muestra de 84 pacientes por muestreo aleatorio simple, teniendo en cuenta los criterios de inclusión y exclusión realizados por criterios de expertos. Resultados: presentaban disfunción temporomandibular 74 pacientes y dentro de ellos 44 (52,4 % tenían disfunción grado II (Moderada. El 97 % de los pacientes con relación molar de clase II, presentaban disfunción temporomandibular. El 42,9 % de los pacientes con una maloclusión, presentaban disfunción grado I. El 60 % de los pacientes con dos maloclusiones presentaban disfunción grado II y el 66,7 % de los pacientes con tres maloclusiones, presentaban disfunción grado III. La mayor cantidad de pacientes tuvieron disfunción grado II (Moderada. Conclusiones: el mayor por ciento de los pacientes con disfunciones presentó una clase II molar y a medida que aumentó el número de maloclusiones aumentó también la severidad de la disfunción.

  16. RadCon: A Radiological Consequences Model

    International Nuclear Information System (INIS)

    Crawford, J.; Domel, R.U.

    2000-05-01

    RadCon estimates the dose received by user selected groups in the population from an accidental release of radionuclides to the environment. The exposure pathways considered are external exposure from the cloud and ground and internal exposure from inhalation and ingestion of contaminated food. Atmospheric dispersion modelling is carried out externally to RadCon.Given a two dimensional time varying air and ground concentration of radioactive elements, RadCon allows the user to: view the air and ground concentration over the affected area, select optional parameters and calculate the dose to people,display the results to the user, and change the parameter values. RadCon offers two user interfaces: 1) the standard graphical user interface which is started using Java DoseApp at the command line, or by setting up a shortcut to this command (particularly when RadCon is installed on a PC) and 2) the text based interface used to generate information for the model inter-comparison exercise . This is initiated using Java BIOMASS at the command line, or an equivalent shortcut. The text based interface was developed for research purposes and is not generally available. Appendices A, B and C provide a summary of instructions on setting up RadCon. This will generally be carried out by the computer support personnel

  17. Iron deposition of the deep grey matter in patients with multiple sclerosis and neuromyelitis optica: A control quantitative study by 3D-enhanced susceptibility-weighted angiography (ESWAN)

    International Nuclear Information System (INIS)

    Chen Xuan; Zeng Chun; Luo Tianyou; Ouyang Yu; Lv Fajin; Rumzan, Reshiana; Wang Zhongping; Li Qi; Wang Jingjie; Hou Huanxin

    2012-01-01

    Purpose: Previous studies have detected abnormal iron deposition in the deep grey matter (DGM) of multiple sclerosis (MS). The regional specificity of the DGM iron deposition in neuromyelitis optica (NMO) is still unclear. We compared the differences in the DGM iron concentration between MS and NMO patients. Methods: We enrolled 42 relapsing–remitting MS (RRMS) patients, 42 NMO patients and 42 healthy controls undergoing brain conventional MRI and three-dimensional (3D)-enhanced T 2 *-weighted angiography (ESWAN) sequences. We obtained the mean phase values (MPVs) for ESWAN-filtered phase images. An analysis of covariance (ANCOVA) was used to compare MPVs among three groups. The correlations of MPVs changes with disease duration and expanded disability status scale (EDSS) were analyzed. Results: The RRMS patients had higher DGM iron concentration than did the NMO and control groups, but only the bilateral substantia nigra (SN) showed a significant statistical difference among three groups (p 0.05). Furthermore, no correlations were found between the DGM iron concentration and EDSS (p > 0.05). Conclusions: We confirm the iron concentration in the DGM iron content of MS patients is more than NMO patients and healthy controls in the same age range. Furthermore, the disease duration was found to be a significant contributor to patients with MS.

  18. Estudio comparativo del efecto del cepillado con una crema dental con propóleos rojos y de un gel con clorofila

    Directory of Open Access Journals (Sweden)

    Estela Gispert Abreu

    1998-12-01

    Full Text Available Se analiza comparativamente el efecto de un gel dental de clorofila y de una crema dental con propóleos rojos sobre varios parámetros relacionados con la caries dental, en escolares que se cepillaron durante 21 días con dichos productos. Se obtuvieron resultados favorables principalmente en la disminución del grado de infección por Streptococcus mutans y la elevación de la capacidad individual de remineralización; salvo en este último no hubo diferencias estadísticamente significativas.Authors made a comparative analysis about effect of chlorophyl dental gel and toothpaste containing red propolis, on some parameters related to dental caries in a group of students that brushed their teeth during 21 days using such products. Favourable results were obtained, mainly in decrease of infection level from Streptococcus mutans, and in increase of individual capacity of remineralization; except for this latter, there weren´t statistically significant differences.

  19. Tratamiento conservador en pacientes con retinoblastoma bilateral

    Directory of Open Access Journals (Sweden)

    Juan C. Suárez

    2008-11-01

    Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

  20. Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad

    OpenAIRE

    Viridiana Vanessa Conzuelo-González

    2009-01-01

    El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria) entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estud...

  1. Terapia asistida con perros en niños con autismo revisión sistemática

    OpenAIRE

    Isaza Narváez, Ana Milena; Muñoz Chilito, Doumer Adrian

    2013-01-01

    Introducción: El autismo es un trastorno temprano y masivo del desarrollo en el cual se afecta la interacción social, el desarrollo del lenguaje, se presentan rituales y estereotipias. Hay evidencia que la interacción con un perro está asociada con efectos positivos en la salud del niño, lo cual se extiende al terreno terapéutico donde la compañía del perro estimula habilidades comunicativas para conectarse con el mundo exterior y romper el aislamiento que lo hace refractario a formas convenc...

  2. Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad

    OpenAIRE

    Viridiana Vanessa Conzuelo-González; Ivonne Vizcarra-Bordi

    2009-01-01

    El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria) entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un est...

  3. Designing of epoxy composites reinforced with carbon nanotubes grown carbon fiber fabric for improved electromagnetic interference shielding

    Directory of Open Access Journals (Sweden)

    B. P. Singh

    2012-06-01

    Full Text Available In this letter, we report preparation of strongly anchored multiwall carbon nanotubes (MWCNTs carbon fiber (CF fabric preforms. These preforms were reinforced in epoxy resin to make multi scale composites for microwave absorption in the X-band (8.2-12.4GHz. The incorporation of MWCNTs on the carbon fabric produced a significant enhancement in the electromagnetic interference shielding effectiveness (EMI-SE from −29.4 dB for CF/epoxy-composite to −51.1 dB for CF-MWCNT/epoxy multiscale composites of 2 mm thickness. In addition to enhanced EMI-SE, interlaminar shear strength improved from 23 MPa for CF/epoxy-composites to 50 MPa for multiscale composites indicating their usefulness for making structurally strong microwave shields.

  4. Efectos del contacto piel con piel del recién nacido con su madre

    Directory of Open Access Journals (Sweden)

    Camila Lucchini Raies

    Full Text Available Antecedentes: el contacto piel con piel ha sido una práctica ancestral en toda cultura, que debido a la institucionalización de la atención del parto, disminuyó en occidente. Se retomó en el marco de la atención humanizada del parto. Objetivo principal: determinar los efectos del contacto piel con piel del recién nacido con su madre. Metodología: revisión bibliográfica de 26 estudios. Límites de búsqueda: new borns, humans, clinical trials, de 10 años de publicación, en bases de datos: Pubmed, ProQuest, CINHAL, Lilacs. Resultados principales: Se observaron beneficios en las variables: duración de lactancia materna, comportamiento neurosensorial, regulación de temperatura, como alternativa al cuidado estándar, disminución en días hospitalización y niveles de cortisol, favorecedor de la interacción madre-hijo y desarrollo infantil. Conclusión principal: el contacto piel con piel brinda múltiples beneficios a recién nacidos. Se presenta como alternativa de cuidado segura, factible de implementar.

  5. Role of AQP4 Antibody Serostatus and its Prediction of Visual Outcome in Neuromyelitis Optica: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lin, Nan; Liu, Qing; Wang, Xiaoyu; Ma, Jianmei; Li, Yuyuan

    2017-01-01

    Backgroud: Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder, which is characterized by severe attacks of optic neuritis and myelitis. Antibodies (Ab) to aquaporin-4 (AQP4) (or NMO-IgG) as a serological biomarker of NMO have been widespread used. Nevertheless, some NMO patients remain seronegative for AQP4-Ab and/or have no detected optic nerve involvement. In addition, no consensus exists on the association between AQP4-Ab serostatus and visual outcome in NMO. To drive a more precise estimate of this postulated relationship, a metaanalysis was performed based on existing relevant studies. Studies were searched by PubMed and MEDLINE up to March 2016. Study quality was assessed, and meta-analysis was conducted using the RevMan 5.1. Odds ratios with 95% confidence interval were calculated and funnel plot was applied to assess the potential publication bias. In a total of 1288 relevant studies, 18 studies satisfied the eligibility criteria and were included in the systemic review. Only 9 studies appeared eligible for the meta-analysis, together including 624 AQP4-Ab-positive and 119 AQP4-Ab-negative NMO patients. The results revealed associations between AQP4-Ab seropositivity and visual impairment in NMO (OR, 3.16; 95% CI, 1.09, 9.19; P = 0.03). The results of subgroup analyses based on different methods of AQP-4 detection also showed significantly differences between AQP4-Ab seropositivity and visual impairment in NMO, especially in CBA subgroup. This meta-analysis indicates that AQP4-Ab serostatus has the positive with poor visual outcome in NMO. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Larvicultura de Rhamdia quelen (Pisces, Pimelodidae con proteína vegetal y animal, suplementadas con plancton

    Directory of Open Access Journals (Sweden)

    Germán Castañeda A.

    2011-12-01

    Full Text Available Objetivo. Determinar el efecto de dietas con diferentes proporciones de fuentes proteicas animales y vegetales suplementadas con plancton sobre el crecimiento y sobrevivencia en larvas de Rhamdia quelen. Materiales y métodos. Fueron formuladas dos dietas experimentales, dieta-1 con 70% de proteína de origen vegetal (torta de soya y dieta-2 con 70% de proteína proveniente de animales (corazón bovino yharina de pescado; se utilizaron cuatro protocolos de alimentación (cinco réplicas por tratamiento: dieta-1 + plancton filtrado en tamiz de 50-200 micras (T1, dieta-2 + plancton filtrado en tamiz de 50-200 micras (T2, dieta-1 (T3, dieta-2 (T4. Las larvas fueron manejadas a una densidad de 20 animales L-1 suministrando alimentohasta aparente saciedad diariamente a las 07:00, 11:00, 16:00 y 21:00 horas; la suplementación con plancton se realizó a las 11:00 y 21:00 horas. Resultados. Entre T1 y T2 no se observaron diferencias estadísticas (p>0.05 en peso final (21.89 ± 15.17mg vs 20.37 ± 10.37mg, longitud total (13.41±2.34mm vs 13.39±1.99 mm, factor de condición (K (0.80±0.13 vs 0.78±0.13 y sobrevivencia (46.6±2.68% vs36.0±7.41%; las diferencias entre T3 y T4 tampoco fueron significativas (3.35±1.40 mg vs 2.98±1.48 mg; 7.54±0.91mm vs 7.33±0.96mm; 0.75±0.13 vs 0.71±0.12; 33.6±9.07% vs 24.8±6.76%, respectivamente; hubo diferencias significativas (p<0.05 entre los grupos suplementados con plancton y los alimentados solo con ración. Conclusiones. La suplementación con plancton fue más efectiva que elofrecimiento solo de ración. La inclusión del 62.9% de torta de soya en la formulación (T1, aparentemente no afectó el crecimiento ni la sobrevivencia.

  7. Ensayo clínico con intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular

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    Anxela Soto-Rodríguez

    2017-01-01

    Conclusiones: Una sencilla intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular mejora aspectos relacionados con la calidad de vida y con hábitos saludables como la actividad física.

  8. Soporte social con el uso de tic’s para cuidadores familiares de personas con enfermedad crónica

    OpenAIRE

    Carrillo, Gloria Mabel; Chaparro, Olivia Lorena; Barrera, Lucy; Sanchez, beatriz; Pinto, Raquel Natividad

    2012-01-01

    Objetivo Determinar la efectividad del soporte social dado con el uso de tecnologías de la información y la comunicación (TIC’S) a los cuidadores familiares de personas con enfermedad crónica.  Material y Métodos. Estudio descriptivo, exploratorio realizado en Bogotá en 2008 y 2009 con 144 cuidadores familiares de personas con enfermedad crónica  que constó de tres etapas para su desarrollo: 1. Planeación, diseño de la TIC’s,  aplicación de  prueba piloto y  selección de  población objeto;  ...

  9. Aquaporin-4 autoantibodies in neuromyelitis optica spectrum disorders: comparison between tissue-based and cell-based indirect immunofluorescence assays

    Directory of Open Access Journals (Sweden)

    Chan Koon H

    2010-09-01

    Full Text Available Abstract Background Neuromyelitis optica spectrum disorders (NMOSD are severe central nervous system inflammatory demyelinating disorders (CNS IDD characterized by monophasic or relapsing, longitudinally extensive transverse myelitis (LETM and/or optic neuritis (ON. A significant proportion of NMOSD patients are seropositive for aquaporin-4 (AQP4 autoantibodies. We compared the AQP4 autoantibody detection rates of tissue-based indirect immunofluorescence assay (IIFA and cell-based IIFA. Methods Serum of Chinese CNS IDD patients were assayed for AQP4 autoantibodies by tissue-based IIFA using monkey cerebellum and cell-based IIFA using transfected HEK293 cells which express human AQP4 on their cell membranes. Results In total, 128 CNS IDD patients were studied. We found that 78% of NMO patients were seropositive for AQP4 autoantibodies by cell-based IIFA versus 61% by tissue-based IFA (p = 0.250, 75% of patients having relapsing myelitis (RM with LETM were seropositive by cell-based IIFA versus 50% by tissue-based IIFA (p = 0.250, and 33% of relapsing ON patients were seropositive by cell-based IIFA versus 22% by tissue-based IIFA (p = 1.000; however the differences were not statistically significant. All patients seropositive by tissue-based IIFA were also seropositive for AQP4 autoantibodies by cell-based IIFA. Among 29 NMOSD patients seropositive for AQP4 autoantibodies by cell-based IIFA, 20 (69% were seropositive by tissue-based IIFA. The 9 patients seropositive by cell-based IIFA while seronegative by tissue-based IIFA had NMO (3, RM with LETM (3, a single attack of LETM (1, relapsing ON (1 and a single ON attack (1. Among 23 NMO or RM patients seropositive for AQP4 autoantibodies by cell-based IIFA, comparison between those seropositive (n = 17 and seronegative (n = 6 by tissue-based IIFA revealed no differences in clinical and neuroradiological characteristics between the two groups. Conclusion Cell-based IIFA is slightly more sensitive

  10. Adolescente femenino con granulomatosis de Wegener fulminante

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    S C Scheffler-Mendoza

    2017-01-01

    Full Text Available Adolescente femenino de 13 años de edad, originaria de Guerrero, grupo étnico mixteco, padres analfabetos y con poco entendimiento del español. Sin otros antecedentes de importancia para el padecimiento. Inició un mes previo con la aparición de una pápula hipercrómica en párpado superior derecho que en los 10 días previos al ingreso aumentó de volumen generando proptosis. Al interrogatorio se negó dolor, lagrimeo, fiebre, o pérdida de peso. Ingresó con fiebre (39.0°C, palidez generalizada, proptosis derecha con exposición de córnea y conjuntiva, eritema periorbitario, movimientos oculares y agudeza visual disminuidos (i.e. contaba dedos a 1 m, pupila con tendencia a midriasis, hiperreactividad a la luz, y fondo de ojo con papila hiperémica edematosa y tortuosidad peripapilar. El resto de exploración no mostró datos relevantes. Se hospitalizó para iniciar tratamiento antimicrobiano parenteral de amplio espectro (i.e. ceftriaxona y vancomicina y abordar proptosis unilateral.

  11. Síntomas depresivos en pacientes con Trastorno por déficit de atención con hiperactividad.

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    Diego Artemio Reátegui Villegas

    2008-07-01

    Full Text Available Objetivos: Determinar la frecuencia de síntomas depresivos en pacientes con Trastorno por déficit de atención con hiperactividad (TDAH, así como determinar su asociación con edad, sexo y comorbilidad psiquiátrica. Material y Método: Se realizó un estudio descriptivo de corte transversal. Se incluyeron pacientes con diagnóstico de TDAH del Instituto Nacional de Salud Mental Honorio Delgado Hideyo Noguchi, desde febrero del 2006 hasta completar el tamaño de la muestra. Se les aplicó a los pacientes el Children´s depression inventory (CDI. Se consideró un punto de corte de 15 para definir presencia de trastorno depresivo. Se analizaron las siguientes variables: edad, sexo, comorbilidad psiquiátrica y sintomatología depresiva. Resultados: Sesenta y cuatro (85,3% fueron varones, en 35/75 (46,7% se encontró CDI ³ 15. No se encontró asociación estadísticamente significativa entre síntomas depresivos y sexo o edad. El síntoma depresivo más frecuente fue el problema del rendimiento escolar (65,3%. Se encontraron 6 pacientes con otra comorbilidad. Conclusión: Existe una alta frecuencia de sintomatología depresiva en niños y adolescentes con diagnóstico de TDAH. (Rev Med Hered 2008;19:96-101 .

  12. Optimizing the management of neuromyelitis optica and spectrum disorders in resource poor settings: Experience from the Mangalore demyelinating disease registry

    Directory of Open Access Journals (Sweden)

    Lekha Pandit

    2013-01-01

    Full Text Available Background: In resource-poor settings, the management of neuromyelitis optica (NMO and NMO spectrum (NMOS disorders is limited because of delayed diagnosis and financial constraints. Aim: To device a cost-effective strategy for the management of NMO and related disorders in India. Materials and Methods: A cost-effective and disease-specific protocol was used for evaluating the course and treatment outcome of 70 consecutive patients. Results: Forty-five patients (65% had a relapse from the onset and included NMO (n = 20, recurrent transverse myelitis (RTM; n = 10, and recurrent optic neuritis (ROPN; n = 15. In 38 (84.4% patients presenting after multiple attacks, the diagnosis was made clinically. Only 7 patients with a relapsing course were seen at the onset and included ROPN (n = 5, NMO (n = 1, and RTM (n = 1. They had a second attack after a median interval of 1 ± 0.9 years, which was captured through our dedicated review process. Twenty-five patients had isolated longitudinally extensive transverse myelitis (LETM, of which 20 (80% remained ambulant at follow-up of 3 ± 1.9 years. Twelve patients (17% with median expanded disability status scale (EDSS of 8.5 at entry had a fatal outcome. Serum NMO-IgG testing was done in selected patients, and it was positive in 7 of 18 patients (39%. Irrespective of the NMO-IgG status, the treatment compliant patients (44.4% showed significant improvement in EDSS (P ≤ 0.001. Conclusions : Early clinical diagnosis and treatment compliance were important for good outcome. Isolated LETM was most likely a post-infectious demyelinating disorder in our set-up. NMO and NMOS disorders contributed to 14.9% (45/303 of all demyelinating disorders in our registry.

  13. Caracterización de pacientes con lesiones pigmentarias de piel con riesgo de transformación maligna

    Directory of Open Access Journals (Sweden)

    María Elena Izquierdo Izquierdo

    2015-06-01

    Full Text Available Fundamento: el melanoma es el más terrible y mortífero de los cánceres de piel. Se origina frecuentemente a partir de un nevo melanocítico con riesgo de transformación maligna. Estas lesiones pigmentadas se diagnostican cada vez más en edades tan tempranas como la adolescencia. Objetivo: caracterizar los pacientes en edades pediátricas con signos de lesiones pigmentarias de la piel con riesgo de transformación maligna. Métodos: se realizó un estudio prospectivo de corte transversal en un grupo de 50 pacientes en edades entre 5 y 19 años, que asistieron a la consulta de dermatología del Hospital Pediátrico de Centro Habana en el año 2010, con signos de lesiones pigmentarias de la piel con riesgo de transformación maligna. Se aplicó un instrumento de recogida de datos, con previo consentimiento informado. Se utilizó la estadística descriptiva para el procesamiento de los datos. Resultados: en la población de estudio predominó la adolescencia temprana, el grupo de riesgo con daño actínico crónico y el fototipo III. Estuvo presente el antecedente familiar de cáncer de piel no-melanoma. La lesión más frecuente fue la de nevo melanocítico displásico. Además, se reportó un caso de carcinoma basal en paciente de fototipo II, perteneciente al grupo de riesgo de xeroderma pigmentoso. Conclusiones: se evidenció la transformación maligna de lesiones pigmentarias en piel de pacientes de grupos de riesgo.

  14. disegnare con ... Alberto Pratelli

    Directory of Open Access Journals (Sweden)

    Roberto Mingucci

    2017-12-01

    Full Text Available Con questa breve intervista ad Alberto Pratelli, (non a caso scelto per aprire questa nuova rubrica intendia-mo inaugurare un dialogo con personalità significati-ve del Disegno di Architettura, che consenta riflessioni dedicate alle sue varie dimensioni, oggi più che mai da approfondire. La suggestione a farlo, viene da un’idea di Pablo Rodri-guez Navarro ed abbiamo quindi pensato di avviarla proprio in questo numero, che Pablo ha accettato di curare su un tema a lui particolarmente caro.

  15. Depresion en pacientes con alteraciones del tiroides

    OpenAIRE

    Radanovic-Grguric´, Ljiljana; Filakovic´, Pavo; Barkic´, Jelena; Mandic´, Nikola; Karner, Ivan; Smoje, Juraj

    2003-01-01

    Nuestro estudio fue realizado en un grupo de 53 mujeres con disfunción tiroidea y 28 mujeres con depresión mayor. Empleamos la Escala de la Depresión de Hamilton, la Escala de Autoevaluación de la Depresión de Zung y la Escala sobre la Impresión Clínica Global. Los resultados del estudio demuestran que la mayoría de los pacientes con disfunción tiroidea se mostraron clínicamente significativos en cuanto al trastorno depresivo. Los episodios depresivos son más frecuentes en pacientes con hipot...

  16. Enfermedad coronaria en pacientes con psoriasis

    Directory of Open Access Journals (Sweden)

    Walter Masson

    2013-10-01

    Full Text Available Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mismo sistema de salud, apareados por edad y sexo. Determinamos la prevalencia de los factores de riesgo cardiovascular y de enfermedad coronaria. Analizamos la asociación entre la enfermedad coronaria y la psoriasis mediante análisis uni y multivariado. Se incluyeron 3 833 sujetos (1 286 pacientes con psoriasis y 2 547 controles. La prevalencia de hipertensión arterial (50% vs. 38%, p < 0.001, tabaquismo (25% vs. 17%, p < 0.001, diabetes (12% vs. 8%, p < 0.001 y enfermedad coronaria (4.98% vs. 3.06%, p = 0.003 fue mayor en los sujetos con psoriasis en comparación con el grupo control. Independientemente de la edad, la presencia de diabetes, hipertensión arterial o tabaquismo, hubo una asociación significativa entre la enfermedad coronaria y la psoriasis (OR 1.48, IC95% 1.04-2.11, p = 0.03. En conclusión, en esta población de Buenos Aires, los pacientes con psoriasis tuvieron una mayor prevalencia de diabetes, hipertensión arterial, tabaquismo y enfermedad coronaria. La asociación entre la psoriasis y la enfermedad coronaria fue independiente de los factores de riesgo explorados.

  17. Mincle Signaling Promotes Con-A Hepatitis

    Science.gov (United States)

    Greco, Stephanie H.; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R.; Nagaraj, Savitha V.; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E.; Katz, Steven C.; Miller, George

    2016-01-01

    Concanavalin-A (Con-A) hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor (CLR) that is critical in the immune response to mycobacteria and fungi, but does not have a well-defined role in pre-clinical models of non-pathogen mediated inflammation. Since Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con-A hepatitis. Acute liver injury was assessed in the murine Con-A hepatitis model using C57BL/6, Mincle−/−, and Dectin-1−/− mice. The role of C/EBPβ and HIF-1α signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con-A hepatitis. Most significantly, Mincle deletion or blockade protected against Con-A hepatitis whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other CLRs did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ related signaling intermediates, C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con-A hepatitis and inhibition of both C/EBPβ and HIF1-α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con-A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation. PMID:27559045

  18. Mincle Signaling Promotes Con A Hepatitis.

    Science.gov (United States)

    Greco, Stephanie H; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R; Nagaraj, Savitha V; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E; Katz, Steven C; Miller, George

    2016-10-01

    Con A hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor that is critical in the immune response to mycobacteria and fungi but does not have a well-defined role in preclinical models of non-pathogen-mediated inflammation. Because Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con A hepatitis. Acute liver injury was assessed in the murine Con A hepatitis model using C57BL/6, Mincle(-/-), and Dectin-1(-/-) mice. The role of C/EBPβ and hypoxia-inducible factor-1α (HIF-1α) signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con A hepatitis. Most significantly, Mincle deletion or blockade protected against Con A hepatitis, whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other C-type lectin receptors did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ-related signaling intermediates C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con A hepatitis and inhibition of both C/EBPβ and HIF-1α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation. Copyright © 2016 by The American Association of Immunologists, Inc.

  19. Cementos con cenizas volantes

    Directory of Open Access Journals (Sweden)

    Ossa M., Mauricio

    1984-03-01

    additions of 20 and 30% .

    Casi la generalidad de los estudios realizados sobre cementos con adición de cenizas volantes se refieren a sus características y comportamiento en pastas, morteros y hormigones, siempre en relación con aquéllos del cemento portland. Esta vez, se desarrolló un trabajo experimental orientado a relacionar entre sí los cementos con adiciones de cenizas volantes y de puzolana natural. Para ello se fabricaron a escala de laboratorio cementos de ambos tipos, empleando como materias primas comunes clinker y yeso y, como variables, diferentes porcentajes de las dos adiciones, que cumplieron previamente los requisitos normalizados en cuanto a sus actividades puzolánicas. La calidad de los cementos fabricados resultó adecuada y concordante con la del cemento portland-puzolánico obtenido a escala industrial con los mismos clinker, yeso y puzolana natural de este estudio. Posteriormente, se determinaron las características de los cementos experimentales y se confeccionaron morteros normales para la realización de ensayos físicos y mecánicos. Los resultados de ensayos indicaron que los cementos con adición de cenizas volantes (CCV requieren menos agua para consistencia normal, presentan tiempos de fraguado mayores y expansiones en autoclave menores que los cementos con adición de puzolana (CP. Los calores de hidratación a 7 y 28 días de edad fueron aproximadamente similares para ambos tipos de cemento. En morteros normales, los cementos CCV mostraron menor retracción de secado, mayor retentividad y mayor fluidez (para igual cantidad de agua que los cementos CP. En los ensayos de exudación se observó que ésta depende más de la finura que el tipo de adición. Finalmente, los ensayos mecánicos señalaron que las resistencias a compresión y flexotracción de los morteros con cementos CCV son menores a edades inferiores que 14 días (del orden de 5 a 10% a un día de edad, pero que a partir de entonces pasan a ser mayores que las de

  20. Efecto de un tratamiento intensivo con insulina sobre la reactividad plaquetaria en pacientes con hiperglucemia que ingresan con un síndrome coronario agudo

    OpenAIRE

    Vivas Balcones, Luis David

    2011-01-01

    El objetivo primario de este trabajo ha sido la valoración del efecto que produce el control estricto de la glucemia mediante un tratamiento intensivo y precoz con insulina sobre la reactividad plaquetaria durante la fase hospitalaria en pacientes que ingresan en una unidad de cuidados intensivos cardiológicos con un síndrome coronario agudo e hiperglucemia, respecto a un tratamiento convencional.

  1. Hiperalgesia asociada al tratamiento con opioides

    OpenAIRE

    A. Gil Martín; M. Moreno García; J. Sánchez-Rubio Ferrández; T. Molina García

    2014-01-01

    La hiperalgesia inducida por opioides es una reacción paradójica caracterizada por una percepción intensificada de dolor relacionada con el uso de estos medicamentos en ausencia de progresión de la enfermedad o de síndrome de retirada. A diferencia de los casos de tolerancia, definida como pérdida de potencia analgésica durante el uso prolongado de opioides, no se produce mejoría con el escalado de dosis. La hiperalgesia inducida por opioides se ha manifestado en pacientes con dosis de manten...

  2. Paciente con tumor de cuerpo carotideo

    Directory of Open Access Journals (Sweden)

    Mariuska Forteza Sáez

    Full Text Available Los tumores de cuerpo carotideo (paragangliomas son neoplasias altamente vascularizadas, muy poco frecuentes y generalmente benignas, originadas en los quimiorreceptores del cuerpo carotideo. Se presenta el caso de un paciente de 54 años, con aumento de volumen cervical derecho, asintomático, con estudio preoperatorio y angiografía realizados por tomografía axial computarizada, que resultan compatibles con tumor de cuerpo carotideo. Se realiza disección subadventicial, informando la biopsia paraganglioma. El tumor fue completamente resecado, sin evidencia de recurrencia y sin complicaciones.

  3. Beneficios de la terapia con resistómetro inspiratorio en los pacientes con esclerosis multiple frente a terapias respiratorias convencionales

    OpenAIRE

    Martín Sánchez, Carlos

    2016-01-01

    [ES] La Universidad de Salamanca (USAL) a través del programa de Doctorado en Oncología Clínica realiza un estudio con ASPRODES, la Asociación Salmantina de Esclerosis Múltiple (ASDEM) y la Asociación Zamorana de Esclerosis Múltiple (AZDEM) para llevar a cabo un estudio experimental con el fin de analizar las ventajas que la terapia respiratoria con resistómetro inspiratorio puede aportar a los pacientes con Esclerosis Múltiple frente a las técnicas de fisioterapia respiratoria convencional. ...

  4. Los adolescentes españoles y sus familias: Calidad en la comunicación con el padre y con la madre y conductas de riesgo relacionadas con el consumo de sustancias adictivas

    OpenAIRE

    Moreno Rodríguez, María del Carmen; Muñoz Tinoco, María Victoria; Pérez Moreno, Pedro Juan; Sánchez Queija, María Inmaculada

    2006-01-01

    Se presenta una reflexión acerca de cómo transcurren los años de la adolescencia en el contexto de la familia, analizando las transformaciones que se producen en las relaciones con los progenitores. El trabajo empírico se centra en una de las dimensiones que definen la calidad de las relaciones en el contexto familiar -la facilidad en la comunicación entre el adolescente y sus padres- y en su relación con algunas conductas de los adolescentes relacionadas con la salud, como es el caso del con...

  5. Santiago, una ciudad con temor

    Directory of Open Access Journals (Sweden)

    Enrique Oviedo S.

    1999-04-01

    Full Text Available El objetivo general de este artículo es evaluar los efectos de la inseguridad ciudadana en el uso del espacio público. Dicha evaluación exige analizar dos relaciones que se establecen en el ámbito de la violencia: la relación entre victimización y percepción de inseguridad; y la que se establece entre actitudes sociales y resolución pacífica de conflictos nacionales. Para ello, se analizaron las variables victimización, percepción de inseguridad, uso del espacio físico, actitudes hacia el sistema institucional político y social y hacia la resolución de conflictos nacionales, y las posibles relaciones entre ellas. Los datos para realizar el estudio se obtuvieron por medio de una encuesta que se llevó a cabo con 1 200 personas de 18 y 70 años de edad residentes en la ciudad de Santiago. Los resultados indican que Santiago es una ciudad de habitantes con temor y que el aumento de la percepción de inseguridad de sus habitantes contrasta con el hecho de que las tasas de victimización se hayan mantenido, más o menos, constantes en los años que precedieron a la encuesta. El temor se relaciona con el abandono del espacio público físico y sociopolítico, así como con el refugio en los espacios y la vida privados. La actitud de resolver los conflictos por medios no pacíficos es frecuente y se asocia en mayor medida con la inseguridad, la actitud negativa hacia la democracia y la falta de expectativas sobre el futuro del país. Los resultados de este estudio respaldan la idea de que para superar el temor la gente tiende a adaptarse a la realidad adoptando una postura conformista, homogeneizando las creencias y los comportamientos, y sobreestimando la fuerza como medio para resolver las diferencias.

  6. Santiago, una ciudad con temor

    Directory of Open Access Journals (Sweden)

    Oviedo S. Enrique

    1999-01-01

    Full Text Available El objetivo general de este artículo es evaluar los efectos de la inseguridad ciudadana en el uso del espacio público. Dicha evaluación exige analizar dos relaciones que se establecen en el ámbito de la violencia: la relación entre victimización y percepción de inseguridad; y la que se establece entre actitudes sociales y resolución pacífica de conflictos nacionales. Para ello, se analizaron las variables victimización, percepción de inseguridad, uso del espacio físico, actitudes hacia el sistema institucional político y social y hacia la resolución de conflictos nacionales, y las posibles relaciones entre ellas. Los datos para realizar el estudio se obtuvieron por medio de una encuesta que se llevó a cabo con 1 200 personas de 18 y 70 años de edad residentes en la ciudad de Santiago. Los resultados indican que Santiago es una ciudad de habitantes con temor y que el aumento de la percepción de inseguridad de sus habitantes contrasta con el hecho de que las tasas de victimización se hayan mantenido, más o menos, constantes en los años que precedieron a la encuesta. El temor se relaciona con el abandono del espacio público físico y sociopolítico, así como con el refugio en los espacios y la vida privados. La actitud de resolver los conflictos por medios no pacíficos es frecuente y se asocia en mayor medida con la inseguridad, la actitud negativa hacia la democracia y la falta de expectativas sobre el futuro del país. Los resultados de este estudio respaldan la idea de que para superar el temor la gente tiende a adaptarse a la realidad adoptando una postura conformista, homogeneizando las creencias y los comportamientos, y sobreestimando la fuerza como medio para resolver las diferencias.

  7. Síndrome disejecutivo en personas con dependencia alcohólica con/sin recidivas

    OpenAIRE

    Fidalgo Martínez, Eva

    2015-01-01

    [ES]En la mayoría de las culturas el alcohol es el depresor del SNC utilizado con más frecuencia y el responsable de una morbilidad y una mortalidad considerables. En la actualidad, el consumo de bebidas alcohólicas constituye un importante problema de salud pública, especialmente en España, que es uno de los países con mayor consumo de alcohol por habitante y año. El objetivo general del estudio es determinar la existencia de diferencias significativas entre dos grupos clínicos de sujetos...

  8. FORTIFICACIÓN DE PULPA DE UCHUVA CON CALCIO, OLIGOFRUCTOSA Y VITAMINA C, ESTABILIZADA CON HIDROCOLOIDE

    Directory of Open Access Journals (Sweden)

    ALBA LUCIA DUQUE

    2014-06-01

    Full Text Available La pulpa de uchuva fortificada con calcio, oligofructosa y vitamina C es un alimento funcional con grandes beneficios para la salud. Para ello se le adicionó componentes biológicamente activos, como ácidos grasos, fibra alimentaria y antioxidantes. En este trabajo se estudió la estabilidad de la pulpa enriquecida en diferentes formulaciones, teniendo en cuenta los criterios de incorporación de calcio y vitamina C (20% del valor diario recomendado VDR y para la oligofructosa (fibra dietaría en relación 1:1 con el calcio. Los resultados obtenidos mostraron que la pulpa de uchuva fortificada con CMC, ologofructosa, calcio y vitamina C presentó en promedio una estabilidad de 87,7±10,0; una viscosidad de 22,8±7,9; una aw de 0,9863±0; pH de 3,3±0,1; acidez de 1,6±0,1; grados Brix de 13,3±0,7; una densidad de 1,32±0 g/mL y las mejores respuestas sensoriales en cuanto a color, aroma, fluidez y sabor.

  9. Intervención psicomotriz en niños con trastorno por déficit de atención con hiperactividad

    OpenAIRE

    Herguedas Esteban, María del Carmen

    2016-01-01

    El trastorno por déficit de atención con hiperactividad (TDAH) es una de las principales causas de fracaso escolar. Los niños con este trastorno deben ser atendidos en una escuela inclusiva que permita responder a las necesidades de todos los alumnos. Se ha desarrollado un trabajo de investigación cuyos objetivos eran: evaluar las alteraciones psicomotoras de los niños con TDAH; elaborar un programa educativo de intervención psicomotriz para niños con TDAH; aplicar dicho programa en un gru...

  10. Energy efficiency standardizing in vertical pumps; Normalizacion de eficiencia energetica en bombas verticales

    Energy Technology Data Exchange (ETDEWEB)

    Acosta Torres, Rosa Aracely; Buendia Dominguez, Eduardo H. [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1996-12-31

    The Instituto de Investigaciones Electricas (IIE) supporting the Comision Nacional para el Ahorro de Energia (CONAE) (National Commission for Energy Saving) developed the project of a standard on energy efficiency of vertical pumps, turbine type with external motor. This documents has fulfilled the necessary formalities for the issuing of a norm, being published the Mexican Official Norm (NOM-001-ENER-1995) on December 22, 1995. This article relates the results of the study for the elaboration of this norm, considering the energy saving, as well as the economic evaluation that supports the project of the norm, indicating also the environmental impact that its implantation will have. [Espanol] El Instituto de Investigaciones Electricas (IIE) apoyando a la Comision Nacional para el Ahorro de Energia (CONAE) elaboro el anteproyecto de norma de eficiencia energetica en bombas verticales tipo turbina con motor externo. Dicho documento ha cumplido con los tramites necesarios para la emision de una norma, habiendose publicado como Norma Oficial Mexicana (NOM-001-ENER-1995) el 22 de diciembre de 1995. En el presente articulo se mencionan los resultados del estudio para la realizacion de esta norma, considerando los ahorros energeticos, asi como la evaluacion economica que sustenta el proyecto de norma, indicando tambien el impacto ambiental que tendra su implantacion.

  11. Energy efficiency standardizing in vertical pumps; Normalizacion de eficiencia energetica en bombas verticales

    Energy Technology Data Exchange (ETDEWEB)

    Acosta Torres, Rosa Aracely; Buendia Dominguez, Eduardo H [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1997-12-31

    The Instituto de Investigaciones Electricas (IIE) supporting the Comision Nacional para el Ahorro de Energia (CONAE) (National Commission for Energy Saving) developed the project of a standard on energy efficiency of vertical pumps, turbine type with external motor. This documents has fulfilled the necessary formalities for the issuing of a norm, being published the Mexican Official Norm (NOM-001-ENER-1995) on December 22, 1995. This article relates the results of the study for the elaboration of this norm, considering the energy saving, as well as the economic evaluation that supports the project of the norm, indicating also the environmental impact that its implantation will have. [Espanol] El Instituto de Investigaciones Electricas (IIE) apoyando a la Comision Nacional para el Ahorro de Energia (CONAE) elaboro el anteproyecto de norma de eficiencia energetica en bombas verticales tipo turbina con motor externo. Dicho documento ha cumplido con los tramites necesarios para la emision de una norma, habiendose publicado como Norma Oficial Mexicana (NOM-001-ENER-1995) el 22 de diciembre de 1995. En el presente articulo se mencionan los resultados del estudio para la realizacion de esta norma, considerando los ahorros energeticos, asi como la evaluacion economica que sustenta el proyecto de norma, indicando tambien el impacto ambiental que tendra su implantacion.

  12. Enfermedad periodontal en pacientes con discapacidad en custodia versus pacientes con discapacidad independientes

    Directory of Open Access Journals (Sweden)

    Fermín-Guerrero-Del Ángel

    2012-01-01

    Full Text Available Objetivo: Identificar el estado de salud periodontal en pacientes con discapacidad en custodia versus pacientes independientes en su higiene oral. Material y métodos: Se examinaron pacientes con discapacidad, ambos sexos, 3 a 19 años que acuden al Servicio de Odontopediatría del Centro de Rehabilitación Infantil Teletón (CRIT Tamaulipas mediante revisión de cavidad oral y aplicación del Índice de Higiene Oral Simplificado (IHOS, Índice Periodontal Comunitario de la Necesidad de Tratamiento (IPCNT y entrevista con su cuidador primario. Se agruparon en dos categorías: Independientes y de Custodia. Resultados: En el total de la muestra la Media y Desviación estándar (D.E. de IPCNT fue de 0.89±0.54, así como el IHOS de 1.88±0.77. El IPCNT en pacientes con discapacidad de Custodia fue 0.91±0.57 e Independientes de 0.86±0.49 (p=0.70, IHOS en pacientes de Custodia 1.89±0.78 e Independientes 1.87±.0.74 (p=.93. IPCNT en géneros masculino 1.03±0.54 y femenino 0.75±0.51 (p=.009. IHOS en pacientes que habitan área rural 2.41±1.25 y área urbana 1.83±0.68 (p=.02. Relación entre la edad y la necesidad de tratamiento periodontal (p=0.001. Frecuencia del cepillado del grupo Independientes 2.03±0.56 y de Custodia 2.00±0.75 (p=.84. Conclusiones: No existe diferencia en el estado de salud periodontal y el grado de higiene oral entre pacientes con discapacidad Independientes y de Custodia. La mayoría de los pacientes Independientes y de Custodia tienen una necesidad de tratamiento de Instrucción de Higiene Oral (TN1 y tienen Higiene Oral Regular.

  13. Demodicidosis en pacientes con rosácea

    Directory of Open Access Journals (Sweden)

    Edhizon Trejo Mucha

    2007-01-01

    Full Text Available Objetivo: Determinar la frecuencia de demodicidosis y sus características clínicas en pacientes con rosácea. Materiales y métodos: Estudio de casos y controles en 42 pacientes con rosácea y 42 controles para describir la presencia y densidad de D. folliculorum. El estudio se realizó en el Hospital Nacional Cayetano Heredia entre marzo y setiembre del 2004, utilizándose la técnica de Tello. Resultados: Demodex folliculorum fue encontrado en los 42 pacientes con rosácea (100% y en 13 (31,0% del grupo control, (p= 0,000. La exposición a gatos, la crianza de roedores y cerdos, la seborrea y el uso de corticoides tópicos fueron mas frecuentes en los pacientes con rosácea. Conclusiones: La presencia de Demodex folliculorum fue más frecuente en los pacientes con rosácea. (Rev Med Hered 2007;18:15-21.

  14. Materiales nanocumpuestos basados en LDPE relleno con nanotubos de carbono con potenciales propiedades bactericidas

    OpenAIRE

    Benigno Escribano, Erika

    2015-01-01

    En este trabajo, se ha seleccionado como material de estudio polietileno de baja densidad, LDPE, ya que es un polímero con múltiples aplicaciones en diversos campos. Se busca como objetivo principal, preparar y caracterizar nuevos materiales basados en LDPE con potenciales propiedades antibacterianas. Para ello, se van a estudiar dos posibles maneras de conseguirlo: La primera de ellas, consiste en realizar un procesado mecánico sobre el polietileno, concretamente, una molienda del alta en...

  15. BIOMASA Y RENDIMIENTO DE FRIJOL CON POTENCIAL EJOTERO EN UNICULTIVO Y ASOCIADO CON GIRASOL

    Directory of Open Access Journals (Sweden)

    J. Garduño-González

    2009-01-01

    Full Text Available El objetivo del presente estudio fue estimar la producción de biomasa, rendimiento y algunos de sus componentes de dos cultivares de frijol (Phaseolus vulgaris L. con potencial ejotero ('Acerado' y 'Criollo', en unicultivo y asociado con dos cultivares de girasol (Helianthus annuus L. ('Sunbright' y 'Victoria'. El estudio se realizó durante el ciclo primavera verano 2006 bajo condiciones de temporal en Tenancingo, Méx. Las variables evaluadas fueron: índice de área foliar (IAF, tasa de asimilación neta (TAN, biomasa total (BT, diámetro de vaina (DV, longitud de vaina (LV, número de vainas·m-2 (NV y rendimiento de vaina·m-2 (RV; las cuales fueron analizadas en arreglo factorial, bajo un diseño de bloques completos al azar con cuatro repeticiones. Para estimar el grado de asociación, entre las variables estudiadas y el rendimiento de vainas, se realizó un análisis de correlación lineal simple. En el factor cultivares se detectaron diferencias estadísticas significativas para la TAN y DV; para el factor sistemas de siembra hubo diferencias significativas para BT, DV, NV y RV. La interacción cultivares * sistema de siembra fue significativa en todas las variables, excepto en la TAN. En ese sentido, las asociaciones 'Criollo' + 'Sunbright', 'Acerado' + 'Victoria' y 'Acerado' en unicultivo, presentaron el mayor RV. Las variables IAF, BT y NV se correlacionaron positiva y significativamente con el rendimiento de vaina. Los resultados indican que 'Criollo' y 'Acerado', asociados con 'Sunbright' y 'Victoria', respectivamente, responden positivamente a la asociación, constituyendo una buena opción para los productores de la región de Tenancingo, México.

  16. Tratamiento con trióxido de arsénico en pacientes con leucemia promielocítica aguda

    Directory of Open Access Journals (Sweden)

    Lidia Clara Suárez Beyríes

    2014-01-01

    Full Text Available Se realizó un estudio observacional, descriptivo y transversal de 17 adultos con leucemia promielocítica aguda, atendidos en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba durante un quinquenio, con vistas a evaluar la eficacia del tratamiento de inducción con trióxido de arsénico. En la casuística, la remisión hematológica completa se obtuvo en 82,4 % de sus integrantes a los 42,2 días como promedio. Predominaron la hepatotoxicidad y los dolores óseos como reacciones adversas más comunes, así como también las hemorragias severas como causa principal de muerte. Con este tratamiento se logró la incorporación laboral de quienes mejoraron totalmente y la sobrevida global hasta la fecha es de 76,4 %

  17. Tratamiento de la tiroiditis de Riedel con triamcinolona

    Directory of Open Access Journals (Sweden)

    Germán Brito Sosa

    Full Text Available Se presenta el primer paciente con una tiroiditis de Riedel que se le aplica un tratamiento alternativo con triamcinolona creado por el profesor Juan Gualberto Vivó Núñez. Es el caso de una mujer de 48 años de edad, que acude al cuerpo de guardia por aumento de volumen de la región anterior del cuello y referir ligera disfagia. Tiene antecedente inicialmente de hipertiroidismo, a los 9 años comenzó con hipotiroidismo y hace aproximadamente un año se le diagnosticó una tiroiditis de Hashimoto, con seguimiento por endocrinología. La ecografía del tiroides muestra un aumento marcado de la glándula tiroidea y las imágenes de la biopsia por aspiración con aguja fina (BAAF son compatibles con una tiroiditis de Hashimoto. Con estos resultados se decide intervenirla quirúrgicamente eliminando así los signos compresivos. La biopsia postoperatoria describe una tiroiditis de Riedel. Por el gran tamaño de los lóbulos tiroideos, se le infiltra triamcinolona 1/2 cc en cada lóbulo, una vez al mes durante cuatro meses; logrando reducir aproximadamente el 50 % de los lóbulos tiroideos. Por lo que se puede apreciar los resultados obtenidos con el uso de la triamcinolona.

  18. pacientes con falla cardiaca

    Directory of Open Access Journals (Sweden)

    Diana Marcela Achury Saldaña

    2007-01-01

    Full Text Available Objetivo: determinar la adherencia al tratamiento de pacientes con falla cardiaca hospitalizados, al aplicar un plan educativo quefomenta el autocuidado.Método: estudio cuasiexperimental (entrevistas enfermera-paciente realizado entre diciembre de 2004 y mayo de 2006, con unamuestra de 50 pacientes seleccionados por conveniencia. Se diseñó un instrumento para evaluar los comportamientos de los pacientes,con base en algunos resultados de la adherencia y sus respectivos indicadores de la taxonomía NOC (Nursing out comes classification. Laadherencia al tratamiento fue medida en dos momentos: el primero durante la hospitalización, seguido de la aplicación del plan educativoantes del alta, que proporcionaba información en el manejo de su enfermedad desde una dimensión física, psicológica y social quepromueve el autocuidado; y el segundo un mes después del alta en su domicilio.Resultados: diferencias estadísticamente significativas (P=0,0001 que demuestran cómo mediante la capacitación al paciente enel manejo de su tratamiento farmacológico y no farmacológico, el establecimiento de una sana relación entre el profesional de enfermeríay el paciente, y la participación de la familia, se logra una total adherencia al tratamiento.Conclusiones: para lograr una adherencia total del paciente con falla cardiaca al tratamiento es necesario un proceso educativo y unseguimiento continuo y personalizado que motive permanentemente al paciente y se le reconozca el papel protagónico en su cuidado y manejo de la enfermedad.

  19. Volumetric properties of room temperature ionic liquid 1. The system of {l_brace}1-methyl-3-ethylimidazolium ethyl sulfate+water{r_brace} at temperature in the range (278.15 to 333.15) K

    Energy Technology Data Exchange (ETDEWEB)

    Lu Xingmei [Department of Chemistry, Shenyang Normal University, Shenyang 110034 (China); Department of Chemistry, Liaoning University, Shenyang 110036 (China); Xu Weiguo [Institute of Salt Lakes, Chinese Academy of Science, Xining 810008 (China); Gui Jinsong [Department of Chemistry, Shenyang Normal University, Shenyang 110034 (China); Li Huawei [Department of Chemistry, Shenyang Normal University, Shenyang 110034 (China); Yang Jiazhen [Institute of Salt Lakes, Chinese Academy of Science, Xining 810008 (China)]. E-mail: jzyanglnu@yahoo.com.cn

    2005-01-01

    This paper reports densities of aqueous solutions of ionic liquid (IL) 1-methyl-3-ethylimidazolium ethyl sulfate (EMISE) that were measured gravimetrically at temperatures (278.15 to 333.15) K. The values of the apparent molar volume, {sup {phi}}V{sub B} and partial molar volume, V-bar B, were determined and apparent molar expansibilities {sup {phi}}E=(({partial_derivative}{phi}{sub B})/{partial_derivative}T)){sub p} of EMISE and the coefficients of thermal expansion of the solutions, {alpha}, were calculated. The values of the apparent molar volume, {sup {phi}}V{sub B}, were fitted by the method of least-squares to a Pitzer's equation to determine the parameters, {beta}{sub MX}{sup (0)V}, {beta}{sub MX}{sup (1)V}, and C{sub MX}{sup V}.

  20. Brain Tissue Volumes and Perfusion Change with the Number of Optic Neuritis Attacks in Relapsing Neuromyelitis Optica: A Voxel-Based Correlation Study.

    Directory of Open Access Journals (Sweden)

    Carlos A Sánchez-Catasús

    Full Text Available Recent neuroimaging studies show that brain abnormalities in neuromyelitis optica (NMO are more frequent than earlier described. Yet, more research considering multiple aspects of NMO is necessary to better understand these abnormalities. A clinical feature of relapsing NMO (RNMO is that the incremental disability is attack-related. Therefore, association between the attack-related process and neuroimaging might be expected. On the other hand, the immunopathological analysis of NMO lesions has suggested that CNS microvasculature could be an early disease target, which could alter brain perfusion. Brain tissue volume changes accompanying perfusion alteration could also be expected throughout the attack-related process. The aim of this study was to investigate in RNMO patients, by voxel-based correlation analysis, the assumed associations between regional brain white (WMV and grey matter volumes (GMV and/or perfusion on one side, and the number of optic neuritis (ON attacks, myelitis attacks and/or total attacks on the other side. For this purpose, high resolution T1-weighted MRI and perfusion SPECT imaging were obtained in 15 RNMO patients. The results showed negative regional correlations of WMV, GMV and perfusion with the number of ON attacks, involving important components of the visual system, which could be relevant for the comprehension of incremental visual disability in RNMO. We also found positive regional correlation of perfusion with the number of ON attacks, mostly overlapping the brain area where the WMV showed negative correlation. This provides evidence that brain microvasculature is an early disease target and suggests that perfusion alteration could be important in the development of brain structural abnormalities in RNMO.

  1. Systematic review of the published data on the worldwide prevalence of John Cunningham virus in patients with multiple sclerosis and neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Sonia Patricia Castedo Paz

    2018-01-01

    Full Text Available OBJECTIVES John Cunningham virus (JCV is a polyoma virus that infects humans, mainly in childhood or adolescence, and presents no symptomatic manifestations. JCV can cause progressive multifocal leukoencephalopathy (PML in immunosuppressed individuals, including those undergoing treatment for multiple sclerosis (MS and neuromyelitis optica (NMO. PML is a severe and potentially fatal disease of the brain. The prevalence of JCV antibodies in human serum has been reported to be between 50.0 and 90.0%. The aim of the present study was to review worldwide data on populations of patients with MS and NMO in order to establish the rates of JCV seropositivity in these individuals. METHODS The present review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the following search terms: “JCV” OR “JC virus” AND “multiple sclerosis” OR “MS” OR “NMO” OR “neuromyelitis optica” AND “prevalence.” These terms were searched for both in smaller and in larger clusters of words. The databases searched included PubMed, MEDLINE, SciELO, LILACS, Google Scholar, and Embase. RESULTS After the initial selection, 18 papers were included in the review. These articles reported the prevalence of JCV antibodies in the serum of patients with MS or NMO living in 26 countries. The systematic review identified data on 29,319 patients with MS/NMO and found that 57.1% of them (16,730 individuals were seropositive for the anti-JCV antibody (range, 40.0 to 69.0%. CONCLUSIONS The median worldwide prevalence of JCV among adults with MS or NMO was found to be 57.1%.

  2. Coriocarcinoma con metástasis pulmonar

    Directory of Open Access Journals (Sweden)

    Vicia Sánchez Abalos

    2014-05-01

    Full Text Available Se presenta el caso clínico de una fémina de 44 años de edad, con 32 semanas de embarazo, la cual fuera ingresada en la Unidad de Cuidados Intensivos del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, por presentar insuficiencia respiratoria aguda como consecuencia de una sepsis. La paciente fue tratada con cefalosporina de tercera generación y ventilación mecánica no invasiva, pero se mantuvieron las características gasométricas de hipoxemia y una mala reacción terapéutica, por lo que se requirió instrumentación de las vías respiratorias y soporte hemodinámico, sin lograr regresión del cuadro clínico, lo cual condujo a un paro cardiorrespiratorio y, con ello, a la muerte. La necropsia mostró un coriocarcinoma del endometrio con metástasis pulmonar

  3. Giochiamo con i robot

    Directory of Open Access Journals (Sweden)

    Andrea Bonarini

    2009-01-01

    Full Text Available "Giochiamo con i robot" e' un laboratorio interattivo per grandi e piccini realizzato per l'edizione 2007 del Festival della Scienza di Genova. Lungo un percorso che va dalla telerobotica alla robotica evolutiva, il laboratorio sviluppa il tema di dare intelligenza ai robot. Questo percorso, le cui tappe sono le varie installazioni, si conclude nella "bottega" dove e' possibile costruire e programmare i propri robot o smontare e modificare quelli esposti durante il percorso didattico. I visitatori sono coinvolti in attivita' ludiche grazie alle quali possonoentrare in contatto con alcune delle idee potenti della robotica,

  4. Intubación de paciente despierto con fibroscopio rígido bajo sedación con remifentanil

    OpenAIRE

    Bocanegra, Juan Carlos; Ríos Medina, Ángela María; Aguirre Ospina, Óscar David

    2010-01-01

    Introducción. Al elegir el manejo de un paciente con vía aérea difícil, conocida o sospechada, es importante plantearse alternativas de intervención. Varios algoritmos de manejo, recomiendan la intubación con paciente despierto, con laringoscopia directa o instrumentos ópticos. Los estiletes rígidos y semirrígidos son dispositivos ópticos desarrollados para el manejo de la vía aérea difícil, que han mostrado ser rápidos, atraumáti-cos y confiables. Objetivos. Describir el uso de diferentes es...

  5. Tumor germinal mixto con componentes de disgerminoma y coriocarcinoma de ovario en mujer adolescente con ataxiatelangiectasia

    Directory of Open Access Journals (Sweden)

    Eduardo Augusto Gálvez-Cuitiva

    2015-11-01

    días. Se suspendió la quimioterapia porque desarrolló choque séptico que puso en riesgo su vida. Por su enfermedad de base permaneció bajo vigilancia. Actualmente, 17 meses después, la paciente vive sin actividad tumoral.  Conclusión: existe asociación entre ataxia-telangiectasia, leucemia y linfomas. Se describe el caso clínico de una paciente con ataxia-telangiectasia y tumor germinal mixto con componente de disgerminoma y coriocarcinoma de ovario. Se propone establecer un tratamiento especial para estos pacientes inmunocomprometidos, con alto riesgo de cáncer pero, a la vez, de no tolerar los esquemas habituales.

  6. Measurement of chromatic dispersion of microstructure optical fibers using interferometric method

    Czech Academy of Sciences Publication Activity Database

    Peterka, Pavel; Kaňka, Jiří; Honzátko, Pavel; Káčik, D.

    2008-01-01

    Roč. 38, č. 2 (2008), s. 295-303 ISSN 0078-5466 R&D Projects: GA AV ČR 1ET300670502; GA MŠk 1P05OC002 Institutional research plan: CEZ:AV0Z20670512 Keywords : chromatic dispersion * optica l fiber measurement * microstructure optica l fibers Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 0.204, year: 2008

  7. An unusual chiasmal visual defect in a patient with neuromyelitis optica: case report Comprometimento quiasmático incomum em um paciente com neuromielite óptica: relato de caso

    Directory of Open Access Journals (Sweden)

    Roberta Martins da Silva Costa

    2007-02-01

    Full Text Available PURPOSE: To report the unusual visual field finding due to a chiasmal neuritis in a 33-year-old female with the diagnosis of optic neuromyelitis optica (Devic's syndrome. METHODS: We report a case of a 33 years old female with limb paraesthesias, weakness in the legs, bowel and bladder dysfunction that was referred to the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo" in October 1995. Six years and four months later she had an acute visual involvement. Ophthalmologic examination, laboratory studies, magnetic resonance imaging (MRI and a 24-2 threshold visual field in the Humphrey field analyzer were performed. RESULTS: The MRI scan showed enlargement and cavitation on the spinal cord and chiasmal involvement (thickening of the chiasm with contrast enhancement and no demyelinating lesions in the brain, brainstem, or cerebellum. The central 24-degree threshold field examination showed an inferior visual field defect bitemporally, disclosing a chiasmal involvement. CONCLUSION: Chiasmal involvement may occur in neuromyelitis optica, probably due to a plaque within the chiasm. The authors call attention to the importance of visual field examination with particular regard to quantifying the visual impairment and follow-up of these patients.OBJETIVO: Relatar o caso de uma mulher de 33 anos de idade, com o diagnóstico de neuromielite óptica (síndrome de Devic acometendo o quiasma óptico que apresentou um escotoma incomum no exame de campo visual. MÉTODOS: Uma paciente do sexo feminino, portadora de parestesias nos membros inferiores, fraqueza nas pernas, disfunção da defecação e disfunção urinária, foi encaminhada para o Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo em outubro do ano de 1995. Seis anos e quatro meses mais tarde ela sofreu acometimento visual agudo. Foram realizados exame oftalmológico completo, exame de líquor, resson

  8. Síndrome coronario agudo con supradesnivel del ST asociado al feocromocitoma con las catecolaminas inicialmente normales

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    Jorge M. Pacheco

    2016-01-01

    Full Text Available Los feocromocitomas son tumores secretores de catecolaminas que cursan con paroxismos de hipertensión o hipotensión arterial y palpitaciones. Son una causa rara del síndrome coronario agudo. Presentamos el caso de una paciente con síndrome coronario agudo secundario a feocromocitoma que inicialmente tenía valores normales de catecolaminas.

  9. Síndrome coronario agudo con supradesnivel del ST asociado al feocromocitoma con las catecolaminas inicialmente normales

    OpenAIRE

    Pacheco, Jorge M.; Pérez Baztarrica, Gabriel; Díaz Bozio, Fernando; Jiménez, Andrés; Porcile, Rafael

    2016-01-01

    Los feocromocitomas son tumores secretores de catecolaminas que cursan con paroxismos de hipertensión o hipotensión arterial y palpitaciones. Son una causa rara del síndrome coronario agudo. Presentamos el caso de una paciente con síndrome coronario agudo secundario a feocromocitoma que inicialmente tenía valores normales de catecolaminas.

  10. O-PRECISION: UNA ALTERNATIVA METODOLÓGICA DE TRABAJO CON PERSONAS CON DISCAPACIDAD FÍSICA E INTELECTUAL

    Directory of Open Access Journals (Sweden)

    Victoria Rey Niño

    2015-04-01

    Full Text Available La Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF define la discapacidad como un término genérico que abarca deficiencias, limitaciones de la actividad y restricciones a la participación. En este caso hablamos de personas con discapacidad física e intelectual por parálisis cerebral, lo que significa que su acceso al mundo de la actividad física se encuentra en la mayoría de los casos muy restringido. Pero existe una modalidad de la orientación llamada Orientación de Precisión u O-Trail que, según la Federación Deportiva de Orientación (FEDO, ha sido adaptada para ofrecer a todos, independientemente de su sexo, edad, capacidad o discapacidad física, la oportunidad de participar en igualdad de condiciones en una típica competición de orientación. Como sugiere Arribas y Sánchez (1998: “En la actividad física podemos encontrar recursos y herramientas de intervención adecuadas a cada contexto y etapa de ciclo vital además, a través de su práctica pueden verse satisfechas determinadas necesidades e intereses personales y grupales, que pueden ser tratados desde un planteamiento educativo” . Este proyecto tiene la intención de ir más allá y pretende utilizar la Orientación de precisión como una herramienta para implementar una alternativa metodológica de trabajo a las actividades que se llevan a cabo con un colectivo de personas con discapacidad física e intelectual en la Asociación Cultural y rehabilitadora de Discapacitados Físicos de Palencia, desarrollando y estimulando sus aspectos intelectuales y sociales mediante una disciplina deportiva desconocida para ellos, con la intención de que aumente su motivación por participar.Objetivo: Implementar la O-Precisión como alternativa metodológica de trabajo con personas con discapacidad física e intelectual con el fin de desarrollar sus capacidades cognitivas y aumentar su autoestima.

  11. Cognitive impairment in neuromyelitis optica spectrum disorders: A comparison of the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale Revised with the Rao Brief Repeatable Neuropsychological Battery.

    Science.gov (United States)

    Fujimori, Juichi; Nakashima, Ichiro; Baba, Toru; Meguro, Yuko; Ogawa, Ryo; Fujihara, Kazuo

    2017-12-01

    Approximately 55% of patients with neuromyelitis optica spectrum disorder (NMOSD) show cognitive impairment as evaluated using the Rao Brief Repeatable Neuropsychological Battery (BRBN), but this frequency appears to be higher than the frequency of specific brain lesions in NMOSD. We studied whether cognitive impairment could be observed in NMOSD patients with no or minor non-specific brain lesions. We evaluated cognitive function in 12 NMOSD and 14 MS patients using the Wechsler Adult Intelligence Scale-III (WAIS-III), the Wechsler Memory Scale-Revised (WMS-R), and the BRBN. We judged as cognitively impaired patients whose scores were below the average by 2 standard deviations or greater in 2 or more cognitive domains. Cognitive impairment was observed in 5 MS patients (35.7%) and in the only NMOSD patient (8.3%) with symptomatic brain lesions, but not in the other NMOSD patients who had no or minor non-specific brain lesions. Meanwhile, 5 NMOSD (41.7%) and 4 MS (28.6%) patients who had normal cognition according to the WAIS-III and WMS-R were assessed as cognitively impaired by the BRBN (which is not standardized for age). Cognitive function in NMOSD patients with no or mild non-specific brain lesions was preserved according to the WAIS-III and WMS-R.

  12. Retinitis por citomegalovirus en un paciente con VIH

    Directory of Open Access Journals (Sweden)

    Alena de los Ángeles Vejerano Duany

    Full Text Available La retinitis por citomegalovirus es la infección ocular más frecuente en pacientes con un recuento de linfocitos CD4 inferior a 200 por µL. El aspecto oftalmoscópico de las lesiones se caracteriza, en la mayoría de los casos, por infiltrados retinianos resultados de la necrosis retiniana producida por citomegalovirus y el edema en asociación con hemorragias. Estas lesiones se disponen, por lo general, siguiendo las arcadas vasculares temporales con invasión hacia la mácula. Se presentó una paciente de 24 años de edad, femenina, blanca, ama de casa, con antecedentes patológicos personales oculares sin datos de interés, y antecedentes patológicos personales generales de ser diagnosticadas con VIH. Hace cuatro años que comenzó con tratamiento antirretroviral, y tuvo cambios de tratamiento en dos ocasiones. El último fue impuesto en mayo del año 2011, con el cual presentó mala adherencia terapéutica, y comenzó desde entonces a presentar disminución de su peso corporal de forma marcada en breve período de tiempo. Refiere que desde hace unos meses comenzó a presentar una disminución progresiva de la agudeza visual en el ojo derecho, acompañado de visión borrosa. Adquiere gran importancia este caso, ya que ante la supervivencia de los pacientes con sida, va a ser cada vez más frecuente la aparición de las afecciones oculares relacionadas con esta enfermedad. Dentro de ellas se encuentran las infecciones oportunistas mayores como la retinitis por citomegalovirus.

  13. Equinoterapia en niños con autismo

    OpenAIRE

    Martinez Alvernia, Carlos Francisco

    2015-01-01

    Introducción: Autismo es un trastorno del desarrollo caracterizado por compromiso en interacción social, habilidades de lenguaje, presentando rituales con estereotipias. Sin tratamientos curativos, actualmente se buscan terapias alternativas. Un incremento de la literatura científica de terapias asistidas con animales se ha evidenciado, demostrando mejoría en pacientes autistas con la equinoterapia. Objetivo: Realizar una revisión sistemática de la literatura para evaluar efectividad de la eq...

  14. Plasma rico en plaquetas en pacientes con gonartrosis

    OpenAIRE

    Álvarez López, Alejandro; Ortega González, Carlos; García Lorenzo, Yenima; Arias Sifontes, Joanka; Ruiz de Villa Suárez, Abel

    2013-01-01

    Fundamento: la aplicación del plasma rico en plaquetas se ha convertido en una modalidad de tratamiento para pacientes con gonartrosis, tanto de forma aislada como en combinación con otros procedimientos. Objetivo: actualizar al personal médico sobre aspectos esenciales relacionados con la aplicación del plasma rico en plaquetas en pacientes con gonartrosis. Método: se realizó una revisión bibliográfica de un total de 300 artículos originales publicados en Pubmed, Hinari y Medline, mediante e...

  15. Estudio de viabilidad de cajones marítimos con hormigón con fibras

    OpenAIRE

    Ramos Marquès, Òscar Gonçal

    2017-01-01

    En este TFM se estudia la viabilidad de sustituir la armadura pasiva por fibras metálicas o plásticas en cajones para obras portuarias. Para ello, en primer lugar, se estudia el procedimiento constructivo de un cajón y las propiedades de los hormigones con fibras. Una vez analizado el estado del conocimiento se procede a escoger un cajón representativo, ya construido con armadura pasiva. El cajón escogido es el cajón tipo 3 del dique est...

  16. Bases tratadas con cemento, en California

    Directory of Open Access Journals (Sweden)

    Chinchilla, M.

    1962-05-01

    Full Text Available El uso de bases tratadas con cemento para autopistas se inició en el Estado de California en 1938, empleándose para carreteras con determinadas condiciones de tráfico. Inicialmente, se especificó el uso obligatorio de plantas mezcladoras para asegurar el debido control de las proporciones adecuadas.

  17. DR Con o:

    African Journals Online (AJOL)

    which could fall under the Ugandan influence. The con-. flict in the ..... The Congolese people and international community within SADC, the AU ..... ments and make peace among themselves. However, one ... friends overnight.There is a great ...

  18. Experiencia con Nexobrid® para el desbridamiento enzimático de quemaduras faciales seguido de tratamiento conservador con Medihoney®

    Directory of Open Access Journals (Sweden)

    José-Manuel Sampietro-De-Luis

    Full Text Available Introducción y Objetivos. El desbridamiento enzimático de las quemaduras ha sido objeto de estudio durante décadas; en este terreno, NexoBrid® (MediWound Ltd., Israel se postula como una prometedora alternativa al desbridamiento quirúrgico clásico. Por otra parte, las propiedades antibacterianas y promotoras de la cicatrización de la miel también se han evaluado recientemente con buenos resultados clínicos. Describimos nuestra experiencia preliminar con el empleo de NexoBrid® para el tratamiento de quemaduras faciales, seguido de curas tópicas con Medihoney® Wound Gel (Derma Sciences Ltd., EE.UU.. Material y Método. Incluimos en el estudio todos los pacientes atendidos en nuestra Unidad de Quemados con quemaduras faciales dérmicas o subdérmicas que afectaban a 2 o más subunidades estéticas. Realizamos desbridamiento enzimático con NexoBrid® en las primeras 24 horas. Posteriormente, llevamos a cabo tratamiento conservador con curas tópicas con Medihoney® Wound Gel. Recogimos todos los datos de calidad del desbridamiento, necesidad de desbridamiento quirúrgico, tiempo hasta epitelización completa, presencia de infección y necesidad de cirugía correctora de secuelas. Resultados. Tratamos 10 pacientes con quemaduras faciales de etiología diversa (llama, flash eléctrico, deflagración, escaldadura y química. El desbridamiento inicial fue completo en todos los pacientes. Se alcanzó la epitelización completa en una media de 13.88 días (10-20 días. Ningún paciente presentó infección clínicamente manifiesta ni precisó desbridamiento quirúrgico, cobertura mediante autoinjertos o cirugía de secuelas. Conclusiones. Nuestra experiencia preliminar indica que parece factible la aplicación de NexoBrid® y su combinación con Medihoney® para el tratamiento conservador de las quemaduras faciales.

  19. Conversazioni autobiografiche con Albino Sacco-Casamassima

    Directory of Open Access Journals (Sweden)

    Orazio Maria Valastro

    2004-03-01

    Full Text Available Nel 1948 venne Olivetti a Matera. Olivetti venne a Matera con un certo ambasciatore americano che praticamente aveva preparato o stava dando una mano per il piano Marschall, venne a Matera e mi vollero incontrare. Io sono stato chiamato dalla piazza, stavo nella piazza, era il mese di luglio, una cosa di questo genere, e andai in un bar, un bar ad angolo mi ricordo in Via Don Minzioni, dove questo Olivetti mi disse 'ma lei che cosa fa coi sassi?' 'Che cos'è questa storia?' Gli raccontai un po' che cosa facevo io con questi amici, avevamo fatto questo, insomma tutto quello che avevamo fatto nei sassi e che volevamo preparare ancora per presentare a qualcuno un piano di revisionamento dei sassi. Mi ricordo, era la prima volta che avevo visto Adriano Olivetti, ne avevo sentito parlare però non avevo mai visto quest'uomo con gli occhi celesti, minuto, coi capelli bianchi, riccioluto, con una cravatta bianca, cosa che mi fece impressione, una specie di angelo.

  20. Peso y talla en niños con retinoblastoma

    Directory of Open Access Journals (Sweden)

    Cecilia Ridaura-Sanz

    2015-03-01

    Full Text Available Introducción: la talla baja se ha descrito como característica clínica de niños con retinoblastoma. Esta particularidad puede estar relacionada directamente con la enfermedad de base o con factores externos.  Objetivo: el propósito de esta investigación fue conocer la frecuencia de talla y peso bajos en niños mexicanos con retinoblastoma y correlacionar los valores antropométricos con variables de la enfermedad y ambientales. Materiales y métodos: se analizaron expedientes clínicos de 346 pacientes con retinoblastoma. Se obtuvieron los datos de peso y talla referidos al ingreso; antes del tratamiento. Se comparó el valor de Z con las referencias de la distribución normal de la población mexicana. La asociación de las medidas antropométricas con las variables clínicas, sociales y genéticas se estableció con la prueba de c2. Resultados: la talla y el peso promedio de los niños con retinoblastoma fueron significativamente más bajos que los de la población general (p < 0.001 y p = 0.013, respectivamente. La talla y peso bajos fueron más frecuentes en niños con enfermedad avanzada, provenientes de medio rural y de bajo nivel socioeconómico. Conclusiones: los déficits en peso y talla en niños con retinoblastoma se deben a factores relacionados con enfermedad avanzada al momento del diagnóstico, lo cual a su vez es consecuencia de la situación de marginación de la población rural mexicana. Dado que la mayoría de las variables sociales y ambientales están muy relacionadas y que no podemos descartar posibles factores genéticos, las conclusiones de este estudio deben verificarse analizando las medidas de los padres y hermanos y establecer grupos comparativos para controlar las variables confusas.

  1. Incidencia y factores asociados con las reacciones adversas del tratamiento antirretroviral inicial en pacientes con VIH

    Directory of Open Access Journals (Sweden)

    Juan Astuvilca

    2007-07-01

    Full Text Available La alta incidencia de reacciones adversas medicamentosas (RAMA al tratamiento antirretroviral de gran actividad (TARGA en pacientes con VIH/SIDA puede afectar la calidad de vida y adherencia al tratamiento. Objetivos: Determinar la incidencia de RAMA del TARGA inicial e identificar los factores asociados con la ocurrencia de RAMA al recibir dicha terapia. Materiales y métodos: Se realizó un estudio de cohorte histórica con todos los pacientes VIH (+ mayores de 18 años que recibieron TARGA por primera vez en el Hospital Nacional Arzobispo Loayza, con un seguimiento de 360 días desde la primera prescripción. Se recabó las RAMA de las historias clínicas y tarjetas de control. Resultados: Se incluyeron 353 pacientes, se encontró una incidencia acumulada de 66,7% de efectos adversos al TARGA inicial y una densidad de incidencia de 9,1 eventos de RAMA por 10 personas año de seguimiento (IC95%: 8,1-10,1. Anemia (23,4%, náuseas (20,6% y rash (17,2% fueron las RAMA más frecuentes. El uso de drogas (OR 2,40; IC95% 1,01-5,67; consumo de alcohol (OR 0.32; IC95%: 0,19-0,55 y estadio SIDA (OR 0,20; IC95%: 0,04-0,95 estuvieron asociadas con la presencia de RAMA. Conclusiones: Existe un alta incidencia de RAMA, siendo la anemia la más frecuente. El uso de drogas es un factor de riesgo para presentar RAMA.

  2. Indicadores de enfermedades mentales en pacientes mexicanos con VIH/SIDA y su relación con la adherencia terapéutica

    Directory of Open Access Journals (Sweden)

    Ismael García-Cedillo

    2011-01-01

    Full Text Available Objetivo. Se analiza la relación entre algunos indicadores de enfermedades mentales y la adherencia terapéutica en pacientes con VIH/SIDA. Participantes. Muestra de 76 pacientes mexicanos infectados por VIH/SIDA. Procedimiento. Entrevista a profundidad a pacientes de un hospital público de la ciudad de San Luis Potosí, México. Resultados. 80% de los participantes presentó indicadores de enfermedades mentales correspondientes a: 28% conducta antisocial; 20% depresión clínica; 13% síndrome de estrés postraumático, 12% psicosis orgánica y 8% discapacidad intelectual. El porcentaje de pacientes infectados con VIH/SIDA con indicadores de enfermedad mental concuerda con los resultados de investigaciones realizadas en otros países. Solamente 7% de los participantes mostró un nivel de adherencia apropiado. La adherencia no guarda una relación lineal con la presencia de indicadores de enfermedad mental. La adherencia se relaciona con la escolaridad, la utilización de estrategias para recordar la toma del medicamento, confiar el estatus a los familiares y apoyo familiar.

  3. CALIDAD DE VIDA RELACIONADA CON LA SALUD EN PACIENTES CON LUPUS ERITEMATOSO SISTÉMICO Y SU RELACIÓN CON DEPRESIÓN, ANSIEDAD Y OPTIMISMO DISPOSICIONAL.

    Directory of Open Access Journals (Sweden)

    Juan Manuel Anaya

    2006-06-01

    Full Text Available La siguiente investigación presenta los resultados de un estudio desarrollado en Colombia sobre la evaluación de la calidad de vida y sus relaciones con la depresión, ansiedad y optimismo disposicional en 32 pacientes con diagnóstico de lupus eritematoso sistémico de la Clínica Universitaria Bolivariana de la ciudad de Medellín, Colombia. Para evaluar la calidad de vida se utilizó el Cuestionario SF36, la ansiedaddepresión fue evaluada mediante el Cuestionario HAD, y se trabajó con el Cuestionario DIOP para medir optimismo. El estudio evidenció que los pacientes perciben una calidad de vida favorable en todas las dimensiones que conforman el cuestionario SF36, no se encontraron niveles clínicamente significativos de ansiedad-depresión, y por último se encontró alta predisposición hacia el optimismo.

  4. Ex situ treatment of sediments with granular activated carbon : a novel remediation technology

    NARCIS (Netherlands)

    Rakowska, M.I.

    2014-01-01

    Over the last decades, industrial and urban development and emisions of many hazardous organic compounds have threatened the ecological quality of marine and freshwater sediments. Sediments accumulate hydrophobic organic compounds (HOCs) such as polycyclic aromatic hydrocarbons (PAHs),

  5. Optical design study of the PEARL beamline at SLS

    Czech Academy of Sciences Publication Activity Database

    Oberta, Peter; Flechsig, U.; Muntwiler, M.; Quitmann, C.

    2011-01-01

    Roč. 635, č. 1 (2011), s. 116-120 ISSN 0168-9002 Institutional research plan: CEZ:AV0Z10100522 Keywords : PGM * beamline design * photo-emision Subject RIV: BH - Optics, Masers, Lasers Impact factor: 1.207, year: 2011

  6. Planificación Neuroquirúrgica con Software Osirix

    Science.gov (United States)

    Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

    2014-01-01

    Introducción: La individualidad anatómica es clave para reducir el trauma quirúrgico y obtener un mejor resultado. Actualmente, el avance en las neuroimágenes ha permitido objetivar esa individualidad anatómica, permitiendo planificar la intervención quirúrgica. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. Caso 1: Paciente con meningioma de la convexidad parasagital izquierda en área premotora; Caso 2: Paciente con macroadenoma hipofisario, operada previamente por vía transeptoesfenoidal en otra institución con una resección parcial; Caso 3: Paciente con lesiones en pedúnculo cerebeloso medio bilateral. Se realizó la planificación prequirúrgica con el software OsiriX, fusionando y reconstruyendo en 3D las imágenes de TC e IRM, para analizar relaciones anatómicas, medir distancias, coordenadas y trayectorias, entre otras funciones. Discusión: El software OsiriX de acceso libre y gratuito permite al cirujano, mediante la fusión y reconstrucción en 3D de imágenes, analizar la anatomía individual del paciente y planificar de forma rápida, simple, segura y económica cirugías de alta complejidad. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente, para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. En el Caso 3 permitió obtener las coordenadas estereotáxicas y trayectoria de una lesión sin representación tomográfica. Conclusión: En casos de no contar con costosos sistemas de neuronavegación o estereotáxia el software OsiriX es una alternativa a la hora de planificar la cirugía, con el objetivo de disminuir el trauma y la morbilidad operatoria. PMID:25165617

  7. El maltrato en las personas con discapacidad

    OpenAIRE

    Revuelta, Lucerga

    2014-01-01

    El maltrato no solo se realiza por acción sino también por omisión, la indiferencia hacia la persona con discapacidad es una forma de maltrato muy frecuente. Por ejemplo, ignorar y desatender las necesidades de la persona con discapacidad o, al contrario, la sobreprotección son maneras de maltrato. Cuando a un niño con discapacidad el padre o cuidador le hace todo, el niño se siente agredido pues le están incapacitando más de lo que su enfermedad ya lo hace.

  8. Actitud de universitarios hacia las personas con discapacidad

    Directory of Open Access Journals (Sweden)

    Alexis Araya-Cortés

    2014-08-01

    Full Text Available El objetivo de este estudio fue describir y comparar la actitud hacia las personas con discapacidad de estudiantes de pedagogía, con estudiantes de otras profesiones y en distintos niveles de formación. Se utilizó un diseño descriptivo y correlacional en el que participaron 260 estudiantes de ambos sexos de una universidad privada de la cuidad de La Serena, Chile. Como instrumento se aplicó la Escala de Actitudes hacia las Personas con Discapacidad de Verdugo, Jenaro y Arias. Los resultados mostraron que la totalidad del alumnado presenta actitudes positivas. En relación con el tipo de carrera y nivel de estudio no se encontraron diferencias estadísticamente significativas. Se puede inferir que los estudiantes presentan una predisposición favorable a comportarse de manera efectiva frente a personas con discapacidad, valorando positivamente sus capacidades y reconociendo sus derechos fundamentales.

  9. Insuficiencia renal aguda relacionada con medicamentos en pacientes hospitalizados

    Directory of Open Access Journals (Sweden)

    Lujan Iavecchia

    2015-11-01

    Conclusiones: La mitad de los episodios de IRA intrahospitalaria se relacionaron con medicamentos. Los pacientes con IRA relacionada con medicamentos presentaron más antecedentes patológicos cardiovasculares, pero menos factores de riesgo de IRA y una menor mortalidad.

  10. ALMACÉN DE CARBONO EN SISTEMAS AGROFORESTALES CON CAFÉ

    Directory of Open Access Journals (Sweden)

    William Espinoza-Domínguez

    2012-01-01

    Full Text Available El presente estudio se realizó con el objetivo de estimar el almacén de carbono en sistemas agroforestales (SAF con base en café en la región de Huatusco, zona de mayor producción de café (Coffea arabiga L. en el estado de Veracruz, México, a fin de obtener información cuantitativa sobre el potencial de mitigación de carbono en los SAF de la región. Para ello, se estimaron los reservorios de carbono en biomasa vegetal y la materia orgánica edáfica existentes en sistemas agroforestales de café-plátano, café-macadamia, café-cedro rosado, café-ganado ovino y café-chalahuite, y como referencia de una condición no agroforestal se incluyeron un bosque primario y un potrero con pradera natural. La recolección de muestras se hizo en parcelas de 4 x 25 m (100 m2, donde se colectó biomasa de vegetación herbácea y mantillo, y para el suelo la profundidad de muestreo fue de 0 a 30 cm. El sistema agroforestal que presentó la mayor cantidad de carbono aéreo, estimado con modelos alelométricos, fue café-cedro rosado (Ca + Ce, con 114 Mg C·ha-1, seguido de los sistemas café - macadamia (Ca + Ma, con 34 Mg C·ha-1; café-chalahuite (Ca + Ch, con 29 Mg C·ha-1; café-plátano velillo (Ca + Pl, con 27 Mg C·ha-1; y por último el sistema silvopastoril (Sp, con 2 Mg C·ha-1. Para el caso del carbono orgánico del suelo, el tratamiento (Ca + Ce fue el que presentó mayor contenido de carbono fácilmente oxidable en el suelo, con 58 Mg C·ha-1, y el menor fue el tratamiento potrero (P, con 50 Mg C·ha-1. Del carbono orgánico total entre los SAF el tratamiento Ca + Ce fue el que tuvo el mayor valor, con 172 Mg C·ha-1, y el tratamiento silvopastoril (Sp presentó el menor, con 65 Mg C·ha-1. De los sistemas evaluados se concluye que, en promedio, los SAF almacenan 102 Mg C·ha-1, mientras que el potrero almacena 52 t C·ha-1, y el bosque primario es el sistema que más almacena carbono total, con un valor de 355 Mg C·ha-1.

  11. TRACCIÓN DE EQUIPOS AGRÍCOLAS CON ECUACIONES MICKLETHWAITE, BEKKER, JANOSI-HANOMOTO Y BRIXIUS EVALUADOS CON VISUAL BASIC

    Directory of Open Access Journals (Sweden)

    Américo José Hossne García

    2017-06-01

    Full Text Available La determinación de la tracción de los tractores agrícolas acredita su empleo eficiente, por ejemplo en: disminución del tiempo oportuno de operación, reducción de daños físicos y terramecánicos, adecuadas característica ingenieriles, tipo y número de neumáticos tractivos y reducción de los costos. El objetivo de este trabajo fue la utilización de las ecuaciones de Micklethwaite, Bekker, Janosi-Hanomoto, y Brixius adaptadas al campo agrícola analizadas con el lenguaje de programación Visual Basic. En la metodología se utilizaron los procedimientos de aplicación de las ecuaciones, las relaciones algebraicas y procedimientos programáticos en Visual Basic 6, diagrama de flujo y el análisis en la tracción sencilla, doble, aperos de tiro y montados; todos, con transferencia de peso y análisis de inestabilidad. El programa desarrollado con sus códigos proporciona una interfaz de usuario intuitiva mediante la vinculación de bases de datos con especificaciones del equipo agrícola, características del neumático, datos del suelo, datos del apero y los coeficientes de las ecuaciones para predecir el rendimiento de un tractor y modelo seleccionados. El programa demostró ser accesible, con mecanismos de uso sin instalación, eficiente y versátil. Las ecuaciones se emplearon con un número de parámetros representativos del área, que pueden ser reemplazados o ampliados y aplicables al agro involucrando la humedad del suelo.

  12. en personas con el VIH/SIDA

    Directory of Open Access Journals (Sweden)

    Ximena Palacios Espinosa

    2006-01-01

    Full Text Available El objetivo de este estudio fue hallar la relación de la intención e ideación suicida con algunas variables sociodemográficas, las características de la enfermedad, el tratamiento antirretroviral y los aspectos piscoafectivos en personas con el VIH/SIDA que residen en Bogotá (Colombia y pertenecientes a una fundación. Para ello, se tomó una muestra de 75 pacientes con VIH positivo a quienes se evaluó a través de una entrevista semiestructurada y dos instrumentos: el inventario de depresión de Beck (IBD y la escala de Ideación Suicida (SSI. Los resultados mostraron que solo 29 personas tenían ideación suicida y 10 intención suicida: De los 10 solo 2 sujetos tenían intención después del diagnóstico. Se encontró una relación estadística significativa para ideación suicida e intención suicida con edad, estrato socioeconómico, estado civil, orientación sexual, las características de la enfermedad, el tratamiento antirretroviral y los aspectos piscoafectivos.

  13. Carcinoma tricofolicular con capacidad metastásica

    Directory of Open Access Journals (Sweden)

    C.B. Pinilla-Martínez

    2015-03-01

    Full Text Available El carcinoma folicular es un tumor maligno derivado del folículo piloso. La mayor parte de los tumores foliculares son benignos, pero en los últimos años se han publicado casos aislados de tumores anexiales con características de malignidad y con una gran agresividad local siendo en principio tumores que se consideraban benignos. Creemos que este tumor está siendo infradiagnosticado, y como consecuencia, infratratado al ser confundido con otros tumores malignos originados en la piel, como el carcinoma basocelular y sobre todo con el carcinoma epidermoide, en parte por poca documentación y por la dificultad para su diagnóstico anatomopatológico. Presentamos un caso de carcinoma tricofolicular en cuero cabelludo en una mujer de 51 años de edad que rápidamente invade sistema nervioso central y que en solo 3 meses metastatiza a pulmón.

  14. Experiencias y recursos con las tics para la atención al alumnado con necesidades educativas especiales

    Directory of Open Access Journals (Sweden)

    Eladio Sebastian Heredero

    2014-02-01

    Full Text Available Este trabajo tiene como objetivo levantar algunas experiencias llevadas a cabo en centros educativos en los que se ponen de manifiesto buenas prácticas con el uso de las tecnologías para la atención al alumnado con necesidades educativas. Se ha realizado a través de una metodología mixta que alterna el trabajo de investigación de campo con el análisis documental, para finalmente llegar a presentar algunos ejemplos clarificadores y eficaces de prácticas educativas concretas. Los ejemplos aquí aportados, tienen como innovación, que nos presentan prácticas de aula, testadas y aplicadas, y a partir de ellas poder establecer algunas conclusiones e ideas para su mejora.

  15. Adolescentes con autolesiones e ideación suicida: un grupo con mayor comorbilidad y adversidad psicosocial

    OpenAIRE

    Mayer Villa, Pablo Adolfo; Morales Gordillo, Nadia; Victoria Figueroa, Gamaliel; Ulloa Flores, Rosa Elena

    2016-01-01

    La creciente prevalencia de conductas suicidas en adolescentes se ha convertido en un problema de salud pública. Existen varios factores asociados con este tipo de conductas, tales como: síntomas depresivos y ansiosos, consumo de sustancias nocivas, trastornos de conducta, violencia familiar, negligencia y abuso sexual en la infancia. Otro factor importante que se asocia con la presencia del comportamiento suicida son las autolesiones, las cuales pueden definirse como conductas deliberadas de...

  16. Sintomatología depresiva en pacientes con fibromialgia

    Directory of Open Access Journals (Sweden)

    Vanessa Moreno

    2010-03-01

    Full Text Available Introducción: La fibromialgia es una entidad frecuente en la práctica clínica y se ha considerado que está asociada con desórdenes psiquiátricos, en particular con depresión, lo cual podría tener un impacto en el tratamiento de esta entidad. Objetivo: Evaluar la prevalencia de síntomas depresivos en pacientes con fibromialgia. Diseño: Estudio observacional y de tipo transversal. Lugar: Servicio de Reumatología, Hospital Departamental María Auxiliadora. Participantes: Pacientes de ambos sexos con diagnóstico de fibromialgia. Intervenciones: Se utilizó la escala de Hamilton para la depresión (HDRS y el recuento de puntos dolorosos para fibromialgia. Principales medidas de resultados: Porcentaje de pacientes con síntomas depresivos. Puntaje total de la HDRS en relación al recuento de puntos dolorosos. Resultados: La edad promedio fue 54,9 ± 14 años, 80% fue del sexo femenino y el número promedio de puntos dolorosos, 14,4 ± 1,5. El 32,7% de pacientes no tenía síntomas de ánimo depresivo, en 27,7% los síntomas fueron leves, en 30,9% moderados y solo en 9% severos. Ningún paciente presentó síntomas compatibles con ánimo depresivo muy severo. Encontramos una correlación significativa entre el número de puntos dolorosos y el puntaje de la escala HDRS (r= 0,740, p< 0,001. Conclusiones: Los síntomas depresivos severos se encuentran en una proporción baja en pacientes con fibromialgia y parecen estar directamente asociados con el número de puntos dolorosos.

  17. Aprendizajes en sincronía con la vida

    Directory of Open Access Journals (Sweden)

    Flor Abarca-Alpízar

    2017-08-01

    Full Text Available Como humanidad sufrimos la desconexión y separación con la vida toda. Esta ruptura impuesta por el paradigma mecanicista predominante en los últimos cuatrocientos años, nos ha llevado a olvidar la visión holista promovida por las culturas originarias y ancestrales. Esta situación prevalece también en los sistemas educativos dominados por la enseñanza memorística y fragmentada, alejada de la vida, del ser y sentir de las personas aprendientes. Para la superación de la crisis planetaria actual es urgente recuperar la visión holista de la vida y del aprendizaje, para lo cual los procesos docentes universitarios son claves para la formación de personas profesionales comprometidas con la plenitud de la vida sobre la tierra. El sentido de este ensayo es reflexionar sobre la importancia que tiene para la superación de la crisis planetaria actual la recuperación de nuestra conectividad con la vida del planeta tierra en sincronicidad con los aprendizajes, porque los procesos vitales y los procesos de aprendizaje son la misma cosa. Este ensayo está organizado en tres momentos. El primero parte del intercambio de seres, saberes, sentires y experiencias para recuperar nuestra conexión perdida con la vida en nuestro planeta tierra. Un segundo momento donde presentamos reflexiones y conceptualización por medio de la construcción colectiva de conocimientos, con apoyo de personas especialistas en la visión holista y los procesos de interaprendizaje, necesarios para salvar la vida toda. El tercer momento de este ensayo está elaborado con propuestas, claves, signos y señales para la conexión de los procesos vitales en sincronía con los procesos de aprendizaje necesarios en los tiempos actuales.

  18. Study of the Generation of Intense Pulsed Electron Beams Using Glow Discharges

    Science.gov (United States)

    1988-02-01

    de Investigaciones Opticas, Rep. Argentina. (2) On leave from PROFET (UNCPBA) Programa de Fisica Experimental Tandil, Rep. Argentina. (3) Edwards... de Investigaciones Opticas, (CIC-BA) Rep. Argentina. Section III-D. Measurements of the plasma density andB. T. Szapiro is on leave from Programa de ...discussed. The radial profiles Szapiro was supported by a fellowship from the Universidad Nacional de show the presence of a high-current-density

  19. Infliximab en pacientes con enfermedad ocular inflamatoria, refractarios a DARMES

    Directory of Open Access Journals (Sweden)

    Elmer R. García-Salazar

    2013-07-01

    Full Text Available Se describe la experiencia con infliximab (anticuerpo monoclonal con una potente acción antiinflamatoria en el tratamiento de enfermedades oculares inflamatorias secundarias a patologías reumáticas y refractarias a drogas antirreumáticas modificadoras de la enfermedad (DARMES. Se evaluó el caso de una paciente de 50 años con artritis reumatoide (AR de fondo activo y una paciente de 37 años con vasculitis anticuerpos anticitoplasma de neutrófilos especifico para mieloperoxidasa (ANCA MPO sin compromiso de órgano noble, ambas con escleritis bilateral y perforación con prolapso de iris del ojo izquierdo. Ellas recibieron infliximab EV en dosis de 3 a 5 mg/kg/dosis, según el esquema, a las 0, 2, 6 y 8 semanas. Infliximab resultó eficaz y seguro para el tratamiento de escleritis asociada a AR y vasculitis ANCA MPO positivo, refractaria a tratamiento con DARMES y corticoides en dosis altas. Los injertos de tejido esclerocorneal evolucionaron favorablemente con infliximab.

  20. Programas de Salud y Género. Mujeres con VIH/SIDA

    Directory of Open Access Journals (Sweden)

    Graciela Enria

    2010-01-01

    Full Text Available La proliferación de trabajos biológicos sobre el proceso del VIH/Sida contrasta con el abordaje de la problemática desde la experiencia de los que lo viven. De entre los involucrados, la mujer se vio implicada desde el comienzo como una de las poblaciones de riesgo de contagiar y de enfermarse. La embarazada, objeto privilegiado de la salud pública, contó con programas especiales y normativas estrictas a través de los programas de salud, que dejaron fuera lo que pasaba con ellas en las relaciones con los compañeros y con ellas mismas; sus experiencias, sus perspectivas, sus nociones de futuro; así como su relación con el sistema de salud y con los médicos. En este trabajo se aplicó una metodología cualitativa basada en entrevistas abiertas a mujeres con VIH de la ciudad de Rosario, Argentina. Los hallazgos remiten a una serie de experiencias que relatan sus estrategias y contradicciones, abriendo puentes hacia la comprensión.

  1. "Sonríe con salud"

    Directory of Open Access Journals (Sweden)

    Rosa María González Ramos

    Full Text Available Introducción: los programas educativos juegan un papel importante ya que permiten modificar hábitos y conductas perjudiciales para la salud. Las personas de la tercera edad deben adquirir los conocimientos necesarios para realizar el auto cuidado de la salud bucal mejorando así su calidad de vida. Objetivo: evaluar los resultados del programa "Sonríe con salud". Métodos: se realizó una investigación descriptiva de corte transversal, con un universo de 74 personas de 60 años y más. Las variables estudiadas fueron: la edad, sexo. Se aplicó una encuesta. Las respuestas se agruparon atendiendo a si poseían o no, conocimientos acerca de la relación entre salud bucal y salud general, las principales enfermedades buco-dentales, realización del autoexamen bucal, efecto del tabaquismo y alcoholismo, ingestión de los alimentos azucarados, calientes, picantes y la importancia de la higiene bucal. La recolección de la información, la realizaron los autores empleando como fuente primaria el cuestionario aplicado en la primera etapa de la investigación. Se utilizaron los valores absolutos y el porcentaje en el análisis de los resultados. Resultados: el grupo de edad de 70 a 79 años fueron los más representados (36,5 % y el sexo femenino con un 59,5 %. Se elevaron los conocimientos relacionados con el efecto perjudicial del alcoholismo al 91,9 % y el tabaquismo al 95,9 %; acerca de la ingestión de alimentos azucarados se elevan al 97,7 % al igual que los alimentos calientes y picantes en un 90,5 %, relativo al autoexamen bucal se superan los conocimientos de su realización al 78,4 % y referente a la higiene bucal se elevan al 91,9 %. Conclusiones: el programa educativo "sonríe con salud" resultó eficaz, al elevar el nivel de conocimientos de los ancianos que recibieron las actividades previstas en el programa.

  2. Tratamiento con inmunoterapia específica en niños con Rinitis Alérgica y/o Asma Bronquial. Área Norte. 2005 - 2007.

    OpenAIRE

    Matilde Iraida Morera Franco; Rigoberto Antonio García Chang; María Mercedes Gómez Paz

    2007-01-01

    Se realizó un estudio descriptivo longitudinal durante el período Enero 2005_ Enero 2007 en el Policlínico Norte del municipio Sancti Spíritus. El universo estuvo constituido por el total de niños con edades de 2_15 años con enfermedades alérgicas, a los que se realizó pruebas de alergia e indicó tratamiento con inmunoterapia específica por vía subcutánea, la muestra estuvo formada por 75 pacientes con asma bronquial, rinitis alérgica y/o ambas enfermedades, con el objetivo de determinar ...

  3. Structural, electronic and optical properties of SrCl2 under hydrostatic stress

    Czech Academy of Sciences Publication Activity Database

    Benmimoun, Y.; Bouhemadou, A.; Khenata, R.; Reshak, Ali H; Amrani, B.; Ameri, M.; Baltache, H.

    2008-01-01

    Roč. 61, č. 2 (2008), s. 165-171 ISSN 1434-6028 Institutional research plan: CEZ:AV0Z60870520 Keywords : generalized gradient aproximation * elastic properties * high- pressure * emision-spectra Subject RIV: BO - Biophysics Impact factor: 1.568, year: 2008

  4. Silla multipropósito con medios auxiliares

    Directory of Open Access Journals (Sweden)

    René Ramón Toledo González

    2009-06-01

    Full Text Available Nuestro país no cuenta con la cantidad de sillones de rueda necesario para suplir las necesites de la población con diferentes tipos de discapacidades, en nuestro municipio existen muchos discapacitados que no pueden trasladarse a los servicios de rehabilitación, ni cuenta con medio de traslado en sus propios hogares lo que entorpecen su evolución y los hace mas dependientes; otro grupo de pacientes poseen sillón de ruedas útil para su traslado pero no para realizar  otras  actividades  de  la  vida  diaria  y  tienen  que  valerse  de  otras personas para realizar las mismas. La silla que hemos creado se hace con recursos y materias primas propias de nuestro país sin tener necesidad de compras de accesorios en el exterior; lo que nos permite a la vez que se resuelva un gran problema económico al país.

  5. Procesamiento de argumentos en personas con afasia

    Directory of Open Access Journals (Sweden)

    Luis Martínez

    2012-06-01

    Full Text Available En las personas con afasia se alteran diversos procesos lingüísticos. Entre las alteraciones más comunes tenemos aquellas que se producen en el procesamiento sintáctico, lo cual es evidente en el procesamiento de los argumentos. Investigaciones previas realizadas a sujetos con afasia reflejan un procesamientodeficiente de argumentos, lo cual se hace más evidente a medida que el número de argumentos aumenta. Se ha encontrado que mientras mayor es la complejidad en la estructura de la oración, los sujetos afásicos manifiestan mayores dificultades en el procesamiento de la misma. El presente estudio indaga en las dificultades que presentan los sujetos adultos con trastornos afásicos hablantes de español en el procesamiento de argumentos durante tareas de descripción. Este trabajo corrobora la evidencia de que los sujetos con afasia manifiestan un manejo deficiente en el procesamiento de argumentos en las tareas señaladas.

  6. Adolescentes con autolesiones e ideación suicida: un grupo con mayor comorbilidad y adversidad psicosocial

    Directory of Open Access Journals (Sweden)

    Pablo Adolfo Mayer Villa

    2016-05-01

    Full Text Available La creciente prevalencia de conductas suicidas en adolescentes se ha convertido en un problema de salud pública. Existen varios factores asociados con este tipo de conductas, tales como: síntomas depresivos y ansiosos, consumo de sustancias nocivas, trastornos de conducta, violencia familiar, negligencia y abuso sexual en la infancia. Otro factor importante que se asocia con la presencia del comportamiento suicida son las autolesiones, las cuales pueden definirse como conductas deliberadas destinadas a producir daño físico sin la intención de provocar la muerte. En adolescentes mexicanos, se ha reportado una frecuencia de autolesiones de 17.1%, con una relación mujer-hombre de 2:1; este problema es tan grave que las clasificaciones diagnósticas psiquiátricas internacionales han propuesto incluir las conductas autolesivas no suicidas como una categoría independiente...

  7. Obliteración de fracturas de seno frontal con colgajos pediculados

    Directory of Open Access Journals (Sweden)

    J. Pefaure

    2014-03-01

    Full Text Available El compromiso del seno frontal con fractura de sus paredes es un tipo de lesión infrecuente, en torno al 5-12% de todas las fracturas faciales. Suele asociarse a lesiones intracraneales, oftalmológicas y a otras fracturas máxilofaciales y cuando conlleva fractura de la pared posterior de seno frontal requiere tratamiento inmediato, siendo necesaria la obliteración del seno frontal debido a la comunicación con meninges y lóbulo frontal, con el riesgo infeccioso que ello representa. Tratamos 18 pacientes con traumatismos craneofaciales y fracturas del seno frontal con compromiso de su pared posterior en el periodo comprendido entre 2007 y 2011; 8 mujeres y 10 varones con edades comprendidas entre los 15 y los 64 años. Todos los casos fueron tratados con reducción y osteosíntesis por vía abierta con distintos abordajes y realizamos en todos colgajos pediculados de vecindad. La vitalidad de los colgajos fue del 100% . Certificamos el posicionamiento correcto mediante tomografía axial computarizada. El tratamiento de las fracturas del seno frontal con compromiso de su pared posterior o del conducto nasofrontal requiere obliteración con tejido vascularizado para evitar comunicaciones con la cavidad nasal.

  8. Diferencias conductuales y cognitivas en dos grupos de escolares con TDAH intervenidos con Arteterapia -vsMetilfenidato y un grupo control

    OpenAIRE

    M. Aurora G. Gallardo Saavedra; Ana Lucía Padrón García; M. del Consuelo Martínez-Wbaldo

    2018-01-01

    Introducción: El trastorno de défcit de atención e hiperactividad TDAH es una entidad neuropsiquiátrica, con prevalencia en la infancia entre 2% y 20%, su tratamiento actual asocia medicamentos y psicoterapia. El arteterapia en salud mental ha sido utilizado para tratar de cambiar el comportamiento y potenciar la cognición. Objetivo: comparar los cambios cognitivo-conductuales en escolares con TDAH tratados con arteterapia-vs-metilfenidato y un grupo control. Método: Ensayo clínico aleatoriza...

  9. The Inactivation of Escherichia Coli Bacteria Labelled with Tritiated Thymidine; Inactivation de Bacteries Escherichia Coli Marquees par la Thymidine Tritiee; 0418 043d 0414 ; Inactivacion de Escherichia Coli Marcada con Timidina Tritiada

    Energy Technology Data Exchange (ETDEWEB)

    Apelgot, Sonia [Institut du Radium, Laboratoire Curie, Paris (France)

    1962-02-15

    'efficacite de chaque atome desintegre pour tuer une bacterie est tres faible. Le calcul du nombre de paires d'ions crees, a l'inactivation, dans la bacterie par les particules {beta} emises au cours de la transmutation des atomes de {sup 3}H montre que ce nombre est comparable a celui laisse dans le cas des rayons X. Il semble que le suicide provoque par les desintegrations de {sup 3}H soit lie directement, a - 196 Degree-Sign C, a l'ionisation produite, dans l'ADN bacterien, par des particules {beta} emises, et a 0 Degree-Sign C, a la transmutation des atomes de {sup 3}H elle-meme. (author) [Spanish] tritiada. Se ha marcado con timidina tritiada el acido desoxirribonucleico de bacterias de la cepa B; thy {sup -}/Sr, que requieren timidina y son resistentes a la estreptomicina. Las mediciones de radiactividad se efectuaron con un contador de centelleador liquido, provisto de dos fotomultiplicadores montados en coincidencia. En las condiciones experimentales utilizadas, el rendimiento de recuento fue del 4,5% y la actividad de fondo, de 130 impulsos por minuto. Las bacterias radiactivas se guardaron a 0 Degree-Sign C y a - 196 Degree-Sign C en ampollas soldadas y se estudio su supervivencia. Los experimentos demuestran que las bacterias radiactivas son inactivadas exponencialmente, en funcion del numero de atomos de tritio que se desintegran. La inactivacion depende tambien de la temperatura. En ambos casos, se determino el efecto letal por transmutacion nuclear comprobandose que es muy debil. Se calculo el numero de pares ionicos generados por las particulas beta emitidas a consecuencia de la transmutacion del {sup 3}H y se observo que es comparable al obtenido en el caso de los rayos X. La muerte, causada por las desintegraciones del {sup 3}H, parece estar directamente relacionada con a ionizacion producida por las particulas beta en el acido desoxirribonucleico de las bacterias. (author) [Russian] Bakterii shtamma B{sup 3}{sub 1} thy{sup -}/Sr, nuzhdajushhiesja v timine i

  10. Anestesia para cesárea en paciente con acondroplasia

    OpenAIRE

    Osorio Rudas, Walter; Socha García, Nury Isabel; Upegui, Alejandro; Ríos Medina, Ángela; Moran, Adrian; Aguirre Ospina, Oscar; Rivera, Carlos

    2012-01-01

    Introducción: En gestantes acondroplásicas se recomienda el parto por cesárea con anestesia general; sin embargo, recientemente se ha reportado el uso de técnicas conductivas con resultados adecuados. Objetivo:Describir el manejo anestésico de una paciente con acondroplasia programada para cesárea utilizando anestesia combinada espinal-epidural. Métodos y resultados:Mostramos el caso de una primigestante acondroplásica con 110 cm de estatura y embarazo de 37 semanas, en quien se realizó cesár...

  11. [Proportion and significance of CD1d(hi)CD5⁺CD19⁺ regulatory B cell in peripheral blood of patients with neuromyelitis optica].

    Science.gov (United States)

    Yang, Fen; Huang, Dehui; Cheng, Chen; Wu, Weiping

    2015-03-01

    To detect the proportion of CD1d(hi)CD5⁺CD19⁺ regulatory B cells (Bregs) in peripheral blood of the patients with neuromyelitis optica (NMO), and explore whether CD1d(hi)CD5⁺CD19⁺ Bregs can play a role as a biomarker in the diagnosis of NMO versus multiple sclerosis (MS). Flow cytometry was performed to detect the proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in peripheral blood from 44 cases of NMO, 38 cases of MS, and 30 healthy controls. The serum level of aquaporin-4 antibody (AQP4-Ab) of patients with NMO was detected by indirect immunofluorescence assay. The proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in CD19⁺ B cells and lymphocytes was significantly lower in NMO group than in MS and control groups; however, there was no significant difference between MS group and control group. The proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in CD19⁺ B cells and lymphocytes was lower in AQP4-Ab-positive NMO patients than in AQP4-Ab-negative NMO patients, and the difference was statistically significant. CD1d(hi)CD5⁺CD19⁺ Bregs may be a biomarker in the differential diagnosis of NMO versus MS.

  12. L’incontro di Bruno Munari con la didattica attiva. I fondamenti pedagogici dei laboratori "Giocare con l’arte".

    Directory of Open Access Journals (Sweden)

    Laura Panizza

    2009-07-01

    Full Text Available Il saggio affronta il tema: quali idee pedagogiche hanno influenzato la progettazione dei laboratori "Giocare con l’arte", ideati da Bruni Munari negli anni Settanta e destinati a trasformare profondamente il modo d’intendere la didattica museale e l’educazione estetico-artistica. L’ipotesi dell’autrice è che questi laboratori riprendano alcuni principi dell’attivismo pedagogico, a cui Munari non fa però esplicito riferimento nei suoi scritti. Per questo motivo, il saggio cerca di ricostruire gli incontri più significativi che possono aver mediato l’approccio alla didattica attiva, soffermandosi in particolare sui rapporti di collaborazione intessuti da Munari con lo scrittore Gianni Rodari e con il pedagogista Giovanni Belgrano. Sia Rodari, sia Belgrano erano legati – seppure con diverse modalità – al Movimento di Cooperazione Educativa, che si proponeva di rinnovare la scuola italiana ispirandosi alla pedagogia deweyana. Attraverso la loro mediazione, Munari può essersi avvicinato all’attivismo, di cui condivideva peraltro molteplici assunti: dall’esigenza di promuovere la creatività del bambino, mediante la sperimentazione di materiali e tecniche, alla concezione dell’educatore come animatore delle attività volte alla padronanza dei saperi. In tal senso, il saggio si propone anche di mostrare la continuità esistente tra questa linea teorica e la riflessione sulla democratizzazione dell’arte intrapresa da Munari già nel 1948, con la fondazione – insieme ad altri artisti – del Movimento Arte Concreta.

  13. 9 CFR 319.301 - Chili con carne with beans.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  14. Linfoma hepático primario: Evolución favorable con quimioterapia combinada con rituximab Primary hepatic lymphoma: favorable outcome with chemotherapy plus rituximab

    Directory of Open Access Journals (Sweden)

    I. Serrano-Navarro

    2008-11-01

    Full Text Available Comunicamos el caso de una paciente con un linfoma hepático primario tratado con éxito con quimioterapia combinada con rituximab. Utilizando los "encabezamientos estándar para búsquedas bibliográficas informatizadas" (Medical Subject Heading revisamos los casos publicados hasta la fecha de esta infrecuente entidad.This article describes the case of a patient with a non-Hodgkin primary hepatic lymphoma who was successfully treated with chemotherapy combined with rituximab. Using the Medical Subject Headings the published reports of this rare entity were reviewed.

  15. Efectos adversos del tratamiento con interferón alfa-2b humano recombinante y rivabirina en pacientes con hepatitis crónica C

    OpenAIRE

    Mulet Pérez, Agustín; Pullés Labadié, Menelio; Gámez Escalona, Martha; Mulet Gámez, Agustín; Díaz Santos, Oscar; Infante Velázquez, Mirtha

    2011-01-01

    INTRODUCCIÓN: el tratamiento de la hepatitis crónica C continúa siendo un reto. La combinación que mejores resultados ha demostrado, es la de interferón con ribavirina, pero puede originar efectos adversos con dificultades para la adherencia al tratamiento que en ocasiones, incluso, obligan a suspenderlo. OBJETIVO: identificar las reacciones adversas del tratamiento de la combinación de interferón con ribavirina. MÉTODOS: se realizó un estudio de una serie de 13 pacientes con hepatitis crónic...

  16. Adenocarcinoma pulmonar metastásico con evolución favorable al tratamiento con ITK-EGFR en un paciente fumador

    Directory of Open Access Journals (Sweden)

    Joseph Jesús Exebio Jara

    2015-04-01

    Full Text Available Introducción: El cáncer de pulmón es el cáncer con mayor mortalidad en ambos sexos. El esquema de manejo actual del adenocarcinoma pulmonar incluye determinar el estado mutacional del receptor del factor de crecimiento epidérmico (EGFR, por ser la diana para el erlotinib, una terapia biológica. Caso clínico: Varón de 62 años, con hábito tabáquico de alto riesgo oncológico, que debuta con un cuadro de cefalea de un mes de evolución, objetivándose por resonancia magnética tumor cerebral. El diagnóstico inmunohistoquímico post quirúrgico fue adenocarcinoma pulmonar metastásico (TTF-1 (+. La tomografía identificó una lesión en el lóbulo superior derecho del pulmón; no presentaba clínica respiratoria. Al ser positivo para la mutación en el exón 21 del gen EGFR, se inició terapia con erlotinib, siendo bien tolerada por el paciente y manteniendo su estabilidad clínica. El paciente sobrevivió por el lapso de 31 meses posterior a su diagnóstico. Discusión: El tratamiento con erlotinib fue inicialmente indicado en el perfil de una paciente mujer, asiática y no fumadora. La eficacia en los estudios en pacientes con cáncer de pulmón de células no pequeñas evidencia que la sobrevida global es 15,9 meses, muy por debajo del visto en el presente caso.

  17. Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis

    DEFF Research Database (Denmark)

    Jarius, Sven; Frederiksen, Jette Lautrup Battistini; Waters, Patrick

    2010-01-01

    Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord.......Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord....

  18. Rate Coefficients for the Reactions of BF with O and O2.

    Science.gov (United States)

    1981-12-21

    2 indicate that indi- vidual molecular orbitals of BF are quite asymmetric so that the small overall dipole moment could be misleading. Nevertheless...radiation effects on materials, lu- brication and surface phenomena, thersionic " emision . photosensitive materials and detectors, atomic frequency standards

  19. Beneficios de la relajación en pacientes con patología cardiovascular y su relación con el patrón de conducta

    OpenAIRE

    Pérez Alonso, Verónica

    2017-01-01

    El objetivo de este estudio fue examinar los posibles efectos que producen las terapias de relajación con respecto a la frecuencia cardíaca, depresión, ansiedad y estrés, en pacientes con patología cardiovascular y su relación con el tipo de personalidad A. Este estudio cuenta con 16 pacientes (6 mujeres y 10 hombres) con edades comprendidas entre 40 y 82 años, todos participantes en el programa de rehabilitación cardíaca. La terapia de relajación se lleva a cabo una vez a la semana utiliz...

  20. PULPOTOMIA CON HIDROXIDO DE CALCIO CON MATERIAL DE SELLAJE EN CAVIDADES CURADAS DESPUES DE 2 AÑOS

    OpenAIRE

    Gruythuysen, Rene J.M.; Weerheijm, Karín L.

    2014-01-01

    El hidróxido de calcio entre otros han sido usados por mucho tiempo en la odontología debido a sus propiedades antibacterianas y a su favorable biocompatibilidad cuando se compara con otros agentes antibacteriales. El hidróxido de calcio entre otros han sido usados por mucho tiempo en la odontología debido a sus propiedades antibacterianas y a su favorable biocompatibilidad cuando se compara con otros agentes antibacteriales.

  1. Terapia con metformina y embarazo en pacientes con síndrome de ovario poliquístico

    OpenAIRE

    Arias E.,María C.; Reid S. de O.,Iván; Acuña S.M.,Margot; Muster O.,Hugo

    2004-01-01

    Estudio prospectivo de seguimiento de 15 pacientes con síndrome de ovario poliquístico (SOP) e hiperinsulinemia que se embarazaron con el uso de metformina, y que se siguieron hasta el parto. Diez continuaron metformina durante el embarazo, hasta las 14 semanas y cinco hasta las 32 semanas. Las 5 pacientes que usaron más tiempo el medicamento no desarrollaron diabetes gestacional a diferencia de las que lo tomaron hasta las 14 semanas que presentaron diabetes gestacional en tres de diez. No e...

  2. Sarcoma de Kaposi en paciente con SIDA

    Directory of Open Access Journals (Sweden)

    Jesús Ramón León Polanco

    2015-01-01

    Full Text Available Se presenta el caso de un paciente masculino de 33 años de edad, con antecedentes de VIH-SIDA desde hace 10 años, que se mantiene en tratamiento con antirretrovirales. Durante todo este tiempo ha presentado varios episodios de infecciones respiratorias, incluyendo tuberculosis pulmonar 5 años atrás. Acude a consulta refiriendo edemas en miembros inferiores acompañado de lesiones en piel de color violáceo de un año de evolución, previamente interpretado como linfangitis rebelde al tratamiento y que se extendió a la cara interna de los muslos y a los miembros inferiores. Con pérdida de peso, no prurito en las lesiones, fiebre, lesiones en la mucosa oral. Se determinó hemoglobina 89 g/L, leucocitos 4,5 x 109 /L, se estudiaron las funciones hepática y renales resultando normales. Radiografías de tórax y ultrasonido abdominal normales. Se realizó estudio anatomopatológico de piel que informó Sarcoma de Kaposi. Se impuso tratamiento con quimioterapia

  3. TIROTOXICOSIS GESTACIONAL: PATOLOGIA CON RIESGO VITAL

    OpenAIRE

    Valdés R.,Enrique; Pilasi M.,Carlos; Núñez U.,Tatiana

    2003-01-01

    Se presenta un caso clínico con diagnóstico final de Tirotoxicosis gestacional que debuta con una complicación excepcional, insuficiencia cardíaca congestiva e hipertensión pulmonar severa. Se presenta la experiencia del Hospital Clínico de la Universidad de Chile, proponiendo que su diagnóstico y tratamiento oportunos son la base del pronóstico de esta patología de riesgo vital para el binomio madre-hijo

  4. Presa con revestimiento asfáltico

    Directory of Open Access Journals (Sweden)

    Proudfit, D. P.

    1960-07-01

    Full Text Available La presa denominada Montgomery se halla situada sobre el río South Platte River, a unos 8 km aguas arriba de la ciudad de Alma, del Estado de Colorado (EE. UU., y en la ladera oriental de la cordillera Continental Divide. El cuerpo o dique de esta presa está constituido por piedra, revestida con una capa de hormigón asfáltico en el paramento de contacto con el agua.

  5. Colaboración con empresa de tasaciones

    OpenAIRE

    CASTILLO MORCILLO, JUAN

    2011-01-01

    Convenios con empresas de tasaciones y valoraciones. El objeto del proyecto es conseguir aprender y dominar el proceso de valoración de los distintos tipos de inmuebles urbanos mediante el cumplimiento de la Orden ministerial ECO/805/2003 Castillo Morcillo, J. (2011). Colaboración con empresa de tasaciones. http://hdl.handle.net/10251/11933. Archivo delegado

  6. Celulitis orbitaria bilateral con endoftalmitis en una paciente con reciente diagnóstico de diabetes mellitus tipo 2

    Directory of Open Access Journals (Sweden)

    Lesley Farrell González

    2014-07-01

    Full Text Available Se presentó una mujer de 74 años al servicio de urgencias del HRAEBI, ISSSTE, el día 2 de septiembre de 2010 con datos de desequilibrio hidroelectrolítico, hipotensión y conjuntivitis bilateral. Sus signos vitales durante su estancia en urgencias fueron: tensión arterial, 80/40 mmHg; temperatura, 38.5 °C; frecuencia respiratoria, 22 rpm; frecuencia cardíaca 89 lpm Se interconsulta al servicio de Oftalmología quienes diagnosticaron celulitis orbitaria bilateral, con no percepción de luz en ambos ojos e igualmente ausencia de reflejos pupilares. Se inició tratamiento con antibióticos intravenosos y se solicitó tomografía computarizada de órbitas y cerebro. Se internó para estabilizar su estado general; durante su estancia se diagnosticó diabetes mellitus y estado inmunosupresivo por datos de candidiasis oral y otros síntomas. La tomografía mostró celulitis orbitaria bilateral con formación de abscesos orbitarios, sin datos de proceso infeccioso a nivel bucal o de senos paranasales. La evolución de la celulitis fue tórpida a pesar de la terapia antibiótica cuádruple (cefotaxima, vancomicina, metronidazol y clindamicina; posteriormente imipenem, clindamicina y vancomicina con desarrollo de endoftalmitis bilateral por lo cual fue necesario eviscerar ambos ojos. Se tomó cultivo directo del vítreo y 3 días después se encontró como germen causal Klebsiella pneumoniae.

  7. Fisioterapia asistida con perros en adolescentes con parálisis cerebral y dificultades en la motricidad fina. Un ensayo clinico

    OpenAIRE

    Ayarza Viadero, Adrián

    2016-01-01

    RESUMEN: Introducción: la parálisis cerebral (PC) se considera como un grupo de trastornos del desarrollo del movimiento y la postura, causantes de la limitación de la actividad. La espasticidad es una de las secuelas más frecuentes, cuya alteración interfiere en la rehabilitación y en las actividades de la vida diaria de estos niños. Una de las terapias alternativas con las que se trata es la terapia con perros. Su principio de aplicación se basa en que la interacción con los perros a la hor...

  8. The neuromyelitis optica presentation and the aquaporin-4 antibody in HIV-seropositive and seronegative patients in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Ahmed I. Bhigjee

    2017-01-01

    Full Text Available Background: The association of the anti-aquaporin-4 (AQP-4 water channel antibody with neuromyelitis optica (NMO syndrome has been described from various parts of the world. There has been no large study describing this association from southern Africa, an HIV endemic area. HIV patients often present with visual disturbance or features of a myelopathy but seldom both either simultaneously or consecutively. We report our experience of NMO in the era of AQP-4 testing in HIV-positive and HIV-negative patients seen in KwaZulu-Natal, South Africa. Methods: A retrospective chart review was undertaken of NMO cases seen from January 2005 to April 2016 in two neurology units serving a population of 7.1 million adults. The clinical, radiological and relevant laboratory data were extracted from the files and analysed. Results: There were 12 HIV-positive patients (mean age 33 years, 9 (75% were women and all 12 were black patients. Of the 17 HIV-negative patients (mean age 32 years, 15 (88% were women and 10 (59% were black people. The clinical features in the two groups ranged from isolated optic neuritis, isolated longitudinally extensive myelitis or combinations. Recurrent attacks were noted in six HIV-positive patients and six HIV-negative patients. The AQP-4 antibody was positive in 4/10 (40% HIV-positive patients and 11/13 (85% HIV-negative patients. The radiological changes ranged from longitudinal hyperintense spinal cord lesions and long segment enhancing lesions of the optic nerves. Three patients, all HIV-positive, had tumefactive lesions with incomplete ring enhancement. Conclusion: This study confirms the presence of AQP-4-positive NMO in southern Africa in both HIV-positive and HIV-negative patients. The simultaneous or consecutive occurrence of optic neuritis and myelitis in an HIV-positive patient should alert the clinician to test for the AQP-4 antibody. It is important to recognise this clinical syndrome as specific therapy is available

  9. Epilepsia de la infancia con paroxismos occipitales

    Directory of Open Access Journals (Sweden)

    Albia Pozo Alonso

    1999-09-01

    Full Text Available Se reporta que la epilepsia de la infancia con paroxismos occipitales constituye un síndrome epiléptico muy bien definido; se incluye en el grupo de las epilepsias idiopáticas relacionadas con localización. Los ataques comienzan habitualmente con síntomas visuales, en ocasiones seguidos por ataques hemiclónicos, parciales complejos y tónicoclónicos generalizados. El electroencefalograma interictal muestra complejos de puntaonda de localización occipital y temporal posterior que desaparecen con la apertura de los ojos. Se presenta una paciente de 8 años de edad que reúne los criterios clínicos y electroencefalográficos de la epilepsia de la infancia con paroxismos occipitales y se enfatiza en la evolución supuestamente benigna de dicho síndrome.Is is reported that epilepsy of childhood with occipital paroxysms is an epileptic syndrome that is well defined. It is included in the group of related idiopathic epilepsies with localization. Seizures habitually begin with visual symptoms, which are ocassionally followed by hemiclonic, complex partial, and generalized tonicclonic seizures. The interictal EEG shows spike-wave complexes of occipital and temporal posterior localization that are suppressed by eye opening. A patient aged 8 in whom the clinical and electroencephalographic criteria of epilepsy of childhood with occipital paroxysms are present is studied in this paper. Emphasis is made on the apparently benign evolution of this syndrome.

  10. Mi palabra favorita. Una actividad con vídeo

    Directory of Open Access Journals (Sweden)

    Susana Cañuelo Carrión

    2012-08-01

    Full Text Available Mi palabra favorita es un actividad que surge a partir de la propuesta que realizael Instituto Cervantes con la web El día E (www.eldiae.es. Este portal fue creado enconmemoración del día del español, que se celebra desde 2009 el último sábado dejunio. Para festejar la vitalidad de la lengua y el interés mundial que despierta, hablantesy aprendientes de todo el mundo pueden explicar en dicho portal cuál es su palabrafavorita. Y pueden hacerlo con un texto, con un pictograma o con un vídeo.

  11. Mi palabra favorita. Una actividad con vídeo

    Directory of Open Access Journals (Sweden)

    Susana Cañuelo Carrión

    2011-01-01

    Full Text Available Mi palabra favorita es un actividad que surge a partir de la propuesta que realiza el Instituto Cervantes con la web El día E (www.eldiae.es. Este portal fue creado en conmemoración del día del español, que se celebra desde 2009 el último sábado de junio. Para festejar la vitalidad de la lengua y el interés mundial que despierta, hablantes y aprendientes de todo el mundo pueden explicar en dicho portal cuál es su palabra favorita. Y pueden hacerlo con un texto, con un pictograma o con un vídeo.

  12. Envasado de Carne de Vacuno con Hueso y Grasa en Atmósfera Modificada con CO2 y CO

    OpenAIRE

    Aspé, Estrella R; Roeckel, Marlene D; Martí, Cristina; Jiménez, Romel

    2008-01-01

    Se evaluó el efecto de envasado en atmósfera modificada (MAP) con bajo contenido de CO (0.1% y 0.4%) y presencia de CO2 sobre el color rojo y la vida útil de carne de vacuno. Se determinaron características microbiológicas, fisicoquímicas, organolépticas-sensoriales y de color del músculo y se compararon los resultados con el MAP de 70%O2+30%CO2. La vida útil de las muestras con O2 fue de 30 días mientras que para las muestras en MAP la vida útil fue de 40 a 45 días y no dependió de la concen...

  13. Composiciones conservantes de aceitunas con actividad antifúngica

    OpenAIRE

    Bautista-Gallego, J.; Arroyo López, Francisco Noé; Garrido Fernández, A.; García García, Pedro; López-López, Antonio; Rodríguez-Gómez, Francisco J.

    2010-01-01

    [ES] La presente invención se refiere a nuevas composiciones conservantes de aceitunas con actividad antiñmgica que comprenden: a. cloruro sódico; b. al menos un ácido con propiedades conservantes; y c. al menos una sal de cinc. Además la presente invención se refiere al procedimiento para la conservación de alimentos mediante dichas composiciones con actividad antiñmgica y al uso de la composición para la conservación de aceitunas frente a microorganismos del reino fungí.

  14. Galaxias australes con núcleo doble

    Science.gov (United States)

    Gimeno, G.; Díaz, R.; Carranza, G.

    Se estudia una muestra de galaxias australes con núcleo doble a partir de una búsqueda extensiva en la literatura. Se analizan las características morfológicas, fotométricas y espectroscópicas de la muestra. Para algunas galaxias se han realizado observaciones con el espectrógrafo multifunción (EMF) de la Estación Astrofísica de Bosque Alegre a partir de las cuales se determinaron parámetros cinemáticos.

  15. Factores asociados con la irregularidad de la ingesta de Dapsona en pacientes con lepra: Dapsona en pacientes con lepra

    Directory of Open Access Journals (Sweden)

    Luis Carlos Orozco Vargas

    2013-04-01

    Full Text Available Introducción: Conocer los factores asociados al cumplimiento del tratamiento en pacientes con lepra, es muy importante para prevenir la resistencia del Mycobacterium leprae y garantizar la cura bacteriológica de estas personas. La prueba de orina para Dapsona, presente en el régimen autoadministrado, es un método sencillo para establecer la regularidad del tratamiento. Objetivo: Explorar los factores asociados a la irregularidad de la ingesta del tratamiento antileproso. Métodos: Estudio de corte transversal de los enfermos que recibieron tratamiento antileproso en un centro dermatológico. La irregularidad se estableció con la prueba de dapsonuria. Se consideró irregular el que presentó la prueba negativa. Las variables sospechosas de influir en la irregularidad se analizaron con regresión logística exacta. Resultados: En el modelo final del análisis multivariado se encontraron cinco variables asociadas, entre éstas sobresalen como factores de riesgo, la ausencia de discapacidad, OR 28.56 (IC90% 1.2-2.1 y la entrega de tratamiento para tiempos mayores a un mes, por cada mes OR 3.41 (IC90% 1.4-9.2 y como factor protector, la aceptación familiar de la enfermedad OR 0.008 (IC90% 0.001-0.24. Conclusión: Aunque es posible que el pequeño tamaño de muestra no haya permitido detectar algunos factores de riesgo informados en otras investigaciones, la mayoría de esos estudios no han realizado análisis multivariado por lo cual es posible que muchos de los factores informados en la literatura no tengan importancia. Salud UIS 2013; 45 (1: 7-14

  16. Detection of Cherenkov radiation: the inverse problem to generation of nondiffracting beams

    Czech Academy of Sciences Publication Activity Database

    Miler, Miroslav; Pala, Jan

    2003-01-01

    Roč. 33, 2-3 (2003), s. 307-313 ISSN 0078-5466. [Polish-Czech-Slovak Optica l Conference on Wave and Quantum Aspects of Contemporary Optics PCS /13./. Krzyzowa, 09.09.2002-13.09.2002] R&D Projects: GA ČR GA102/01/0429 Institutional research plan: CEZ:AV0Z2067918 Keywords : Cherenkov radiation * holographic optica l elements * laser beams * diffraction Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 0.221, year: 2003

  17. Tratamiento con inmunoterapia específica en niños con Rinitis Alérgica y/o Asma Bronquial. Área Norte. 2005 - 2007.

    Directory of Open Access Journals (Sweden)

    Matilde Iraida Morera Franco

    2007-10-01

    Full Text Available Se realizó un estudio descriptivo longitudinal durante el período Enero 2005_ Enero 2007 en el Policlínico Norte del municipio Sancti Spíritus. El universo estuvo constituido por el total de niños con edades de 2_15 años con enfermedades alérgicas, a los que se realizó pruebas de alergia e indicó tratamiento con inmunoterapia específica por vía subcutánea, la muestra estuvo formada por 75 pacientes con asma bronquial, rinitis alérgica y/o ambas enfermedades, con el objetivo de determinar el comportamiento del tratamiento con inmunoterapia específica se aplicó el método porcentual para el análisis de resultados, donde el grupo etáreo que predominó fue de 2 _5 años, más del 65 % de los pacientes tratados refirieron mejoría de los síntomas las causas más frecuentes de abandono de tratamiento fue la aparición de infecciones intercurrentes, no ocurrió reacción anafiláctica en ninguno de los casos estudiados, el tratamiento con inmunoterapia puede reducir el uso de otros tratamientos asociados como Intal, antihistamínicos, broncodilatadores y esteroides.

  18. SATISFACCIÓN DE LAS PERSONAS CON LESIÓN MEDULAR CON EL SERVICIO DE PROMOCIÓN DE LA AUTONOMÍA PERSONAL EN LAS ISLAS BALEARES

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Capó-Juan

    2016-01-01

    Full Text Available Fundamentos: El Servicio de Promoción de la Autonomía Personal pretende ofrecer atención a sujetos con discapacidad física y/o físico-psíquica grave, entre ellos, a personas con lesión medular. Estas personas se encuentran en una fase crónica y por ello requieren medidas fisioterápicas educativo–terapéuticas. El objetivo de este estudio fue determinar la satisfacción de las personas con lesión medular que acuden a este servicio. Métodos: Se llevó a cabo un estudio descriptivo, transversal, cuantitativo después de un seguimiento terapéutico de dieciséis meses que se inició en marzo de 2015. La muestra final del estudio fue de 25 personas con lesión medular (17 hombres y 8 mujeres que supusieron el 83% del total de las atendidas. Al finalizar la intervención terapéutica, estas personas respondieron al cuestionario SERVQHOS que consta de diecinueve preguntas y pretende medir la calidad asistencial de los servicios prestados. Se llevó a cabo un análisis estadístico a través Microsoft Office Excel 2013 y SPSS 23, calculando medias y desviaciones estándar o frecuencias y porcentajes. Resultados: El factor externo mejor valorado fue la apariencia del personal con un 4,5 de media y el peor valorado la accesibilidad y/o señalización con un 2,6 de media. El factor interno mejor valorado fue la amabilidad del personal con un 4,8 de media y el peor valorado la rapidez con la que se consigue lo que se solicita, con un 4,2 de media. Conclusiones: Tras el estudio se concluye que la calidad ofrecida está determinada por los factores internos (amabilidad, confianza y disposición de ayudar y que las debilidades vienen relacionadas con factores externos estructurales del centro.

  19. Tuberculosis congénita asociada con tuberculosis materna miliar diseminada

    Directory of Open Access Journals (Sweden)

    Luis Miguel Sosa

    2007-12-01

    Se presenta el caso de una mujer primigestante con tuberculosis miliar diseminada, con inicio de las manifestaciones en el puerperio inmediato, diagnóstico en el segundo mes del puerperio y desenlace fatal. Además, se presenta el caso de su hijo prematuro con manifestaciones desde el nacimiento, evidencia de complejo pulmonar primario, atelectasia persistente por obstrucción bronquial por las adenopatías e infección por citomegalovirus; recibió tratamiento estándar con mejoría.

  20. PIGMENTACIÓN, CRECIMIENTO Y SUPERVIVENCIA DE CRÍAS CARPA KOI (CYPRINUS CARPIO VAR. HAEMATOPTERUS ALIMENTADAS CON DIETAS CON INCLUSIONES DE ACEITE DE LANGOSTILLA ROJA (PLEURONCODES PLANIPES

    Directory of Open Access Journals (Sweden)

    Gloria L. Gil R.

    2015-01-01

    Full Text Available En este estudio se evaluó el efecto de la inclusión de aceite de langostilla roja (Pleuroncodes planipes sobre el crecimiento, supervivencia y pigmentación del tegumento de crías de carpa koi (Cyprinus carpio var. haematopterus. El estudio consistió en tres experimentos: experimento 1, con fotoperiodo de 4 h L / 20 h O y aguas claras; experimento 2, con fotoperiodo 12 h L/ 12 h O y aguas claras, y, experimento 3, cuyo fotoperiodo fue de 12 h L /12 O y aguas con algas. En estos experimentos, dos variedades de crías de carpa koi -naranjas y con manchas oscuras- fueron alimentadas con dietas adicionadas con aceite de langostilla a diferentes porcentajes de inclusión (0, 1, 2 y 3 %, con el 5% de alimento con relación a la biomasa de cada unidad experimental. Al final de cada uno de los experimentos se tomaron fotografías de los organismos y se analizó la coloración con el modelo de matiz-saturación-brillantez de cuatro regiones anatómicas en ambas variedades de crías y en los experimentos 1 y 2 se evaluaron parámetros biológicos: supervivencia, ganancia en longitud y en peso, y porcentaje de incremento en peso y en longitud. Las dietas adicionadas con aceite de langostilla roja no fueron rechazadas por los organismos, y no se observaron efectos negativos en las variables evaluadas. En general, la inclusión de aceite influyó en la pigmentación de las crías de color naranja y en el crecimiento y la coloración de los organismos con manchas oscuras, particularmente cuando el fotoperiodo fue de 12 L/ 12 O.