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Sample records for porus acusticus internus

  1. Hemangioma of the porus acusticus. Impact of imaging studies: case reports

    Energy Technology Data Exchange (ETDEWEB)

    Petit-Lacour, M.C.; Marsot-Dupuch, K.; Hadj-Rabia, M.; Doyon, D.; Lasjaunias, P. [Dept. of Neuroradiology, Kremlin-Bicetre Hospital (France); Sterkers, O. [Dept. of Oto-rhino-laryngology, Beaujon Hospital, Clichy (France); Bobin, S. [Dept. of Oto-rhino-laryngology, Kremlin-Bicetre Hospital (France)

    2001-12-01

    Hemangiomas are tumors. Hemangiomas near the geniculate ganglion or in the internal acoustic meatus are well known but rare. We present two cases of hemangiomas located at the porus acusticus, an even more rare site. MRI showed a millimeter-sized tumor, located in the porus acusticus, developing perpendicular to the axis of the acoustico-facial nerves, surrounding them. They were hyperintense on T1-weighted images, strongly hyperintense on T2-weighted images with a characteristic progressive and marked enhancement after injection of gadolinium DTPA. Similar signal abnormalities were present in the adjacent temporal bone, and CT scan demonstrated a honeycomb appearance with intra-tumoral bony spicules. These imaging criteria allows differentiation between hemangioma and neurinoma. We hypothesize that this location is related to the presence of a rich vascular plexus of the dura mater in this area. (orig.)

  2. Hemangioma of the porus acusticus. Impact of imaging studies: case reports

    International Nuclear Information System (INIS)

    Petit-Lacour, M.C.; Marsot-Dupuch, K.; Hadj-Rabia, M.; Doyon, D.; Lasjaunias, P.; Sterkers, O.; Bobin, S.

    2001-01-01

    Hemangiomas are tumors. Hemangiomas near the geniculate ganglion or in the internal acoustic meatus are well known but rare. We present two cases of hemangiomas located at the porus acusticus, an even more rare site. MRI showed a millimeter-sized tumor, located in the porus acusticus, developing perpendicular to the axis of the acoustico-facial nerves, surrounding them. They were hyperintense on T1-weighted images, strongly hyperintense on T2-weighted images with a characteristic progressive and marked enhancement after injection of gadolinium DTPA. Similar signal abnormalities were present in the adjacent temporal bone, and CT scan demonstrated a honeycomb appearance with intra-tumoral bony spicules. These imaging criteria allows differentiation between hemangioma and neurinoma. We hypothesize that this location is related to the presence of a rich vascular plexus of the dura mater in this area. (orig.)

  3. MR Imaging Features of Obturator Internus Bursa of the Hip

    International Nuclear Information System (INIS)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh

    2008-01-01

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium

  4. MR Imaging Features of Obturator Internus Bursa of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2008-08-15

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium

  5. Significance of bone changes at the meatus acusticus internus in tumours of the auditory nerve and in the 'empty' extended internal auditory meatus

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    Grehn, S.

    1988-06-01

    The unilateral extension of shortening of the internal auditory meatus is a very safe bony sign of the presence of a neurinoma of the auditory nerve. Differential diagnosis is necessary to exclude an 'empty' extended internal auditory meatus. On the other hand, 31% of the definitely established neurinomas do not show up in the plain tomogram. These facts prove that despite the presence or absence of allegedly definite bony changes at the internal auditory meatus further diagnostic measures are imperative, especially an air meatography in conjunction with high resolution computed tomography.

  6. Metrizamide cisternography in the diagnosis of acoustic neurinomas

    Energy Technology Data Exchange (ETDEWEB)

    Servo, A.; Porras, M.; Jaeaeskinen, J.

    1981-02-01

    Seventy-three cisternographies with metrizamide were performed on 69 patients, mainly for diagnosis of an acoustic neurinoma. Of the 31 patients with pathological findings on cisternography 26 underwent surgery for 23 acoustic neurinomas, one neurinoma of the facial nerve, and two meningiomas. For diagnosing small tumours of the cerebellopontine cistern, cisternography is superior to all other neuroradiological methods. Tomography of the porus acusticus internus and CT scanning are the initial radiological methods in patients with signs of cerebellopontine angle lesions; if no lesion is disclosed by these two methods cisternography with metrizamide should be performed to exclude a small tumor, particularly a small acoustic neurinoma.

  7. Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

    Science.gov (United States)

    Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle

    2017-10-01

    This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

  8. Megadolichobasilarartery as a rare cause of a hydrocephalus internus -synopsis of modern imaging techniques

    International Nuclear Information System (INIS)

    Lemke, A.J.; Sander, B.; Benndorf, G.; Balzer, J.; Boerschel, M.F.; Hosten, N.; Sprung, C.; Ricke, J.; Felix, R.; Lanksch, W.R.

    1995-01-01

    Megadolichobasilarartery (MDB), i.e. the widened, elongated and tortuous course of the basilar artery, has been the topic of numerous publications; about 350 cases have been reported world-wide. It can cause many symptoms; isolated or combined cranial nerve lesions and ischemic or hemorrhagic changes are the most frequent. A hydrocephalus internus is a rare occurrence and many patients do not exhibit any symptoms. To date, angiography, computed tomography, and to an increasing extent magnetic resonance imaging (MRI) are the principal methods for diagnosis of MDB. Angiographic-like representations with CT and MRI are further developments which represent an alternative to angiography. With the help of special MRI sequences, furthermore, non-invasive CSF flow measurements for the etiologic evaluation of a hydrocephalus can be performed. For the example of a patient with MDB and hydrocephalus internus, the possibilities of modern imaging techniques are presented and discussed. (orig.) [de

  9. Obturator internus pyomyositis manifested as sciatica in a patient with subacute bacterial endocarditis: A rare case report.

    Science.gov (United States)

    Hsu, Wei-Ching; Hsu, Jin-Yi; Chen, Michael Yu-Chih; Liang, Chung-Chao

    2016-07-01

    Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative.

  10. Modeling Laterality of the Globus Pallidus Internus in Patients With Parkinson's Disease.

    Science.gov (United States)

    Sharim, Justin; Yazdi, Daniel; Baohan, Amy; Behnke, Eric; Pouratian, Nader

    2017-04-01

    Neurosurgical interventions such as deep brain stimulation surgery of the globus pallidus internus (GPi) play an important role in the treatment of medically refractory Parkinson's disease (PD), and require high targeting accuracy. Variability in the laterality of the GPi across patients with PD has not been well characterized. The aim of this report is to identify factors that may contribute to differences in position of the motor region of GPi. The charts and operative reports of 101 PD patients following deep brain stimulation surgery (70 males, aged 11-78 years) representing 201 GPi were retrospectively reviewed. Data extracted for each subject include age, gender, anterior and posterior commissures (AC-PC) distance, and third ventricular width. Multiple linear regression, stepwise regression, and relative importance of regressors analysis were performed to assess the predictive ability of these variables on GPi laterality. Multiple linear regression for target vs. third ventricular width, gender, AC-PC distance, and age were significant for normalized linear regression coefficients of 0.333 (p laterality of 0.19 mm per mm of ventricular width, 0.11 mm per mm of AC-PC distance, 0.017 mm per year in age, and 0.54 mm increase for male gender. This variability highlights the limitations of indirect targeting alone, and argues for the continued use of MRI as well as intraoperative physiological testing to account for such factors that contribute to patient-specific variability in GPi localization. © 2016 International Neuromodulation Society.

  11. Obturator internus muscle autotransfer: a new concept for the treatment of anismus. Clinical experience.

    Science.gov (United States)

    Farag, A

    1997-01-01

    In this study 20 patients suffering from chronic constipation due to spastic anal sphincters were operated upon using a new surgical technique. The technique aimed at constructing an active anal dilator mechanism using the obturator internus muscles mobilized from both sides and sutured to the side wall of the anal canal in order to overcome the spastic anal sphincters during defaecation. This series included 3 failures (15%), 16 successful cases (80%), and 1 dissatisfied patient despite normal postoperative investigations (5%). Eleven patients (55%) showed immediate postoperative normalization of their defaecation. Five patients (25%) showed normalization of their defaecation after 10 sessions of electric stimulation of the transposed muscles given 1 month postoperatively for 10 successive days. All the successful cases (16 patients) maintained their good results during the period of follow-up which ranged from 16 to 45 months (average = 30.31 months). For the successful cases, follow-up was from 16 to 42 months (average = 26.72 months). Immediate postoperative complications included 3 cases of wound infection and 2 cases of transient incontinence to gases which responded completely to postoperative Faradic stimulation. No cases of persistent incontinence of any degree were detected among the 20 patients studied. The 3 failures were mainly due to avoidable technical problems. The technique was safe, easy, and physiological, using a strictly perineal approach.

  12. Neuronal firing in the globus pallidus internus and the ventrolateral thalamus related to parkinsonian motor symptoms

    Institute of Scientific and Technical Information of China (English)

    CHEN Hai; ZHUANG Ping; ZHANG Yu-qing; LI Jian-yu; LI Yong-jie

    2009-01-01

    Background It has been proposed that parkinsonian motor signs result from hyperactivity in the output nucleus of the basal ganglia, which suppress the motor thalamus and cortical areas. This study aimed to explore the neuronal activity in the globus pallidus internus (GPi) and the ventrolateral thalamic nuclear group (ventral oral posterior/ventral intermediate, Vop/Vim) in patients with Parkinson's disease (PD).Methods Twenty patients with PD who underwent neurosurgery were studied. Microelectrode recording was performed in the GPi (n=10) and the Vop/Vim (n=10) intraoperatively. Electromyography (EMG) contralateral to the surgery was simultaneously performed. Single unit analysis was carried out. The interspike intervals (ISI) and coefficient of variation (CV) of ISI were calculated. Histograms of ISI were constructed. A unified Parkinson's disease rating scale (UPDRS) was used to assess the clinical outcome of surgery.Results Three hundred and sixty-three neurons were obtained from 20 trajectories. Of 175 GPi neurons, there were 15.4% with tremor frequency, 69.2% with tonic firing, and 15.4% with irregular discharge. Of 188 thalamic neurons, there were 46.8% with tremor frequency, 22.9% with tonic firing, and 30.3% with irregular discharge. The numbers of three patterns of neuron in GPi and Vop/Vim were significantly different (P <0.001). ISI analysis revealed that mean firing rate of the three patterns of GPi neurons was (80.9±63.9) Hz (n=78), which was higher than similar neurons with 62.9 Hz in a normal primate. For the Vop/Vim group, ISI revealed that mean firing rate of the three patterns of neurons (n=95) was (23.2±17.1) Hz which was lower than similar neurons with 30 Hz in the motor thalamus of normal primates. UPDRS indicated that the clinical outcome of pallidotomy was (64.3±9.5)%, (83.4±19.1)% and (63.4±36.3)%, and clinical outcome of thalamotomy was (92.2±12.9)%, (68.0±25.2)% and (44.3±27.2)% for tremor, rigidity and bradykinesia, respectively

  13. Holmes’ Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

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    Sabri Aydın

    2017-05-01

    Full Text Available A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery.

  14. Serial 1H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia

    International Nuclear Information System (INIS)

    Chernov, Mikhail F.; Iseki, Hiroshi; Takakura, Kintomo; Ochiai, Taku; Taira, Takaomi; Hori, Tomokatsu; Ono, Yuko; Nakamura, Ryoichi; Muragaki, Yoshihiro

    2008-01-01

    The physiological mechanisms of deep brain stimulation (DBS) are not completely clear. Our understanding of them may be facilitated with the use of proton magnetic resonance spectroscopy ( 1 H-MRS). Serial 1 H-MRS of both thalami was performed during the course of DBS of bilateral globus pallidus internus in a patient with primary generalized dystonia. Two days after microelectrode implantation, a pulse frequency of 185 Hz was applied for stimulation. It resulted in relief of symptoms and a decrease of Burke-Fahn-Marsden dystonia rating scale (BFMDRS) scores, and was accompanied by a prominent increase of N-acetylaspartate (NAA)/choline-containing compounds (Cho) ratio, a mild increase of NAA/creatine (Cr) ratio, and a moderate decrease of Cho/Cr ratio. Two weeks later, for a search of the optimal stimulation mode, the pulse frequency was switched to 60 Hz, which resulted in clinical deterioration and significant increase of BFMDRS scores. At that time, all investigated 1 H-MRS-detected metabolic parameters had nearly returned to the pretreatment levels. Use of serial 1 H-MRS investigations of various brain structures during DBS in cases of movement disorders permits detailed evaluation of the treatment response, has a potential for its possible prediction, and may facilitate understanding of the physiological mechanisms of stimulation. (orig.)

  15. Obturator externus was larger, while obturator internus size was similar in ballet dancers compared to nondancing athletes.

    Science.gov (United States)

    Mayes, Susan; Ferris, April-Rose; Smith, Peter; Cook, Jill

    2018-06-02

    To compare the cross-sectional area (CSA) of hip external rotators, obturator externus (OE) and obturator internus (OI), in ballet dancers and nondancing athletes, and evaluate the relationship between obturator muscle size and hip pain. Case-control study. Elite ballet and sport. 33 male and female professional ballet dancers and 33 age and sex-matched athletes. CSA's of OE and OI measured on magnetic resonance imaging (MRI) of one hip. Hip pain was scored with the Copenhagen Hip and Groin Outcome Score (HAGOS): HAGOS pain score of 100 was defined as no pain and a score less than 100 was defined as pain. Participants weight and height. Estimated marginal mean CSA of OE was 14% larger in dancers than athletes (p = 0.01, ηp2 = 0.1); the size of OI was similar (p > 0.05). Men and women in both groups had similar sized OI and OE. There was no interaction between the estimated marginal mean CSA of either obturator and hip pain. It appears that ballet selectively increases muscle size of OE, but not OI. Obturator size was not related to mild hip pain, as OE and OI size was similar in dancers and athletes with and without pain. Copyright © 2018. Published by Elsevier Ltd.

  16. Accuracy and reliability of three-dimensional surface reconstruction measurement

    International Nuclear Information System (INIS)

    Mizukami, Chikashi; Yamamoto, Etsuo; Ohmura, Masaki; Oiki, Hiroyuki; Tsuji, Jun; Muneta, Yuki; Tanabe, Makito; Hakuba, Nobuhiro; Azemoto, Syougo.

    1993-01-01

    We are using a new three-dimensional (3-D) surface reconstruction system to measure the temporal bones. This system offers the advantage of observation of the external aperture of the vestibular aqueduct and the porus acusticus internus in living subjects. However, its accuracy has not been confirmed. To investigate the accuracy of this new system, we measured the length of an in situ ceramic ossicular replacement prosthesis (CORP) of known length of 6.0 mm using 3-D surface reconstruction, conventional plain X-ray and polytomography. The CORP was scanned in the axial, sagittal and oblique directions. The mean measured length obtained with the 3-D surface reconstruction images was 5.94±0.21 on vertical scans, 5.91±0.27 on horizontal scans, and 6.01±0.25 on oblique scans. There were no significant differences among the measured lengths obtained in the three directions. Therefore, this 3-D surface reconstruction measurement system is considered to be reliable. Conversely, the mean measured length obtained by plain X-ray was 7.98±0.20, and by polytomography it was 7.94±0.23. These conventional methods have the inherent disadvantage of magnification of size which consequently requires correction. (author)

  17. Immediate recovery of neurological function in response to deep brain stimulation of the globus pallidus internus in a patient with idiopathic camptocormia

    Directory of Open Access Journals (Sweden)

    I. Madrazo

    2016-04-01

    Full Text Available Camptocormia is a major disabling abnormality characterized by severe forward flexion of the thoracolumbar spine. We report here on the effectiveness of deep brain stimulation (DBS for the management of a case of untreatable idiopathic camptocormia. The patient, a 51-year-old male, with an 11-year-long history of radicular pain. Camptocormia symptomatology initiated 4 years ago. Preoperative muscle electrodiagnostic testing was within normal limits. Myopathy was ruled out. In the standing position myokymic discharges were recorded. Under local anesthesia and stereotactic control, electrodes for DBS were placed bilaterally in the globus pallidus internus. Patient's symptoms disappeared immediately following DBS. This response cannot be attributed to the surgical procedure itself. When stimulators were turned “off” accidentally, the patient returned immediately to his pre-surgery condition. Erect posture and walking were restored when stimulators were back “on”.

  18. Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: A Meta-Analysis.

    Science.gov (United States)

    Combs, Hannah L; Folley, Bradley S; Berry, David T R; Segerstrom, Suzanne C; Han, Dong Y; Anderson-Mooney, Amelia J; Walls, Brittany D; van Horne, Craig

    2015-12-01

    Parkinson's disease (PD) is a common, degenerative disorder of the central nervous system. Individuals experience predominantly extrapyramidal symptoms including resting tremor, rigidity, bradykinesia, gait abnormalities, cognitive impairment, depression, and neurobehavioral concerns. Cognitive impairments associated with PD are diverse, including difficulty with attention, processing speed, executive functioning, memory recall, visuospatial functions, word-retrieval, and naming. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is FDA approved and has been shown to be effective in reducing motor symptoms of PD. Studies have found that stimulating STN and GPi are equally effective at improving motor symptoms and dyskinesias; however, there has been discrepancy as to whether the cognitive, behavioral, and mood symptoms are affected differently between the two targets. The present study used random-effects meta-analytic models along with a novel p-curve analytic procedure to compare the potential cognitive and emotional impairments associated with STN-DBS in the current literature to those associated with GPi-DBS. Forty-one articles were reviewed with an aggregated sample size of 1622 patients. Following STN-DBS, small declines were found in psychomotor speed, memory, attention, executive functions, and overall cognition; and moderate declines were found in both semantic and phonemic fluency. However, GPi-DBS resulted in fewer neurocognitive declines than STN-DBS (small declines in attention and small-moderate declines in verbal fluency). With regards to its effect on depression symptomatology, both GPi-DBS and STN-DBS resulted in lower levels of depressive symptoms post-surgery. From a neurocognitive standpoint, both GPi-DBS and STN-DBS produce subtle cognitive declines but appears to be relatively well tolerated.

  19. Deep Brain Stimulation of the Globus Pallidus Internus in Patients with Intractable Tourette Syndrome: A 1-year Follow-up Study

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hua Zhang; Jian-Yu Li; Yu-Qing Zhang; Yong-Jie Li

    2016-01-01

    Background:Deep brain stimulation (DBS) has been a promising treatment for patients with refractory Tourette syndrome (TS) for more than a decade.Despite successful DBS treatment of TS in more than 100 patients worldwide,studies with a large patient sample and long-term follow-up assessments are still scarce.Accordingly,we investigated the clinical efficacy and safety of globus pallidus internus (GPi) DBS in the treatment of intractable TS in 24 patients with a l-year follow-up assessment.Methods:Bilateral/unilateral GPi-DBS was performed in 24 patients with TS.We evaluated symptoms of tics and obsessive-compulsive disorder (OCD) through the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive-compulsive Scale (Y-BOCS).We used the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) to evaluate the safety of the treatment.We conducted follow-up assessments of all patients for at least 12 months (12-99 months).Results:Symptoms of tics and OCD were significantly relieved at a 12-month follow-up assessment.The mean YGTSS score was 74.04 ± 11.52,49.83 ± 10.91,32.58 ± 7.97,and 31.21 ± 8.87 at baseline,3,6,and 12 months,respectively.The mean YGTSS scores obtained at the follow-up assessments were significantly different from the baseline (P < 0.05).The improvement in motor tics was superior to that in phonic tics.The mean Y-BOCS scores were 21.61 ± 4.97,18 ± 4.58,14.39 ± 3.99,and 13.78 ± 4.56 at baseline,3,6,and 12 months,respectively (P < 0.05).We observed a remarkable improvement in psychiatric comorbidities,such as OCD and attention-deficit hyperactivity disorder,after the procedure.WAIS-RC scores were comparable before and after the operation.There were no severe postoperative complications.Conclusion:GPi-DBS appears to comprehensively alleviate tic symptoms and psychiatric comorbidities in patients with TS,thus significantly improving patients' quality of life.

  20. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation for the Treatment of Patients With Parkinson's Disease: Executive Summary.

    Science.gov (United States)

    Rughani, Anand; Schwalb, Jason M; Sidiropoulos, Christos; Pilitsis, Julie; Ramirez-Zamora, Adolfo; Sweet, Jennifer A; Mittal, Sandeep; Espay, Alberto J; Martinez, Jorge Gonzalez; Abosch, Aviva; Eskandar, Emad; Gross, Robert; Alterman, Ron; Hamani, Clement

    2018-06-01

    Is bilateral subthalamic nucleus deep brain stimulation (STN DBS) more, less, or as effective as bilateral globus pallidus internus deep brain stimulation (GPi DBS) in treating motor symptoms of Parkinson's disease, as measured by improvements in Unified Parkinson's Disease Rating Scale, part III (UPDRS-III) scores? Given that bilateral STN DBS is at least as effective as bilateral GPi DBS in treating motor symptoms of Parkinson's disease (as measured by improvements in UPDRS-III scores), consideration can be given to the selection of either target in patients undergoing surgery to treat motor symptoms. (Level I). Is bilateral STN DBS more, less, or as effective as bilateral GPi DBS in allowing reduction of dopaminergic medication in Parkinson's disease? When the main goal of surgery is reduction of dopaminergic medications in a patient with Parkinson's disease, then bilateral STN DBS should be performed instead of GPi DBS. (Level I). Is bilateral STN DBS more, less, or as effective as bilateral GPi DBS in treating dyskinesias associated with Parkinson's disease? There is insufficient evidence to make a generalizable recommendation regarding the target selection for reduction of dyskinesias. However, when the reduction of medication is not anticipated and there is a goal to reduce the severity of "on" medication dyskinesias, the GPi should be targeted. (Level I). Is bilateral STN DBS more, less, or as effective as bilateral GPi DBS in improving quality of life measures in Parkinson's disease? When considering improvements in quality of life in a patient undergoing DBS for Parkinson's disease, there is no basis to recommend bilateral DBS in 1 target over the other. (Level I). Is bilateral STN DBS associated with greater, lesser, or a similar impact on neurocognitive function than bilateral GPi DBS in Parkinson disease? If there is significant concern about cognitive decline, particularly in regards to processing speed and working memory in a patient undergoing DBS

  1. Cochlear vertebral entrapment syndrome: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Liu Chinghsiung; Lin Shinnkuang E-mail: sk1943@adm.cgmh.org.tw; Chang Yeujhy

    2001-11-01

    The authors describe a patient with isolated involvement of vestibulocochlear nerve by a huge vascular loop from vertebral dolichoectasia. No other neurological deficit was found except for unilateral hearing loss. Abnormal brainstem auditory evoked potential study indicated a retrocochlear lesion. The brain computed tomography (CT) and magnetic resonance imaging (MRI) studies demonstrated an abnormally enhanced vascular lesion impinged on the left porus acusticus with a displacement of the brainstem to the right. There was no infarction in the brainstem. A cerebral angiography demonstrated a megadolichoectatic horizontal loop at the intracranial portion of the left vertebral artery. There was no thrombus or atherosclerosis in the vertebrobasilar system. A mechanical compression by a vascular loop is the only possible pathogenesis for hearing loss. The authors diagnose this condition as cochlear vertebral entrapment syndrome.

  2. Analisa Tegangan, Regangan Dan Deformasi Pada Perkerasan Konvensional Dan Perkerasan Porus

    Directory of Open Access Journals (Sweden)

    Mukhammad Mukhlis

    2018-02-01

    Full Text Available In Indonesia generally use conventional flexible pavement, where the ability to pass water is not good. One prevention effort is using porous flexible pavement. To determine the effect of stress, strain, and deformation on porous and conventional pavement, a semi-field pavement study was conducted and focused on improving track performance. Semi-field scale is an analytical method that using a certain scale that can represent the actual conditions that occur in the field, both on the load, material, and thickness. From the measurement results, the value of stress and strain increased along with the increasing number of tracks. Meanwhile, the deformation on the surface of the asphalt due to the passing wheel load increases as the number of tracks increases.

  3. A study and development of a system for the determination of porus plates permeability

    International Nuclear Information System (INIS)

    Leitao Junior, C.B.; Zorzetto, L.F.

    1989-07-01

    A device employed for the study of flux in porous media and another one employed for the determination of permeability of porous plate are presented in this work. Experimental data and calculation obtained from the above cited systems are also presented. (author) [pt

  4. The Effects of Viscous Dissipation on Convection in a Porus Medium

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    T Raja Rani

    2017-05-01

    Full Text Available The aim of this paper is to study of the effects of variable physical properties and viscous dissipation on a free convective flow over a vertical plate with a variable temperature embedded in a porous medium. We study the effects of varying physical properties on heat transfer and on flow when the medium is filled with some commonly used experimental fluids, in particular, Glycerin, Water and Methyl chloride (a commonly refrigerant. A similarity transformation technique is used to reduce the partial differential equations governing the flow. The resulting system of non-linear coupled ordinary differential equations is solved numerically with appropriate boundary conditions using the Runge-Kutta-Gill method coupled with a shooting technique. Using this approach, a study is conducted on both hot and cold plates and results presented using a combination of graphical illustrations and tables of the effect of changing a variety of physical parameters, in particular, the temperature and viscosity of the fluid.

  5. Thermal performance of a porus radial fin with natural convection and radiative heat losses

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    Darvishi M.T.

    2015-01-01

    Full Text Available An analytic (series solution is developed to describe the thermal performance of a porous radial fin with natural convection in the fluid saturating the fin and radiation heat loss from the top and bottom surfaces of the fin. The HAM results for the temperature distribution and base heat flux are compared with the direct numerical results and found to be very accurate.

  6. Neurosurgical treatment of extracerebral tumors

    International Nuclear Information System (INIS)

    Antoniadis, G.; Kretschmer, T.; Braun, V.; Rath, S.; Richter, H.P.

    1998-01-01

    Extracerebral tumors represent 29-30% of the intracranial tumors. Meningiomas rank first in incidence with 13-19%, followed by neurinomas and pituitary adenomas, 6-8% each. Due to their slow growth rate, meningiomas in the initial stages do not produce symptoms. Complete recovery can be achieved by complete removal of the tumor, which in general is possible in case of tumor sites at the convexity. Meningiomas at the basis, or meningiomas spreading into the sinus sagittalis superior often cannot be totally removed, so that for treatment of remaining or recurrent tumors and anaplastic meningiomas, post-operative radiation therapy is recommended. Neurinomas of the nervus acusticus originate at the N. vestibularis and may spread from the Meatus acusticus internus into the brain stem. With the modern methods of microsurgery combined with intraoperative monitoring it is possible to preserve the Nn. facialis and cochlearis and their functions. As an alternative to surgery, radiosurgery techniques have been on trial in the last few years. Via transsphenoidal approach, intra- and suprasellar pituitary adenomas can be completely destroyed. Parasellar tumors can be resected by transcranial approach only. Remaining tumors in the Sinus cavernosus, or recurrent adenomas, should receive post-surgery radiation treatment. (orig./CB) [de

  7. Constructive interference in steady state(CISS) 3DFT MR imaging of the inner ear and adjacent structures

    International Nuclear Information System (INIS)

    Chung, Eun Chul; Choi, Hae Young; Lee, Jung Sik; Ko, Eun Joo; Lee, Myung Sook

    1997-01-01

    To assess the value of 3 dimensional fourier transformation interference in steady state magnetic resonance imaging(3DFT CISS MRI) in depicting the inner ear and vascular structures. Using 3DFT CISS axial and coronal MRI scans of both ears with 17.1msec/8.0msec/50 degree(TR/TE/FA) and 0.9mm in nominal thickness, we studied 68 normal ears of 34 volunteers aged between 15 and 54 years. We assessed the visualization of the membranous labyrinth, and of cranial nerves VII and VIII in the inner ear canal. We analyzed the location of the vascular loop of the anterior inferior cerebellar artery in relation to cranial nerves VII and internal auditory canal. To define the three-dimensional images of the membranous labyrinth, MIP reconstruction of axial images was carried out. The very high signal of the intralabyrinth fluid enabled one hundred percent of the membranous labrynth to be seen There was a lack of contrast between soft tissue and bone such as the facial verve canal, vestibular aqueduct and canal of the subarcuate artery. In 25% of cases, the vascular loop was recognized in the porus acusticus, and in 6% of cases, inside the internal auditory canal. 3DFT CISS MRI is useful for determining the detailed anatomy of the inner ear and the nearby vascular loop. This special MR technique can be added as a routine protocol in the study of diseases of the inner ear

  8. Involvement of the subthalamic nucleus and globus pallidus internus in attention

    Czech Academy of Sciences Publication Activity Database

    Bocková, M.; Chládek, Jan; Jurák, Pavel; Halámek, Josef; Baláž, M.; Rektor, I.

    2011-01-01

    Roč. 118, č. 8 (2011), s. 1235-1245 ISSN 0300-9564 R&D Projects: GA AV ČR IAA200650801; GA MŠk ED0017/01/01 Institutional research plan: CEZ:AV0Z20650511 Keywords : basal ganglia * ERP * ERD/S * attention * DBS Subject RIV: FH - Neurology Impact factor: 2.730, year: 2011

  9. Malignant Neuroleptic Syndrome following Deep Brain Stimulation Surgery of Globus Pallidus Pars Internus in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Jae Meen Lee

    2016-02-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS surgery in a cerebral palsy (CP patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity, and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired, despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after DBS surgery, irrespective of continued dopaminergic medication.

  10. Defining the Limits of Endoscopic Access to Internal Auditory Canal.

    Science.gov (United States)

    Master, Adam; Hamiter, Mickie; Cosetti, Maura

    2016-12-01

    To quantify surgical access to the internal auditory canal (IAC) using an exclusively endoscopic transcanal approach (EETA) and investigate surgically relevant relationships with neurovascular and osseous landmarks of the temporal bone. Anatomical dissection of two paired temporal bones and 15 unpaired temporal bones was performed using an exclusively endoscopic approach to IAC. The dissection proceeded until the cerebellopontine angle (CPA) could be accessed. Following dissection, all the specimens were subjected to computed tomography (CT) imaging. Anatomage InVivo5 software was used to analyze the CT scans and record measurements. CPA access and visualization of the labyrinthine segment of the facial nerve were achieved in all specimens. The mean distances from the carotid artery, jugular bulb, and middle fossa to the surgical opening (or fundostomy) of IAC were 4.1±1.5, 6.4±2.5, and 5.5±1.9 mm, respectively. The mean cross-sectional areas of the fundostomy and tympanic ring were 30.8±10.4 and 67.7±11.3 mm2. The mean distances from the osteo-cartilaginous junction and tympanic ring to the porus acusticus were 29±2.6 and 21±2.3 mm, respectively. Transcanal access to the entire IAC can be safely achieved using an exclusively endoscopic approach. Generous removal of the cochlear promontory can be accomplished while a safe distance is maintained from key neurovascular structures. EETA to IAC offers a minimally invasive alternative to patients without serviceable hearing for intrameatal and medial IAC tumors. Increased knowledge of crucial anatomical relationships involved in this approach will facilitate acceptance and utilization.

  11. Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex.

    Science.gov (United States)

    Alonso, Fernando; Kassem, Mohammad W; Iwanaga, Joe; Oskouian, Rod J; Loukas, Marios; Demerdash, Amin; Tubbs, R Shane

    2017-08-16

    Vascular loops in the cerebellopontine angle (CPA) and their relationship to cranial nerves have been used to explain neurological symptoms. The anterior inferior cerebellar artery (AICA) has variable branches producing vascular loops that can compress the facial cranial nerve (CN) VII and vestibulocochlear (CN VIII) nerves. AICA compression of the facial-vestibulocochlear nerve complex can lead to various clinical presentations, including hemifacial spasm (HFS), tinnitus, and hemiataxia. The formation of arterial loops inside or outside of the internal auditory meatus (IAM) can cause abutment or compression of CN VII and CN VIII. Twenty-five (50 sides) fresh adult cadavers underwent dissection of the cerebellopontine angle in the supine position. In regard to relationships between the AICA and the nerves of the facial/vestibulocochlear complex, 33 arteries (66%) traveled in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Five arteries (10%) traveled below the CN VII/VIII complex, six (12%) traveled posterior to the nerve complex, four (8%) formed a semi-circle around the upper half of the nerve complex, and two (4%) traveled between and partially separated the nervus intermedius and facial nerve proper. Our study found that the majority of AICA will travel in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Although the relationship between the AICA and porus acusticus and AICA and the nerves of the CN VII/VIII complex are variable, based on our findings, some themes exist. Surgeons should consider these with approaches to the cerebellopontine angle.

  12. Trigeminalt trofisk syndrom--

    DEFF Research Database (Denmark)

    Kjaerskov, Mette Wanscher; Bygum, Anette

    2009-01-01

    Trigeminal trophic syndrome (TTS) is a rare but well-described syndrome consisting of the triad: paraesthesia, anaesthesia and crescent-shaped ulceration of the ala nasi. We report a case of a 62-year-old woman presenting with TTS after operative excision of an acusticus neurinoma. She attended s...

  13. Forschungszentrum Juelich. Annual report 2008

    International Nuclear Information System (INIS)

    Frick, Frank; Roegener, Wiebke

    2009-07-01

    The following topics are dealt with: The precise lattice QCD mass calculation of protons and neutrons by means of the JUGENE supercomputer, the early diagnosis of morbus Alzheimer, the fabrication of vertebra-column implants consisting of porus titanium, software for the improvement of the spatial resolution in electron microscopy by means of aberration corrections. (HSI)

  14. Forschungszentrum Juelich. Annual report 2008; Forschungszentrum Juelich. Jahresbericht 2008

    Energy Technology Data Exchange (ETDEWEB)

    Frick, Frank; Roegener, Wiebke

    2009-07-15

    The following topics are dealt with: The precise lattice QCD mass calculation of protons and neutrons by means of the JUGENE supercomputer, the early diagnosis of morbus Alzheimer, the fabrication of vertebra-column implants consisting of porus titanium, software for the improvement of the spatial resolution in electron microscopy by means of aberration corrections. (HSI)

  15. Using otolith morphometric and morphology characteristics to identify carangids species in the Persian Gulf and Oman Sea

    OpenAIRE

    Mansourkiaei, Ana

    2010-01-01

    In a survey on 524 specimens from 18 different species belonging to the Carangidae family collected from The Persian Gulf, otolithes (Sagittae) are extracted from under gills region. After washing, their morphometric parameters measured. These parameters are otolith length, width, weight and length of antirostrum, width and length of rostrum, width in right and left sagittae. In addition to the otolith outline, mode position and mode opening of the Sulcus acusticus was examined. Data indicate...

  16. MR imaging of accessory muscles of the ankle

    International Nuclear Information System (INIS)

    Mondello, Eduardo; Nazar, Miguel E.; Martin, Eduardo

    2001-01-01

    Purpose: The purpose of this work is to describe the normal anatomy and the characteristics in MRI of the accessory muscles of the posterior ankle: the accessory soleus, accessory flexor digitorum longus, peroneus quartus, tibiocalcaneus internus and peroneocalcaneus internus. Material and methods: There were evaluated 280 symptomatic patients between 18 and 40 years old (85 % males). MR was performed in High Field Magnetic Resonance Units (1.5 T y 1.0 T) and multiplanar sequences. Results: We found 2 peroneus quartus (0.7%), 2 accessory soleus muscles (0.7%), 3 accessory flexor digitorum longus (1.07%) and 1 peroneocalcaneus internus (0.35%). Conclusion: The knowledge of the accessory muscles of the posterior ankle allow to explain different painful pathologies with instability or tendinous tears, which are difficult to diagnose if the muscle are not adequately recognized. (author)

  17. A randomized double-blind crossover trial comparing subthalamic and pallidal deep brain stimulation for dystonia

    DEFF Research Database (Denmark)

    Schjerling, Lisbeth; Hjermind, Lena E; Jespersen, Bo

    2013-01-01

    Object The authors' aim was to compare the subthalamic nucleus (STN) with the globus pallidus internus (GPi) as a stimulation target for deep brain stimulation (DBS) for medically refractory dystonia. Methods In a prospective double-blind crossover study, electrodes were bilaterally implanted in ...

  18. Massively Parallel Optical-to-Electronic Data Transfer

    Science.gov (United States)

    1992-07-27

    is an angle of 0.43 degrees (0.75 mrad). A TeO2 Bragg cell with an acoustic velocity of 6.16 x 10 cm/sec and a center frequency of 60 Mhz has an...laminated face to face and attached to a glass substrate. As shown in Figure 5-1, the diffracted 632.8 nm power exhibits a true maximum because, unlike the...in Photopolymers An attempt was made to stabilize the geometry of the photopolymer by infiltrating a solution of the photopolymer into a porus glass

  19. Observations on lycaenid butterflies from Panbari Reserve Forest and adjoining areas, Kaziranga, Assam, northeastern India

    Directory of Open Access Journals (Sweden)

    Monsoon Jyoti Gogoi

    2015-12-01

    Full Text Available A checklist of 116 taxa of Lycaenidae (Blues along with notes on important species in low elevation forest of Panbari Reserve, Kaziranga - West Karbi Hills, upper Assam is reported in this paper based on surveys conducted during 2007–2012 and some recent sightings till date.  Important sightings include Blue Gem Poritia erycinoides elsiei, Square-band Brownie Miletis nymphys porus, Plain Plushblue Flos apidanus ahamus, Blue Royal Ancema carmentalis, Elwes Silverline Spindasis elwesi, Artipe skinneri, etc. 

  20. Otolith atlas for the western Mediterranean, north and central eastern Atlantic

    Directory of Open Access Journals (Sweden)

    Victor M. Tuset

    2008-07-01

    Full Text Available The sagittal otolith of 348 species, belonging to 99 families and 22 orders of marine Teleostean fishes from the north and central eastern Atlantic and western Mediterranean were described using morphological and morphometric characters. The morphological descriptions were based on the otolith shape, outline and sulcus acusticus features. The morphometric parameters determined were otolith length (OL, mm, height (OH, mm, perimeter (P; mm and area (A; mm2 and were expressed in terms of shape indices as circularity (P2/A, rectangularity (A/(OL×OH, aspect ratio (OH/OL; % and OL/fish size. The present Atlas provides information that complements the characterization of some ichthyologic taxa. In addition, it constitutes an important instrument for species identification using sagittal otoliths collected in fossiliferous layers, in archaeological sites or in feeding remains of bony fish predators.

  1. Direct visualization of anatomic subfields within the superior aspect of the human lateral thalamus by MRI at 7T.

    Science.gov (United States)

    Kanowski, M; Voges, J; Buentjen, L; Stadler, J; Heinze, H-J; Tempelmann, C

    2014-09-01

    The morphology of the human thalamus shows high interindividual variability. Therefore, direct visualization of landmarks within the thalamus is essential for an improved definition of electrode positions for deep brain stimulation. The aim of this study was to provide anatomic detail in the thalamus by using inversion recovery TSE imaging at 7T. The MR imaging protocol was optimized on 1 healthy subject to segment thalamic nuclei from one another. Final images, acquired with 0.5(2)-mm2 in-plane resolution and 3-mm section thickness, were compared with stereotactic brain atlases to assign visualized details to known anatomy. The robustness of the visualization of thalamic nuclei was assessed with 4 healthy subjects at lower image resolution. Thalamic subfields were successfully delineated in the dorsal aspect of the lateral thalamus. T1-weighting was essential. MR images had an appearance very similar to that of myelin-stained sections seen in brain atlases. Visualized intrathalamic structures were, among others, the lamella medialis, the external medullary lamina, the reticulatum thalami, the nucleus centre médian, the boundary between the nuclei dorso-oralis internus and externus, and the boundary between the nuclei dorso-oralis internus and zentrolateralis intermedius internus. Inversion recovery-prepared TSE imaging at 7T has a high potential to reveal fine anatomic detail in the thalamus, which may be helpful in enhancing the planning of stereotactic neurosurgery in the future. © 2014 by American Journal of Neuroradiology.

  2. External auditory exostoses and hearing loss in the Shanidar 1 Neandertal.

    Directory of Open Access Journals (Sweden)

    Erik Trinkaus

    Full Text Available The Late Pleistocene Shanidar 1 older adult male Neandertal is known for the crushing fracture of his left orbit with a probable reduction in vision, the loss of his right forearm and hand, and evidence of an abnormal gait, as well as probable diffuse idiopathic skeletal hyperostosis. He also exhibits advanced external auditory exostoses in his left auditory meatus and larger ones with complete bridging across the porus in the right meatus (both Grade 3. These growths indicate at least unilateral conductive hearing (CHL loss, a serious sensory deprivation for a Pleistocene hunter-gatherer. This condition joins the meatal atresia of the Middle Pleistocene Atapuerca-SH Cr.4 in providing evidence of survival with conductive hearing loss (and hence serious sensory deprivation among these Pleistocene humans. The presence of CHL in these fossils thereby reinforces the paleobiological and archeological evidence for supporting social matrices among these Pleistocene foraging peoples.

  3. Sciatica and claudication caused by ganglion cyst.

    Science.gov (United States)

    Yang, Guang; Wen, Xiaoyu; Gong, Yubao; Yang, Chen

    2013-12-15

    Case report. We report a rare case that a ganglion cyst compressed the sciatic nerve and caused sciatica and claudication in a 51-year-old male. Sciatica and claudication commonly occurs in spinal stenosis. To our knowledge, only 4 cases have been reported on sciatica resulting from posterior ganglion cyst of hip. A 51-year-old male had a 2-month history of radiating pain on his right leg. He could only walk 20 to 30 m before stopping and standing to rest for 1 to 3 minutes. Interestingly, he was able to walk longer distances (about 200 m) when walking slowly in small steps, without any rest. He had been treated as a case of lumbar disc herniation, but conservative treatment was ineffective. On buttock examination, a round, hard, and fixative mass was palpated at the exit of the sciatic nerve. MR imaging of hip revealed a multilocular cystic mass located on the posterior aspect of the superior gemellus and obturator internus, compressing the sciatic nerve. On operation, we found that the cyst extended to the superior gemellus and the obturator internus, positioned right at the outlet of the sciatic nerve. At 18 months of follow-up, the patient continued to be symptom free. He returned to comprehensive physical activity with no limitations. For an extraspinal source, a direct compression on the sciatic nerve also resulted in sciatica and claudication. A meticulous physical examination is very important for the differential diagnosis of extraspinal sciatica from spinal sciatica.

  4. Magnetic resonance imaging identification of muscular and ligamentous structures of the female pelvic floor

    International Nuclear Information System (INIS)

    Bezerra, Maria Rita Lima; Soares, Adriano Fleury F.; Faintuch, Salomao; Goldman, Suzan Menasce; Ajzen, Sergio A.; D'Ippolito, Giuseppe; Szejnfeld, Jacob; Girao, Manoel

    2001-01-01

    The objective was to determine the frequency and to assess the interobserver agreement of identification of muscular and ligamentous pelvic floor structures using magnetic resonance imaging. The method: twenty asymptomatic female volunteers (aged 20-80 years old; mean: 50) were submitted to magnetic resonance imaging (1.5 T) examinations of the pelvis. Turbo spin-echo sequences were employed to obtain T1 and T2 weighted images on axial and sagittal planes. Two independent observers evaluated the scans in order to identify the levator ani (coccygeal, pubococcygeal, iliococcygeal and puborectalis muscles), obturatorius internus and urethral sphincter muscles, and the pubovesical and pubourethral ligaments. The frequency and the interobserver agreement of the identification of the anatomical structures were assessed (kappa statistic - κ). The results: the frequency of identification of the structures ranged from 50 to 100%, and was slightly lower for identification of the ligaments. Interobserver agreement was as follows: levator ani and obturatorius internus muscle (κ=1), pubococcygeal (κ=0.62), iliococcygeal (κ=0.86), puborectalis (κ= 0.27), coccygeal (κ=0) and urethral sphincter muscles (κ=1), pubovesical (κ=0.50) and pubourethral (κ=0.58) ligaments. The conclusion: magnetic resonance imaging of the pelvis allowed precise identification of the main muscular and ligamentous pelvic floor structures in most individuals, whereas interobserver agreement was considered good. (author)

  5. Magnetic resonance imaging identification of muscular and ligamentous structures of the female pelvic floor; Identificacao das estruturas musculo-ligamentares do assoalho pelvico feminino na ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Bezerra, Maria Rita Lima; Soares, Adriano Fleury F.; Faintuch, Salomao; Goldman, Suzan Menasce; Ajzen, Sergio A.; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: mrcfc@ig.com.br; Girao, Manoel [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo, SP (Brazil). Dept. de Ginecologia

    2001-12-01

    The objective was to determine the frequency and to assess the interobserver agreement of identification of muscular and ligamentous pelvic floor structures using magnetic resonance imaging. The method: twenty asymptomatic female volunteers (aged 20-80 years old; mean: 50) were submitted to magnetic resonance imaging (1.5 T) examinations of the pelvis. Turbo spin-echo sequences were employed to obtain T1 and T2 weighted images on axial and sagittal planes. Two independent observers evaluated the scans in order to identify the levator ani (coccygeal, pubococcygeal, iliococcygeal and puborectalis muscles), obturatorius internus and urethral sphincter muscles, and the pubovesical and pubourethral ligaments. The frequency and the interobserver agreement of the identification of the anatomical structures were assessed (kappa statistic - {kappa}). The results: the frequency of identification of the structures ranged from 50 to 100%, and was slightly lower for identification of the ligaments. Interobserver agreement was as follows: levator ani and obturatorius internus muscle ({kappa}=1), pubococcygeal ({kappa}=0.62), iliococcygeal ({kappa}=0.86), puborectalis ({kappa}= 0.27), coccygeal ({kappa}=0) and urethral sphincter muscles ({kappa}=1), pubovesical ({kappa}=0.50) and pubourethral ({kappa}=0.58) ligaments. The conclusion: magnetic resonance imaging of the pelvis allowed precise identification of the main muscular and ligamentous pelvic floor structures in most individuals, whereas interobserver agreement was considered good. (author)

  6. MR diffusion weighted imaging of the prostate adenocarcinoma after endocrinotherapy: preliminary results

    International Nuclear Information System (INIS)

    Chen Zhiqiang; Wang Xiaoying; Li Feiyu; Guo Xuemei; Jiang Xuexiang; Guo Yulin

    2007-01-01

    Objective: To assess the changes of the apparent diffusion coefficient (ADC) values of cancerous and noncancerous regions of prostate peripheral zone in prostate cancer patients with and without endocrinotherapy. Methods: Diffusion-weighted echo-planar imaging (EPI) were performed in 32 patients with diagnosed prostate cancer, including 18 patients who were treated with endocrinotherapy over 6 months and 14 untreated matched control patients. According to the pathological results obtained by ultrasound guided biopsy, the locations of the prostate cancerous regions were marked at one or more of the sextants. The ADC values of the bladder and the obturator internus were also measured. Results: The mean ADC values of cancerous and noncancerous regions in 14 untreated controls were (1.22±0.25) x 10 -3 , (1.59 ± 0.19) x 10 -3 mm 2 /s, respectively (t=7.03, P -3 mm 2 /s in noncancerous regions, but increased to (1.46 ± 0.30) x 10 -3 mm 2 /s in cancerous regions. There still had significant difference between the cancerous and the noncancerous regions (t=2.46, P 0.05), in bladder and the obturator internus (t=0.48, 1.64; P>0.05). Conclusion: Measurement of ADCs might be useful to evaluate the efficacy of endocrinotherapy for patients with prostate cancer. (authors)

  7. TVT-S in the U position--anatomical study.

    Science.gov (United States)

    Hubka, Petr; Nanka, Ondrej; Martan, Alois; Grim, Milos; Zvarova, Jana; Masata, Jaromir

    2011-02-01

    The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site. We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle. In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05). There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.

  8. Identificación de stocks pesqueros de la corvina de río (Plagioscion ternetzi de los ríos Paraguay y Paraná, mediante el análisis morfométrico de sus otolitos

    Directory of Open Access Journals (Sweden)

    Esteban Avigliano

    2015-09-01

    Full Text Available La identificación de stocks pesqueros es un requisito básico para el manejo y la gestión de la pesca. El objetivo de este trabajo fue describir por primera vez los otolitos de la corvina de Río P. ternetzi y evaluar la existencia de diferentes stocks pesqueros entre dos áreas de la Cuenca del Plata, cuenca baja del Río Paraguay y el Río Paraná medio. Con este fin, cinco índices morfométricos aplicados sobre los otolitos sagittae (rectangularidad, circularidad AO/LO, SS/SO y PS/PO fueron comparados entre los sitios de estudio. Los otolitos sagittae son semicirculares y presentan bordes lisos. El sulcus acusticus es de tipo heterosulcoide y curvo, con abertura pseudoostio-caudal. Se observaron diferencias significativas para circularidad, rectangularidad, SS/SO y PS/PO (t- test, P 69%. Los resultados obtenidos sugieren que las poblaciones de esta especie de los ríos Paraguay y Paraná estarían parcialmente separadas, aunque mantendrían flujo de individuos entre las mismas.

  9. An approach to unraveling the coexistence of snappers (Lutjanidae using otolith morphology

    Directory of Open Access Journals (Sweden)

    Zahra Sadighzadeh

    2014-09-01

    Full Text Available The sagittae otolith morphology of marine fishes has been used in many ecomorphological studies to explain certain ecological adaptations of species to habitat. Our study compares the sagittal otolith shapes of ten species of snappers (Family Lutjanidae inhabiting the Persian Gulf. We used a morphometric analysis of the otolith measurements (length, height, perimeter, area and weight and of the ratio between the area of the sulcus acusticus and the area of the otolith (S:O. The otolith contour was also analysed using wavelets as a mathematical descriptor. Morphological variations in the otoliths were associated with the morphology and external colouration of snappers as well as ecological traits. An analysis of the interspecific S:O ratio suggested that the highest ratios occurred in snappers inhabiting shallower waters. A categorical multivariate analysis, including morphological, ecological and otolith size factors, showed that the species adapted to dim light conditions had a greater otolith perimeter. An analysis of variance of the otolith contour revealed zones with a higher interspecific variability, although only the antero-dorsal zone showed differing patterns. Although the otolith patterns appear to have a phylogenetic component, they might also be related to diel activity rhythms or to the light conditions in the habitat. The results of the study showed that variation in otolith morphology can be used to explain the coexistence of sympatric species.

  10. Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

    Science.gov (United States)

    Coquet, Thomas; Lefranc, Michel; Chenin, Louis; Foulon, Pascal; Havet, Éric; Peltier, Johann

    2018-03-15

    In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.

  11. Teknologi Proses Pembuatan Molecular Sieve TiZA Untuk Pemekatan Asam Nitrat

    Directory of Open Access Journals (Sweden)

    Ali Nurdin

    2017-10-01

    Full Text Available Molecular sieve zeolit dapat memurnikan campuran larutan yang bersifat azeotrop yang tidak bisa dilakukan menggunakan metode distilasi biasa. Namun, masih memiliki kelemahan dalam half life time molecular sieve tersebut, khususnya stabilitas bahan apabila digunakan pada larutan yang bersifat korosif seperti larutan asam atau basa. Pada penelitian ini telah  dilakukan pembuatan molecular sieve zeolit A yang dimodifikasi  dengan penambahan 10% titanium. Molecular sieve titanium - zeolit A (TiZA dibuat dengan dengan metode hidrotermal pada temperatur 110 °C dan kalsinasi pada temperatur 500 °C. Karakterisasi dilakukan antara lain menggunakan X-ray Diffraction (XRD, Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy (SEM-EDX dan karakterisasi pori dengan metode physisorption menggunakan nitrogen pada temperatur 44 K. Molecular sieve TiZA yang dihasilkan stabil terhadap temperatur tinggi, dan larutan asam. Modifikasi zeolit A dengan titanium telah mampu meningkatkan stabilitas molecular sieve Ti-zeolit A dalam larutan asam nitrat selama 24 jam. Distribusi ukuran pori BJH (Barret Joyner Halenda  yang sempit menggambarkan ukuran yang homogen dengan didominasi oleh mikro porus dengan diameter rata-rata sekitar 4Å. Uji coba pemurnian asam nitrat dengan menggunakan molecular sieve secara single stage dapat meningkatkan kemurnian asam nitrat dari 70% hingga 85%.

  12. Dural opening/removal for combined petrosal approach: technical note.

    Science.gov (United States)

    Terasaka, Shunsuke; Asaoka, Katsuyuki; Kobayashi, Hiroyuki; Sugiyama, Taku; Yamaguchi, Shigeru

    2011-03-01

    Detailed descriptions of stepwise dural opening/removal for combined petrosal approach are presented. Following maximum bone work, the first dural incision was made along the undersurface of the temporal lobe parallel to the superior petrosal sinus. Posterior extension of the dural incision was made in a curved fashion, keeping away from the transverse-sigmoid junction and taking care to preserve the vein of Labbé. A second incision was made perpendicular to the first incision. After sectioning the superior petrosal sinus around the porus trigeminus, the incision was extended toward the posterior fossa dura in the middle fossa region. The tentorium was incised toward the incisura at a point just posterior to the entrance of the trochlear nerve. A third incision was made longitudinally between the superior petrosal sinus and the jugular bulb. A final incision was initiated perpendicular to the third incision in the presigmoid region and extended parallel to the superior petrosal sinus connecting the second incision. The dural complex consisting of the temporal lobe dura, the posterior fossa dura, and the freed tentorium could then be removed. In addition to extensive bone resection, our strategic cranial base dural opening/removal can yield true advantages for the combined petrosal approach.

  13. Meningitis tuberculosa: Clinical findings and results of cranial computed tomography

    International Nuclear Information System (INIS)

    Trautmann, M.; Loddenkemper, R.; Hoffmann, H.G.; Krankenhaus Zehlendorf, Berlin; Allgemeines Krankenhaus Altona

    1982-01-01

    Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases. (orig.) [de

  14. Twiddler's syndrome in a patient with a deep brain stimulation device for generalized dystonia

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Schweder, Patrick M; Joint, Carole

    2011-01-01

    Deep brain stimulation (DBS) is the technique of neurostimulation of deep brain structures for the treatment of conditions such as essential tremor, dystonia, Parkinson's disease and chronic pain syndromes. The procedure uses implanted deep brain stimulation electrodes connected to extension leads...... and an implantable pulse generator (IPG). Hardware failure related to the DBS procedure is not infrequent, and includes electrode migration and disconnection. We describe a patient who received bilateral globus pallidus internus DBS for dystonia with initially good clinical response, but the device eventually failed....... Radiographs showed multiple twisting of the extension leads with disconnection from the brain electrodes and a diagnosis of Twiddler's syndrome was made. Twiddler's syndrome was first described in patients with cardiac pacemakers. Patients with mental disability, elderly and obese patients are at increased...

  15. Meningitis tuberculosa: Clinical findings and results of cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Trautmann, M.; Loddenkemper, R.; Hoffmann, H.G.

    1982-10-01

    Guided by 9 own observations between 1977 and 1981, new diagnostic facilities in tuberculous meningitis are discussed. For differentiation from viral meningitis, measurement of CSF lactic acid concentration in addition to that of CSF glucose has proved to be of value in recent years. In accordance with the literature, two cases of this series which were examined for CSF lactic acid concentration showed markedly elevated levels of 8,4 rsp. 10,4 mmol/l. In contrast to this, in viral meningitis usually values of less than 3.5 mmol/l are found. Additionally, the presence of hypochlor- and hyponatremia, which could be demonstrated in 6 of our 9 patients, may raise the suspicion of tuberculous etiology. In the series presented, cranial computed tomography was of greatest diagnostic value, enabling the diagnosis of hydrocephalus internus in 5, and basal arachnoiditis in 2 cases.

  16. Malignant Transformation of Endometriosis in the Ischioanal Fossa

    Directory of Open Access Journals (Sweden)

    Jordan S. Klebanoff

    2018-01-01

    Full Text Available We present the case of a 28-year-old nulliparous female with malignant transformation of an ectopic focus of endometriosis in the right ischioanal fossa. A 28-year-old nulliparous patient with a past medical history of polycystic ovarian syndrome (PCOS was diagnosed with endometrioid adenocarcinoma in her right ischioanal fossa. Initially, patient presented to an emergency department and underwent a CT scan of the appendix to rule out appendicitis. A multiloculated cystic lesion adjacent to the right obturator internus muscle was found. She underwent surgical resection of the mass, which confirmed FIGO grade 2 endometrioid adenocarcinoma, followed by localized radiation therapy. Malignancy arising in endometriosis is rare, and the influence of PCOS on the rate of malignant transformation is not well established.

  17. [Bilateral Pallidotomy for Tardive Dystonia:A Case Report].

    Science.gov (United States)

    Kohara, Kotaro; Taira, Takaomi; Horisawa, Shiro; Hanada, Tomoko; Kawamata, Takakazu

    2017-11-01

    Tardive dystonia is a movement disorder related to the use of dopamine-receptor-blocking drugs. Several reports have shown that deep brain stimulation of the globus pallidus internus(GPi-DBS)is effective in treating tardive dystonia. However, a few reports demonstrated the efficacy of ablation of the GPi(pallidotomy). We herein report a case of tardive dystonia successfully treated with bilateral pallidotomy. A 32-year-old man developed severe tardive dystonia 10 years after the chronic use of antipsychotic drugs. Withdrawal of the drugs and botulinum toxin injections were ineffective. The patient underwent bilateral pallidotomy for tardive dystonia because of rejection of the implanted DBS devices. Significant improvement was observed, with a 95% decrease in the Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS)movement score, and no severe adverse events occurred. Symptomatic relief persisted for nine months. Pallidotomy is a feasible and efficacious procedure for tardive dystonia treatment without the use of hardware implantations.

  18. Pelvic girdle sepsis in childhood. An illustrative case of the difficulty in diagnosis.

    LENUS (Irish Health Repository)

    Street, John

    2012-02-03

    The child who presents with fever, limp and hip pain will often undergo multiple diagnostic procedures before a definitive diagnosis is made. We describe a diagnostically challenging case of a 14-year-old boy presenting with an atraumatic painful limp and pyrexia. Eventually the diagnosis of obturator internus muscle abscess with associated ischial osteomyelitis was made. Of the 19 previous cases reported, four children had associated osteomyelitis and were of an older age. Symptomatology varies, clinical examination is non-specific and the diagnosis can be difficult. Haematological indices are more predictive than in cases of classical osteomyelitis or septic arthritis. Subtle features on conventional radiography and isotope bone scanning should not be overlooked while CT and MRI may be complementary in diagnosis.

  19. High resolution MR imaging of the anal sphincter using an intravaginal surface coil; Hochaufloesende Magnetresonanztomographie des Analsphinkters mit einer intravaginalen Oberflaechenspule

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Schimpfle, M. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany); Franz, H. [Frauenklinik, Tuebingen Univ. (Germany); Lobinger, B. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany); Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Tuebingen Univ. (Germany)

    1995-06-01

    MR imaging was performed using a 1.0 T unit. In 10 females (6 nullipara, one primipara without and three primipara with postpartum faecal incontinence) a surface coil, originally designed for endorectal use, was placed into the vagina. Transverse oblique T{sub 1}-weighted spin echo and double echo turbo spin echo sequences with T{sub 2}- and proton density-weighting were acquired parallel to the puborectal, rectococcygeal and anorectal planes. Three readers analysed the images in consensus. The anatomic structures of the external and internal sphincter as well as the mucosa were differentiated in all cases with a good contrast. The best results were yielded by the proton density weighting. In one case of faecal incontinence a sphincter defect after repair of a complete rupture of the anal sphincter was shown. In another case irregularities in the structure of the external sphincter and perineum were visualised. (orig./MG) [Deutsch] Die Magnetresonanztomographie (MRT) wurde an einem 1,0-Tesla-Geraet durchgefuehrt. Bei 10 Frauen (6 Nulliparae, eine Primipara ohne und drei Primiparae mit postpartaler Stuhlinkontinenz) wurde eine Oberflaechenspule, die urspruenglich zur endorektalen Anwendung konzipiert war, intravaginal eingefuehrt. Es wurden T{sub 1}-gewichtete Spin-Echo-Sequenzen sowie Doppel-Echo-Turbo-Spin-Echo-Sequenzen mit T{sub 2}- und Protonendichtegewichtung parallel zur puborektalen, rektokokzygealen und anorektalen Ebene akquiriert. Drei Auswerter analysierten die Aufnahmen im Konsensmodus. Die anatomischen Strukturen des Musculus sphincter ani externus und internus sowie die Mukosa konnten in allen Faellen gut differenziert werden. Das beste Ergebnis wurde mit der Protonendichte-Gewichtung erzielt. In einem Fall von Stuhlinkontinenz zeigte sich ein kombinierter Defekt des M. sphincter ani internus und externus nach Naht eines Dammrisses III. Grades. In einem weiteren Fall waren Irregularitaeten im Perineum und externen Sphinkteranteil darzustellen. (orig./MG)

  20. Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome: The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry.

    Science.gov (United States)

    Martinez-Ramirez, Daniel; Jimenez-Shahed, Joohi; Leckman, James Frederick; Porta, Mauro; Servello, Domenico; Meng, Fan-Gang; Kuhn, Jens; Huys, Daniel; Baldermann, Juan Carlos; Foltynie, Thomas; Hariz, Marwan I; Joyce, Eileen M; Zrinzo, Ludvic; Kefalopoulou, Zinovia; Silburn, Peter; Coyne, Terry; Mogilner, Alon Y; Pourfar, Michael H; Khandhar, Suketu M; Auyeung, Man; Ostrem, Jill Louise; Visser-Vandewalle, Veerle; Welter, Marie-Laure; Mallet, Luc; Karachi, Carine; Houeto, Jean Luc; Klassen, Bryan Timothy; Ackermans, Linda; Kaido, Takanobu; Temel, Yasin; Gross, Robert E; Walker, Harrison C; Lozano, Andres M; Walter, Benjamin L; Mari, Zoltan; Anderson, William S; Changizi, Barbara Kelly; Moro, Elena; Zauber, Sarah Elizabeth; Schrock, Lauren E; Zhang, Jian-Guo; Hu, Wei; Rizer, Kyle; Monari, Erin H; Foote, Kelly D; Malaty, Irene A; Deeb, Wissam; Gunduz, Aysegul; Okun, Michael S

    2018-03-01

    Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome. To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome. The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide. Patients with medically refractory symptoms received DBS implantation in the centromedian thalamic region (93 of 163 [57.1%]), the anterior globus pallidus internus (41 of 163 [25.2%]), the posterior globus pallidus internus (25 of 163 [15.3%]), and the anterior limb of the internal capsule (4 of 163 [2.5%]). Scores on the Yale Global Tic Severity Scale and adverse events. The International Deep Brain Stimulation Database and Registry enrolled 185 patients (of 171 with available data, 37 females and 134 males; mean [SD] age at surgery, 29.1 [10.8] years [range, 13-58 years]). Symptoms of obsessive-compulsive disorder were present in 97 of 151 patients (64.2%) and 32 of 148 (21.6%) had a history of self-injurious behavior. The mean (SD) total Yale Global Tic Severity Scale score improved from 75.01 (18.36) at baseline to 41.19 (20.00) at 1 year after DBS implantation (P tic subscore improved from 21.00 (3.72) at baseline to 12.91 (5.78) after 1 year (P tic subscore improved from 16.82 (6.56) at baseline to 9.63 (6.99) at 1 year (P Tourette syndrome but also with important adverse events. A publicly available website on outcomes of DBS in patients with Tourette syndrome has been provided.

  1. T2-weighted signal intensity-selected volumetry for prediction of pathological complete response after preoperative chemoradiotherapy in locally advanced rectal cancer.

    Science.gov (United States)

    Kim, Sungwon; Han, Kyunghwa; Seo, Nieun; Kim, Hye Jin; Kim, Myeong-Jin; Koom, Woong Sub; Ahn, Joong Bae; Lim, Joon Seok

    2018-06-01

    To evaluate the diagnostic value of signal intensity (SI)-selected volumetry findings in T2-weighted magnetic resonance imaging (MRI) as a potential biomarker for predicting pathological complete response (pCR) to preoperative chemoradiotherapy (CRT) in patients with rectal cancer. Forty consecutive patients with pCR after preoperative CRT were compared with 80 age- and sex-matched non-pCR patients in a case-control study. SI-selected tumor volume was measured on post-CRT T2-weighted MRI, which included voxels of the treated tumor exceeding the SI (obturator internus muscle SI + [ischiorectal fossa fat SI - obturator internus muscle SI] × 0.2). Three blinded readers independently rated five-point pCR confidence scores and compared the diagnostic outcome with SI-selected volumetry findings. The SI-selected volumetry protocol was validated in 30 additional rectal cancer patients. The area under the receiver-operating characteristic curve (AUC) of SI-selected volumetry for pCR prediction was 0.831, with an optimal cutoff value of 649.6 mm 3 (sensitivity 0.850, specificity 0.725). The AUC of the SI-selected tumor volume was significantly greater than the pooled AUC of readers (0.707, p volumetry in post-CRT T2-weighted MRI can help predict pCR after preoperative CRT in patients with rectal cancer. • Fibrosis and viable tumor MRI signal intensities (SIs) are difficult to distinguish. • T2 SI-selected volumetry yields high diagnostic performance for assessing pathological complete response. • T2 SI-selected volumetry is significantly more accurate than readers and non-SI-selected volumetry. • Post-chemoradiation therapy T2-weighted MRI SI-selected volumetry facilitates prediction of pathological complete response.

  2. Spatial Expression of Otolith Matrix Protein-1 and Otolin-1 in Normally and Kinetotically Swimming Fish.

    Science.gov (United States)

    Weigele, Jochen; Franz-Odendaal, Tamara A; Hilbig, Reinhard

    2015-10-01

    Kinetosis (motion sickness) has been repeatedly shown to affect some fish of a given clutch following the transition from 1g to microgravity or from hypergravity to 1g. This susceptibility to kinetosis may be correlated with irregular inner ear otolith growth. Otoliths are mainly composed of calcium carbonate and matrix proteins, which play an important role in the process of otolith mineralization. Here, we examine the morphology of otoliths and the expression pattern of the major otolith proteins OMP-1 and otolin-1 in a series of hypergravity experiments. In the utricle, OMP-1 is present in centripetal (medial) and centrifugal (lateral) regions of the meshwork area. In the saccule, OMP-1 was expressed within a dorsal and a ventral narrow band of the meshwork area opposite to the periphery of the sulcus acusticus. In normal animals, the spatial expression pattern of OMP-1 reaches more posteriorly in the centrifugal aspect and is considerably broader in the centripetal portion of the utricle compared to kinetotic animals. However, otolin-1 was not expressed in the utricule. In the saccule, no differences were observed for either gene when comparing normal and kinetotically behaving fish. The difference in the utricular OMP-1 expression pattern between normally and kinetotically swimming fish indicates a different otolith morphology and thus a different geometry of the otoliths resting on the corresponding sensory maculae. As the utricle is the endorgan responsible for sensing gravity, the aberrant morphology of the utricular otoliths, based on OMP-1 expression, likely leads to the observed kinetotic behavior. © 2015 Wiley Periodicals, Inc.

  3. The morphology of saccular otoliths as a tool to identify different mugilid species from the Northeastern Atlantic and Mediterranean Sea

    Science.gov (United States)

    Callicó Fortunato, Roberta; Benedito Durà, Vicent; Volpedo, Alejandra

    2014-06-01

    In the Northeastern Atlantic and Mediterranean Sea there are 8 species of the Mugilidae family: Mugil cephalus, Liza aurata, Liza ramada, Oedalechilus labeo, Chelon labrosus, Liza saliens, Liza carinata and Liza haematocheila. The identification of mugilids is very important for local fisheries management and regulations, but it is difficult using gross morphological characters. This work aims to contribute to the identification of mullets present in the Northeastern Atlantic Ocean and Mediterranean Sea using saccular otolith features of each species. Specimens of C. labrosus, L. aurata, L. ramada, L. saliens and M. cephalus were obtained from Delta del Ebro (40°38'N-0°44'E) in artisanal catches. For L. carinata and O. labeo photographs extracted from AFORO online database were used. L. haematocheila was not studied for lack of otolith samples. A general pattern of the saccular otoliths for this family was identified: the shape of the otoliths are rectangular to oblong with irregular margins; they present a heterosulcoid, ostial sulcus acusticus, with an open funnel-like ostium to the anterior margin and a closed, tubular cauda, ending towards the posterior ventral corner, always larger than the ostium. In the present study, the mugilid species could be recognized using their saccular otolith morphology. Here we give the first key to identify Northeastern Atlantic and Mediterranean mullets. The distinctive features between the species were the position and centrality of the sulcus, the curvature of the cauda, the presence of areal depositions and plateaus, and the type of anterior and posterior regions. These features could be used not only to reinforce the identification keys through morphological and meristic characters of the species, but also to identify the species consumed by piscivores, being the otoliths the only identifiable remains of the individuals.

  4. Using otolith shape for intraspecific discrimination: the case of gurnards (Scorpaeniformes, Triglidae

    Directory of Open Access Journals (Sweden)

    Stefano Montanini

    2015-11-01

    Full Text Available The sagittal otoliths are sound transducers and play an important role in fish hearing. Triglidae (Teleostei, Scorpaeniformes are known for sound producing ability in agonistic contexts related to territorial defence, reproduction and competitive feeding (Amorim et al., 2004. Chelidonichthys cuculus and C. lucerna show a significant body size-depth relationship and specie-specific feeding strategies with growth. Both juveniles and adults of C. cuculus prey necto-benthic invertebrates while C. lucerna specimens change diet from crustaceans to teleost during growth (Stagioni et al., 2012; Vallisneri et al., 2014; Montanini et al., 2015. The goal of this study was to analyze intraspecific shape variations in sagitta of model species of gurnards. 217 specimens were collected during bottom trawl surveys in Adriatic sea (northeastern Mediterranean. Each left sagitta was removed, cleaned in ultrasounds bath and kept dry. The otolith digital images were processed to calculate five shape indices (aspect ratio, roundness, rectangularity, ellipticity and circularity. Indices were normalised to avoid allometric effects according to Lleonart et al. (2000, than processed by linear discriminant analysis (LDA. The SHAPE program was used to extract the outline and to assess the variability of shapes (EFA method and estimated it through the study of principal component analysis (PCA. Considering the first two discriminant functions, LDA plot showed a clearly separation between juvenile and adults for both species. About EFA, the first 4 principal component discriminated over 80% of variance and significant differences were found at critical size between juveniles and adults for all the components analysed. The allometric trends corresponded to a relative elongation of the sulcus acusticus and an increase of excisura ostii. The combined use of the two external outlines methods should be highly informative for intraspecific discrimination and might be related to

  5. Pyrrhopyginae: gêneros novos e revalidados (Lepidoptera, Hesperiidae Pyrrhopyginae: new and revalidated genera (Lepidoptera, Hespe-riidae

    Directory of Open Access Journals (Sweden)

    Olaf H.H. Mielke

    2002-03-01

    zereda rufinucha (Godman & Salvin, 1879, Chalypyge zereda rufipectus (Godman & Salvin, 1879, Chalypyge zereda zepha (Evans, 1951, Ochropyge ruficauda (Hayward, 1932, Melanopyge cossea (H. Druce, 1875, Melanopyge erythrosticta (Godman & Salvin, 1879, Melanopyge hoffmannl (Freeman, 1977, Melanopyge maculosa (Hewitson, 1866, Melanopyge mulleri (Bell, 1934, Jonaspyge Jonas (C. Felder & R. Felder, 1859, Jonaspyge aesculapus (Staudinger, 1876, Jonaspyge tzotzlll (Freemann, 1969, Creonpyge creon creon (H. Druce, 1874, Creonpyge creon lillana (Nicolay & Small, 1969, Creonpyge creon laylori (Nicolay & Small, 1981, Cyanopyge sangaris (Skinner, 1921, Mysarbia sejanus sejanus (Hoppfer, 1874, Mysarbia sejanus erythrostigma (Ršber, 1925, Arnysoria galgala (Hewitson, 1866, Mimardaris aetata (Godman & Salvin, 1879, Mimardaris Umax (Evans, 1951, Mimardaris mlnthe (Godman & Salvin, 1879, Mimardaris montra (Evans, 1951, Mimardaris pityusa (Hewitson, 1875, Mimardaris porus poms (Evans, 1951, Mimardaris porus mortis (Evans, 1951, Mimardaris sela sela (Hewitson, 1866, Mimardaris sela aequatorea (Róber, 1925, Mimardaris sela chanchamayonis (Draudt, 1924, Mimardaris sela periphema (Hewitson, [1875], and Mimardaris sela peruviana (Draudt, 1921. The following is a new synonym: Tamyris hygieia C. Felder & R. Felder, 1867 of Pyrrhopyga [sic] zereda Hewitson, 1866. Mysarbia sejanus stolli Mielke, ssp. n. is a replacement name for Papilio thasus Stoll, 1781, preoccupied by Stoll, 1780.

  6. Pelvic and hind limb musculature of Staurikosaurus pricei (Dinosauria: Saurischia

    Directory of Open Access Journals (Sweden)

    Orlando N. Grillo

    2011-03-01

    Full Text Available The study of pelvic and hind limb bones and muscles in basal dinosaurs is important for understanding the early evolution of bipedal locomotion in the group. The use of data from both extant and extinct taxa placed into a phylogenetic context allowed to make well-supported inferences concerning most of the hind limb musculature of the basal saurischian Staurikosaurus pricei Colbert, 1970 (Santa Maria Formation, Late Triassic of Rio Grande do Sul, Brazil. Two large concavities in the lateral surface of the ilium represent the origin of the muscles iliotrochantericus caudalis plus iliofemoralis externus (in the anterior concavity and iliofibularis (in the posterior concavity. Muscle ambiens has only one head and originates from the pubic tubercle. The origin of puboischiofemoralis internus 1 possibly corresponds to a fossa in the ventral margin of the pré-acetabular iliac process. This could represent an intermediate stage prior to the origin of a true pré-acetabular fossa. Muscles caudofemorales longus et brevis were likely well developed, and Staurikosaurus is unique in bearing a posteriorly projected surface for the origin of caudofemoralis brevis.O estudo da musculatura pelvica e do membro posterior em dinossauros basais e importante para entender a evolução inicial do bipedalismo em dinossauros Saurischia. Empregando uma metodologia que tem como base dados obtidos a partir de taxons viventes e extintos posicionados em um contexto filogenetico, foi possivel fazer inferencias bem suportadas relativas a maior parte dos musculos do membro posterior do dinossauro Saurischia basal Staurikosaurus pricei Colbert, 1970 (Formação Santa Maria, Triassico Superior do Rio Grande do Sul, Brasil. Duas grandes concavidades na superficie lateral do ilio correspondem a origem dos musculos iliotrochantericus caudalis e iliofeoralis externus (compartilhando a concavidade anterior e para o musculo iliofibularis (na concavidade posterior. O musculo ambiens

  7. Analysis and control of a parallel lower limb based on pneumatic artificial muscles

    Directory of Open Access Journals (Sweden)

    Feilong Jiang

    2016-12-01

    Full Text Available Most robots that are actuated by antagonistic pneumatic artificial muscles are controlled by various control algorithms that cannot adequately imitate the actual muscle distribution of human limbs. Other robots in which the distribution of pneumatic artificial muscle is similar to that of human limbs can only analyze the position of the robot using perceptual data instead of rational knowledge. In order to better imitate the movement of a human limb, the article proposes a humanoid lower limb in the form of a parallel mechanism where muscle is unevenly distributed. Next, the kinematic and dynamic movements of bionic hip joint are analyzed, where the joint movement is controlled by an observer-based fuzzy adaptive control algorithm as a whole rather than each individual pneumatic artificial muscle and parameters that are optimized by a neural network. Finally, experimental results are provided to confirm the effectiveness of the proposed method. We also document the role of muscle in trajectory tracking for the piriformis and musculi obturator internus in isobaric processes.

  8. Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia.

    Science.gov (United States)

    Calheiros-Trigo, Francisca; Linhares, Paulo

    2014-01-01

    Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia. Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported. Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  9. Contribution of subcortical structures to cognition assessed with invasive electrophysiology in humans

    Directory of Open Access Journals (Sweden)

    Thomas F Münte

    2008-07-01

    Full Text Available Implantation of deep brain stimulation (DBS electrodes via stereotactic neurosurgery has become a standard procedure for the treatment of Parkinson’s disease. More recently, the range of neuropsychiatric conditions and the possible target structures suitable for DBS have greatly increased. The former include obsessive compulsive disease, depression, obesity, tremor, dystonia, Tourette’s syndrome and cluster-headache. In this article we argue that several of the target structures for DBS (nucleus accumbens, posterior inferior hypothalamus, nucleus subthalamicus, nuclei in the thalamus, globus pallidus internus, nucleus pedunculopontinus are located at strategic positions with brain circuits related to motivational behaviors, learning, and motor regulation. Recording from DBS electrodes either during the operation or post-operatively from externalized leads while the patient is performing cognitive tasks tapping the functions of the respective circuits provides a new window on the brain mechanisms underlying these functions. This is exemplified by a study of a patient suffering from obsessive-compulsive disease from whom we recorded in a flanker task designed to tap action monitoring processes while he received a DBS electrode in the right nucleus accumbens. Clear error-related modulations were obtained from the target structure, demonstrating a role of the nucleus accumbens in action monitoring. Based on recent conceptualizations of several different functional loops and on neuroimaging results we suggest further lines of research using this new window on brain functions.

  10. Swallowing and deep brain stimulation in Parkinson’s disease: A systematic review

    Science.gov (United States)

    Troche, Michelle S.; Brandimore, Alexandra E.; Foote, Kelly D.; Okun, Michael S.

    2013-01-01

    The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson’s disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. “on” vs. “off”, pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. PMID:23726461

  11. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Isen, K. [Karaelmas Univ., Zonguldak (Turkey). School of Medicine; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-02-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5{+-}18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  12. Common therapeutic mechanisms of pallidal deep brain stimulation for hypo- and hyperkinetic movement disorders

    Science.gov (United States)

    Iriki, Atsushi; Isoda, Masaki

    2015-01-01

    Abnormalities in cortico-basal ganglia (CBG) networks can cause a variety of movement disorders ranging from hypokinetic disorders, such as Parkinson's disease (PD), to hyperkinetic conditions, such as Tourette syndrome (TS). Each condition is characterized by distinct patterns of abnormal neural discharge (dysrhythmia) at both the local single-neuron level and the global network level. Despite divergent etiologies, behavioral phenotypes, and neurophysiological profiles, high-frequency deep brain stimulation (HF-DBS) in the basal ganglia has been shown to be effective for both hypo- and hyperkinetic disorders. The aim of this review is to compare and contrast the electrophysiological hallmarks of PD and TS phenotypes in nonhuman primates and discuss why the same treatment (HF-DBS targeted to the globus pallidus internus, GPi-DBS) is capable of ameliorating both symptom profiles. Recent studies have shown that therapeutic GPi-DBS entrains the spiking of neurons located in the vicinity of the stimulating electrode, resulting in strong stimulus-locked modulations in firing probability with minimal changes in the population-scale firing rate. This stimulus effect normalizes/suppresses the pathological firing patterns and dysrhythmia that underlie specific phenotypes in both the PD and TS models. We propose that the elimination of pathological states via stimulus-driven entrainment and suppression, while maintaining thalamocortical network excitability within a normal physiological range, provides a common therapeutic mechanism through which HF-DBS permits information transfer for purposive motor behavior through the CBG while ameliorating conditions with widely different symptom profiles. PMID:26180116

  13. Abnormal neuronal activity in Tourette syndrome and its modulation using deep brain stimulation

    Science.gov (United States)

    Israelashvili, Michal; Loewenstern, Yocheved

    2015-01-01

    Tourette syndrome (TS) is a common childhood-onset disorder characterized by motor and vocal tics that are typically accompanied by a multitude of comorbid symptoms. Pharmacological treatment options are limited, which has led to the exploration of deep brain stimulation (DBS) as a possible treatment for severe cases. Multiple lines of evidence have linked TS with abnormalities in the motor and limbic cortico-basal ganglia (CBG) pathways. Neurophysiological data have only recently started to slowly accumulate from multiple sources: noninvasive imaging and electrophysiological techniques, invasive electrophysiological recordings in TS patients undergoing DBS implantation surgery, and animal models of the disorder. These converging sources point to system-level physiological changes throughout the CBG pathway, including both general altered baseline neuronal activity patterns and specific tic-related activity. DBS has been applied to different regions along the motor and limbic pathways, primarily to the globus pallidus internus, thalamic nuclei, and nucleus accumbens. In line with the findings that also draw on the more abundant application of DBS to Parkinson's disease, this stimulation is assumed to result in changes in the neuronal firing patterns and the passage of information through the stimulated nuclei. We present an overview of recent experimental findings on abnormal neuronal activity associated with TS and the changes in this activity following DBS. These findings are then discussed in the context of current models of CBG function in the normal state, during TS, and finally in the wider context of DBS in CBG-related disorders. PMID:25925326

  14. MRI-Based Multiscale Model for Electromagnetic Analysis in the Human Head with Implanted DBS

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    Maria Ida Iacono

    2013-01-01

    Full Text Available Deep brain stimulation (DBS is an established procedure for the treatment of movement and affective disorders. Patients with DBS may benefit from magnetic resonance imaging (MRI to evaluate injuries or comorbidities. However, the MRI radio-frequency (RF energy may cause excessive tissue heating particularly near the electrode. This paper studies how the accuracy of numerical modeling of the RF field inside a DBS patient varies with spatial resolution and corresponding anatomical detail of the volume surrounding the electrodes. A multiscale model (MS was created by an atlas-based segmentation using a 1 mm3 head model (mRes refined in the basal ganglia by a 200 μm2 ex-vivo dataset. Four DBS electrodes targeting the left globus pallidus internus were modeled. Electromagnetic simulations at 128 MHz showed that the peak of the electric field of the MS doubled (18.7 kV/m versus 9.33 kV/m and shifted 6.4 mm compared to the mRes model. Additionally, the MS had a sixfold increase over the mRes model in peak-specific absorption rate (SAR of 43.9 kW/kg versus 7 kW/kg. The results suggest that submillimetric resolution and improved anatomical detail in the model may increase the accuracy of computed electric field and local SAR around the tip of the implant.

  15. The impact of multichannel microelectrode recording (MER) in deep brain stimulation of the basal ganglia.

    Science.gov (United States)

    Kinfe, Thomas M; Vesper, Jan

    2013-01-01

    Deep brain stimulation (DBS) of the basal ganglia (Ncl. subthalamicus, Ncl. ventralis intermedius thalami, globus pallidus internus) has become an evidence-based and well-established treatment option in otherwise refractory movement disorders. The Ncl. subthalamicus (STN) is the target of choice in Parkinson's disease.However, a considerable discussion is currently ongoing with regard to the necessity for micro-electrode recording (MER) in DBS surgery.The present review provides an overview on deep brain stimulation and (MER) of the STN in patients with Parkinson's disease. Detailed description is given concerning the multichannel MER systems nowadays available for DBS of the basal ganglia, especially of the STN, as a useful tool for target refinement. Furthermore, an overview is given of the historical aspects, spatial mapping of the STN by MER, and its impact for accuracy and precision in current functional stereotactic neurosurgery.The pros concerning target refinement by MER means on the one hand, and cons including increased bleeding risk, increased operation time, local or general anesthesia, and single versus multichannel microelectrode recording are discussed in detail. Finally, the authors favor the use of MER with intraoperative testing combined with imaging to achieve a more precise electrode placement, aiming to ameliorate clinical outcome in therapy-resistant movement disorders.

  16. Deep brain stimulation changes basal ganglia output nuclei firing pattern in the dystonic hamster.

    Science.gov (United States)

    Leblois, Arthur; Reese, René; Labarre, David; Hamann, Melanie; Richter, Angelika; Boraud, Thomas; Meissner, Wassilios G

    2010-05-01

    Dystonia is a heterogeneous syndrome of movement disorders characterized by involuntary muscle contractions leading to abnormal movements and postures. While medical treatment is often ineffective, deep brain stimulation (DBS) of the internal pallidum improves dystonia. Here, we studied the impact of DBS in the entopeduncular nucleus (EP), the rodent equivalent of the human globus pallidus internus, on basal ganglia output in the dt(sz)-hamster, a well-characterized model of dystonia by extracellular recordings. Previous work has shown that EP-DBS improves dystonic symptoms in dt(sz)-hamsters. We report that EP-DBS changes firing pattern in the EP, most neurons switching to a less regular firing pattern during DBS. In contrast, EP-DBS did not change the average firing rate of EP neurons. EP neurons display multiphasic responses to each stimulation impulse, likely underlying the disruption of their firing rhythm. Finally, neurons in the substantia nigra pars reticulata display similar responses to EP-DBS, supporting the idea that EP-DBS affects basal ganglia output activity through the activation of common afferent fibers. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Effect of Deep Brain Stimulation on Parkinson's Nonmotor Symptoms following Unilateral DBS: A Pilot Study

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    Nelson Hwynn

    2011-01-01

    Full Text Available Parkinson’s disease (PD management has traditionally focused largely on motor symptoms. Deep brain stimulation (DBS of the subthalamic nucleus (STN and globus pallidus internus (GPi are effective treatments for motor symptoms. Nonmotor symptoms (NMSs may also profoundly affect the quality of life. The purpose of this pilot study was to evaluate NMS changes pre- and post-DBS utilizing two recently developed questionnaires. Methods. NMS-Q (questionnaire and NMS-S (scale were administered to PD patients before/after unilateral DBS (STN/GPi targets. Results. Ten PD patients (9 STN implants, 1 GPi implant were included. The three most frequent NMS symptoms identified utilizing NMS-Q in pre-surgical patients were gastrointestinal (100%, sleep (100%, and urinary (90%. NMS sleep subscore significantly decreased (−1.6 points ± 1.8, =0.03. The three most frequent NMS symptoms identified in pre-surgical patients using NMS-S were gastrointestinal (90%, mood (80%, and cardiovascular (80%. The largest mean decrease of NMS scores was seen in miscellaneous symptoms (pain, anosmia, weight change, and sweating (−7 points ± 8.7, and cardiovascular/falls (−1.9, =0.02. Conclusion. Non-motor symptoms improved on two separate questionnaires following unilateral DBS for PD. Future studies are needed to confirm these findings and determine their clinical significance as well as to examine the strengths/weaknesses of each questionnaire/scale.

  18. Adaptive autoregressive identification with spectral power decomposition for studying movement-related activity in scalp EEG signals and basal ganglia local field potentials

    Science.gov (United States)

    Foffani, Guglielmo; Bianchi, Anna M.; Priori, Alberto; Baselli, Giuseppe

    2004-09-01

    We propose a method that combines adaptive autoregressive (AAR) identification and spectral power decomposition for the study of movement-related spectral changes in scalp EEG signals and basal ganglia local field potentials (LFPs). This approach introduces the concept of movement-related poles, allowing one to study not only the classical event-related desynchronizations (ERD) and synchronizations (ERS), which correspond to modulations of power, but also event-related modulations of frequency. We applied the method to analyze movement-related EEG signals and LFPs contemporarily recorded from the sensorimotor cortex, the globus pallidus internus (GPi) and the subthalamic nucleus (STN) in a patient with Parkinson's disease who underwent stereotactic neurosurgery for the implant of deep brain stimulation (DBS) electrodes. In the AAR identification we compared the whale and the exponential forgetting factors, showing that the whale forgetting provides a better disturbance rejection and it is therefore more suitable to investigate movement-related brain activity. Movement-related power modulations were consistent with previous studies. In addition, movement-related frequency modulations were observed from both scalp EEG signals and basal ganglia LFPs. The method therefore represents an effective approach to the study of movement-related brain activity.

  19. Effect of Deep Brain Stimulation on Speech Performance in Parkinson's Disease

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    Sabine Skodda

    2012-01-01

    Full Text Available Deep brain stimulation (DBS has been reported to be successful in relieving the core motor symptoms of Parkinson's disease (PD and motor fluctuations in the more advanced stages of the disease. However, data on the effects of DBS on speech performance are inconsistent. While there are some series of patients documenting that speech function was relatively unaffected by DBS of the nucleus subthalamicus (STN, other investigators reported on improvements of distinct parameters of oral control and voice. Though, these ameliorations of single speech modalities were not always accompanied by an improvement of overall speech intelligibility. On the other hand, there are also indications for an induction of dysarthria as an adverse effect of STN-DBS occurring at least in some patients with PD. Since a deterioration of speech function has more often been observed under high stimulation amplitudes, this phenomenon has been ascribed to a spread of current-to-adjacent pathways which might also be the reason for the sporadic observation of an onset of dysarthria under DBS of other basal ganglia targets (e.g., globus pallidus internus/GPi or thalamus/Vim. The aim of this paper is to review and evaluate reports in the literature on the effects of DBS on speech function in PD.

  20. Botox combined with myofascial release physical therapy as a treatment for myofascial pelvic pain

    Science.gov (United States)

    Scott, Lauren; Wyman, Allison; Mora, Nelsi; Miladinovic, Branko; Bassaly, Renee; Hoyte, Lennox

    2017-01-01

    Purpose To report the effects of combined onabotulinumtoxinA (Botox) injections and myofascial release physical therapy on myofascial pelvic pain (MFPP) by comparing pre- and posttreatment average pelvic pain scores, trigger points, and patient self-reported pelvic pain. Secondary outcomes were to examine posttreatment complications and determine demographic differences between patients with/without an improvement in pain. Materials and Methods This was an Institutional Review Board approved retrospective case series on women over 18 years with MFPP who received Botox and physical therapy between July 2006 and November 2014. Presence of trigger points and pelvic pain scores were determined by digital palpation of the iliococcygeus, puborectalis, obturator internus, and rectus muscles. Average pelvic pain scores (0–10) reflected an average of the scores obtained from palpation of each muscle. Self-reported improvement in pain was recorded as yes/no. Results Fifty women met the inclusion/exclusion criteria. Posttreatment, patients had lower average pelvic pain scores (3.7±4.0 vs. 6.4±1.8, p=0.005), and fewer trigger points (44% vs. 100%, pphysical therapy under anesthesia can be effective in treating women with chronic pelvic pain secondary to MFPP. PMID:28261683

  1. Effect of the daily consumption of ostrich and bovine meat on the lipid metabolism in rats

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    Edvaldo Vasconcelos de Carvalho-Filho

    2011-03-01

    Full Text Available The objective of this study is to evaluate the effect of the daily consumption of ostrich meat (lliofemuralis internus and bovine meat (Psoas major on the lipid metabolism in adult mice. The analyses of the centesimal composition of the meats and preparation of the diets were accomplished following the recommendations of the American Institute of Nutrition-AIN-93. Three groups of 150 day-old animals: group I (diet I, with casein, group II (diet II, with ostrich meat, and group III (diet III with bovine meat were fed for 13 weeks with the respective diets and weight gain, food efficiency coefficient, total cholesterol, lipoprotein fractions, hepatic, transaminases and body fat percentage and hepatic fat content were evaluated. No difference (p < 0.05 it was found for weight gain and coefficients for feed efficiency among the groups. Total cholesterol, HDL-cholesterol, LDL-cholesterol, relationship of total cholesterol/HDL-cholesterol, VLDL, triglycerides and hepatic transaminases were also not different among the groups (p < 0.05. This research suggests that the consumption of ostrich meat or thin bovine meat on a daily basis does not raise concerns about weight gain, and an increase in the plasma concentrations of lipoprotein and levels of hepatic transaminase.

  2. Surgical Treatment of Dyskinesia in Parkinson’s Disease

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    Renato Puppi Munhoz

    2014-04-01

    Full Text Available One of the main indications for stereotactic surgery in Parkinson’s disease (PD is the control of levodopa induced dyskinesia. This can be achieved by by pallidotomy and globus pallidus internus (GPi deep brain stimulation (DBS or by subthalamotomy and subthalamic nucleus (STN DBS, which usually allow for a cut down in the dosage of levodopa. DBS has assumed a pivotal role in stereotactic surgical treatment of PD and, in fact, ablative procedures are currently considered surrogates, particularly when bilateral procedures are required, as DBS does not produce a brain lesion and the stimulator can be programmed to induce better therapeutic effects while minimizing adverse effects. Interventions in either the STN and the GPi seem to be similar in controlling most of the other motor aspects of PD, nonetheless, GPi surgery seems to induce a more particular and direct effect on dyskinesia, while the antidyskinetic effect of STN interventions is mostly dependent on a reduction of dopaminergic drug dosages. Hence, the si ne qua non condition for a reduction of dyskinesia when STN interventions are intended is their ability to allow for a reduction of levodopa dosage. Pallidal surgery is indicated when dyskinesia is a dose-limiting factor for maintaining or introducing higher adequate levels of dopaminergic therapy. Also medications used for the treatment of PD may be useful for the improvement of several non-motor aspects of the disease, including sleep, psychiatric, and cognitive domains, therefore, dose reduction of medication withdrawal are not always a fruitful objective.

  3. Deep Brain Stimulation for Tourette-Syndrome: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Baldermann, Juan Carlos; Schüller, Thomas; Huys, Daniel; Becker, Ingrid; Timmermann, Lars; Jessen, Frank; Visser-Vandewalle, Veerle; Kuhn, Jens

    2016-01-01

    A significant proportion of patients with Tourette syndrome (TS) continue to experience symptoms across adulthood that in severe cases fail to respond to standard therapies. For these cases, deep brain stimulation (DBS) is emerging as a promising treatment option. We conducted a systematic literature review to evaluate the efficacy of DBS for GTS. Individual data of case reports and series were pooled; the Yale Global Tic Severity Scale (YGTSS) was chosen as primary outcome parameter. In total, 57 studies were eligible, including 156 cases. Overall, DBS resulted in a significant improvement of 52.68% (IQR = 40.74, p < 0.001) in the YGTSS. Analysis of controlled studies significantly favored stimulation versus off stimulation with a standardized mean difference of 0.96 (95% CI: 0.36-1.56). Disentangling different target points revealed significant YGTSS reductions after stimulation of the thalamus, the posteroventrolateral part and the anteromedial part of the globus pallidus internus, the anterior limb of the internal capsule and nucleus accumbens with no significant difference between these targets. A significant negative correlation of preoperative tic scores with the outcome of thalamic stimulation was found. Despite small patient numbers, we conclude that DBS for GTS is a valid option for medically intractable patients. Different brain targets resulted in comparable improvement rates, indicating a modulation of a common network. Future studies might focus on a better characterization of the clinical effects of distinct regions, rather than searching for a unique target. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Isen, K.; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-01-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5±18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  5. [The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].

    Science.gov (United States)

    Hu, Xu-Dong; Ma, Wei-Hu; Jiang, Wei-Yu; Ruan, Chao-Yue; Chen, Yun-Lin

    2017-02-25

    To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease. From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning. The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up( P degenerative disease.

  6. Improvement of Isolated Myoclonus Phenotype in Myoclonus Dystonia after Pallidal Deep Brain Stimulation

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    Ritesh Ramdhani

    2016-03-01

    Full Text Available Background: Myoclonus–dystonia is a condition that manifests predominantly as myoclonic jerks with focal dystonia. It is genetically heterogeneous with most mutations in the epsilon sarcoglycan gene (SGCE. In medically refractory cases, deep brain stimulation (DBS has been shown to provide marked sustainable clinical improvement, especially in SGCE-positive patients. We present two patients with myoclonus–dystonia (one SGCE positive and the other SGCE negative who have the isolated myoclonus phenotype and had DBS leads implanted in the bilateral globus pallidus internus (GPi. Methods: We review their longitudinal Unified Myoclonus Rating Scale scores along with their DBS programming parameters and compare them with published cases in the literature. Results: Both patients demonstrated complete amelioration of all aspects of myoclonus within 6–12 months after surgery. The patient with the SGCE-negative mutation responded just as well as the patient who was SGCE positive. High-frequency stimulation (130 Hz with amplitudes greater than 2.5 V provided therapeutic benefit. Discussion: This case series demonstrates that high frequency GPi-DBS is effective in treating isolated myoclonus in myoclonus–dystonia, regardless of the presence of SGCE mutation.

  7. Surgery for Dystonia and Tremor.

    Science.gov (United States)

    Crowell, Jason L; Shah, Binit B

    2016-03-01

    Surgical procedures for dystonia and tremor have evolved over the past few decades, and our understanding of risk, benefit, and predictive factors has increased substantially in that time. Deep brain stimulation (DBS) is the most utilized surgical treatment for dystonia and tremor, though lesioning remains an effective option in appropriate patients. Dystonic syndromes that have shown a substantial reduction in severity secondary to DBS are isolated dystonia, including generalized, cervical, and segmental, as well as acquired dystonia such as tardive dystonia. Essential tremor is quite amenable to DBS, though the response of other forms of postural and kinetic tremor is not nearly as robust or consistent based on available evidence. Regarding targeting, DBS lead placement in the globus pallidus internus has shown marked efficacy in dystonia reduction. The subthalamic nucleus is an emerging target, and increasing evidence suggests that this may be a viable target in dystonia as well. The ventralis intermedius nucleus of the thalamus is the preferred target for essential tremor, though targeting the subthalamic zone/caudal zona incerta has shown promise and may emerge as another option in essential tremor and possibly other tremor disorders. In the carefully selected patient, DBS and lesioning procedures are relatively safe and effective for the management of dystonia and tremor.

  8. TVT ABBREVO: cadaveric study of tape position in foramen obturatum and adductor region.

    Science.gov (United States)

    Hubka, Petr; Nanka, Ondrej; Masata, Jaromir; Martan, Alois; Svabik, Kamil

    2016-07-01

    The aim of the study was to describe fixation of the TVT ABBREVO and establish whether the tape penetrates through obturator muscles and membrane (obturator complex) into the adductor region and, if so, how far it penetrates. Eight formalin-embalmed female cadavers were used to simulate TVT ABBREVO surgery (totalling 16 insertions). Following tape insertion, dissection was performed and ends of the tape were identified. In cases of penetration, the length of tape penetrating into the adductor region was measured. Of the 16 cases, the tape ended in the obturator membrane in eight, in the internal obturator muscle in one, and penetrated through the obturator membrane into the external obturator muscle in five, where it remained. In two cases, it penetrated through the obturator internus muscle, obturator membrane and obturator externus muscle into the group of thigh adductors; one penetration was by 3 mm and the second by 10 mm. No contact with the obturator nerve or its branches was noted in any case. No TVT contact with the obturator nerve was noted; tape penetrated into the adductor region in two of the 16 cases.

  9. Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study

    Directory of Open Access Journals (Sweden)

    Fábio Renovato França

    2010-01-01

    Full Text Available OBJECTIVE: To contrast the efficacy of two exercise programs, segmental stabilization and strengthening of abdominal and trunk muscles, on pain, functional disability, and activation of the transversus abdominis muscle (TrA, in individuals with chronic low back pain. DESIGN: Our sample consisted of 30 individuals, randomly assigned to one of two treatment groups: segmental stabilization, where exercises focused on the TrA and lumbar multifidus muscles, and superficial strengthening, where exercises focused on the rectus abdominis, abdominus obliquus internus, abdominus obliquus externus, and erector spinae. Groups were examined to discovere whether the exercises created contrasts regarding pain (visual analogical scale and McGill pain questionnaire, functional disability (Oswestry disability questionnaire, and TrA muscle activation capacity (Pressure Biofeedback Unit = PBU. The program lasted 6 weeks, and 30-minute sessions occurred twice a week. Analysis of variance was used for inter- and intra-group comparisons. The significance level was established at 5%. RESULTS: As compared to baseline, both treatments were effective in relieving pain and improving disability (p<0.001. Those in the segmental stabilization group had significant gains for all variables when compared to the ST group (p<0.001, including TrA activation, where relative gains were 48.3% and -5.1%, respectively. CONCLUSION: Both techniques lessened pain and reduced disability. Segmental stabilization is superior to superficial strengthening for all variables. Superficial strengthening does not improve TrA activation capacity.

  10. Long-Term Effect of GPi-DBS in a Patient With Generalized Dystonia Due to GLUT1 Deficiency Syndrome

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    Idil Hanci

    2018-05-01

    Full Text Available Treatment outcomes from pallidal deep brain stimulation are highly heterogeneous reflecting the phenotypic and etiologic spectrum of dystonia. Treatment stratification to neurostimulation therapy primarily relies on the phenotypic motor presentation; however, etiology including genetic factors are increasingly recognized as modifiers of treatment outcomes. Here, we describe a 53 year-old female patient with a progressive generalized dystonia since age 25. The patient underwent deep brain stimulation of the globus pallidus internus (GPi-DBS at age 44. Since the clinical phenotype included mobile choreo-dystonic features, we expected favorable therapeutic outcome from GPi-DBS. Although mobile dystonia components were slightly improved in the long-term outcome from GPi-DBS the overall therapeutic response 9 years from implantation was limited when comparing “stimulation off” and “stimulation on” despite of proper electrode localization and sufficient stimulation programming. In order to further understand the reason for this limited motor symptom response, we aimed to clarify the etiology of generalized dystonia in this patient. Genetic testing identified a novel heterozygous pathogenic SLC2A1 mutation as cause of glucose transporter type 1 deficiency syndrome (GLUT1-DS. This case report presents the first outcome of GPi-DBS in a patient with GLUT1-DS, and suggests that genotype relations may increasingly complement phenotype-based therapy stratification of GPi-DBS in dystonia.

  11. Mental Health-Related Healthcare Use Following Bilateral Deep Brain Stimulation For Parkinson's Disease.

    Science.gov (United States)

    Westbay, Lauren C; Cao, Lishan; Burnett-Zeigler, Inger; Reizine, Natalie; Barton, Brandon; Ippolito, Dolores; Weaver, Frances M; Stroupe, Kevin T

    2015-01-01

    The subthalamic nucleus (STN) and the globus pallidus internus (GPi) are both effective targets for deep brain stimulation (DBS) to relieve motor symptoms of Parkinson's disease. However, studies have reported varied effects on mental health-related adverse events and depressed mood following DBS. The current observational study sought to compare mental health healthcare utilization and costs for three years following STN or GPi DBS. For a cohort of Veterans (n = 161) with Parkinson's disease who participated in a larger multi-site randomized trial, we compared mental health outpatient visits, medication use, inpatient admissions, and associated costs by DBS target site (STN vs. GPi). Neither group nor time differences were significant for mental health outpatient or inpatient utilization following DBS. Overall costs associated with mental health visits and medications did not differ by time or by group. However, the percentage of patients with mental health medication use increased in the 6-month and 6 to 12 month periods post-surgery. The STN group had significantly greater increase in medication use at 6 to 12 months post-surgery compared to the GPi group (p use following surgery, this study suggests that mental health healthcare use and costs are stable over time and similar between DBS targets. Prior research findings of mental health-related adverse events and mood following DBS did not translate to greater mental health service utilization in our cohort. The changes seen in the year following surgery may reflect temporary adjustments with stabilization over time.

  12. Staged pallidotomy: MRI and clinical follow-up in status dystonicus.

    Science.gov (United States)

    Franzini, Angelo; Levi, Vincenzo; Franzini, Andrea; Dones, Ivano; Messina, Giuseppe

    2017-11-28

    We report on a patient affected by Status Distonicus who was treated with Deep Brain Stimulation electrodes implanted in the Globus Pallidus internus (Gpi) and used for serial radiofrequency lesions. The evolution of radiofrequency lesions was monitored by post-operative and late Magnetic Resonance Imaging (MRI). After the first lesion the patient did improve, though not in a significant fashion. Therefore, three further radiofrequency lesions were delivered 2, 4 and 6 days respectively after surgery with subsequent improvement of dystonic movements. MRI scans performed at 8 days, 3 months, and 6 months after surgery showed a diffuse T2-hyperintense and T1-hypointense GPi signal alteration which progressively decreased over time. We confirm that the possibility to stage pallidotomies over time using a couple of new contacts is a safe and efficacious procedure in treating SD patients where the lesions themselves are limited by the appearance of side effects, or in patients showing a poor response to a single lesion. As far as we know, this is the first description of MRI evolution and monitoring of a staged pallidotomy.

  13. Micromorphology of flowers and the structure of floral nectaries in Orobanche alsatica Kirschl.

    Directory of Open Access Journals (Sweden)

    Aneta Sulborska

    2014-04-01

    closed stomata. Dried nectar forming granularities or/and layers was frequently noticed on the stomatal cell surface or inside the porus. The epidermal cells of the nectary had smaller sizes, were more equidimensional, and had fewer cuticular striae than the neighbouring cells covering the ovary. Numerous different size starch grains were present in the epidermal cells of the gland and in the secretory cell layers.

  14. Mechanistic modelling of Middle Eocene atmospheric carbon dioxide using fossil plant material

    Science.gov (United States)

    Grein, Michaela; Roth-Nebelsick, Anita; Wilde, Volker; Konrad, Wilfried; Utescher, Torsten

    2010-05-01

    Various proxies (such as pedogenic carbonates, boron isotopes or phytoplankton) and geochemical models were applied in order to reconstruct palaeoatmospheric carbon dioxide, partially providing conflicting results. Another promising proxy is the frequency of stomata (pores on the leaf surface used for gaseous exchange). In this project, fossil plant material from the Messel Pit (Hesse, Germany) is used to reconstruct atmospheric carbon dioxide concentration in the Middle Eocene by analyzing stomatal density. We applied the novel mechanistic-theoretical approach of Konrad et al. (2008) which provides a quantitative derivation of the stomatal density response (number of stomata per leaf area) to varying atmospheric carbon dioxide concentration. The model couples 1) C3-photosynthesis, 2) the process of diffusion and 3) an optimisation principle providing maximum photosynthesis (via carbon dioxide uptake) and minimum water loss (via stomatal transpiration). These three sub-models also include data of the palaeoenvironment (temperature, water availability, wind velocity, atmospheric humidity, precipitation) and anatomy of leaf and stoma (depth, length and width of stomatal porus, thickness of assimilation tissue, leaf length). In order to calculate curves of stomatal density as a function of atmospheric carbon dioxide concentration, various biochemical parameters have to be borrowed from extant representatives. The necessary palaeoclimate data are reconstructed from the whole Messel flora using Leaf Margin Analysis (LMA) and the Coexistence Approach (CA). In order to obtain a significant result, we selected three species from which a large number of well-preserved leaves is available (at least 20 leaves per species). Palaeoclimate calculations for the Middle Eocene Messel Pit indicate a warm and humid climate with mean annual temperature of approximately 22°C, up to 2540 mm mean annual precipitation and the absence of extended periods of drought. Mean relative air

  15. Níveis de triglicerídeos intra e extracelulares em músculos humanos mediante ¹H-ERM: um estudo de caso Niveles de triglicéridos intra y extracelulares en músculos humanos mediante 1H-ERM: estudio de caso Levels of intra and extra cellular triglycerides in human muscles by means of ¹H-ERM: a case study

    Directory of Open Access Journals (Sweden)

    Maria Gisele dos Santos

    2004-10-01

    (ET triglycerides consumption in the soleus, tibialis anticus, vastus internus muscles, after 4 hours training ride on the road. This study used a top-level cyclist as a case study. Magnetic resonance studies used the following spectroscopy parameters imposed to adjust the time, such as the distance of the frequency between the signs IT and ET of the similar chemical nature. We were able to conclude that the vastus internus was the muscle which demonstrated the largest triglyceride consumption as the energetic substrate after a 4 hour bike ride on the road. Thus, we can infer that a workout at 80% of the VO2max enabled the consumption of intra muscle triglyceride during exercise.

  16. Dynamic stereotypic responses of basal ganglia neurons to subthalamic nucleus high frequency stimulation in the parkinsonian primate

    Directory of Open Access Journals (Sweden)

    Anan eMoran

    2011-04-01

    Full Text Available Deep brain stimulation in the subthalamic nucleus (STN is a well-established therapy for patients with severe Parkinson‟s disease (PD; however, its mechanism of action is still unclear. In this study we explored static and dynamic activation patterns in the basal ganglia during high frequency macro-stimulation of the STN. Extracellular multi-electrode recordings were performed in primates rendered parkinsonian using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Recordings were preformed simultaneously in the STN and the globus pallidus externus and internus. Single units were recorded preceding and during the stimulation. During the stimulation, STN mean firing rate dropped significantly, while pallidal mean firing rates did not change significantly. The vast majority of neurons across all three nuclei displayed stimulation driven modulations, which were stereotypic within each nucleus but differed across nuclei. The predominant response pattern of STN neurons was somatic inhibition. However, most pallidal neurons demonstrated synaptic activation patterns. A minority of neurons across all nuclei displayed axonal activation. Temporal dynamics were observed in the response to stimulation over the first 10 seconds in the STN and over the first 30 seconds in the pallidum. In both pallidal segments, the synaptic activation response patterns underwent delay and decay of the magnitude of the peak response due to short term synaptic depression. We suggest that during STN macro stimulation the STN goes through a functional ablation as its upper bound on information transmission drops significantly. This notion is further supported by the evident dissociation between the stimulation driven pre-synaptic STN somatic inhibition and the post-synaptic axonal activation of its downstream targets. Thus, basal ganglia output maintains its firing rate while losing the deleterious effect of the STN. This may be a part of the mechanism leading to the beneficial

  17. Dystonia.

    Science.gov (United States)

    Morgante, Francesca; Klein, Christine

    2013-10-01

    The purpose of this review is to provide an update on the classification, phenomenology, pathophysiology, and treatment of dystonia. A revised definition based on the main phenomenologic features of dystonia has recently been developed in an expert consensus approach. Classification is based on two main axes: clinical features and etiology. Currently, genes have been reported for 14 types of monogenic isolated and combined dystonia. Isolated dystonia (with dystonic tremor) can be caused by mutations in TOR1A (DYT1), TUBB4 (DYT4), THAP1 (DYT6), PRKRA (DYT16), CIZ1 (DYT23), ANO3 (DYT24), and GNAL (DYT25). Combined dystonias (with parkinsonism or myoclonus) are further subdivided into persistent (GCHI [DYT5], SGCE [DYT11], and ATP1A3 [DYT12], with TAF1 most likely but not yet proven to be linked to DYT3) and paroxysmal (PNKD [DYT8], PRRT2 [DYT10], and SLC2A1 [DYT18]). Recent insights from neurophysiologic studies identified functional abnormalities in two networks in dystonia: the basal ganglia-sensorimotor network and, more recently, the cerebellothalamocortical pathway. Besides the well-known lack of inhibition at different CNS levels, dystonia is specifically characterized by maladaptive plasticity in the sensorimotor cortex and loss of cortical surround inhibition. The exact role (modulatory or compensatory) of the cerebellar-cortical pathways still has to be further elucidated. In addition to botulinum toxin for focal forms, deep brain stimulation of the globus pallidus internus is increasingly recognized as an effective treatment for generalized and segmental dystonia. The revised classification and identification of new genes for different forms of dystonia, including adult-onset segmental dystonia, enable an improved diagnostic approach. Recent pathophysiologic insights have fundamentally contributed to a better understanding of the disease mechanisms and impact on treatment, such as functional neurosurgery and nonpharmacologic treatment options.

  18. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

    Science.gov (United States)

    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium. Copyright © 2016 Elsevier GmbH. All rights reserved.

  19. Target Selection Recommendations Based on Impact of Deep Brain Stimulation Surgeries on Nonmotor Symptoms of Parkinson′s Disease

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Wang

    2015-01-01

    Full Text Available Objective: This review examines the evidence that deep brain stimulation (DBS has extensive impact on nonmotor symptoms (NMSs of patients with Parkinson′s disease (PD. Data Sources: We retrieved information from the PubMed database up to September, 2015, using various search terms and their combinations including PD, NMSs, DBS, globus pallidus internus (GPi, subthalamic nucleus (STN, and ventral intermediate thalamic nucleus. Study Selection: We included data from peer-reviewed journals on impacts of DBS on neuropsychological profiles, sensory function, autonomic symptoms, weight changes, and sleep disturbances. For psychological symptoms and cognitive impairment, we tried to use more reliable proofs: Random, control, multicenter, large sample sizes, and long period follow-up clinical studies. We categorized the NMSs into four groups: those that would improve definitively following DBS; those that are not significantly affected by DBS; those that remain controversial on their surgical benefit; and those that can be worsened by DBS. Results: In general, it seems to be an overall beneficial effect of DBS on NMSs, such as sensory, sleep, gastrointestinal, sweating, cardiovascular, odor, urological symptoms, and sexual dysfunction, GPi-DBS may produce similar results; Both STN and Gpi-DBS are safe with regard to cognition and psychology over long-term follow-up, though verbal fluency decline is related to DBS; The impact of DBS on behavioral addictions and dysphagia is still uncertain. Conclusions: As the motor effects of STN-DBS and GPi-DBS are similar, NMSs may determine the target choice in surgery of future patients.

  20. The effect of low frequency stimulation of the pedunculopontine tegmental nucleus on basal ganglia in a rat model of Parkinson's disease.

    Science.gov (United States)

    Park, Eunkyoung; Song, Inho; Jang, Dong Pyo; Kim, In Young

    2014-08-08

    The pedunculopontine nucleus (PPN) has recently been introduced as an alternative target to the subthalamic nucleus (STN) or globus pallidus internus (GPi) for the treatment of advanced Parkinson's disease with severe and medically intractable axial symptoms such as gait and postural impairment. However, it is little known about how electrical stimulation of the PPN affects control of neuronal activities between the PPN and basal ganglia. We examined how low frequency stimulation of the pedunculopontine tegmental nucleus (PPTg) affects control of neuronal activities between the PPN and basal ganglia in 6-OHDA lesioned rats. In order to identify the effect of low frequency stimulation on the PPTg, neuronal activity in both the STN and substantia nigra par reticulata (SNr) were recorded and subjected to quantitative analysis, including analysis of firing rates and firing patterns. In this study, we found that the firing rates of the STN and SNr were suppressed during low frequency stimulation of the PPTg. However, the firing pattern, in contrast to the firing rate, did not exhibit significant changes in either the STN or SNr of 6-OHDA lesioned rats during low frequency stimulation of the PPTg. In addition, we also found that the firing rate of STN and SNr neurons displaying burst and random pattern were decreased by low frequency stimulation of PPTg, while the neurons displaying regular pattern were not affected. These results indicate that low frequency stimulation of the PPTg affects neuronal activity in both the STN and SNr, and may represent electrophysiological efficacy of low frequency PPN stimulation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Dynamic stereotypic responses of Basal Ganglia neurons to subthalamic nucleus high-frequency stimulation in the parkinsonian primate.

    Science.gov (United States)

    Moran, Anan; Stein, Edward; Tischler, Hadass; Belelovsky, Katya; Bar-Gad, Izhar

    2011-01-01

    Deep brain stimulation (DBS) in the subthalamic nucleus (STN) is a well-established therapy for patients with severe Parkinson's disease (PD); however, its mechanism of action is still unclear. In this study we explored static and dynamic activation patterns in the basal ganglia (BG) during high-frequency macro-stimulation of the STN. Extracellular multi-electrode recordings were performed in primates rendered parkinsonian using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Recordings were preformed simultaneously in the STN and the globus pallidus externus and internus. Single units were recorded preceding and during the stimulation. During the stimulation, STN mean firing rate dropped significantly, while pallidal mean firing rates did not change significantly. The vast majority of neurons across all three nuclei displayed stimulation driven modulations, which were stereotypic within each nucleus but differed across nuclei. The predominant response pattern of STN neurons was somatic inhibition. However, most pallidal neurons demonstrated synaptic activation patterns. A minority of neurons across all nuclei displayed axonal activation. Temporal dynamics were observed in the response to stimulation over the first 10 seconds in the STN and over the first 30 seconds in the pallidum. In both pallidal segments, the synaptic activation response patterns underwent delay and decay of the magnitude of the peak response due to short term synaptic depression. We suggest that during STN macro-stimulation the STN goes through a functional ablation as its upper bound on information transmission drops significantly. This notion is further supported by the evident dissociation between the stimulation driven pre-synaptic STN somatic inhibition and the post-synaptic axonal activation of its downstream targets. Thus, BG output maintains its firing rate while losing the deleterious effect of the STN. This may be a part of the mechanism leading to the beneficial effect of DBS in PD.

  2. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

    International Nuclear Information System (INIS)

    Hernando, Moises Fernandez; Cerezal, Luis; Perez-Carro, Luis; Abascal, Faustino; Canga, Ana

    2015-01-01

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included ''piriformis syndrome,'' a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation. (orig.)

  3. The Palatal Interpterygoid Vacuities of Temnospondyls and the Implications for the Associated Eye- and Jaw Musculature.

    Science.gov (United States)

    Witzmann, Florian; Werneburg, Ingmar

    2017-07-01

    A diagnostic feature of temnospondyls is the presence of an open palate with large interpterygoid vacuities, unlike the closed palate of most other early tetrapods, in which the vacuities are either slit-like or completely absent. Attachment sites on neurocranium and palatal bones in temnospondyls allow the reconstruction of a powerful m. retractor bulbi and a large, sheet-like m. levator bulbi that formed the elastic floor of the orbit. This muscle arrangement indicates that temnospondyls were able to retract the eyeballs through the interpterygoid vacuities into the buccal cavity, like extant frogs and salamanders. In contrast, attachment sites on palate and neurocranium suggest a rather sauropsid-like arrangement of these muscles in stem-tetrapods and stem-amniotes. However, the anteriorly enlarged, huge interpterygoid vacuities of long-snouted stereospondyls suggest that eye retraction was not the only function of the vacuities here, since the eye-muscles filled only the posterior part of the vacuities. We propose an association of the vacuities in temnospondyls with a long, preorbital part of the m. adductor mandibulae internus (AMIa). The trochlea-like, anterior edge of the adductor chamber suggests that a tendon of the AMIa was redirected in an anteromedial direction in the preorbital skull and dorsal to the pterygoids. This tendon then unfolded into a wide aponeurosis bearing the flattened AMIa that filled almost the complete interpterygoid vacuities anterior to the orbits. Our muscle reconstructions permit comprehensive insights to the comparative soft tissue anatomy of early tetrapods and provide the basis for a biomechanic analysis of biting performances in the future. Anat Rec, 300:1240-1269, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Coordination of deep hip muscle activity is altered in symptomatic femoroacetabular impingement.

    Science.gov (United States)

    Diamond, Laura E; Van den Hoorn, Wolbert; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; O'Donnell, John; Hodges, Paul W

    2017-07-01

    Diagnosis of femoroacetabular impingement (FAI) is increasing, yet the associated physical impairments remain poorly defined. This morphological hip condition can cause joint pain, stiffness, impaired function, and eventually hip osteoarthritis. This exploratory study compared coordination of deep hip muscles between people with and without symptomatic FAI using analysis of muscle synergies (i.e., patterns of activity of groups of muscles activated in synchrony) during gait. Fifteen individuals (11 males) with symptomatic FAI (clinical examination and imaging) and 14 age- and sex-comparable controls without morphological FAI underwent testing. Intramuscular fine-wire and surface electrodes recorded electromyographic activity of selected deep and superficial hip muscles. A non-negative matrix factorization algorithm extracted three synergies which were compared between groups. Information regarding which muscles were activated together in the FAI group (FAI group synergy vector) was used to reconstruct individual electromyography patterns and compare groups. Variance accounted for (VAF) by three synergies was less for the control (94.8 [1.4]%) than FAI (96.0 [1.0]%) group (p = 0.03). VAF of obturator internus was significantly higher in the FAI group (p = 0.02). VAF of the reconstructed individual electromyography patterns with the FAI or control group vector were significantly higher for the FAI group (p hip muscles in the synergy related to hip joint control during early swing differed between groups. This phase involves movement towards the impingement position, which has relevance for the interpretation of synergy differences and potential clinical importance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1494-1504, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  5. Muscle Damage After Total Hip Arthroplasty Through the Direct Anterior Approach for Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Kawasaki, Masashi; Hasegawa, Yukiharu; Okura, Toshiaki; Ochiai, Satoshi; Fujibayashi, Takayoshi

    2017-08-01

    Total hip arthroplasty (THA) through the direct anterior approach (DAA) is known to cause less muscle damage than other surgical approaches. However, more complex primary cases, such as developmental dysplasia of the hip (DDH), might often cause muscle damage. The objective of the present study was to clarify the muscle damage observed 1 year after THA through the DAA for DDH using magnetic resonance imaging. We prospectively compared the muscle cross-sectional area (M-CSA) and fatty atrophy (FA) in muscles by magnetic resonance imaging and the Harris hip score before and at 1-year follow-up after THA through the DAA in 3 groups: 37 patients with Crowe group 1 DDH (D1), 13 patients with Crowe group 2 and 3 DDH (D2 + 3), and 12 patients with osteonecrosis as a control. THA through the DAA for D1 displayed significantly decreased M-CSA and significantly increased FA in the gluteus minimus (Gmini), the tensor fasciae latae (TFL), and the obturator internus (OI). Patients with D2 + 3 group did not have decreased M-CSA in the TFL or increased FA in the Gmini. Postoperatively, a significant negative correlation was observed between the M-CSA and FA for the OI in patients with D1 and D2 + 3. THA through the DAA for DDH caused the damage in the Gmini, the TFL, and the OI; severe damage was observed in the OI, showing increased FA with decreased M-CSA in patients with both D1 and D2 + 3. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes.

    Directory of Open Access Journals (Sweden)

    M Eriksson Crommert

    Full Text Available The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0° to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA, obliquus internus (OI with intra-muscular electrodes, and from rectus abdominis (RA, erector spinae (ES and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement.

  7. The Head and Neck Anatomy of Sea Turtles (Cryptodira: Chelonioidea) and Skull Shape in Testudines

    Science.gov (United States)

    Jones, Marc E. H.; Werneburg, Ingmar; Curtis, Neil; Penrose, Rod; O’Higgins, Paul; Fagan, Michael J.; Evans, Susan E.

    2012-01-01

    Background Sea turtles (Chelonoidea) are a charismatic group of marine reptiles that occupy a range of important ecological roles. However, the diversity and evolution of their feeding anatomy remain incompletely known. Methodology/Principal Findings Using computed tomography and classical comparative anatomy we describe the cranial anatomy in two sea turtles, the loggerhead (Caretta caretta) and Kemp’s ridley (Lepidochelys kempii), for a better understanding of sea turtle functional anatomy and morphological variation. In both taxa the temporal region of the skull is enclosed by bone and the jaw joint structure and muscle arrangement indicate that palinal jaw movement is possible. The tongue is relatively small, and the hyoid apparatus is not as conspicuous as in some freshwater aquatic turtles. We find several similarities between the muscles of C. caretta and L. kempii, but comparison with other turtles suggests only one of these characters may be derived: connection of the m. adductor mandibulae internus into the Pars intramandibularis via the Zwischensehne. The large fleshy origin of the m. adductor mandibulae externus Pars superficialis from the jugal seems to be a characteristic feature of sea turtles. Conclusions/Significance In C. caretta and L. kempii the ability to suction feed does not seem to be as well developed as that found in some freshwater aquatic turtles. Instead both have skulls suited to forceful biting. This is consistent with the observation that both taxa tend to feed on relatively slow moving but sometimes armoured prey. The broad fleshy origin of the m. adductor mandibulae externus Pars superficialis may be linked to thecheek region being almost fully enclosed in bone but the relationship is complex. PMID:23144831

  8. Altered neuronal firing pattern of the basal ganglia nucleus plays a role in levodopa-induced dyskinesia in patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Xiaoyu eLi

    2015-11-01

    Full Text Available Background: Levodopa therapy alleviates the symptoms of Parkinson's disease (PD, but long-term treatment often leads to motor complications such as levodopa-induced dyskinesia (LID. Aim: To explore the neuronal activity in the basal ganglia nuclei in patients with PD and LID. Methods: Thirty patients with idiopathic PD (age, 55.1±11.0 years; disease duration, 8.7±5.6 years were enrolled between August 2006 and August 2013 at the Xuanwu Hospital, Capital Medical University, China. Their Hoehn and Yahr scores ranged from 2 to 4 and their UPDRS III scores were 28.5±5.2. Fifteen of them had severe LID (UPDRS IV scores of 6.7±1.6. Microelectrode recording was performed in the globus pallidus internus (GPi and subthalamic nucleus (STN during pallidotomy (n=12 or STN deep brain stimulation (DBS; bilateral, n=12; unilateral, n=6. The firing patterns and frequencies of various cell types were analyzed by assessing single cell interspike intervals (ISIs and the corresponding coefficient of variation (CV. Results: A total of 295 neurons were identified from the GPi (n=12 and STN (n=18. These included 26 (8.8% highly grouped discharge, 30 (10.2% low frequency firing, 78 (26.4% rapid tonic discharge, 103 (34.9% irregular activity, and 58 (19.7% tremor-related activity. There were significant differences between the two groups (P<0.05 for neurons with irregular firing, highly irregular cluster-like firing, and low-frequency firing. Conclusion: Altered neuronal activity was observed in the basal ganglia nucleus of GPi and STN, and may play important roles in the pathophysiology of PD and LID.

  9. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

    Energy Technology Data Exchange (ETDEWEB)

    Hernando, Moises Fernandez; Cerezal, Luis; Perez-Carro, Luis; Abascal, Faustino; Canga, Ana [Diagnostico Medico Cantabria (DMC), Department of Radiology, Santander, Cantabria (Spain); Valdecilla University Hospital, Orthopedic Surgery Department Clinica Mompia (L.P.C.), Santander, Cantabria (Spain); Valdecilla University Hospital, Department of Radiology, Santander, Cantabria (Spain)

    2015-03-05

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included ''piriformis syndrome,'' a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation. (orig.)

  10. The head and neck anatomy of sea turtles (Cryptodira: Chelonioidea and skull shape in Testudines.

    Directory of Open Access Journals (Sweden)

    Marc E H Jones

    Full Text Available Sea turtles (Chelonoidea are a charismatic group of marine reptiles that occupy a range of important ecological roles. However, the diversity and evolution of their feeding anatomy remain incompletely known.Using computed tomography and classical comparative anatomy we describe the cranial anatomy in two sea turtles, the loggerhead (Caretta caretta and Kemp's ridley (Lepidochelys kempii, for a better understanding of sea turtle functional anatomy and morphological variation. In both taxa the temporal region of the skull is enclosed by bone and the jaw joint structure and muscle arrangement indicate that palinal jaw movement is possible. The tongue is relatively small, and the hyoid apparatus is not as conspicuous as in some freshwater aquatic turtles. We find several similarities between the muscles of C. caretta and L. kempii, but comparison with other turtles suggests only one of these characters may be derived: connection of the m. adductor mandibulae internus into the Pars intramandibularis via the Zwischensehne. The large fleshy origin of the m. adductor mandibulae externus Pars superficialis from the jugal seems to be a characteristic feature of sea turtles.In C. caretta and L. kempii the ability to suction feed does not seem to be as well developed as that found in some freshwater aquatic turtles. Instead both have skulls suited to forceful biting. This is consistent with the observation that both taxa tend to feed on relatively slow moving but sometimes armoured prey. The broad fleshy origin of the m. adductor mandibulae externus Pars superficialis may be linked to thecheek region being almost fully enclosed in bone but the relationship is complex.

  11. Motor control patterns during an active straight leg raise in pain-free subjects.

    Science.gov (United States)

    Beales, Darren John; O'Sullivan, Peter Bruce; Briffa, N Kathryn

    2009-01-01

    Repeated measures. To investigate motor control (MC) patterns of normal subjects during the low level physical load of the active straight leg raise (ASLR). Aberrant MC patterns, as observed with the ASLR test, are considered to be a mechanism for ongoing pain and disability in subjects with chronic musculoskeletal pelvic girdle pain. These patterns may not only affect the provision of lumbopelvic stability, but also respiration and the control of continence. Greater understanding of MC patterns in pain-free subjects may improve the management of pelvic girdle pain. METHODS.: Fourteen pain-free nulliparous women were examined during the ASLR. Electromyography of the anterior abdominal wall, right chest wall and the anterior scaleni, intraabdominal pressure (IAP), intrathoracic pressure (ITP), respiratory rate, pelvic floor kinematics, and downward leg pressure of the nonlifted leg were compared between a left and right ASLR. There was greater activation of obliquus internus abdominis and obliquus externus abdominis on the side of the ASLR. The predominant pattern of activation for the chest wall was tonic activation during an ipsilateral ASLR, and phasic respiratory activation lifting the contralateral leg. Respiratory fluctuation of both IAP and ITP did not differ lifting either leg. The baseline shifts of these pressure variables in response to the physical demand of lifting the leg was also the same either side. There was no difference in respiratory rate, pelvic floor kinematics, or downward leg pressure. Pain-free subjects demonstrate a predominant pattern of greater ipsilateral tonic activation of the abdominal wall and chest wall on the side of the ASLR. This was achieved with minimal apparent disruption to IAP and ITP. The findings of this study demonstrate the plastic nature of the abdominal cylinder and the flexibility of the neuromuscular system in controlling load transference during an ASLR.

  12. Moving forward: advances in the treatment of movement disorders with deep brain stimulation

    Directory of Open Access Journals (Sweden)

    Terry K Schiefer

    2011-11-01

    Full Text Available The modern era of stereotactic and functional neurosurgery has ushered in state of the art technologies for the treatment of movement disorders, particularly Parkinson’s disease (PD, tremor, and dystonia. After years of experience with various surgical therapies, the eventual shortcomings of both medical and surgical treatments, and several serendipitous discoveries, deep brain stimulation (DBS has risen to the forefront as a highly effective, safe, and reversible treatment for these conditions. Idiopathic advanced Parkinson’s disease can be treated with thalamic, globus pallidus internus (GPi, or subthalamic nucleus (STN DBS. Thalamic DBS primarily relieves tremor while GPi and STN DBS alleviate a wide range of Parkinsonian symptoms. Thalamic DBS is also used in the treatment of other types of tremor, particularly essential tremor, with excellent results. Both primary and various types of secondary dystonia can be treated very effectively with GPi DBS. The variety of anatomical targets for these movement disorders is indicative of the network-level dysfunction mediating these movement disturbances. Despite an increasing understanding of the clinical benefits of DBS, little is known about how DBS can create such wide sweeping neuromodulatory effects. The key to improving this therapeutic modality and discovering new ways to treat these and other neurologic conditions lies in better understanding the intricacies of DBS. Here we review the history and pertinent clinical data for DBS treatment of PD, tremor, and dystonia. Our search criteria for PubMed included combinations of the following terms: DBS, neuromodulation, movement disorders, PD, tremor, dystonia, and history. Dates were not restricted.

  13. MRI findings of radiation-induced changes in the urethra and periurethral tissues after treatment for prostate cancer

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    Marigliano, Chiara; Donati, Olivio F.; Vargas, Hebert Alberto; Akin, Oguz; Goldman, Debra A.; Eastham, James A.; Zelefsky, Michael J.; Hricak, Hedvig

    2013-01-01

    Purpose: To assess radiotherapy (RT)-induced changes in the urethra and periurethral tissues after treatment for prostate cancer (PCa). Methods and materials: This retrospective study included 108 men (median age, 64 years; range, 43–87 years) who received external-beam radiotherapy (EBRT) and/or brachytherapy for PCa and underwent endorectal-coil MRI of the prostate within 180 days before RT and a median of 20 months (range, 2–62 months) after RT. On all MRIs, two readers independently measured the urethral length (UL) and graded the margin definition (MD) of the urethral wall and the signal intensities (SIs) of the urethral wall and pelvic muscles on 4-point scales. Results: The mean urethral length decreased significantly from pre- to post-RT MRI (from 15.2 to 12.6 mm and from 14.4 to 12.9 mm for readers 1 and 2, respectively; both p-values <0.0001). Brachytherapy resulted in greater urethral shortening than EBRT. After RT, SI in the urethral wall increased in 57% (62/108) and 35% (38/108) of patients (readers 1 and 2, respectively). The frequency and magnitude of SI increase in pelvic muscles depended on muscle location. In the obturator internus muscle, SI increased more often after EBRT than after brachytherapy, while in the periurethral levator ani muscle SI increased more often after brachytherapy than after EBRT. Conclusion: After RT for PCa, MRI shows urethral shortening and increased SI of the urethral wall and pelvic muscles in substantial percentages of patients

  14. MRI findings of radiation-induced changes in the urethra and periurethral tissues after treatment for prostate cancer

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    Marigliano, Chiara [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Radiology, University “Sapienza”, Rome (Italy); Donati, Olivio F., E-mail: olivio.donati@usz.ch [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich (Switzerland); Vargas, Hebert Alberto; Akin, Oguz; Goldman, Debra A. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Eastham, James A. [Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Zelefsky, Michael J. [Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hricak, Hedvig, E-mail: hricakh@mskcc.org [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2013-12-01

    Purpose: To assess radiotherapy (RT)-induced changes in the urethra and periurethral tissues after treatment for prostate cancer (PCa). Methods and materials: This retrospective study included 108 men (median age, 64 years; range, 43–87 years) who received external-beam radiotherapy (EBRT) and/or brachytherapy for PCa and underwent endorectal-coil MRI of the prostate within 180 days before RT and a median of 20 months (range, 2–62 months) after RT. On all MRIs, two readers independently measured the urethral length (UL) and graded the margin definition (MD) of the urethral wall and the signal intensities (SIs) of the urethral wall and pelvic muscles on 4-point scales. Results: The mean urethral length decreased significantly from pre- to post-RT MRI (from 15.2 to 12.6 mm and from 14.4 to 12.9 mm for readers 1 and 2, respectively; both p-values <0.0001). Brachytherapy resulted in greater urethral shortening than EBRT. After RT, SI in the urethral wall increased in 57% (62/108) and 35% (38/108) of patients (readers 1 and 2, respectively). The frequency and magnitude of SI increase in pelvic muscles depended on muscle location. In the obturator internus muscle, SI increased more often after EBRT than after brachytherapy, while in the periurethral levator ani muscle SI increased more often after brachytherapy than after EBRT. Conclusion: After RT for PCa, MRI shows urethral shortening and increased SI of the urethral wall and pelvic muscles in substantial percentages of patients.

  15. Weight Gain following Pallidal Deep Brain Stimulation: A PET Study.

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    Paul Sauleau

    Full Text Available The mechanisms behind weight gain following deep brain stimulation (DBS surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN or the globus pallidus internus (GPi. Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET and weight gain following GPi-DBS in patients with Parkinson's disease (PD. Body mass index was calculated and brain activity prospectively measured using 2-deoxy-2[18F]fluoro-D-glucose PET four months before and four months after the start of GPi-DBS in 19 PD patients. Dopaminergic medication was included in the analysis to control for its possible influence on brain metabolism. Body mass index increased significantly by 0.66 ± 1.3 kg/m2 (p = 0.040. There were correlations between weight gain and changes in brain metabolism in premotor areas, including the left and right superior gyri (Brodmann area, BA 6, left superior gyrus (BA 8, the dorsolateral prefrontal cortex (right middle gyrus, BAs 9 and 46, and the left and right somatosensory association cortices (BA 7. However, we found no correlation between weight gain and metabolic changes in limbic and associative areas. Additionally, there was a trend toward a correlation between reduced dyskinesia and weight gain (r = 0.428, p = 0.067. These findings suggest that, unlike STN-DBS, motor improvement is the major contributing factor for weight gain following GPi-DBS PD, confirming the motor selectivity of this target.

  16. Transvaginal Pelvic Floor Muscle Injection Technique: A Cadaver Study.

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    Gupta, Priyanka; Ehlert, Michael; Sirls, Larry T; Peters, Kenneth

    Women with pelvic floor dysfunction can have tender areas on vaginal examination, which can be treated with trigger-point injections. There are no publications to evaluate the accuracy of pelvic floor muscle injections. Trigger-point injections were performed on 2 fresh cadaveric pelvises using a curved nasal cannula guide and 7-in spinal needle. This was performed using our standard template of 2 sets of injections at the 1-, 3-, and 5-o'clock positions distally and proximally. The first pelvis was dissected to examine dye penetration. Based on these results, we modified our technique and repeated the injections on the second cadaver. We dissected the second pelvis and compared our findings. The 1-o'clock proximal and distal injections stained the obturator internus and externus near the insertion at the ischiopubic ramus. The 3-o'clock injections stained the midbody of the pubococcygeus and puborectalis. The distal 5-o'clock position was too deep and stained the fat of the ischiorectal space. The proximal 5-o'clock injection stained the area of the pudendal nerve. Our goal at the distal 5-o'clock position was to infuse the iliococcygeus muscle, so we shortened the needle depth from 2 to 1 cm beyond the cannula tip. In our second dissection, the distal 5-o'clock injection again stained only the fat of the ischiorectal space. This is the first study to characterize the distribution of pelvic floor muscle injections in a cadaver model and confirms the ability to deliver medications effectively to the pelvic floor muscles.

  17. Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women.

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    Amanda C Amorim

    Full Text Available Pelvic floor muscle (PFM force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation. Twenty healthy, nulliparous women were evaluated using two strain-gauge dynamometers (one cylinder-like inside the vaginal cavity, and the other measuring hip adduction/abduction forces around both thighs while performing three different tasks: (a isolated PFM contraction; (b PFM contraction combined with hip adduction (30% and 50% maximum hip force; and (c PFM contraction combined with hip abduction (30% and 50% maximum hip force. Data were sampled at 100Hz and subtracted from the offset if existent. We calculated a gradient between the isolated PFM contraction and each hip condition (Δ Adduction and Δ Abduction for all variables: Maximum force (N, instant of maximum-force occurrence (s, mean force in an 8-second window (N, and PFM force loss (N.s. We compared both conditions gradients in 30% and 50% by paired t-tests. All variables did not differ between hip conditions both in 30% and 50% of maximum hip force (p>.05. PFM contraction combined with isometric hip abduction did not increase vaginal force in healthy and nulliparous women compared to PFM contraction combined with isometric hip adduction. Therefore, so far, the use of hip adduction or abduction in PFM training and treatments are not justified for improving PFM strength and endurance.

  18. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait.

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    Carbone, V; van der Krogt, M M; Koopman, H F J M; Verdonschot, N

    2016-06-14

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of the 56 MT parts contained in a state-of-the-art MS model. We used two metrics, namely a Local Sensitivity Index (LSI) and an Overall Sensitivity Index (OSI), to distinguish the effect of the perturbation on the predicted force produced by the perturbed MT parts and by all the remaining MT parts, respectively, during a simulated gait cycle. Results indicated that sensitivity of the model depended on the specific role of each MT part during gait, and not merely on its size and length. Tendon slack length was the most sensitive parameter, followed by maximal isometric muscle force and optimal muscle fiber length, while nominal pennation angle showed very low sensitivity. The highest sensitivity values were found for the MT parts that act as prime movers of gait (Soleus: average OSI=5.27%, Rectus Femoris: average OSI=4.47%, Gastrocnemius: average OSI=3.77%, Vastus Lateralis: average OSI=1.36%, Biceps Femoris Caput Longum: average OSI=1.06%) and hip stabilizers (Gluteus Medius: average OSI=3.10%, Obturator Internus: average OSI=1.96%, Gluteus Minimus: average OSI=1.40%, Piriformis: average OSI=0.98%), followed by the Peroneal muscles (average OSI=2.20%) and Tibialis Anterior (average OSI=1.78%) some of which were not included in previous sensitivity studies. Finally, the proposed priority list provides quantitative information to indicate which MT parts and which MT parameters should be estimated most accurately to create detailed and reliable subject-specific MS models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Primary fixation of mini slings: a comparative biomechanical study in vivo

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    Paulo Palma

    2012-04-01

    Full Text Available INTRODUCTION AND OBJECTIVES: The mini sling concept for stress urinary incontinence is an anatomical approach that involves placing a midurethral low-tension tape anchored to the obturator internus muscles bilaterally. They overcome the blind passage of long needles and all the related complications. There are many different devices available and because these are outpatient procedures, primary fixation plays an important role in the outcome. The objective is to evaluate the primary fixation of the various devices of attachment of the commercially available mini-slings through biomechanical tests. MATERIALS AND METHODS: A total of 45 Wistar rats were divided in 3 groups of 15 rats each. They underwent 5 subcutaneous implantation of different mini slings and one polipropilene mesh (control, as follows: TVT-Secur® (Gynecare, USA, Type 1 polypropylene mesh (control; Ophira Mini Sling System® (Promedon, Argentina, Tissue Fixation System® (TFS PTY, Australia, Zipper Sling® and "T device" (Prosurg, USA. The abdominal wall was removed on bloc at different times after implant for biomechanical evaluation, which consisted in application of unidirectional force to the extremity of the fixation system or mesh, until it was completely removed from the tissue using a tension meter (Nexygen 3.0 Universal Testing Machine - LLOYD Instruments. The force was measured in Newtons (N. RESULTS: There was significant difference in the resistance to extraction among the different fixation systems. At 7 days the Ophira Mini Sling System® presented the best fixation and "T dispositive" the worst. CONCLUSION: Ophira mini sling System® presented the best primary fixation at 7º, 14º and 30º days. The impact of this feature in the clinical setting needs to be verified.

  20. The head and neck anatomy of sea turtles (Cryptodira: Chelonioidea) and skull shape in Testudines.

    Science.gov (United States)

    Jones, Marc E H; Werneburg, Ingmar; Curtis, Neil; Penrose, Rod; O'Higgins, Paul; Fagan, Michael J; Evans, Susan E

    2012-01-01

    Sea turtles (Chelonoidea) are a charismatic group of marine reptiles that occupy a range of important ecological roles. However, the diversity and evolution of their feeding anatomy remain incompletely known. Using computed tomography and classical comparative anatomy we describe the cranial anatomy in two sea turtles, the loggerhead (Caretta caretta) and Kemp's ridley (Lepidochelys kempii), for a better understanding of sea turtle functional anatomy and morphological variation. In both taxa the temporal region of the skull is enclosed by bone and the jaw joint structure and muscle arrangement indicate that palinal jaw movement is possible. The tongue is relatively small, and the hyoid apparatus is not as conspicuous as in some freshwater aquatic turtles. We find several similarities between the muscles of C. caretta and L. kempii, but comparison with other turtles suggests only one of these characters may be derived: connection of the m. adductor mandibulae internus into the Pars intramandibularis via the Zwischensehne. The large fleshy origin of the m. adductor mandibulae externus Pars superficialis from the jugal seems to be a characteristic feature of sea turtles. In C. caretta and L. kempii the ability to suction feed does not seem to be as well developed as that found in some freshwater aquatic turtles. Instead both have skulls suited to forceful biting. This is consistent with the observation that both taxa tend to feed on relatively slow moving but sometimes armoured prey. The broad fleshy origin of the m. adductor mandibulae externus Pars superficialis may be linked to thecheek region being almost fully enclosed in bone but the relationship is complex.

  1. The common iliac artery in the ground squirrel (Citellus citellus

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    Blagojević M.

    2013-01-01

    Full Text Available The common iliac arteries (a. iliaca communis dextra et a. iliaca communis sinistra are the terminal branches of the abdominal aorta. The paired external iliac artery (a. iliaca externa dextra et a. iliaca externa sinistra is a stronger branch of the paired common iliac artery. Before they leave the abdominal cavity and continue as the femoral arteries (a. femoralis dextra et a. femoralis sinistra each external iliac artery forms the following branches: 1. The internal pudendal artery (a. pudenda interna which, with its branches, supplies the tensor fasciae latae and quadriceps muscles (a. circumflexa femoris lateralis, cranial region of the urinary bladder, cranial end of the uterine horn in females, the deferent duct and tail of the epididymis in males (a. umbilicalis the rectum, the external anal sphincter and perineum (a. rectalis caudalis with blood. 2. The obturator artery (a. obturatoria, which supplies both of the obturator muscles, as well as the proximal end of the adductor muscle. 3. The pudendoepigastric trunk (truncus pudendoepigastricus is a short vessel, which with its branches (a. pudenda externa, a. epigastrica caudalis et a. urethrogenitalis supplies the caudal end of the rectus abdominis muscle, tip of the penis, preputium, superficial inguinal lymph nodes, scrotum in males and inguinal mamma in females, transversus and internus abdominis muscles, neck of the urinary bladder, urethra, vagina and vulva in females and accessory glands in males. 4. Paired internal iliac arteries (a. iliaca interna dextra et a. iliaca interna sinistra are thinner branches than the external iliac arteries. The internal iliac artery with its branches supplies the cranial and caudal parts of the gluteal muscles (a. glutea cranialis et a. glutea caudalis, as well as the muscles of the lateral side of the tail (a. caudalis lateralis. [Projekat Ministarstva nauke Republike Srbije, br. 143018

  2. Coherence of neuronal firing of the entopeduncular nucleus with motor cortex oscillatory activity in the 6-OHDA rat model of Parkinson's disease with levodopa-induced dyskinesias.

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    Jin, Xingxing; Schwabe, Kerstin; Krauss, Joachim K; Alam, Mesbah

    2016-04-01

    The pathophysiological mechanisms leading to dyskinesias in Parkinson's disease (PD) after long-term treatment with levodopa remain unclear. This study investigates the neuronal firing characteristics of the entopeduncular nucleus (EPN), the rat equivalent of the human globus pallidus internus and output nucleus of the basal ganglia, and its coherence with the motor cortex (MCx) field potentials in the unilateral 6-OHDA rat model of PD with and without levodopa-induced dyskinesias (LID). 6-hydroxydopamine-lesioned hemiparkinsonian (HP) rats, 6-OHDA-lesioned HP rats with LID (HP-LID) rats, and naïve controls were used for recording of single-unit activity under urethane (1.4 g/kg, i.p) anesthesia in the EPN "on" and "off" levodopa. Over the MCx, the electrocorticogram output was recorded. Analysis of single-unit activity in the EPN showed enhanced firing rates, burst activity, and irregularity compared to naïve controls, which did not differ between drug-naïve HP and HP-LID rats. Analysis of EPN spike coherence and phase-locked ratio with MCx field potentials showed a shift of low (12-19 Hz) and high (19-30 Hz) beta oscillatory activity between HP and HP-LID groups. EPN theta phase-locked ratio was only enhanced in HP-LID compared to HP rats. Overall, levodopa injection had no stronger effect in HP-LID rats than in HP rats. Altered coherence and changes in the phase lock ratio of spike and local field potentials in the beta range may play a role for the development of LID.

  3. FISIKA MEDIK PROSES PENDENGARAN

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    Lili Irawati

    2012-09-01

    task to detect and interpret the sound.The main function of the external ear is collecting and connecting sound toward the meatus acusticus externa. Middle ear consist three bones (ossicle that will amplify pressure of 20 times than sound wave to yield fluid vibrationin the cochlear. In internal ear there are cochlear, basillary membrane establish cochlear duct base. The basillary membrane is most important because in it internal portion there are corti organs which is hearing sense organ. The corti organ, located on basillary membrane in entire its length, contain hair cells which is the soundTINJAUAN PUSTAKA156receptors. The hair cells yield nerve signal if surface hair undergo mechanically transformation result from fluid movement in internal ear. The high resonance frequency from basillary membrane take place near the base, sound wave site enter cochlear via oval window and low resonance frequency take place near the apex. The inner hair cells change mechanical sound style (the cochlear fluid vibration become electrical impulse of hearing (potential act delivering hearing messenger to cerebral cortex.Key word : hearing process

  4. Indirect veneer treatment of anterior maxillary teeth with enamel hypoplasia

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    Devi Eka Juniarti

    2010-09-01

    , malformasi, dapat mempengaruhi penampilan penderita terutama saat tersenyum. Kelainan gigi tersebut pada akhirnya dapat memperburuk penampilan penderita. Malformasi gigi dapat disebabkan oleh kelainan pada masa perkembangan gigi, misalnya hipoplasia enamel. Hipoplasia enamel adalah kelainan perkembangan yang disebabkan sedikitnya matriks enamel sehingga terjadi ketipisan dan porusnya enamel. Hipoplasia enamel dapat disebabkan gangguan kalsifikasi matriks saat pembentukan dan perkembangan matriks enamel, kerusakan dan perubahan permanen ini dapat melibatkan satu atau beberapa gigi. Tujuan: Tujuan perawatan ini memperbaiki diskolorasi dan tekstur permukaan gigi depan rahang atas akibat hipoplasia enamel menggunakan veneer indirek berbahan porselen. Kasus: Seorang penderita wanita 20 tahun dengan hipoplasia enamel datang ke Rumah Sakit Gigi dan Mulut Pendidikan Fakultas Kedokteran Gigi Universitas Airlangga. Penderita ingin memperbaiki gigi depan rahang atas yang secara klinis tampak bercak putih opak seperti kapur dan porus pada permukan labial gigi. Tatalaksana kasus: Veneer indirek dengan bahan porselen dipilih sebagai restorasi oleh karena segi estetik, kekuatan dan tidak mengiritasi ginggiva. Restorasi ini dapat meningkatkan kepercayaan diri penderita dan memperbaiki fungsi gigi. Kesimpulan: Veneer indirek merupakan perawatan yang efektif, dapat meningkatkan penampilan dan kepercayan diri penderita.

  5. Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease.

    Science.gov (United States)

    Liu, Yi; Li, Weina; Tan, Changhong; Liu, Xi; Wang, Xin; Gui, Yuejiang; Qin, Lu; Deng, Fen; Hu, Changlin; Chen, Lifen

    2014-09-01

    Deep brain stimulation (DBS) is the surgical procedure of choice for patients with advanced Parkinson disease (PD). The globus pallidus internus (GPi) and the subthalamic nucleus (STN) are commonly targeted by this procedure. The purpose of this meta-analysis was to compare the efficacy of DBS in each region. MEDLINE/PubMed, EMBASE, Web of Knowledge, and the Cochrane Library were searched for English-language studies published before April 2013. of studies investigating the efficacy and clinical outcomes of DBS of the GPi and STN for PD were analyzed. Six eligible trials containing a total of 563 patients were included in the analysis. Deep brain stimulation of the GPi or STN equally improved motor function, measured by the Unified Parkinson's Disease Rating Scale Section III (UPDRSIII) (motor section, for patients in on- and off-medication phases), within 1 year postsurgery. The change score for the on-medication phase was 0.68 (95% CI - 2.12 to 3.47, p > 0.05; 5 studies, 518 patients) and for the off-medication phase was 1.83 (95% CI - 3.12 to 6.77, p > 0.05; 5 studies, 518 patients). The UPDRS Section II (activities of daily living) scores for patients on medication improved equally in both DBS groups (p = 0.97). STN DBS allowed medication dosages to be reduced more than GPi DBS (95% CI 129.27-316.64, p < 0.00001; 5 studies, 540 patients). Psychiatric symptoms, measured by Beck Depression Inventory, 2nd edition scores, showed greater improvement from baseline after GPi DBS than after STN DBS (standardized mean difference -2.28, 95% CI -3.73 to -0.84, p = 0.002; 3 studies, 382 patients). GPi and STN DBS improve motor function and activities of daily living for PD patients. Differences in therapeutic efficacy for PD were not observed between the 2 procedures. STN DBS allowed greater reduction in medication for patients, whereas GPi DBS provided greater relief from psychiatric symptoms. An understanding of other symptomatic aspects of targeting each region and long

  6. Feedforward responses of transversus abdominis are directionally specific and act asymmetrically: implications for core stability theories.

    Science.gov (United States)

    Allison, Garry T; Morris, Sue L; Lay, Brendan

    2008-05-01

    Experimental laboratory study supplemented with a repeated case study. To examine bilateral muscle activity of the deep abdominals in response to rapid arm raising, specifically to examine the laterality and directional specificity of feedforward responses of the transversus abdominis (TrA). Based on the feedforward responses of trunk muscles during rapid arm movements, authors have concluded that the deep trunk muscles have different control mechanisms compared to the more superficial muscles. It has been proposed that deep trunk muscles such as TrA contribute substantially to the stability of the lumbar spine and that this is achieved through simultaneous bilateral feedforward activation. These inferences are based on unilateral fine-wire electromyographic (EMG) data and there are limited investigations of bilateral responses of the TrA during unilateral arm raising. Bilateral fine-wire and surface EMG data from the anterior deltoid, TrA, obliquus internus (OI), obliquus externus, biceps femoris, erector spinae, and rectus abdominis during repeated arm raises were recorded at 2 kHz. EMG signal linear envelopes were synchronized to the onset of the anterior deltoid. A feedforward window was defined as the period up to 50 ms after the onset of the anterior deltoid, and paired onsets for bilateral muscles were plotted for both left and right arm movements. Trunk muscles from the group data demonstrated differences between sides (laterality), which were systematically altered when alternate arms were raised (directional specificity). This was clearly evident for the TrA but less obvious for the erector spinae. The ipsilateral biceps femoris and obliquus externus, and contralateral OI and TrA, were activated earlier than the alternate side for both right and left arm movements. This was a consistent pattern over a 7-year period for the case study. Data for the rectus abdominis derived from the case study demonstrated little laterality or directionally specific

  7. Deep brain stimulation for the treatment of childhood dystonic cerebral palsy.

    Science.gov (United States)

    Keen, Joseph R; Przekop, Allison; Olaya, Joffre E; Zouros, Alexander; Hsu, Frank P K

    2014-12-01

    Deep brain stimulation (DBS) for dystonic cerebral palsy (CP) has rarely been reported, and its efficacy, though modest when compared with that for primary dystonia, remains unclear, especially in the pediatric population. The authors present a small series of children with dystonic CP who underwent bilateral pallidal DBS, to evaluate the treatment's efficacy and safety in the pediatric dystonic CP population. The authors conducted a retrospective review of patients (under the age of 18 years) with dystonic CP who had undergone DBS of the bilateral globus pallidus internus between 2010 and 2012. Two of the authors independently assessed outcomes using the Barry-Albright Dystonia Scale (BADS) and the Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFMDRS-M). Five children were diagnosed with dystonic CP due to insults occurring before the age of 1 year. Mean age at surgery was 11 years (range 8-17 years), and the mean follow-up was 26.6 months (range 2-42 months). The mean target position was 20.6 mm lateral to the midcommissural point. The mean preoperative and postoperative BADS scores were 23.8 ± 4.9 (range 18.5-29.0) and 20.0 ± 5.5 (range 14.5-28.0), respectively, with a mean overall percent improvement of 16.0% (p = 0.14). The mean preoperative and postoperative BFMDRS-M scores were 73.3 ± 26.6 (range 38.5-102.0) and 52.4 ± 21.5 (range 34.0-80.0), respectively, with a mean overall percent improvement of 28.5% (p = 0.10). Those stimulated at least 23 months (4 patients) improved 18.3% (p = 0.14) on the BADS and 30.5% (p = 0.07) on the BFMDRS-M. The percentage improvement per body region yielded conflicting results between rating scales; however, BFMDRS-M scores for speech showed some of the greatest improvements. Two patients required hardware removal (1 complete system, 1 unilateral electrode) within 4 months after implantation because of infections that resolved with antibiotics. All postoperative dystonia rating scale scores improved with pallidal

  8. Phylogenetic patterns and correlation of key structures for jumping: bone crests and cross-sectional areas of muscles in Leptodactylus (Anura, Leptodactylidae).

    Science.gov (United States)

    Ponssa, María Laura; Fratani, Jéssica; Abdala, Virginia

    2018-05-01

    Anurans are characterized by their saltatory mode of locomotion, which is associated with a specific morphology. The coordinated action of the muscles and bones of the pelvic girdle is key to the transmission of the force of the hindlimbs to the axial skeleton during jumping. Two features are critical for optimal locomotory performance: the cross-sectional area of muscle and the bone crest attachment sites. The first character is a proxy of the force exerted by the muscle, whereas the crests are muscle attachments sites related to muscle force. The provisory relationship between these features has previously been identified and bone crest size can be used to infer the magnitude and, therefore, muscle force in fossils records. In this work, we explore the correlation between the cross-sectional area of essential muscles to the jumping mechanism (longissimus dorsi, extensor iliotibialis B, tenuissimus, puboischiofemoralis internus B, coccygeo-sacralis and coccygeo-iliacus) and the bone crests where these muscles are inserted (dorsal tubercle, dorsal crest and urostylar crest) in species of the genus Leptodactylus. This genus, along with other leptodactylids, exhibits a diversity of locomotor modes, including jumping, hopping, swimming and burrowing. We therefore analyzed the morphometric variation in the two features, cross-sectional area and bone crest area, expecting a correlation with different locomotor types. Our results showed: (i) a correlation between the urostylar crest and the cross-sectional area of the related muscles; (ii) that the bone crest surface area of urostyle and ilium and the cross-sectional area of the corresponding muscles can be utilized to infer locomotor faculties in leptodactylid frogs; and (iii) that the evolution of both characters demonstrates a general tendency from lower values in leptodactylid ancestors to higher values in the Leptodactylus genus. The results attest to the importance of the comparison of current ecological and

  9. A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference.

    Science.gov (United States)

    Halliday, Mark H; Pappas, Evangelos; Hancock, Mark J; Clare, Helen A; Pinto, Rafael Z; Robertson, Gavin; Ferreira, Paulo H

    2016-07-01

    Study Design Randomized clinical trial. Background Motor control exercises are believed to improve coordination of the trunk muscles. It is unclear whether increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie method. Furthermore, it is unclear which approach may have superior clinical outcomes. Objectives The primary aim was to compare the effects of the McKenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference. The secondary aim was to conduct a between-group comparison of outcomes for pain, function, and global perceived effect. Methods Seventy people with chronic low back pain who demonstrated a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie method or with motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors. Results No significant between-group difference was found for trunk muscle thickness of the transversus abdominis (-5.8%; 95% confidence interval [CI]: -15.2%, 3.7%), obliquus internus (-0.7%; 95% CI: -6.6%, 5.2%), and obliquus externus (1.2%; 95% CI: -4.3%, 6.8%). Perceived recovery was slightly superior in the McKenzie group (-0.8; 95% CI: -1.5, -0.1) on a -5 to +5 scale. No significant between-group differences were found for pain or function (P = .99 and P = .26, respectively). Conclusion We found no significant effect of treatment group for trunk muscle thickness. Participants reported a slightly greater sense of perceived recovery with the McKenzie method than with the motor control approach. Level of Evidence Therapy, level 1b-. Registered September 7, 2011 at www.anzctr.org.au (ACTRN12611000971932). J Orthop Sports Phys Ther 2016;46(7):514-522. Epub 12 May 2016. doi:10.2519/jospt.2016.6379.

  10. Neuropsychological performance changes following subthalamic versus pallidal deep brain stimulation in Parkinson's disease: a systematic review and metaanalysis.

    Science.gov (United States)

    Elgebaly, Ahmed; Elfil, Mohamed; Attia, Attia; Magdy, Mayar; Negida, Ahmed

    2018-02-01

    Studies comparing subthalamus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for the management of Parkinson's disease in terms of neuropsychological performance are scarce and heterogeneous. Therefore, we performed a systematic review and metaanalysis to compare neuropsychological outcomes following STN DBS versus GPi DBS. A computer literature search of PubMed, the Web of Science, and Cochrane Central was conducted. Records were screened for eligible studies, and data were extracted and synthesized using Review Manager (v. 5.3 for Windows). Seven studies were included in the qualitative synthesis. Of them, four randomized controlled trials (n=345 patients) were pooled in the metaanalysis models. The standardized mean difference (SMD) of change in the Stroop color-naming test favored the GPi DBS group (SMD=-0.31, p=0.009). However, other neuropsychological outcomes did not favor either of the two groups (Stroop word-reading: SMD=-0.21, p=0.08; the Wechsler Adult Intelligence Scale (WAIS) digits forward: SMD=0.08, p=0.47; Trail Making Test Part A: SMD=-0.05, p=0.65; WAIS-R digit symbol: SMD=-0.16, p=0.29; Trail Making Test Part B: SMD=-0.14, p=0.23; Stroop color-word interference: SMD=-0.16, p=0.18; phonemic verbal fluency: bilateral DBS SMD=-0.04, p=0.73, and unilateral DBS SMD=-0.05, p=0.83; semantic verbal fluency: bilateral DBS SMD=-0.09, p=0.37, and unilateral DBS SMD=-0.29, p=0.22; Boston Naming Test: SMD=-0.11, p=0.33; Beck Depression Inventory: bilateral DBS SMD=0.15, p=0.31, and unilateral DBS SMD=0.36, p=0.11). There was no statistically significant difference in most of the neuropsychological outcomes. The present evidence does not favor any of the targets in terms of neuropsychological performance.

  11. MR image analysis of cranial nerve involvement in nasopharyngeal carcinoma%鼻咽癌脑神经受累的MR影像分析

    Institute of Scientific and Technical Information of China (English)

    戴刚毅; 王仁生; 覃玉桃; 马姗姗; 肖帅; 黄国军; 孙丕云

    2011-01-01

    目的:探讨鼻咽癌MR脑神经受累的常见部位和诊断标准.方法:回顾性分析23例有脑神经症状的初治鼻咽癌脑神经受累的MR 表现和部位.结果:20例海绵窦受累(双侧受累13例),Meckel腔受累8例(双侧受累1例),14例圆孔扩大,20例卵圆孔扩大,10例翼腭窝脂肪间隙消失,12例翼内肌和翼外肌之间脂肪间歇受累,6例眶上裂增宽,11例眶下裂增宽,8例舌下神经孔肿块占位,1例颈静脉孔肿块占位.结论:MR可显示鼻咽癌脑神经受累,有助于准确分期、精确勾画靶区.%OBJECTIVE:To evaluate MR of nasopharyngeal carcinoma common site of cranial nerve involvement and diagnostic criteria. METHODS: Retrospective analysis the MR performance and position of cranial nerve involvement in 23 cases with cranial nerve symptoms who were first diagnosed as nasopharyngeal carcinoma was performed. RESULTS: Totally 20 patients with cavernous sinus invasion (13 cases with bilateral invasion), Meckel cavity invasion in 8 cases(1 case with bilateral invasion), foramen rotundum expansion in 14 cases and foramen ovale expansion in 20 cases, 10 cases of disappearance of fat space pterygopalatine fossa, 12 cases of involvement of fat space between musculi pterygoideus internus and musculi pterygoideus, 6 cases of fissurae orbitalis superior widened, 11 cases of fissurae orbitalis inferior widened, 8 cases of mass occupying the hypoglossal nerve, one case of jugular foramen mass occupying. CONCLUSION: MR can show nasopharyngeal cranial nerve involvement, and help us accurate staging and precise outline target.

  12. The Use of Three Dimensional Printed Interactive Models and a Digital Anatomy Case Study to Improve Medical Student Understanding of Pelvic and Perineal Anatomy

    Science.gov (United States)

    Solis, Laura de Jesus

    The anatomy of the pelvis and perineum is especially complex for novice students. In the Language of Medicine Module (Gross Anatomy and Embryology), medical students are expected to learn a high volume of material in a short time. The study of these regions is especially challenging due to the limited visibility of structures and difficulty of dissection. Understanding of the spatial relationships of the pelvic and perineal structures is important to acquire the foundational knowledge for future clinical application. Traditional methods such as dissection, prosected specimens, peer teaching, and radiological images are used at UT Health San Antonio to teach these regions. Emerging three dimensional technologies applied in computer based models and printed physical models serve as alternative ways to teach Anatomy. This study examines the effectiveness of adding two active learning methods that use these technologies to teach the anatomy of the pelvis and perineum in the Language of Medicine module, as assessed by exam performance and a satisfaction survey. The learning methods included female pelvic and perineal printed models with simulated anatomical contents made with arts and crafts material, and a digital anatomy case study using BodyVizRTM. In 2016, 220 medical students in four groups (A-D) rotated between demonstrations on prosected cadavers and interactive sessions with each 3D learning tool. Student exam performance was assessed as the percentage of points obtained on select written and practical exam questions relevant to the anatomy of the pelvis and perineum. Across four years, practical exam performance for all relevant pelvic and perineal tags (structures tagged with a string or pin) shows a consistent decline of averages from 2013 (83%) to 2015 (75.7%). This decline was slightly reversed in 2016 (76.6%) following the integration of the 3D learning tools. The analysis of the obturator internus muscle tag, a tag included in the practical exams across

  13. Image Quality Assessment of 2D versus 3D T2WI and Evaluation of Ultra-high b-Value (b=2,000 mm/s2) DWI for Response Assessment in Rectal Cancer.

    Science.gov (United States)

    Hausmann, Daniel; Liu, Jing; Budjan, Johannes; Reichert, Miriam; Ong, Melissa; Meyer, Mathias; Smakic, Arman; Grimm, Robert; Strecker, Ralph; Schoenberg, Stefan O; Wang, Xiaoying; Attenberger, Ulrike I

    2018-02-01

    The purpose of this IRB-approved, retrospective study was to compare image quality between 2D and high-resolution 3D, T2-weighted (T2WI) magnetic resonance imaging (MRI) sequences and to investigate the additional value of ultra-high b-value diffusion-weighted imaging (DWI; b=2,000 mm/s 2 ) for both rectal cancer staging and evaluating treatment response. From 12 February to 24 August 2016, 26 consecutive patients (22 males, four females; mean age: 61.9±14.0 years) with histologically-proven rectal cancer. In total 31 examinations [12 prior to and 19 after chemoradiation (CRT)] were included. The patients underwent pelvic MRI on a 3.0-T scanner (Magnetom Skyra, Erlangen, Germany). Three radiologists (3, 4, and 5 years of experience in MRI, respectively) independently assessed all images and rated the image quality of DWI (b=800 mm/s 2 ), apparent diffusion coefficient map, DWI (b=2,000 mm/s 2 ), 3D sagittal T2WI, 3D axial T2WI, 2D sagittal T2WI, and 2D axial T2WI of each patient, respectively. In addition, signal intensity ratios (SIR) were calculated between rectal cancer and obturator internus muscle (background) in all patients after CRT on DWI (b=2,000 mm/s 2 ) and correlated with histopathological regression grade (RG). Tumor delineation was significantly better by 2D T2WI than 3D T2WI both before and after CRT (before CRT: Z=-3.2, p=0.02; after CRT: Z=-4.408, p3D sagittal: 4.00±0.48; 2D sagittal: 4.03±0.34, p=0.713; 3D axial: 3.85±0.61, 2D axial: 3.78±0.64, p=0.537). Independent t-test showed significantly higher SIR between those with RG 1 or 2 (moderate response: mean score=2.02) and those with RG 3+4 (good response: mean score=0.8) (t=3.044, p=0.011). In those with RG 4 (complete response), SIR of b2000 was 0.946 compared to a 1.41 average of the whole cohort. In two patients, tumor was invisible on b2000 following CRT (RG 3 and 4, respectively). Interobserver agreement was mostly good (κ≥0.6) regarding image quality assessment, except for poor

  14. Bilateral pallidotomy for generalized dystonia Palidotomia bilateral para distonias generalizadas

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-06-01

    Full Text Available OBJECTIVE: To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia. BACKGROUND: Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure. METHODS: Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM. Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively. RESULTS: The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58% was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure. CONCLUSIONS: Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure.As distonias generalizadas são freqüentemente um desafio terapêutico, com pobres respostas aos tratamentos farmacológicos. As cirurgias estereotáxicas, como a palidotomia, têm sido utilizadas com êxito no tratamento da doença de Parkinson e estudos

  15. The Effectiveness of four Motor Games for the Abdominal Conditioning Eficacia de cuatro juegos motores para el acondicionamiento de los músculos del abdomen

    Directory of Open Access Journals (Sweden)

    B. Flores

    2010-09-01

    Full Text Available

    The purpose of this study was to determine the effectiveness of four traditional motor games (“the tunnel”, “the chicken battle”, “the drunk” and “the wheelbarrow race” for strengthening the abdominal muscles. Electromyography (EMG was collected from rectus abdominis (RA, external oblique (EO, and internal oblique (IO from twelve healthy volunteers during the performance of the games and the trunk curl-up exercise. The EMG amplitude was averaged and normalized using maximal voluntary isometric contractions. A two-way ANOVA (muscle / task was used to compare the level of contraction activity and the way the abdominal muscles co-activated during the different tasks. For EO and IO, the EMG amplitudes during the games were equal or greater than the EMG amplitudes of the curl up. The wheelbarrow race produced the highest intensity of contraction for all muscles. The curl up principally activated RA and IO. On the other hand, the games activated the oblique muscles with higher intensity than RA. On the basis of these results, the motor games are effective for abdominal conditioning.
    KEY WORDS: motor games, exercises, training, abdominal muscles, electromyography.

     

    El objetivo de este estudio fue determinar la eficacia de cuatro juegos motores (“el túnel”, “la pelea de gallinas”, “el tentetieso” y “la carretilla” para el fortalecimiento de los músculos del abdomen. Para ello, se registró la electromiografía de los músculos rectus (RA, obliquus externus (OE y obliquus internus abdominis (OI de 12 voluntarios sanos durante la ejecución de los juegos y del ejercicio de encorvamiento del tronco. La amplitud electromiográfica fue promediada y normalizada respecto a la contracción voluntaria isométrica máxima. Posteriormente, se realizó un ANOVA de dos factores (músculo / tarea para comparar la intensidad de la activación muscular y