The increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood during vagal afferents stimulation or after angiotensin II infusion

International Nuclear Information System (INIS)

Goraca, A.; Orlowska-Majdak, M.; Traczyk, W.Z.

1996-01-01

It has previously been demonstrated that the cardiodepressant activity is present in the bovine hypothalamic extract and in the fluid incubating the posterior pituitary lobe i n situ . The present study was an attempt to reveal if the cardiodepressant factor and vasopressin were simultaneously released from the pituitary into blood. The samples of venous blood flowing from the sella turcica and, for comparison, from the posterior paw were collected in anesthetized rats. Blood from the sella turcica was collected with a fine cannula inserted into the internal maxillary vein. The concentration of vasopressin in blood plasma was determined by radioimmunoassay and cardiodepressant activity-using a biological test on a spontaneously discharged pacemaker tissue of the right auricle of the right heart atrium. Stimulation of the central ends of the cut vagus nerves or intra-arterial infusion of angiotensin II simultaneously caused an increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood. The cardiodepressant activity and vasopressin concentration was also enhanced to some degree in blood outflowing from the posterior paw. Present results indicate that both vasopressin and the cardiodepressant factor are released into blood from the posterior pituitary lobe. (author). 37 refs, 4 figs

The increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood during vagal afferents stimulation or after angiotensin II infusion

Energy Technology Data Exchange (ETDEWEB)

Goraca, A.; Orlowska-Majdak, M.; Traczyk, W.Z. [Akademia Medyczna, Lodz (Poland). Katedra Fizjologii

1996-12-31

It has previously been demonstrated that the cardiodepressant activity is present in the bovine hypothalamic extract and in the fluid incubating the posterior pituitary lobe {sup i}n situ{sup .} The present study was an attempt to reveal if the cardiodepressant factor and vasopressin were simultaneously released from the pituitary into blood. The samples of venous blood flowing from the sella turcica and, for comparison, from the posterior paw were collected in anesthetized rats. Blood from the sella turcica was collected with a fine cannula inserted into the internal maxillary vein. The concentration of vasopressin in blood plasma was determined by radioimmunoassay and cardiodepressant activity-using a biological test on a spontaneously discharged pacemaker tissue of the right auricle of the right heart atrium. Stimulation of the central ends of the cut vagus nerves or intra-arterial infusion of angiotensin II simultaneously caused an increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood. The cardiodepressant activity and vasopressin concentration was also enhanced to some degree in blood outflowing from the posterior paw. Present results indicate that both vasopressin and the cardiodepressant factor are released into blood from the posterior pituitary lobe. (author). 37 refs, 4 figs.

Empty Sella Syndrome

Science.gov (United States)

... Publications Definition Empty Sella Syndrome (ESS) is a disorder that involves the sella turcica , a bony structure at the base of the brain that surrounds and protects the pituitary gland. ESS is often discovered during radiological imaging tests ...

Reflections on imaging diagnosis of sella masses

International Nuclear Information System (INIS)

Hernandez Yero, Jose Arturo; Jorge Gonzalez, Raquel

2005-01-01

Some reflections were made on imaging diagnosis of sella masses, specifying some characteristics of the main sella masses and their appearance in magnetic resonance imaging. The purpose was to call the attention on this important issue on the basis that modern imaging advances offer very useful distinctive elements in the diagnosis of a group of masses located in the sella turcica region. The paper underlined details of signal intensity in pituitary adenomas, craniopharyngiomas, Rathkes pouch cysts, hypophyseal hyperplasia and the so-called empty sella syndrome, among other causes of anatomical changes in sella region. It was concluded that magnetic resonance imaging would be the ideal method for a better diagnosis of sella masses, but if this technique was not available, then contrast-enhanced tomography would be useful in under 2 mm views. The importance of a multidisciplinary team of clinicians, endocrinologists, imaging specialists, neurosurgeons and anatomy pathologists to reach more accurate diagnosis and better therapeutic results was stressed

Review of empty sella syndrome and its surgical management

African Journals Online (AJOL)

Wael Fouad

2011-08-19

Aug 19, 2011 ... Abstract Introduction: Empty sella syndrome (ESS) is a condition in which the sella turcica is par- ..... previous surgery, radiotherapy, or medical treatment for ... sella that appeared large and filled with CSF extending down-.

Sella size and jaw bases - Is there a correlation???

Directory of Open Access Journals (Sweden)

Neha

2016-01-01

Full Text Available Introduction: Sella turcica is an important cephalometric structure and attempts have been made in the past to correlate its dimensions to the malocclusion. However, no study has so far compared the size of sella to the jaw bases that determine the type of malocclusion. The present study was undertaken to find out any such correlation if it exists. Materials and Methods: Lateral cephalograms of 110 adults consisting of 40 Class I, 40 Class II, and 30 Class III patients were assessed for the measurement of sella length, width, height, and area. The maxillary length, mandibular ramus height, and body length were also measured. The sella dimensions were compared among three malocclusion types by one-way ANOVA. Pearson correlation was calculated between the jaw size and sella dimensions. Furthermore, the ratio of jaw base lengths and sella area were calculated. Results and Conclusion: Mean sella length, width and area were found to be greatest in Class III, followed by Class I and least in Class II though the results were not statistically significant. 3 out of 4 measured dimensions of sella, correlated significantly with mandibular ramus and body length each. However, only one dimension of sella showed significant correlation with maxilla. The mandibular ramus and body length show a nearly constant ratio to sella area (0.83–0.85, 0.64–0.65, respectively in all the three malocclusions. Thus, mandible has a definite and better correlation to the size of sella turcica.

Empty sella syndrome presenting as panhypopituitarism in a child

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Sharmin Jahan

2016-08-01

Full Text Available Empty Sella refers to the absence or relative absence of the pituitary gland on radiologic imaging of the Sella turcica. This is usually an incidental finding, and as few as 10% patients presents with Hypopituitarism. The authors report a 13.5-year-old boy who presei1ted with short stature and absence of signs of pubertal onset. Hormonal assay showed panhypopi­tuitarism. X-ray left wrist joint showed delayed bone age and finally MRl of the brain revealed empty Sella. Growth hormone replacement therapy was started to increase the height. The boy is now on regular follow up to monitor response to treatment.

[Primary hypothyroidism associated with empty sella turcica and hypopituitarism].

Science.gov (United States)

Milosević, Maja; Stojanović, Milos; Nesović, Milica

2005-01-01

Empty sella syndrome is a rather frequent neuroradiological finding in the general population and can be associated with hypopituitarism. Examinations reveal low pituitary hormone levels and lack of response to stimuli. Most patients suffer from central hypothyroidism as part of pituitary insufficiency. Primary hypothyroidism is a rare finding in these patients. We present 3 patients: one female and two male, suffering from complete hypopituitarism, as part of the empty sella syndrome diagnosed due to low concentrations of all pituitary hormones, elevated TSH and low thyroid hormones. TRH, LHRH, ACTH and ITT tests, as well as IGF1 have confirmed hypopituitarism and primary hypothyroidism. CT and NMR in all three patients showed empty sella without a tumor in it. The diagnosis of primary hypothyrodism in the first patient was made before hypopituitarism has taken place, or at the same time in the second patient, whereas in the third patient it was diagnosed twenty years later. In two patients anti-TPO and anti-Tg antibody levels were high, and in the third patient they were not elevated. It can be assumed that the etiology of primary hypothyrodism in all three patients was of autoimmune origin, which caused thyroid hypofunction. High level of TSH in all three patients and especially in the patient whose hypopituitarism was diagnosed twenty years later, showed presence of thyrotrophic cells in the pituitary. Evaluation of the hypothalamic-pituitary-thyroid axis was carried out during the complete substitution therapy of hypopituitarism. Diagnosing primary hypothyroidism associated with hypopituitarism helps improving the knowledge on empty sella syndrome and points to different clinical syndromes characterized by lack of mixoedema, although approach to therapy is the same for both primary and central hypothyroidism.

Magnetic resonance imaging finding of empty sella in obesity related idiopathic intracranial hypertension is associated with enlarged sella turcica

Energy Technology Data Exchange (ETDEWEB)

Ranganathan, Sudarshan; Lee, Sang H.; Checkver, Adam; Sklar, Evelyn; Danton, Gary H. [University of Miami, Department of Radiology, Miami, FL (United States); Lam, Byron L. [University of Miami, Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, FL (United States); Alperin, Noam [University of Miami, Department of Radiology, Miami, FL (United States); University of Miami Leonard M. Miller School of Medicine, Department of Radiology, Professional Arts Center, Miami, FL (United States)

2013-08-15

Empty sella in MRI is an important finding associated with idiopathic intracranial hypertension (IIH). This study assesses the sensitivity and reproducibility of several morphological measures of the sella and pituitary gland to identify the measure that best differentiates IIH from controls. Additionally, the study assesses reversal in gland compression following treatment. Sagittal 3D-T1W sequence with 1 mm isotropic resolution was obtained from ten newly diagnosed IIH patients and 11 matched healthy controls. Follow-up MRI scans were obtained from eight patients at 1-week post-lumbar puncture and acetazolamide treatment. 1D and 2D measures of absolute and normalized heights and cross-sectional areas of the gland and sella were obtained to identify the measure that best differentiates IIH patients and controls. Overall area-based measurements had higher sensitivity than length with p < 0.0001 for sella area compared with p = 0.004 for normalized gland height. The gland cross-sectional areas were similar in both cohorts (p = 0.557), while the sella area was significantly larger in IIH, 200 {+-} 24 versus 124 {+-} 25 mm{sup 2}, with the highest sensitivity and specificity, 100 % and 90.9 %, respectively. Absolute gland area was the most sensitive measure for assessing post treatment changes, with 100 % sensitivity and 50 % specificity. Average post-treatment gland area was 18 % larger (p = 0.016). Yet, all eight patients remained within the empty sella range based on a normalized gland area threshold of 0.41. Sellar area is larger in IIH, and it demonstrated highest sensitivity for differentiating IIH from control subjects, while absolute gland area was more sensitive for detecting post treatment changes. (orig.)

Primary hypothyroidism associated with empty sella turcica and hypopituitarism

OpenAIRE

Milošević Maja; Stojanović Miloš; Nešović Milica

2005-01-01

Introduction Empty sella syndrome is a rather frequent neuroradiological finding in the general population and can be associated with hypopituitarism. Examinations reveal low pituitary hormone levels and lack of response to stimuli. Most patients suffer from central hypothyroidism as part of pituitary insufficiency. Primary hypothyreoidism is a rare finding in these patients. Case report We present 3 patients: one female and two male, suffering from complete hypopituitarism, as part of the em...

Magnetic resonance imaging of sella turcica: evaluation of patients with galactorrhea, amenorrhea and hyperprolactinemia

International Nuclear Information System (INIS)

Santos, Alair Augusto Sarmet M.D. dos; Moreira, Denise Madeira; Andreiuolo, Pedro Angelo

1999-01-01

We have selected 135 cases of patients who have done magnetic resonance imaging of sella region, carried out from September, 1991 to August, 1996, who had galactorrhea (G), amenorrhea(A), and hyperprolactinemia (H), isolated or in association. The patients were divided in seven groups, according to the presence of these symptoms and signs. All examinations were made in a private clinic in the city of Rio de Janeiro, Brazil. Correlating these patients with the results of the magnetic resonance images, we found 57 micro adenomas, 31 normal examinations, 22 macro adenomas, 11 pituitary hyperplasias, 7 empty sella and 7 cases included in other aspects. The micro adenoma predominated in groups 1 (GAH), 2 (GH), 3 (HA) and 5 (H), that is, in all groups whose patients had hyperprolactinemia. In macro adenomas, a bright signal on T 1-weighted images indicates pituitary apoplexy with intratumoral hemorrhage. All in all, the magnetic resonance imaging is excellent method to be used in the evaluation of patients with changes in the hypothalamic-pituitary axis. (author)

Clinical characteristics of acromegalic patients with empty sella and their outcomes following transsphenoidal surgery.

Science.gov (United States)

Sasagawa, Yasuo; Hayashi, Yasuhiko; Tachibana, Osamu; Oishi, Masahiro; Fukui, Issei; Iizuka, Hideaki; Nakada, Mitsutoshi

2017-08-01

To analyze the clinical characteristics of acromegalic patients with empty sella (ES, herniation of the subarachnoid space within the sella turcica) and the impact of ES on transsphenoidal surgery in such patients. Seventy-eight patients, newly diagnosed with acromegaly who underwent transsphenoidal surgery were included. ES was defined as the pituitary gland and adenoma occupying less than 50% of the sella turcica on midsagittal magnetic resonance (MR) imaging. Twelve patients (15.4%), predominantly female (10 women, p = .047), had ES in preoperative MR imaging. ES patients had smaller mean tumor diameter (6.3 mm) than non-ES patients (11.2 mm, p = .001). In preoperative MR imaging, occult adenoma was found in three (25%) ES and three (4.5%) non-ES patients (p = .044). Intraoperative cerebrospinal fluid (CSF) leakage was more frequent in the ES patients than in the non-ES patients (58.3 vs. 25.8%, p = .024). This led to an increased rate of sellar floor reconstruction using abdominal fat and/or postoperative lumber drainage in the ES patients (ES: 41.7 vs. non-ES: 16.7%, p = .063). Endocrinological remission after surgery was more frequent in the non-ES patients (72.7%) than in the ES patients (58.3%) (p = .248). Co-existence of acromegaly with ES is not rare, and is associated with occult adenoma, intra/postoperative CSF leakage, and a worse endocrinological outcome after transsphenoidal surgery; although, the underlying mechanism remains unclear.

Drainage or Packing of the Sella? Transsphenoidal Surgery for Primary Pituitary Abscess: Report of Two Cases

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Soichi Oya

2009-01-01

Full Text Available The detailed surgical procedure of the transsphenoidal surgery for pituitary abscess has scarcely been described previously because it is a very rare clinical entity. The authors reported two cases of primary pituitary abscess. In case 1, the anterior wall of the sella turcica was reconstructed with the vomer bone after irrigating the abscess cavity, but the sella was not packed by fat for fear of the persistent infection by devascularized tissues. This led to the postoperative meningocele, the cerebrospinal fluid leak, and bacterial meningitis despite the successful abscess drainage. In case 2, tight sellar packing and reconstruction of the sellar wall were performed to avoid these postoperative complications, which resulted in complete drainage and uneventful postoperative course. Although accumulation of more cases is obviously needed to establish the definitive surgical technique in pituitary abscess surgery, our experience might suggest that packing of the sella is not impeditive for postoperative sufficient drainage.

Empty sella syndrome

International Nuclear Information System (INIS)

Park, Chang Yoon

1973-01-01

The enlarged sella was encountered ordinarily as intrasellar lesion such as pituitary tumor or secondary increased intracranial pressure without certain mechanism. 1951 Busch discovered from his extensive autopsy cases that defects or incomplete attachment of diaphragm sella brings sella enlargement either slightly or moderately enlarged sella with subarachnoid extension. Toennis et al in 1955 discussed enlarged sella due to via infundibular defects or loosely attached stalk area of diaphragm sella from secondary increased intracranial pressure. Du Boulay and others differentiate the entity of none tumor origin of sella enlargement either from raised intracranial pressure or parasella changes, Hence, 'empty sella' was loosely used terminology. We observed following three representative cases in various empty sella syndrome. Case 1: air extended into the sella by pneumoencephalogram. Case 2: chiasma recess herniated into the sella secondary to dilated third ventricle from right thalamic tumor extension. Case 3: enlarged sella firstly mimic intrasella tumor but found intrasella fluid of cerebro-spinal content of extended subarchnoid space into sella. Above changes readily observed by pneumoencephalogram and other means

The morphology of the sella turcica in velocardiofacial syndrome suggests involvement of a neural crest developmental field

DEFF Research Database (Denmark)

Mølsted, Kirsten; Boers, Maria; Kjaer, Inger

2010-01-01

. The deviations were mostly in the posterior part of the dorsum sellae. Individuals with VCFS had increased cranial base angles. The results of this study combined with the information in the literature on the main defects in VCFS (palatal abnormalities, cardiac anomalies, thymic hypoplasia or aplasia......, hypothyroidism, and posterior brain abnormality), suggest involvement of a specific developmental field....

Primary empty sella and GH deficiency: prevalence and clinical implications

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Maurizio Poggi

2012-01-01

Full Text Available Primary empty sella (PES is a particular anatomical condition characterized by the herniation of liquor within the sella turcica. The pathogenesis of this alteration, frequently observed in general population, is not yet completely understood. Recently reports demonstrated, in these patients, that hormonal pituitary dysfunctions, specially growth hormone (GH/insulin-like growth factor (IGF-I axis ones, could be relevant. The aim of this paper is to evaluate GH/IGF-I axis in a group of adult patients affected by PES and to verify its clinical relevance. We studied a population of 28 patients with a diagnosis of PES. In each patient we performed a basal study of thyroid, adrenal and gonadal - pituitary axis and a dynamic evaluation of GH/IGF-I after GH-releasing hormone (GHRH plus arginine stimulation test. To evaluate the clinical significance of GH/IGF-I axis dysfunction we performed a metabolic and bone status evaluation in every patients. We found the presence of GH deficit in 11 patients (39.2 %. The group that displayed a GH/IGF-I axis dysfunction showed an impairment in metabolic profile and bone densitometry. This study confirms the necessity to screen the pituitary function in patients affected by PES and above all GH/IGF-I axis. Moreover the presence of GH deficiency could be clinically significant.

Aspergillosis of the sphenoid sinus simulating a pituitary tumor

Energy Technology Data Exchange (ETDEWEB)

Larranaga, J.; Fandino, J.; Gomez-Bueno, J.; Botana, C.; Rodriguez, D.; Gonzalez-Carrero, J.

1989-09-01

Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimiced a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia. (orig.).

Diagnostic significance of roeitgenography in hyperprolactinemia

International Nuclear Information System (INIS)

Vejnberg, Eh.G.; Vepkhvadze, R.Ya.; Kapanadze, B.B.; Sabakhtarashvili, M.A.; Gorgoshidze, B.V.; Kvachadze, M.N.; Sepiashvili, A.O.

1984-01-01

Altogether 87 patients with hyperprolactinemia were examined by roentgenography of the skull with sella turcica, tomography of sella turcica, pneumopelvigraphy, roentgeno- and thermomammography. Prolactin-secreting hypophyseal macro-or microadenoma was found in 17 patients. A high informative value of roentgenoradiological examination of such patients was established which facilitates correct and early diagnosis as well as a choice of appropriate therapeutic tactics

Tumors in the region of the sella turcica; Tumoren der Sellaregion

Energy Technology Data Exchange (ETDEWEB)

Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostischeund Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2009-07-15

Tumors of the pituitary gland can lead to limitation of hypophysis function (hypophysis insufficiency) or hypersecretion of different hormones (acromegaly, Cushing's syndrome, prolactinoma, TSH-secreting adenoma). The optic chiasma lies in close proximity to the pituitary gland and can be compressed by tumors leading to visual disturbances (bilateral hemianopsia). Tumors can be separated into hormone secreting and hormone inactive tumors, as well as into microadenoma with a diameter <10 mm and macroadenomas >10 mm. A rare group of tumors of the hypophysis region are craniopharyngiomas, meningiomas, germinomas, gliomas, metastases and granulomotous inflammations, such as sarcoidosis and tuberculosis. (orig.) [German] Bei Tumoren der Hypophysenregion kann es zu einer Einschraenkung der Hypophysenfunktion (Hypophyseninsuffizienz) kommen, aber auch zu einem Hypersekretionssyndrom (Akromegalie, Cushing-Syndrom, Prolaktinom, TSH-sezernierendes Adenom). Unmittelbar ueber der Hypophysenregion liegt das Chiasma opticum, wodurch es bei Tumoren der Hypophysenregion zur Beeintraechtigung des Sehens kommen kann, meist als Verschlechterung des Sehfeldes beider Augen nach lateral (bitemporale Hemianopsie). Man unterscheidet hormonaktive und -inaktive Tumoren. Es werden Mikroadenome mit einem Durchmesser bis 10 mm und Makroadenome, die groesser als 10 mm sind, unterschieden. Eine seltenere Gruppe von Tumoren der Hypophysenregion sind die Kraniopharyngeome, Meningeome, Germinome, Gliome, Metastasen und granulomatoese Entzuendungen (Sarkoidose, Tuberkulose). (orig.)

Magnetic resonance imaging of sella turcica: evaluation of patients with galactorrhea, amenorrhea and hyperprolactinemia; Ressonancia magnetica da sela turca: avaliacao de pacientes com galactorreia, amenorreia e hiperprolactinemia

Energy Technology Data Exchange (ETDEWEB)

Santos, Alair Augusto Sarmet M.D. dos [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Dept. de Radiologia; Moreira, Denise Madeira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Andreiuolo, Pedro Angelo [Beneficencia Portuguesa de Niteroi, RJ (Brazil). Servico de Radiologia Santa Cruz Scan

1999-08-01

We have selected 135 cases of patients who have done magnetic resonance imaging of sella region, carried out from September, 1991 to August, 1996, who had galactorrhea (G), amenorrhea(A), and hyperprolactinemia (H), isolated or in association. The patients were divided in seven groups, according to the presence of these symptoms and signs. All examinations were made in a private clinic in the city of Rio de Janeiro, Brazil. Correlating these patients with the results of the magnetic resonance images, we found 57 micro adenomas, 31 normal examinations, 22 macro adenomas, 11 pituitary hyperplasias, 7 empty sella and 7 cases included in other aspects. The micro adenoma predominated in groups 1 (GAH), 2 (GH), 3 (HA) and 5 (H), that is, in all groups whose patients had hyperprolactinemia. In macro adenomas, a bright signal on T 1-weighted images indicates pituitary apoplexy with intratumoral hemorrhage. All in all, the magnetic resonance imaging is excellent method to be used in the evaluation of patients with changes in the hypothalamic-pituitary axis. (author)

Determinants of Virulence and In Vitro Development Colocalize on a Genetic Map of Setosphaeria turcica.

Science.gov (United States)

Mideros, Santiago X; Chung, Chia-Lin; Wiesner-Hanks, Tyr; Poland, Jesse A; Wu, Dongliang; Fialko, Ariel A; Turgeon, B Gillian; Nelson, Rebecca J

2018-02-01

Generating effective and stable strategies for resistance breeding requires an understanding of the genetics of host-pathogen interactions and the implications for pathogen dynamics and evolution. Setosphaeria turcica causes northern leaf blight (NLB), an important disease of maize for which major resistance genes have been deployed. Little is known about the evolutionary dynamics of avirulence (AVR) genes in S. turcica. To test the hypothesis that there is a genetic association between avirulence and in vitro development traits, we (i) created a genetic map of S. turcica, (ii) located candidate AVRHt1 and AVRHt2 regions, and (iii) identified genetic regions associated with several in vitro development traits. A cross was generated between a race 1 and a race 23N strain, and 221 progeny were isolated. Genotyping by sequencing was used to score 2,078 single-nucleotide polymorphism markers. A genetic map spanning 1,981 centimorgans was constructed, consisting of 21 linkage groups. Genetic mapping extended prior evidence for the location and identity of the AVRHt1 gene and identified a region of interest for AVRHt2. The genetic location of AVRHt2 colocalized with loci influencing radial growth and mycelial abundance. Our data suggest a trade-off between virulence on Ht1 and Ht2 and the pathogen's vegetative growth rate. In addition, in-depth analysis of the genotypic data suggests the presence of significant duplication in the genome of S. turcica.

Metastatic Mantle Cell Lymphoma to the Pituitary Gland: Case Report and Literature Review

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Arthur Wang

2016-01-01

Full Text Available We present an unusual case of a metastatic mantle cell lymphoma (MCL to the pituitary gland. The patient had a known history of MCL for which she previously received chemotherapy. She presented with new-onset diplopia and confusion, and reported a history of progressive vision blurriness associated with headache, nausea, and vomiting. MRI of the brain showed an enhancing lesion within the sella turcica involving the cavernous sinuses bilaterally, extending into Meckel's cave on the left, and abutting the optic nerves bilaterally. Following surgical excision, histopathology revealed the tumor to be a MCL. Metastatic pituitary tumors are rare and have been estimated to make up 1% of tumors discovered in the sellar region. The two most common secondary metastatic lesions to the sella are breast and lung carcinoma followed by prostate, renal cell, and gastrointestinal carcinoma. Metastatic lymphoma to the pituitary gland is especially rare and is estimated to constitute 0.5% of all metastatic tumors to the sella turcica. To our knowledge, this is the first reported case of MCL metastasizing to the pituitary gland.

Long-term maxillomandibular changes after maxillary distraction osteogenesis in growing children with cleft lip with or without palate.

Science.gov (United States)

Honda, Aya; Baba, Yoshiyuki; Ogawa, Takuya; Suzuki, Shoichi; Moriyama, Keiji

2013-03-01

Objective : To evaluate the long-term maxillomandibular changes after maxillary distraction osteogenesis in growing children having cleft lip with or without cleft palate. Patients : Eight Japanese patients with cleft lip with or without cleft palate aged 9.3 to 13.1 years. Measures : The maxillary and mandibular positions before (T0), immediately after (T1), and 1, 3, and 5 years after distraction osteogenesis (T2, T3, and T4, respectively) measured on cephalograms superimposed at the sella turcica with the Frankfort horizontal plane as the horizontal reference. The anterior nasal spine (x, y), pogonion (x), and menton (y) were used for linear measurements, and sella turcica-nasion-point A, sella turcica-nasion-point B, and point A-nasion-point B angles were used for angular measurements. Results : The mean horizontal maxillary advancement (anterior nasal spine [x]) was 12.3 mm during T0 to T1, but -2.7, -1.1, and -0.1 mm of the posttreatment changes were observed during T1 to T2, T2 to T3, and T3 to T4, respectively. Anterior nasal spine (y) shifted 2.3 mm downward during T0 to T1, and further downward changes were observed during T1 to T2 and T2 to T3 (P < .05). Pogonion (x) did not show distinct changes due to individual variance, but menton (y) shifted downward from T1 to T4. Sella turcica-nasion-point A significantly decreased during T1 to T2 and T2 to T3 but not during T3-T4. Point A-nasion-point B significantly decreased only during T2 to T3, and sella turcica-nasion-point B did not show any distinct change. Conclusions : There was no further maxillary advancement after distraction osteogenesis in the growing children with cleft lip with or without cleft palate. Therefore, long-term observation and management of occlusion in case of the mandibular growth pattern are important.

A study on secondary images in panoramic radiograph

International Nuclear Information System (INIS)

Cho, Dai Hee; Kim, Han Pyong

1984-01-01

This study was performed to observe the secondary images and to analyse the relationships between the primary and secondary images in panoramic radiograph. Using the Morita's Panex-EC panoramic x-ray machine and the human dry skull, the author analysed 17 radiographs which were selected from 65 radiographs of the dry skull that attached the radiopaque materials, and the attached regions of the radiopaque materials were the normal anatomical structures which were important and selected as a region for the evaluation of the secondary images effectively. The results were as follows; 1. The cervical vertebrae showed three images. The midline image was the most distorted and less clear, and bilateral images were slightly superimposed over the posterior border of the mandibular ramus. 2. In mandible, the secondary image of the posterior border of the ramus was superimposed on the opposite ramus region, and this image was elongated from the anterior border of the ramus to the lateral side of the posterior border of the ramus. The secondary image of the condyle was observed on the upper area of the coronoid process, the sigmoid notch and the condyle in opposite side. 3. In maxilla, the posterior region of the hard palate showed the secondary image on the lower part of the nasal cavity and the medial wall of the maxillary sinus. 4. The primary images of the occipital condyle and the mastoid process appeared on the same region, and only the secondary image of the occipital condyle was observed symmetrically on the opposite side with similar shape to the primary one. 5. In the cranial base, the anatomical structures of the midsagittal portions like a inferior border of the frontal sinus, sella turcica, inferior border of the sphenoid sinus and inferior border of the posterior part of the occipital bone showed the similar shape between the primary and secondary images symmetrically. 6. The petrous portion of the temporal bone showed the secondary image of the lateral side of

Contrast-enhanced MRI of intrasellar arachnoid cysts: relationship between the pituitary gland and cyst

International Nuclear Information System (INIS)

Nomura, M.; Kanazawa Univ. School of Medicine; Tachibana, O.; Hasegawa, M.; Kohda, Y.; Nakada, M.; Yamashima, T.; Yamashita, J.; Suzuki, M.

1996-01-01

We recently encountered two large intrasellar arachnoid cysts extending to the suprasellar region. The intensity of the cyst contents was identical to that of the cerebrospinal fluid on both T1- and T2-weighted MRI. On contrast-enhanced MRI, the pituitary gland was compressed posteroinferiorly and flattened in the sella turcica. In this report of rare intrasellar arachnoid cysts the discussion is focused on dislocation of the pituitary gland. (orig.)

Variability of the cranial and dental phenotype in Williams syndrome.

Science.gov (United States)

Axelsson, Stefan

2005-01-01

Williams syndrome (WS) is a rare congenital disorder involving the cardiovascular system, connective tissue, and the central nervous system, resulting in mild to moderate mental retardation, a specific cognitive profile, unique personality characteristics, distinctive facial features, and cardiovascular disease. The majority of individuals with a clinical diagnosis of WS have a contiguous gene deletion at chromosome 7 (7q11.23). Physical features include characteristic facial features with full prominent cheeks, wide mouth, long philtrum, small nose with depressed nasal bridge, heavy orbital ridges, medial eyebrow flare, dental abnormalities, hoarse voice, growth retardation, and cardiovascular abnormalities (most commonly supravalvular aortic stenosis and/or peripheral pulmonary artery stenosis). The cognitive profile is distinctive, consisting of strengths in auditory memory, language, and face-processing, but extreme weakness in visuospatial, numerical and problem-solving abilities. Neurological studies have identified a significantly decreased brain volume in adult individuals with WS with relatively normal development of the limbic, frontal and cerebellar structures. The aims were to analyse the neurocranium, the craniofacial region, and the dentition in a well defined Norwegian group of individuals with WS. In order to accomplish this, normative cephalometric standards for the neurocranium, including the cranial base and the sella turcica, were established for Norwegian males and females from 6 to 21 years of age, using lateral radiographic cephalograms from the Oslo University Craniofacial Growth Archive. The study material comprised radiographic lateral cephalograms, orthopantomograms and dental casts from 62 individuals with WS ranging from 4 to 44 years. The lateral cephalograms, orthopantomograms and dental casts were analysed using standard methods reported in the literature. Neurocranium: The results from the cephalometric analyses showed that the size

Empty sella syndrome secondary to intrasellar cyst in adolescence.

Science.gov (United States)

Raiti, S; Albrink, M J; Maclaren, N K; Chadduck, W M; Gabriele, O F; Chou, S M

1976-09-01

A 15-year-old boy had growth failure and failure of sexual development. The probable onset was at age 10. Endocrine studies showed hypopituitarism with deficiency of growth hormone and follicle-stimulating hormone, an abnormal response to metyrapone, and deficiency of thyroid function. Luteinizing hormone level was in the low-normal range. Posterior pituitary function was normal. Roentgenogram showed a large sella with some destruction of the posterior clinoids. Transsphenoidal exploration was carried out. The sella was empty except for a whitish membrane; no pituitary tissue was seen. The sella was packed with muscle. Recovery was uneventful, and the patient was given replacement therapy. On histologic examination,the cyst wall showed low pseudostratified cuboidal epithelium and occasional squamous metaplasia. Hemosiderin-filled phagocytes and acinar structures were also seen. The diagnosis was probable rupture of an intrasellar epithelial cyst, leading to empty sella syndrome.

Shift of the pituitary stalk in intrasellar pituitary adenomas

International Nuclear Information System (INIS)

Ito, Jusuke; Tokiguchi, Susumu; Nakamori, Akitoshi; Watanabe, Akira; Yokoyama, Motoharu.

1982-01-01

Fifty-one patients from a group of 344 patients undergoing the evaluation of intrasellar or parasellar tumors were diagnosed on CT as having an intrasellar pituitary adenoma. Axial transverse sections were performed at -10 0 to Reid's basal line, using 1.5-mm-thick slices and sagittal and coronal reformation. Of these 51 patients, 17 showed a shift of the pituitary stalk. The area where a tumor was thought to be located within the sella turcica on preoperative CT became defective on CT after transsphenoidal surgery in all cases. Histological verification was obtained in all cases. Also, the shift of the pituitary stalk was normalized or markedly improved after surgery in all cases. In functioning tumors, all cases except two showed an endocrinologically normal state or a marked improvement after transsphenoidal surgery. On the basis of the above-mentioned facts, it was concluded that the shift of the pituitary stalk in intrasellar pituitary adenomas indicated the evidence of a mass and its location in the sella turcica. However, a shift of the pituitary stalk was also observed under other conditions, such as empty sella and tuberculum sellae meningioma, and so it is not a pathognomonic finding in intrasellar pituitary adenomas. (author)

The primary empty sella in children and its significance

International Nuclear Information System (INIS)

Tokiguchi, Susumu; Tsuchiya, Toshiaki; Ito, Jusuke

1983-01-01

The primary empty sella has been thought to be rare in children; only a few children have been described in the literature. The majority of such cases have been associated with congenital anomalies, optic atrophies, or cerebrospinal fluid rhinorrheas. We now report four cases of the primary empty sella in children. Two of the patients(Case 1 and Case 3) were prepubescent and had primary generalized epilepsy, while Case 2 and Case 4 complained of attacks of vascular headache and peri-orbital pain respectively. None of them showed any clinical evidence of endocrine disturbance. Ophthalmological examination revealed no abnormalities. The association of the primary empty sella with such disorders as primary epilepsy, attacks of vascular headache, and peri-orbital pain were thought to be almost certainly coincidental; the possibility was suggested that the empty sella might be present in children as an anatomical variant or as an acquired process in a certain percentage of them. (author)

Hemorrhagic chondroid chordoma mimicking pituitary apoplexy

Energy Technology Data Exchange (ETDEWEB)

Lee, H.J.; Kalnin, A.J.; Holodny, A.I. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Schulder, M.; Grigorian, A. [Dept. of Neurosurgery, University Hospital, Newark, NJ (United States); Sharer, L.R. [Dept. of Pathology, University Hospital, Newark, NJ (United States)

1998-11-01

We describe a hemorrhagic chondroid chordoma involving the sella turcica with suprasellar extension. The CT and MRI appearances mimiked a hemorrhagic pituitary adenoma. Chondroid chordoma is a variant composed of elements of both chordoma and cartilaginous tissue. An uncommon bone neoplasm, located almost exclusively in the spheno-occipital region, it is usually not considered in the differential diagnosis of a tumor with acute hemorrhage in the sellar region. We discuss the clinical and radiological characteristics which may allow one to differentiate chondroid chordoma from other tumors of this area. (orig.) With 3 figs., 9 refs.

Sellar tumors; Tumoren der Sellaregion

Energy Technology Data Exchange (ETDEWEB)

Weber, M.A.; Essig, M. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Radiologie; Zoubaa, S. [GSF - Forschungszentrum fuer Gesundheit und Umwelt, Neuherberg, Muenchen (Germany). Abt. Neuropathologie; Politi, M.; Grunwald, I. [Universitaetsklinikum Saarland, Homburg (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie

2007-06-15

Because of the complex anatomy, examination of the sella turcica and hypophysis needs a dedicated MR sequence protocol. Not every sellar lesion is a pituitary adenoma. Thus, this review article summarizes the most frequently encountered intra-, supra-, and parasellar tumors and lesions. Differential diagnoses comprise besides adenoma among others craniopharyngioma, meningioma, glioma, germinoma, hamartoma, aneurysm, trigeminal schwannoma, pituitary carcinoma, chordoma, metastasis, infection, and empty sella. Characteristic imaging findings are presented and correlated to micro- and macro-pathology. (orig.)

Extension and origin of parasellar meningiomas. Evaluation on MRI

International Nuclear Information System (INIS)

Hara, Yoshie; Nakamura, Mitsugu; Asada, Masahiro; Tamaki, Norihiko

1997-01-01

We evaluated MRI of forty patients who had histologically confirmed meningiomas around the sella turcica. Coronal section of the spin-echo/fast spin-echo T 1 weighted imaging (with and without GD-DTPA enhancement) were mainly investigated. We precisely examined two points; the location of the bulk of tumor mass, the anatomical relationship between the tumor and the anterior clinoid process, superior orbital fissure, optic nerve, and the internal carotid artery (ICA). Based on MRI findings, we recognized five different tumor origins. Meningiomas originating lateral to the anterior clinoid process never extended medially into the cavernous sinus or the sella turcica, while tumors originating medial to the anterior clinoid process did not migrate laterally beyond the process. Tumors originating from the cavernous sinus tended to invade though the dura into the superior orbital fissure and involved the anterior clinoid process. Based upon the tumor origin and their extension investigated as revealed by MRI, we speculated that the anterior clinoid process and the tough dural folds attached to it (the anterior and posterior petroclinoid ligaments, and the interclinoid ligament) played important roles as barriers against the extension of meningiomas. These dural folds may be the unique part of the dura that most resists invasion of meningiomas from extracavernous regions. Meningiomas originated from the inferomedial surface of the anterior clinoid process may have been misdiagnosed as tuberculum sellae meningiomas; however, the close anatomical relation of the tumor origin and the distal carotid suggests their potential to directly invade the internal carotid artery. (K.H.)

description of the normal variants of the anatomical shapes of the ...

African Journals Online (AJOL)

Emmanuel Ameh

the types of floor of the sella turcica in relation to sex of the subjects studied, the difference in frequency of ..... and brain. The skull (Volume 1, Book 1). Mosby,. St. Louis. 1971; 359-405. 4. Jones RM ... Physics, biology and protection. Mosby, St.

Case Study

African Journals Online (AJOL)

IndexCopernicus Portal System

The medium- term evolution was marked by prolonged amenorrhea, fatigue and apathy. In the light of this clinical picture, Sheehan's syndrome was suspected and confirmed by a pituitary and cerebral MRI which showed an empty sella turcica (figure1). Hormone profiles including cortisol, plasma ACTH, thyroid hormones,.

Empty sella syndrome associated with hormone deficiency in adults

International Nuclear Information System (INIS)

Oleaga, L.; Paja, M.; Goni, F.; Grande, J.; Grande, D.; Merino, M.; Delgado, A.

1999-01-01

The objective of this study was to correlate the magnetic resonance (MR) images in patients with hormone deficiencies with the clinical data and the hormonal status. We studied 11 cases ef empty sella with different peripheral pituitary deficiencies. Hormone levels were determined according to standard laboratory methods. All the patients underwent MR imaging. The studies were carried out with a 1 Tesla superconducting magnet, using the cranial cavity for transmission and reception. Segittal and coronal T1-weighted spin-echo sequences (TR/TE: 600/15 ms), axial T2-weighted spin-echo sequences (TR/TE: 3,500/19/93 ms) and gadolinium-enhanced (=.2 cc/kg body weight) sagital and coronal T1-weighted spin-echo sequences (TR/TE: 600/15 ms) were employed. Six of the patients presented partial or total hypopituitarism associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH); there was one case of panhypopituitarism without SIADH and four cases of primary hypothyroidism, there of which were associated with pituitary deficiency, MR imaging revealed five cases of partially empty sella with residual pituitary gland on the sella floor and six cases in which the sella was completely empty. This study also identified six cases of normally situated neurohypophysis, another four in which the neurohypophysis could not be identified and one case of ectopic neurohypophysis. MR imaging is the technique of choice in the study of abnormal hypothalamic-pituitary activity. Empty and partially empty sella should be included among the frequent causes of hypopituitarism, although there is no clear relationship between the degree of adenohypophyseal insufficiency and the degree of atrophy of this system as viewed in MR images. In some cases, this entity may be the radiological sign of a phase in the development of an autoimmune inflammatory process involving the pituitary gland. (Author) 16 refs

[Etiological diagnosis of central diabetes insipidus: about 41 cases].

Science.gov (United States)

Chaker, Fatma; Chihaoui, Melika; Yazidi, Meriem; Slimane, Hedia

2016-01-01

The occurrence of polyuria-polydipsia syndrome with hypotonic urine requires careful diagnostic strategy. This study aims to evaluate diagnostic modalities for central diabetes insipidus. We conducted a retrospective study of 41 cases with central diabetes insipidus (CDI). Data were collected at the Department of Endocrinology, University Hospital La Rabta, Tunis, from 1990 to 2013. We identified the circumstances for detecting CDI, the abnormalities in anterior pituitary assessment and pituitary imaging. CDI occurred in the postoperative period in 20 patients. The average urine 24-hour volume was significantly higher in patients with CDI outside a surgical setting. Water deprivation test was successful in all patients who benefited from it. Outside of neurosurgery, infiltration causes were found in 6 patients and tumor causes were found in 6 patients. CDI was associated with empty sella turcica in 1 case and idiopathic sella turcica in 3 patients. Hypothalamic-pituitary magnetic resonance imaging and anterior pituitary balance sheet are systematic outside pituitary surgery setting and obvious primary polydipsia.

Xanthomatosis, pituitary gland, Magnetic Resonance Imaging, Sella turcica

International Nuclear Information System (INIS)

Jang, Seok Jin; Kim, Eui Jong; Choi, Woo Seok; Park, Bong Jin

2011-01-01

Xanthomatous hypophysitis is a rare inflammatory disorder of the pituitary gland of unknown prevalence that causes pituitary dysfunction and a mass-like lesion. The authors report a case of 40-year-old man with a visual disturbance and a confirmed diagnosis of xanthomatous hypophysitis.

Genetics of Resistance and Pathogenicity in the Maize/Setosphaeria turcica Pathosystem and Implications for Breeding

Directory of Open Access Journals (Sweden)

Ana L. Galiano-Carneiro

2017-08-01

Full Text Available Northern corn leaf blight (NCLB, the most devastating leaf pathogen in maize (Zea mays L., is caused by the heterothallic ascomycete Setosphaeria turcica. The pathogen population shows an extremely high genetic diversity in tropical and subtropical regions. Varietal resistance is the most efficient technique to control NCLB. Host resistance can be qualitative based on race-specific Ht genes or quantitative controlled by many genes with small effects. Quantitative resistance is moderately to highly effective and should be more durable combatting all races of the pathogen. Quantitative resistance must, however, be analyzed in many environments (= location × year combinations to select stable resistances. In the tropical and subtropical environments, quantitative resistance is the preferred option to manage NCLB epidemics. Resistance level can be increased in practical breeding programs by several recurrent selection cycles based on disease severity rating and/or by genomic selection. This review aims to address two important aspects of the NCLB pathosystem: the genetics of the fungus S. turcica and the modes of inheritance of the host plant maize, including successful breeding strategies regarding NCLB resistance. Both drivers of this pathosystem, pathogen, and host, must be taken into account to result in more durable resistance.

WAJM 29(2) LATEST.pmd

African Journals Online (AJOL)

user1

Pregnancy Associated with Recurrent Acromegaly: A Case Report. Associée à la grossesse avec récurrentes acromégalie: Un ... disorder. Pregnancy is an unusual event in acromegalic females because fertility is often reduced. .... Computed tomography. (CT) scan of brain showed no significant enlargement of sella turcica ...

The basal cell naevus syndrome - radiographic findings in the skull

International Nuclear Information System (INIS)

Stoll, P.; Dueker, J.; Weingart, D.

1986-01-01

Besides uni- and multiocular jaw cysts the Gorlin Goltz syndrome shows other characteristic radiographic findings which help to ensure diagnosis. These are particularly calcification of the falx cerebri and a so called ''bridging'' between processus clinoideus anterior and posterior of the sella turcica. The importance of early diagnosis is stressed. (orig.) [de

Basal cell naevus syndrome - radiographic findings in the skull

Energy Technology Data Exchange (ETDEWEB)

Stoll, P.; Dueker, J.; Weingart, D.

1986-09-01

Besides uni- and multiocular jaw cysts the Gorlin Goltz syndrome shows other characteristic radiographic findings which help to ensure diagnosis. These are particularly calcification of the falx cerebri and a so called ''bridging'' between processus clinoideus anterior and posterior of the sella turcica. The importance of early diagnosis is stressed.

Pituitary gland tumors

International Nuclear Information System (INIS)

Jesser, J.; Schlamp, K.; Bendszus, M.

2014-01-01

This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15 % of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65 % of pituitary gland adenomas secrete hormones whereby approximately 50 % secrete prolactin, 10 % secrete growth hormone (somatotropin) and 6 % secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10 % of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland. (orig.) [de

[Pituitary gland tumors].

Science.gov (United States)

Jesser, J; Schlamp, K; Bendszus, M

2014-10-01

This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15% of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65% of pituitary gland adenomas secrete hormones whereby approximately 50% secrete prolactin, 10% secrete growth hormone (somatotropin) and 6% secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10% of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland.

Intrasellar abscess simultaning a Rathke's clef cyst

Energy Technology Data Exchange (ETDEWEB)

Nakashima, Toshihiko; Murakawa, Takatsugu; Iwai, Tomohiko; Hirata, Toshifumi; Sakai, Noboru

1983-08-01

Both symptomatic Rathke's cleft cyst and intrasellar abscess are exceedingly rare. We present a case of intrasellar abscess developed in a Rathke's cleft cyst. A 60-year-old man was admitted to our hospital with complaints of polyuria, polydipsia, headache, and remittent fever. On admission, his neurological and ophthalmological examination was normal. Panhypopituitarism was revealed by endocrine testing. Plain-skull X-ray films showed no abnormalities, but a CT scan showed a small cystic lesion with a ring-like enhancement in the sella turcica and paranasal sinusitis. Further sagittal reconstruction of the CT scan demonstrated that the diaphragma sellae protruded upwards and that the pituitary stalk was markedly enhanced and enlarged. After the sinusitis improved, transsphenoidal surgery was carried out. Approximately 1 ml of the purulent contents were aspirated from the intrasellar region. The postoperative course was uneventful. A histological examination of the abscess wall revealed a ciliated columnar epithelium and inflammatory-cell infiltration beneath the epithelium.

Intrasellar abscess simultaning a Rathke's cleft cyst

International Nuclear Information System (INIS)

Nakashima, Toshihiko; Murakawa, Takatsugu; Iwai, Tomohiko; Hirata, Toshifumi; Sakai, Noboru

1983-01-01

Both symptomatic Rathke's cleft cyst and intrasellar abscess are exceedingly rare. We present a case of intrasellar abscess developed in a Rathke's cleft cyst. A 60-year-old man was admitted to our hospital with complaints of polyuria, polydipsia, headache, and remittent fever. On admission, his neurological and ophthalmological examination was normal. Panhypopituitarism was revealed by endocrine testing. Plain-skull X-ray films showed no abnormalities, but a CT scan showed a small cystic lesion with a ring-like enhancement in the sella turcica and paranasal sinusitis. Further sagittal reconstruction of the CT scan demonstrated that the diaphragma sellae protruded upwards and that the pituitary stalk was markedly enhanced and enlarged. After the sinusitis improved, transsphenoidal surgery was carried out. Approximately 1 ml of the purulent contents were aspirated from the intrasellar region. The postoperative course was uneventful. A histological examination of the abscess wall revealed a ciliated columnar epithelium and inflammatory-cell infiltration beneath the epithelium. (author)

The neuroradiological study of craniopharyngiomas; A comparison with non-functioning pituitary macroadenomas

Energy Technology Data Exchange (ETDEWEB)

Oikawa, Susumu; Takemae, Toshiki; Kobayashi, Shigeaki (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1992-06-01

The neuroradiological manifestations of 10 surgically verified craniopharyngiomas are retrospectively studied and compared with those of 8 non-functioning pituitary macroadenomas. The saucer-like appearance of the sella turcica on a craniogram was noted in 2 of the 10 craniopharyngiomas and in 2 of the 8 pituitary adenomas. A ballooning of the sella turcica was observed in one of the 10 craniopharyngiomas and in 5 of the 8 pituitary adenomas. Calcification on CT scan was presented in only 5 craniopharyngiomas. On a plain CT scan, no craniopharyngioma manifested any high-density mass except calcification. Four pituitary adenomas showed a slightly high density, though. A cystic lesion was revealed in all the craniopharyngiomas and in 4 pituitary adenomas. All the craniopharyngiomas except for one intrasellar type and all the pituitary adenomas were enhanced with a contrast medium. The solid portion in one craniopharyngioma and in one pituitary adenoma was high-intensity on T[sub 1]-weighted MRI. The cystic portion in 4 craniopharyngiomas and in 2 pituitary adenomas manifested a high intensity on a T[sub 1]-weighted image. A normal pituitary gland located on the floor of the sella was disclosed in all the craniopharyngiomas on a sagittal T[sub 1]-weighted image; however in all the pituitary adenomas, no normal pituitary gland was found at least not on the floor of the sella. The presence of a normal pituitary gland on the sellar floor on sagittal T[sub 1]-weighted MRI may be a new differential diagnostic point between craniopharyngioma and pituitary macroadenoma. Calcification, cystic formation, and density on a plain CT scan seem to be useful evidence for diagnosis. (author).

The neuroradiological study of craniopharyngiomas

International Nuclear Information System (INIS)

Oikawa, Susumu; Takemae, Toshiki; Kobayashi, Shigeaki

1992-01-01

The neuroradiological manifestations of 10 surgically verified craniopharyngiomas are retrospectively studied and compared with those of 8 non-functioning pituitary macroadenomas. The saucer-like appearance of the sella turcica on a craniogram was noted in 2 of the 10 craniopharyngiomas and in 2 of the 8 pituitary adenomas. A ballooning of the sella turcica was observed in one of the 10 craniopharyngiomas and in 5 of the 8 pituitary adenomas. Calcification on CT scan was presented in only 5 craniopharyngiomas. On a plain CT scan, no craniopharyngioma manifested any high-density mass except calcification. Four pituitary adenomas showed a slightly high density, though. A cystic lesion was revealed in all the craniopharyngiomas and in 4 pituitary adenomas. All the craniopharyngiomas except for one intrasellar type and all the pituitary adenomas were enhanced with a contrast medium. The solid portion in one craniopharyngioma and in one pituitary adenoma was high-intensity on T 1 -weighted MRI. The cystic portion in 4 craniopharyngiomas and in 2 pituitary adenomas manifested a high intensity on a T 1 -weighted image. A normal pituitary gland located on the floor of the sella was disclosed in all the craniopharyngiomas on a sagittal T 1 -weighted image; however in all the pituitary adenomas, no normal pituitary gland was found at least not on the floor of the sella. The presence of a normal pituitary gland on the sellar floor on sagittal T 1 -weighted MRI may be a new differential diagnostic point between craniopharyngioma and pituitary macroadenoma. Calcification, cystic formation, and density on a plain CT scan seem to be useful evidence for diagnosis. (author)

New medical application: nuclear scattering radiography

International Nuclear Information System (INIS)

Saudinos, J.

1977-01-01

Nuclear scattering of 1 GeV protons is used to obtain three dimensional radiographies with a volume resolution of about 1 mm 3 . The information is different from the one given by X-ray radiographies and in particular one may get radiographies of the hydrogen included in objects. Results on a vertebral column and a 'sella turcica' are presented [fr

MRI and MR angiography of persistent trigeminal artery

International Nuclear Information System (INIS)

Piotin, M.; Miralbes, S.; Cattin, F.; Marchal, H.; Amor-Sahli, M.; Moulin, T.; Bonneville, J.F.

1996-01-01

We describe the MRA and MR angiography (MRA) features of persistent trigeminal artery (PTA) found incidentally in eight patients, with special attention to its origin, site and course. The different patterns of posterior communicating arteries were also noted. The PTA were shown on sagittal, coronal and axial MRI and on MRA. In four cases, the PTA arose from the lateral aspect of the intracavernous internal carotid artery, ran caudally, passing round the bottom of the dorsum sellae to join the basilar artery. In the other four cases, it arose from the medial aspect, ran caudally through the sella turcica and pierced the dorsum sellae to join the basilar artery. The posterior communicating arteries were present unilaterally in five cases and bilaterally in one, and absent bilaterally in two. Identification of a PTA with a trans-sellar course is crucial if a trans-sphenoidal surgery is planned. (orig.). With 3 figs

Pathology galactorrhea. Dynamic tests of prolactin secretion evaluation and the adenohypophyseal functional reserve

International Nuclear Information System (INIS)

Oliveira, B.C. de.

1979-01-01

Stimulus and supression tests of prolactin secretion and reserve evaluation of others hypophyseal trophin in thirty-seven patients, of feminine sex with galactorrhea and twelve normal volunteers with the objective of determinate the validity for etiologic diagnostic of pathologic galactorrhea are described. Simple radiography of brain and sella turcica on anteroposterior incidence and profile followed by plane tomography in all patients with pathological galactorrhea are also presented. (author)

Refraction-contrast bone imaging using synchrotron radiation

International Nuclear Information System (INIS)

Mori, Koichi; Sekine, Norio; Sato, Hitoshi; Shikano, Naoto; Shimao, Daisuke; Shiwaku, Hideaki; Hyodo, Kazuyuki; Oka, Hiroshi

2002-01-01

The X-ray refraction-contrast imaging using synchrotron radiation with some X-ray energies is successfully performed at B120B2 of SPring-8. The refraction-contrast images of bone samples such as human dried proximal phalanx, wrist, upper cervical vertebrae and sella turcica and as mouse proximal femur using the synchrotron X-ray are always better in image contrast and resolution than those of the absorption-contrast images using the synchrotron X-ray and/or the conventional X-ray tube. There is much likeness in the image contrast and resolution of trabeculae bone in the human dried proximal phalanx between X-ray energy of 30 keV at sample-to-film distance of 1 m and those of 40, 50 keV at those of 4,5 m, respectively. High-energy refraction-contrast imaging with suitable sample-to-film distance could reduce the exposure dose in human imaging. In the refraction-contrast imaging of human wrist, upper cervcal vertebrae, sella turcica and mouse proximal femur using the synchrotron X-ray, we can obtain better image contrast and resolution to correctly extract morphological information for diagnosis corresponding to each of the clinical field than those of the absorption-contrast images. (author)

Bony Regeneration of the Sella after Transsphenoidal Pituitary Surgery.

Science.gov (United States)

Yahia-Cherif, Mehdi; Delpierre, Isabelle; Hassid, Sergio; De Witte, Olivier

2016-04-01

The purpose of this study is to demonstrate the possible bony regrowth of the sella after transsphenoidal surgery without any intraoperative sellar reconstruction. Radiologic findings of the sella were reviewed in patients with pituitary tumors treated by transsphenoidal surgery. In 17 patients who had postoperative cranial computed tomography scans, bony regeneration of the sellar floor was evaluated by comparing immediate and late postoperative scans. The bony opening reduction was measured in transverse and sagittal planes. The median bony opening diameter in the transverse plane was 8.8 mm (interquartile range [IQR] 5.7-11.4) on the first scan and 4.2 mm (IQR 0.8-6.8) on the second scan. In the sagittal plane, it was 4.8 mm (IQR 1.8-6.8) on the first scan and 2.9 mm (IQR 1.6-3.9) on the second scan. These changes occurred in a median time of 36 months (IQR 22-42). There was a statistically significant decrease of the bony opening diameters in both the transverse and sagittal planes (P transsphenoidal pituitary surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Pituitary gland tumors; Hypophysentumoren

Energy Technology Data Exchange (ETDEWEB)

Jesser, J.; Schlamp, K.; Bendszus, M. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany)

2014-10-15

This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15 % of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65 % of pituitary gland adenomas secrete hormones whereby approximately 50 % secrete prolactin, 10 % secrete growth hormone (somatotropin) and 6 % secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10 % of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland. (orig.) [German] Diese Arbeit ist eine Uebersicht ueber die haeufigsten Hypophysentumoren und deren Differenzialdiagnosen mit Augenmerk auf die

Schizophernia and empty sella – casual or correlated?

OpenAIRE

Wix-Ramos, Richard Joseph; Capote, Eduardo; Mendoza, Milet; Garcia, Margreth; Ezequiel, Uribe

2011-01-01

Summary A male patient, 44 years old, with schizophrenia which started at the age of 18. At his last follow-up visit, laboratory tests and brain magnetic resonance imaging (MRI) were performed, revealing the presence of a sellar arachnoidocele. To our knowledge, there is only one similar case report of a set of male monozygotic triplets with schizophrenia and empty sella syndrome. High-resolution chromosome analysis found an extra band at chromosome 15p in all the triplets and their father. W...

Infrasellar craniopharyngioma: case report

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Falavigna Asdrubal

2001-01-01

Full Text Available We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. The embryology, clinical features and radiographic investigation of these tumors are discussed.

X-Ray semiotics of cranial involvement in endocrine diseases

International Nuclear Information System (INIS)

Spuzyak, M.I.; Kramnoj, I.E.; Belaya, L.M.; Tyazhelova, O.V.; Litvinenko, V.M.

1992-01-01

The incidence and type of X-ray semeiotics of the skull involvement were studied in 703 patients with endocrine diseases. Craniorgam analysis involved study of the thickness and structure of the vault bones, shape and size of the skull, status of the sutures, internal plate relief, changes of the base of the skull, of the sella turcica first of all, and facial bone. The characteristic X-ray symprom complexes of the involvement of the skull in some endocrine diseases were distinguished

Pituitary stalk compression by the dorsum sellae: possible cause for late childhood onset growth disorders.

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Taoka, Toshiaki; Iwasaki, Satoru; Okamoto, Shingo; Sakamoto, Masahiko; Nakagawa, Hiroyuki; Otake, Shoichiro; Fujioka, Masayuki; Hirohashi, Shinji; Kichikawa, Kimihiko

2006-06-01

The purpose of this study was to evaluate the relationship between pituitary stalk compression by the dorsum sellae and clinical or laboratory findings in short stature children. We retrospectively reviewed magnetic resonance images of the pituitary gland and pituitary stalk for 34 short stature children with growth hormone (GH) deficiency and 24 age-matched control cases. We evaluated the degree of pituitary stalk compression caused by the dorsum sellae. Body height, GH level, pituitary height and onset age of the short stature were statistically compared between cases of pituitary stalk compression with associated stalk deformity and cases without compression. Compression of the pituitary stalk with associated stalk deformity was seen in nine cases within the short stature group. There were no cases observed in the control group. There were no significant differences found for body height, GH level and pituitary height between the cases of pituitary stalk compression with associated stalk deformity and cases without compression. However, a significant difference was seen in the onset age between cases with and without stalk compression. Pituitary stalk compression with stalk deformity caused by the dorsum sellae was significantly correlated with late childhood onset of short stature.

Empty sella syndrome associated with hormone deficiency in adults; Silla turca vacia asociada a disfuncion hormonal en adultos

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Oleaga, L.; Paja, M.; Goni, F.; Grande, J.; Grande, D. [Hospital de Basurto. Bilbao (Spain); Merino, M. [Hospital General Yague (Spain); Delgado, A. [Hospital Marques de Valdecilla. Santander (Spain)

1999-07-01

The objective of this study was to correlate the magnetic resonance (MR) images in patients with hormone deficiencies with the clinical data and the hormonal status. We studied 11 cases ef empty sella with different peripheral pituitary deficiencies. Hormone levels were determined according to standard laboratory methods. All the patients underwent MR imaging. The studies were carried out with a 1 Tesla superconducting magnet, using the cranial cavity for transmission and reception. Segittal and coronal T1-weighted spin-echo sequences (TR/TE: 600/15 ms), axial T2-weighted spin-echo sequences (TR/TE: 3,500/19/93 ms) and gadolinium-enhanced (=.2 cc/kg body weight) sagital and coronal T1-weighted spin-echo sequences (TR/TE: 600/15 ms) were employed. Six of the patients presented partial or total hypopituitarism associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH); there was one case of panhypopituitarism without SIADH and four cases of primary hypothyroidism, there of which were associated with pituitary deficiency, MR imaging revealed five cases of partially empty sella with residual pituitary gland on the sella floor and six cases in which the sella was completely empty. This study also identified six cases of normally situated neurohypophysis, another four in which the neurohypophysis could not be identified and one case of ectopic neurohypophysis. MR imaging is the technique of choice in the study of abnormal hypothalamic-pituitary activity. Empty and partially empty sella should be included among the frequent causes of hypopituitarism, although there is no clear relationship between the degree of adenohypophyseal insufficiency and the degree of atrophy of this system as viewed in MR images. In some cases, this entity may be the radiological sign of a phase in the development of an autoimmune inflammatory process involving the pituitary gland. (Author) 16 refs.

Value of petrosal sinus sampling: coexisting acromegaly, empty sella and meningioma

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Yarman, S.; Minareci, Oe.

2004-01-01

Simultaneous occurrence of an intracranial meningioma and a growth hormone (GH)-producing pituitary adenoma is exceedingly rare, as is coexistence of an empty sella and acromegaly. We report all these rare entities in the same patient. We evaluated the role of inferior petrosal sinus sampling for lateralisation of an adenoma in this patient. (orig.)

Value of petrosal sinus sampling: coexisting acromegaly, empty sella and meningioma

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Yarman, S. [Div. of Endocrinology, Metabolism and Nutrition, Istanbul Univ., Istanbul (Turkey); Minareci, Oe. [Dept. of Radiology, Medical Faculty of Istanbul Univ., Istanbul (Turkey)

2004-12-01

Simultaneous occurrence of an intracranial meningioma and a growth hormone (GH)-producing pituitary adenoma is exceedingly rare, as is coexistence of an empty sella and acromegaly. We report all these rare entities in the same patient. We evaluated the role of inferior petrosal sinus sampling for lateralisation of an adenoma in this patient. (orig.)

Schizophernia and empty sella - casual or correlated?

International Nuclear Information System (INIS)

Wix-Ramos, R. J.; Ezequiel, U.; Capote, E.; Mendoza, M.; Garcia, M.

2011-01-01

A male patient, 44 years old, with schizophrenia which started at the age of 18. At his last followup visit, laboratory tests and brain magnetic resonance imaging (MRI) were performed, revealing the presence of a sellar arachnoidocele. To our knowledge, there is only one similar case report of a set of male mono zygotic triplets with schizophrenia and empty sella syndrome. High-resolution chromosome analysis found an extra band at chromosome 15p in all the triplets and their father. We performed a similar evaluation in our patient and his family to compare the results and identify new information on neuro anatomical abnormalities, hormonal alterations or genetic origins of schizophrenia. (authors)

Prolactin-secreting adenoma as part of the multiple endocrine neoplasia--type I (MEN-I) syndrome.

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Levine, J H; Sagel, J; Rosebrock, G; Gonzalez, J J; Nair, R; Rawe, S; Powers, J M

1979-06-01

Two patients presented with the galactorrhea-amenorrhea syndrome. One patient had previously had parathyroid hyperplasia and the other an insulinoma. Preoperative evaluation of each patient revealed hyperprolactinemia and radiological evidence of an abnormal sella turcica. Pituitary adenomas were identified and removed at surgery. Immunostaining techniques confirmed the presence of prolactin-containing cells in both tumors. We propose that prolactin-secreting tumors be considered as part of the MEN-I syndrome, and that patients presenting with the galactorrhea-amenorrhea syndrome be screened and followed sequentially for evidence of other endocrine neoplasia.

Empty sella syndrome in a male child with failure to thrive.

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Rath, Debasmita; Sahoo, Ranjan Kumar; Choudhury, Jasashree; Dash, Dillip Kumar; Mohapatra, Anuspandana

2015-01-01

Empty sella syndrome (ESS) is commonly seen in adult and is considered as an infrequent finding in childhood. It may be diagnosed incidentally on imaging in asymptomatic children. However, most of the children with ESS present with features of hypothalamic-pituitary dysfunction. We report a case of ESS in a child with features of failure to thrive as well as hypopituitarism and review the literature briefly on the subject.

Panhypopituitarism with empty sella a sequel of pituitary hyperplasia due to chronic primary hypothyroidism.

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Dutta, Deep; Maisnam, Indira; Ghosh, Sujoy; Mukhopadhyay, Pradip; Mukhopadhyay, Satinath; Chowdhury, Subhankar

2012-12-01

Asymptomatic reversible pituitary hyperplasia is common in patients with untreated primary hypothyroidism. Occurrence of empty sella (ES) in this scenario is extremely rare (only three reports till the date) and panhypopituitarism has not been reported in such patients. We report a 27 year man with severe short stature (height-133 cm; standard deviation score-7.36) and delayed puberty who had symptoms suggestive of hypothyroidism along with chronic persistent headache since 6 years of age. Pituitary imaging done for headache at 11 years age showed pituitary hyperplasia. He was diagnosed of primary hypothyroidism for the 1(st) time at 21 year age, a diagnosis which was likely missed for 15 years. Levothyroxine therapy leads to resolution of all symptoms and a height gain of 28 cm over last 6 years. Evaluation for lack of progression of puberty along with chronic nausea, vomiting, fatigue and weight loss for the last 1 year revealed secondary hypocortisolism (9 am cortisol-4.8 mcg/dl; ACTH-3.2 pg/ml), growth hormone deficiency (IGF-1: 65 ng/ml; normal: 117-325 ng/ml) and hypogonadotrophic hypogonadism (9 am testosterone: 98 ng/dl; [280-1500] LH-0.01 mIU/L [1.14-5.75]) with ES on magnetic resonance imaging (MRI) brain. Uncontrolled thyrotroph hyperplasia due to chronic untreated primary hypothyroidism for 15 years may have been damaging the adjacent corticotrophs, somatotrophs and gonadotrophs resulting in panhypopituitarism and empty sella. This is perhaps the first report of panhypopituitarism with empty sella syndrome developing in a patient with pituitary hyperplasia, a sequel of chronic untreated primary hypothyroidism.

78 FR 13870 - Roberto Sella; Notice of Declaration of Intention and Soliciting Comments, Protests, and/or...

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2013-03-01

... be used by a geothermal heating and cooling system located under the pond. Excess power will then be... 7, 2012. d. Applicant: Roberto Sella. e. Name of Project: Hydro-electric and Geothermal Alternative...

Schizophernia and empty sella – casual or correlated?

Science.gov (United States)

Wix-Ramos, Richard Joseph; Capote, Eduardo; Mendoza, Milet; Garcia, Margreth; Ezequiel, Uribe

2011-01-01

Summary A male patient, 44 years old, with schizophrenia which started at the age of 18. At his last follow-up visit, laboratory tests and brain magnetic resonance imaging (MRI) were performed, revealing the presence of a sellar arachnoidocele. To our knowledge, there is only one similar case report of a set of male monozygotic triplets with schizophrenia and empty sella syndrome. High-resolution chromosome analysis found an extra band at chromosome 15p in all the triplets and their father. We performed a similar evaluation in our patient and his family to compare the results and identify new information on neuroanatomical abnormalities, hormonal alterations or genetic origins of schizophrenia. PMID:22802833

Panhypopituitarism with empty sella a sequel of pituitary hyperplasia due to chronic primary hypothyroidism

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Deep Dutta

2012-01-01

Full Text Available Asymptomatic reversible pituitary hyperplasia is common in patients with untreated primary hypothyroidism. Occurrence of empty sella (ES in this scenario is extremely rare (only three reports till the date and panhypopituitarism has not been reported in such patients. We report a 27 year man with severe short stature (height-133 cm; standard deviation score-7.36 and delayed puberty who had symptoms suggestive of hypothyroidism along with chronic persistent headache since 6 years of age. Pituitary imaging done for headache at 11 years age showed pituitary hyperplasia. He was diagnosed of primary hypothyroidism for the 1 st time at 21 year age, a diagnosis which was likely missed for 15 years. Levothyroxine therapy leads to resolution of all symptoms and a height gain of 28 cm over last 6 years. Evaluation for lack of progression of puberty along with chronic nausea, vomiting, fatigue and weight loss for the last 1 year revealed secondary hypocortisolism (9 am cortisol-4.8 mcg/dl; ACTH-3.2 pg/ml, growth hormone deficiency (IGF-1: 65 ng/ml; normal: 117-325 ng/ml and hypogonadotrophic hypogonadism (9 am testosterone: 98 ng/dl; [280-1500] LH-0.01 mIU/L [1.14-5.75] with ES on magnetic resonance imaging (MRI brain. Uncontrolled thyrotroph hyperplasia due to chronic untreated primary hypothyroidism for 15 years may have been damaging the adjacent corticotrophs, somatotrophs and gonadotrophs resulting in panhypopituitarism and empty sella. This is perhaps the first report of panhypopituitarism with empty sella syndrome developing in a patient with pituitary hyperplasia, a sequel of chronic untreated primary hypothyroidism.

Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

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Meij, B. P. [Utrecht University, Utrecht (Netherlands); Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H. A.W.; Verlaat, J.W. van ' t

1997-07-15

Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons.

Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

International Nuclear Information System (INIS)

Meij, B.P.; Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H.A.W.; Verlaat, J.W. van 't

1997-01-01

Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons

Pseudotumor Cerebri Resulting in Empty Sella Syndrome and Multiple Pituitary Hormone Deficiencies

Science.gov (United States)

2017-09-14

A 17 year old male was referred to pediatric endocrinology with concerns for stalled puberty in the setting of known PTC. He was diagnosed with PTC...size led to a preliminary laboratory evaluation. This resulted In a referral to pediatric endocrinology for significantly low testosterone and an...studies were reviewed and a partially empty sella was appreciated by a pediatric radiologist on retrospective evaluation (Image 1 ). There were no

Use of radioimmunoassay to diagnose some forms of endocrine sterility

International Nuclear Information System (INIS)

Balabolkin, M.I.; Gerasimov, G.A.

1984-01-01

The possibility is considered of using a metoclopramide test combined with radioimmunoassay for determing prolactin in the blood to diagnose some forms of endocrine sterility Of 17 women examined 5 are practically healthy, sterility of 6 women is caused by tumor of hypophysis verified by X-rayograms, 6 women suffered from disorderded prolactin secretion and sterility without roentgenologic signs of disordered sella turcica. Metoclopramide has been injected intravenously in the 10 mm dose. A series of advantages is noted of the metoclopramide sample characteristic of high availability of the preparation and practically complete absence of side-effects

Investigating the application of diving endoscopic technique in determining the extent of pituitary adenoma resection via the trans-nasal-sphenoidal approach.

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Gao, Hai-Bin; Wang, Li-Qing; Zhou, Jian-Yun; Sun, Wei

2018-04-01

The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope. The diving endoscopic technique allowed surgeons to directly observe the structure inside a tumor cavity in high-definition. In the present study, 24 patients had pituitary macroadenomas or microadenomas that did not invade the cavernous sinus, and were considered to have undergone successful total resection. Among these patients, no tumor residues were observed through the diving endoscopic technique. Some white lichenoid or fibrous cord-like tissues in the tumor cavity were considered to be remnants of tumors. However, pathology confirmed that these were not tumor tissues. For tumors that invaded the cavernous sinus in 13 patients, observation could only be conducted under the angulation endoscope of the diving endoscope; i.e., the operation could not be conducted under an endoscope. The present study suggests that the diving endoscopic technique may be used to directly observe the resection extent of tumors within the tumor cavity, especially the structure of the tumor cavity inside the sella turcica. The present study also directly validates the reliability of pituitary adenoma resection under endoscope-assisted microscope. In addition, the diving endoscopic technique also allows the surgeon to observe the underwater environment within the sella turcica.

Ectopic pituitary null cell adenoma arising from the infundibulum in the third ventricle: A successful endonasal transsphenoidal resection after long-term follow-up MR imaging – A technical note

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Yuichiro Yoneoka, M.D., Ph.D.

2017-12-01

Conclusion: To our best knowledge, this is the first case with long-term preoperative follow-up images, which can bridge the knowledge gap in operations of third ventricle ectPA as following: (1 Truly third ventricle ectPA can exist, (2 the third ventricle ectPA extended into the sella turcica along the pituitary stalk, (3 this ectPA can arise from the suprasellar peri-infundibular ectopic pituitary cells or the pars tuberalis of the adenohypophysis, and therefore adhere to the optic chiasm, (4 thus neurosurgeons should take great care in resection of ectPA arising from the infundibulum, and (5 it can be resected through an endoscopic extended transsphenoidal approach.

Cerebrospinal fluid rhinorrhea as a complication of ACTH-secreting pituitary macroadenoma in a patient with morbid obesity

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Dar'ya Viktorovna Petrova

2014-11-01

Full Text Available Cushing's disease (CD is a progressive neuroendocrine disease caused by a pituitary tumor producing excessive amounts of ACTH. In most cases (80-85% the cause of the disease is a pituitary corticotroph microadenomas (located within the sella, measuring 3–10 mm, rarely multiple microadenomas and only 15% of cases are presented as corticotroph hyperplasia or pituitary macroadenoma extending beyond the sella. The macroadenomas in CD usually extend suprasellar (10%, infrasellar tumor growth is relatively rare (5%. If the clinical picture is subtle, the symptoms are caused by the development "mass effect" of the tumor as it propagates to the surrounding pituitary structures. Suprasellar growth leads to compression of the optic chiasm with narrowing of visual fields, infrasellar growth destructs the bottom of the sella turcica and may cause nasal cerebrospinal fluid leak, which is dangerous due depressurization of the cranial cavity and its communication with environmental pathogens, development of life-threatening conditions such as meningitis, meningoencephalitis, ventriculitis. Leading life-threatening complications of the CD are infectious and cardiovascular. But in the case of nasal liquorrhea with expansion of the tumor in sphenoid sinus with destruction of the bottom of the sella, there is an immediate threat to the life of the patient. This article presents an example of a patient with morbid obesity and lack of specific clinical manifestations of CD, in whom the diagnosis of disease CD was made on the results of laboratory and instrumental examination, which experienced a spontaneous nasal cerebrospinal fluid leak.

Inflammatory Myofibroblastic Tumour of the Skull Base

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Jean-Philippe Maire

2013-01-01

Full Text Available Inflammatory myofibroblastic tumors (IMTs are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT was indicated at a low dose; 20 Gy in 10 fractions of 2 Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well.

The "suprasellar notch," or the tuberculum sellae as seen from below: definition, features, and clinical implications from an endoscopic endonasal perspective.

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de Notaris, Matteo; Solari, Domenico; Cavallo, Luigi M; D'Enza, Alfonso Iodice; Enseñat, Joaquim; Berenguer, Joan; Ferrer, Enrique; Prats-Galino, Alberto; Cappabianca, Paolo

2012-03-01

The tuberculum sellae is a bony elevation ridge that lines up the anterior aspect of the sella, dividing it from the chiasmatic groove. The recent use of the endoscopic endonasal transtuberculum approach has provided surgeons with a method to reach the suprasellar area, offering a new surgical point of view somehow "opposite" of this area. The authors of this study aimed to define the tuberculum sellae as seen from the endoscopic endonasal view while also providing CT-based systematic measurements to objectively detail the anatomical features of such a structure, which was renamed the "suprasellar notch." The authors analyzed routine skull CT scans from 24 patients with no brain pathology or fractures and measured the interoptic distance at the level of the limbus sphenoidale, the chiasmatic groove sulcal length and width, and the angle of the suprasellar notch. Indeed, the suprasellar notch was defined as the angle between 2 lines, the first passing through the tuberculum sellae midpoint and perpendicular to the cribriform plate, and a second line passing between 2 points, the midpoints of the limbus sphenoidale and the tuberculum sellae. Moreover, the authors performed on 15 cadaveric heads an endoscopic endonasal transplanum transtuberculum approach with the aid of a neuronavigator to achieve a step-by-step comparison with the radiological data. The whole CT scanning set was statistically analyzed to determine the statistical interdependency of the suprasellar notch angle with the other 3 measurements, that is, the sulcal length at the midline, the interoptic distance at the optic canal entrance, and the interoptic distance at the limbus. Based on the endoscopic endonasal view and CT imaging analysis, the authors identified a certain anatomical variability and thus introduced a new classification of the suprasellar notch: Type I, angle 138°. They then analyzed the surgical implications of the endoscopic endonasal approach to the suprasellar area, which could be

Computed tomography of Rathke's cleft cyst

International Nuclear Information System (INIS)

Shiokawa, Yoshiaki; Teramoto, Akira; Mayanagi, Yoshiaki; Hanamura, Tetsu; Noguchi, Makoto; Takakura, Kintomo.

1986-01-01

The computed tomography (CT) findings in six cases of Rathke's cleft cyst (RCC) were presented. According to the location of the RCC, we divided these cases into two types - the suprasellar type and the intrasellar type. The characteristic CT findings are as follows: SUPRASELLAR type 1. smooth, round mass, 2. various densities, 3. no enhancement, INTRASELLAR type 1. low-density area in the posterior sella turcica, 2. no enhancement, 3. suprasellar high-density mass; enhanced pituitary gland pushed up by the intrasellar RCC. As RCC are more common than was formerly suspected, this disease should always be considered in the differential diagnosis of a patient showing a non-enhancing, non-calcified sellar/suprasellar cyst on CT scans. (author)

Computed tomography of Rathke's cleft cyst

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Shiokawa, Yoshiaki; Teramoto, Akira; Mayanagi, Yoshiaki; Hanamura, Tetsu; Noguchi, Makoto; Takakura, Kintomo

1986-02-01

The computed tomography (CT) findings in six cases of Rathke's cleft cyst (RCC) were presented. According to the location of the RCC, we divided these cases into two types - the suprasellar type and the intrasellar type. The characteristic CT findings are as follows: SUPRASELLAR type 1. smooth, round mass, 2. various densities, 3. no enhancement, INTRASELLAR type 1. low-density area in the posterior sella turcica, 2. no enhancement, 3. suprasellar high-density mass; enhanced pituitary gland pushed up by the intrasellar RCC. As RCC are more common than was formerly suspected, this disease should always be considered in the differential diagnosis of a patient showing a non-enhancing, non-calcified sellar/suprasellar cyst on CT scans.

Polyglandular autoimmune syndrome iii with hypoglycemia and association with empty sella and hypopituitarism

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Samia Abdulla Bokhari

2017-01-01

Full Text Available A 25-year-old Saudi female with a known case of autoimmune thyroiditis presented to the Emergency Room in stuporous condition. A blood test revealed a blood sugar level of 1.7 mmols/l (30.6 mg/dl. The patient was resuscitated with intravenous glucose. Further evaluations of the patient revealed celiac disease and idiopathic thrombocytopenia with preexisting autoimmune thyroiditis (polyglandular autoimmune syndrome III [PAS III]. The severe hypoglycemia, coupled with 6 years of infertility evaluation, revealed a rare association of empty sella syndrome with hypopituitarism {PAS II}.

Anatomical features of skull base and oral cavity: a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery.

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Amelot, Aymeric; Trunet, Stephanie; Degos, Vincent; André, Olivier; Dionnet, Aurore; Cornu, Philippe; Hans, Stéphane; Chauvet, Dorian

2015-10-01

The role of transoral robotic surgery (TORS) in the skull base emerges and represents the natural progression toward miniinvasive resections in confined spaces. The accessibility of the sella via TORS has been recently described on fresh human cadavers. An anatomic study is mandatory to know if this approach would be feasible in the majority of patients regardless of their oral morphological features. From 30 skull base CT scans from patients who were asked to open their mouth as wide as they can, we measured specific dimensions of the oral cavity and the skull base, such as length of the palate, mouth opening and distance from the sella to the palate. All data were acquired on a sagittal midline plane and on a 25° rotation plane, which simulated the axis of the robotic instruments. Looking at the projection of the dental palatine line on the sella, we studied possible predictive factors of sellar accessibility and tried to bring objective data for surgical feasibility. We also proposed an angle α to study the working angle at the skull base. We observed that the maximal mouth opening was a good predictive factor of sellar accessibility by TORS (p < 0.05). The mouth aperture threshold value for a good sensitivity, over 80 %, was comparable to the mean value of mouth opening in our series, 38.9 and 39.4 mm respectively. Moreover, we showed a statistically significant increase of the working angle α at the skull base comparing the lateral access to the midline one (p < 0.05). This seemed to quantitatively demonstrate that the robotic arms placed at the labial commissure of the mouth can reach the sella. From these anatomical features and previous cadaveric dissections, we assume that TORS may be feasible on a majority of patients to remove pituitary adenomas.

Cerebrospinal meningitis in a 30 -year -old patient as first manifestation of pituitary macroadenoma.

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Andrysiak -Mamos, Elżbieta; Żochowska, Ewa; Kaźmierczyk -Puchalska, Agnieszka; Sagan, Leszek; Sowińska -Przepiera, Elżbieta; Zając -Marczewska, Małgorzata; Kojder, Ireneusz; Syrenicz, Anhelli

The most common clinical and neurological signs and symptoms of pituitary macroadenomas include headache, vision impairment and cranial nerve palsy. The patient presented in this article was admitted to the Intensive Care Unit at regional hospital; at admission, the patient was unconscious, he had convulsions and spasms, and a 3 -day history of headache and body temperature up to 41.5°C. The patient with suspected neuroinfection was transferred to the Department of Infectious Diseases of the Pomeranian Medical University in Szczecin (PMU), where cerebrospinal meningitis of bacterial etiology was established based on cerebrospinal fluid investigations and the presence of pituitary abscess was suggested based on magnetic resonance imaging (MRI). Magnetic resonance imaging findings included an extensive pathological lesion with the diameter of 27 × 28 × 38 mm located in the sellar-suprasellar region, with intensive peripheral contrast enhancement. The lesion protrudes into the sphenoid sinus through the lowered bottom of sella turcica and the fluid content has also been visualized in the sphenoid sinus. After 10 -day antibiotic therapy, the patient was transferred to neurosurgery ward for surgical treatment. The pathological lesion was partially evacuated during right frontotemporal craniotomy. The patient’s general condition after the surgery was moderately severe; the patient was conscious, able to follow simple commands, presenting hemiparesis of the left side of the body, particularly affecting left lower limb and with speech disturbances. The signs of hypopituitarism affecting all hormonal axes were also observed and the patient was transferred to the Department of Endocrinology of the PMU for further treatment. Follow -up MRI scan continued to show the presence of pathological mass in the sellar -suprasellar region, which penetrated into the sphenoid sinus through damaged sellar bottom. After correction of reduced hormone levels and several weeks of

Three-dimension visualization of transnasal approach for revealing the metasellar organization

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Liang XUE

2012-07-01

Full Text Available Objective To elevate the anatomical cognitive level by investigating the metasellar organization viatransnasal approach in a virtual-reality (VR setting. Methods Twenty-eight patients, with spontaneous subarachnoid hemorrhage but without pathological changes of nasal cavity and sella turcica, underwent the lamellar imaging examination and CT angiogram with Discovery Ultra 16. The data were collected and entered in the Dextroscope in DICOM format. Visualization research was carried out viathe transnasal approach in a virtual-reality (VR setting. Results The anatomic structures of transnasal approach were allowed to be observed dynamically and spatially. When exposing the lateral border of cavernous carotid artery, it was important to excise the ethmoid cornu, open posterior ethmoid sinus and sphenopalatine foramen, control sphenopalatine artery, properly drill out pterygoid process and reveal pterygoid canal. Conclusion It is the key point to remove the ethmoid cornu, uncinate process and bone of the anterior region of sphenoidal sinus, and control sphenopalatine artery viatransnasal approach to expose the metasellar structure. The cavernous carotid arteries are the most important anatomic structure, should be adequately exposed and conserved.

Microadenomas e adenomas hipersecretantes da hipófise, aspectos anátomo-radiológicos Microadenomas and hypersecreting pituitary adenomas: radiographic aspects

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Jean Lorrain Vezina

1975-06-01

Full Text Available São apresentados os primeiros sinais radiográficos de alteração selar encontrados nos casos de adenomas hipofisários hipersecretantes. O achado de duplo contôrno selar e de pequenas bosseladuras com o auxílio da tomografia selar tem permitido o diagnóstico da localização de microadenomas, a partir do que tem sido possível operar os pacientes no estágio inicial, quando o tumor não causou ainda lesões irreversíveis nos tecidos circunjacentes, o que facilita sobremaneira a cirurgia sem lesar o tecido hipofisário sadio, dando maiores possibilidades para o restabelecimento das funções hipofisárias ao normal. É feita uma classificação anátomo-radiológica da sela túrcica em 4 estágios, que é de grande utilidade para o prognóstico cirúrgico pois observa-se a cura em mais de 90% dos casos no estágio 1, de 75% no estágio 2, de 50% no estágio 3 e de menos de 10% no estágio 4, na primeira cirurgia.The early radiographic changes of the sella turcica in the cases of hypersecreting pituitary adenomas (Cushing disease, acromegaly, amenorrhea-galac- torrhea are reported and discussed. The finding of the double contour of the sellar floor and the small crescentic bulging of its antero-inferior wall, with the aid of the tomographic cuts of the sella, has permited the diagnosis of the microadenoma's localization. With this it is possible the achievement of a seletive excision of the lesion in the initial stage, when the tumor has not caused yet irreversible damage to the inside normal pituitary tissue. This surgery is perfomed in the precocious stage with the primary goal to preserve the normal gland, without hurt it to avoid postoperative hipopituitarism. A anatomo-radiologic classification of the alterations sella turcica in 4 grades is made, which is of great utility for the surgical prognostic, since we have observed clinical and biological cure over 90% in the grade 1, 75% in the grade 2, 50% in the grade 3 and up to 10% in the

A study of radiation exposure dose in young dental patients

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Hatakeyama, Atsushi

1983-01-01

In order to clarify the trend in dental radiography for young patients up to 18 years old and the accompanying radiation exposures, surveys were made at Fukuoka Dental College Hospital and thirty-five dental offices in Fukuoka city and Kitakyushu city. Each kind of radiography increased in average number with age and 16-18 group was given 4.60 times of radiography of one kind or another in the clinic of college hospital. In the dental offices, the number of radiography taken was about one-fourth that of the clinic of college hospital. Although exposure dose varies with exposure factors, distance and angle of exposure, in addition to time factor, were found to affect doses subtly. In the clinic of college hospital the average of estimated doses to organs per person per year were 105.4 mrad (25.2 mrad for 5-year-old children) in the salivary gland, 55.9 mrad (18.9 mrad for 5-year-old) in the thyroid gland, 52.1 mrad (15.0 mrad for 5-year-old) in the lens of the eye and 52.2 mrad (8.7 mrad for 5-year-old) in the sella turcica. In the dental offices, the same average of estimated doses to organs were 40.5 mrad (7.4 mrad for 5-year-old) in the salivary gland, 17.4 mrad (8.0 mrad for 5-year-old) in the thyroid gland, 12.2 mrad (6.1 mrad for 5-year-old) in the lens of eye and 13.1 mrad (1.3 mrad for 5-year-old) in the sella turcica. In all kinds of radiograpy, the estimated doses in genital glands were in μrad. In the dental offices, both the percentage of young patients to all patients and the radiographing rate were lower as compared with those in the clinic of college hospital. The estimated doses were also lower at one-half to one-fifth and those by age and by organ were found to be one-tenth or lower. (J.P.N.)

Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome

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Jovanović Dragan

2009-01-01

Full Text Available Introduction. Hemorrhagic fever with renal syndrome (HFRS is acute infective multisystemic disease followed by febrility, hemorrhages and acute renal insufficiency. Bleeding in the anterior pituitary lobe leading to tissue necrosis occurs in acute stage of severe clinical forms of HFRS, while atrophy of the anterior pituitary lobe with diminution of the gland function occurs after recovery stage. Case report. We presented a patient with the development of chronic renal insufficiency and hypopituitarism as complication that had been diagnosed six years after Hantavirus infection. Magnetic resonance of the pituitary gland revealed atrophy and empty sella turcica. Conclusion. Regarding frequency of this viral infection and its endemic character in some parts of our country partial and/or complete loss of pituitary function should be considered during the late stage of HFRS.

Cushing-type ectopic pituitary adenoma with unusual pathologic features

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Kristopher T. Kimmell, MD

2014-06-01

Full Text Available Ectopic pituitary adenomas comprise, by varying reports, approximately 1-2% of all pituitary adenomas. They are often located in the nasopharyngeal region associated with the pharyngeal pituitary. The location and pathologic features of these masses make them atypical when compared with intrasellar pituitary adenomas. A 54-year-old man presented with vertebral compression fracture and physical stigmata of Cushing’s disease. Biochemical testing confirmed hypercortisolemia responsive to high dose dexamethasone suppression. MRI of the head demonstrated an enhancing mass in the posterior aspect of the sphenoid sinus not involving the sella turcica. Endoscopic biopsy followed by resection confirmed this mass to be a pituitary adenoma with unusual pathologic features. Most notably, the tumor cells demonstrated large, eosinophilic, vacuolated cytoplasm. Immunohistochemical profile of the tumor was typical of an ACTH secreting tumor, notably with positivity for ACTH. The patient did well from his surgery. Post-operatively his serum cortisol level normalized and he remains in chemical remission one year after surgery. Ectopic pituitary adenomas are an unusual manifestation of hormonally active pituitary neoplastic disease. Their atypical clinical presentations, location, and pathologic features can make them a diagnostic challenge. Clinicians should be aware of these entities, especially when considering differential diagnosis for a mass in the sphenoid sinus and nasopharyngeal region.

Fat-suppressed dynamic MR imaging for the postoperative evaluation of pituitary adenomas

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Akada, Kiyohiro

2000-01-01

The usefulness of the early post operative evaluation of pituitary adenomas with fat-suppressed MR imaging was studied. Thirty patients with pituitary adenoma, who underwent trans-sphenoidal surgery were analyzed. These include 22 with macroadenoma (3 recurrent cases) and 8 with microadenoma (2 recurrent cases). In all cases after adenoma resection, fat tissue was placed into the sella turcica to prevent postoperative cerebro-spinal fluid leakage and infections. T1-weighted and Gd DTPA-enhanced MR images were obtained using a 1.5-T superconductive MRI system (Shimadzu Co., Ltd.) by a standard technique and also by a fat suppression technique (chemical shift selective presaturation: CHESS) after surgery. It was difficult to discriminate between hematoma, fat tissue and pituitary posterior lobe on T1-weighted images within 1 month after surgery because of high-signal intensity. However, these regions could be distinguished one another by the CHESS technique. Normal pituitary anterior lobe could be identified in 86% of macroadenoma cases using Gd CHESS dynamic study, whereas it was identified only in 23% by standard technique. Normal anterior lobe was identified in 100% of microadenoma cases using Gd CHESS dynamic study. The residual tumors were found to invade into the supra sella or cavernous sinus, and these lesions could be distinguished from the surrounding tissue by the CHESS dynamic study in 83%, whereas only 33% could be distinguished by the standard technique. Although the fat tissue showed a time-sequence decrease in volume, high-signal intensity sometimes lasted long in association with degenerative granulation. In conclusion, CHESS dynamic MR Imaging study is useful for detection of the normal pituitary lobe and residual adenomas after trans-sphenoidal surgery. (author)

Gross tumor volume (GTV) and clinical target volume (CTV) for radiation therapy of benign skull base tumours

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Maire, J.P.; Liguoro, D.; San Galli, F.

2001-01-01

Skull base tumours represent a out 35 to 40% of all intracranial tumours. There are now many reports in the literature confirming the fact that about 80 to 90% of such tumours are controlled with fractionated radiotherapy. Stereotactic and 3-dimensional treatment planning techniques increase local control and central nervous system tolerance. Definition of the gross tumor volume (GTV) is generally easy with currently available medical imaging systems and computers for 3-dimensional dosimetry. The definition of the clinical target volume (CTV) is more difficult to appreciate: it is defined from the CTV plus a margin, which depends on the histology and anterior therapeutic history of the tumour. It is important to take into account the visible tumour and its possible extension pathways (adjacent bone, holes at the base of skull) and/or an anatomic region (sella turcica + adjacent cavernous sinus). It is necessary to evaluate these volumes with CT Scan and MRI to appreciate tumor extension in a 3-dimensional approach, in order to reduce the risk of marginal recurrences. The aim of this paper is to discuss volume definition as a function of tumour site and tumour type to be irradiated. (authors)

A primary sellar neuroblastoma mimicking a pituitary adenoma: A case report

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Kim, Dong Gun; Heo, Young Jin; Kim, Eun Kyoung; Baek, Jin Wook; Jeong, Hae Woong; Jung, Hyun Seok [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2016-12-15

Intracranial neuroblastomas are uncommon malignant tumors that usually arise in the supratentorial parenchymal or paraventricular location. A primary neuroblastoma arising in the sella turcica is extremely rare. We report a case of a 76-year-old man who presented with progressive bitemporal hemianopsia. His pituitary hormone levels were within the normal range, except for slightly increased prolactin. Pituitary magnetic resonance imaging revealed a solitary sellar mass with supra- and parasellar extension that mimicked a non-functioning pituitary adenoma or meningioma. The tumor was excised by transsphenoidal resection. Histopathologic analysis revealed small cells surrounded by a dense fibrillary stroma as well as strong expression of neural markers. Hence, the patient was diagnosed with sellar neuroblastoma. Prolactin levels normalized in the immediate postoperative period, although visual disturbances persisted. Herein, we describe the clinical manifestations, MRI characteristics, and histopathologic findings of this case.

Late onset isotretinoin resistant acne conglobata in a patient with acromegaly

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Jain Kapil

2008-01-01

Full Text Available A 55 year-old male presented with multiple pus-discharging abscesses and sinuses and mutilating scarring on the gluteal region and back prevalent for the last ten years with exacerbations and remissions. Physical examination revealed acromegaly with frontal bossing, prognathism, a barrel chest and acral hypertrophy. Dermatological examination revealed cutis verticis gyrata, thick eyelids, a large triangular nose, a thickened lower lip, macroglossia, widely spaced teeth and widened skin pores with wet and oily skin. Hair was fine and nails were flat and wide. There were multiple inflammatory papules, tender nodules, draining sinuses, and grouped, polyporous comedones as well as multiple and extensive depressed and keloidal scars localized predominantly over the gluteal region with a few scattered lesions over the back. A computed tomography (CT scan showed widened sella turcica. His basal fasting growth hormone (GH levels were markedly raised (230 ng/mL; normal 1-5 ng/mL while the prolactin levels were moderately raised (87 ng/mL; normal 2-5 ng/mL. These findings were consistent with a diagnosis of acromegaly. The patient was put on antibiotics, nonsteroidal antiinflammatory drugs and isotretinoin at a dose of 1 mg/kg/day, which was increased to 1.5 mg/kg/day. Except for an initial mildly beneficial response, the skin lesions were largely resistant to high doses of isotretinoin at the end of four months.

Large pituitary incidentaloma in a patient with sarcoidosis

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Leena Jalota

2014-07-01

Full Text Available A 60 year old male with a medical history of pulmonary sarcoidosis and chronic low testosterone presented to his allergist for excessive lacrimation. Computed tomography (CT scan of sinuses ordered for possible blocked nasolacrimal duct revealed an abnormal expansion of the sella turcica. Magnetic resonance imaging suggested a homogeneously enhancing 4 cm soft tissue mass enveloping the internal carotid and abutting the optic nerves. Since the patient indicated no symptoms, it was felt to be consistent with a pituitary incidentaloma. Laboratory investigation showed only minimally elevated prolactin. Visual field testing at the office was normal but computed campimetry was suggestive of few minimally depressed points in the supra-temporal quadrant on the right. Even with high suspicion of neurosarcoidosis, the patient had a surgical indication so he underwent transsphenoidal excision of the mass with no complications. Pathology was consistent with a null-cell pituitary adenoma.

Computed tomography in neoplastic diseases of the skull base and adjacent areas using EMI scanner CT-1000

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Ono, Yoshimi; Ohtake, Eiji; Asakura, Koichi; Tanohata, Kazunori; Ito, Otomasa

1980-01-01

CT-findings of 145 patients with and without neoplastic diseases of the skull base were evaluated using EMI CT-1000. Analysis of 64 patients without any lesion at the skull base showed more artifacts compared with that of higher slices, so that good or fair images were obtained only in 64% of this groups of patients. The most important factor in producing artifacts are considered to be caused by patient's movement. We also evaluated the tumor extension to the skull base in 81 patients. They were 24 brain tumors, 21 pituitary adenomas, and 36 nasopharyngeal and paranasal cancers. Four out of 24 brain tumors showed extracranial extension, 12 pituitary adenomas infiltrating outside of the sella turcica, and 10 cases of nasopharyngeal cancers showed intracranial extension. It was concluded that CT presented an excellent information in evaluating the degree of extension of neoplasms which invading to the skull base. (author)

Panhypopituitarism due to metastases to the hypothalamus and the pituitary resulting from primary breast cancer: a case report and review of the literature.

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Peppa, Melpomeni; Papaxoinis, Georgios; Xiros, Nikolaos; Raptis, Sotirios A; Economopoulos, Theofanis; Hadjidakis, Dimitrios

2009-11-01

Pituitary metastasis occurs rarely in cancer patients and often remains undiagnosed. However, early detection and appropriate treatment can improve the patient's quality of life and possibly prolong survival. Herein, we describe the case of a 52-year-old woman with panhypopituitarism caused by metastases to the hypothalamus and pituitary from primary breast cancer. She had a 5-year history of breast cancer with metastases to the bones 1.5 years after initial diagnosis and mastectomy. She presented with severe headaches, generalized fatigue, dizziness, hypotension, difficulties with balance and coordination, polyuria, and polydipsia. Laboratory work-up revealed panhypopituitarism (central diabetes insipidus; hypothyroidism; and low prolactin, gonadotrophin, and adrenocorticotropic hormone levels), and magnetic resonance imaging confirmed the pituitary and hypothalamic involvement. She received hormone replacement therapy, radiation therapy of the sella turcica and suprasellar lesion, and chemotherapy, with significant improvement of her clinical status, but she died 15 months later.

Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves.

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Kim, Soo Ryang; Kanda, Fumio; Kobessho, Hiroshi; Sugimoto, Koji; Matsuoka, Toshiyuki; Kudo, Masatoshi; Hayashi, Yoshitake

2006-11-07

We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves

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Soo Ryang Kim; Fumio Kanda; Hiroshi Kobessho; Koji Sugimoto; Toshiyuki Matsuoka; Masatoshi Kudo; Yoshitake Hayashi

2006-01-01

We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-yearold woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI)disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement.The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

Pituitary Adenoma Recurrence Suspected on Central Hyperthyroidism Despite Empty Sella and Confirmed by 68Ga-DOTA-TOC PET/CT.

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Gauthé, Mathieu; Sarfati, Julie; Bourcigaux, Nathalie; Christin-Maitre, Sophie; Talbot, Jean-Noël; Montravers, Françoise

2017-06-01

Thyrotropin-secreting pituitary adenomas are very rare tumors, known to present overexpression of somatostatin receptor subtype 2 and which may consequently demonstrate abnormal uptake on Ga-DOTA-TOC PET/CT. A 67-year-old woman with a history of operated pituitary macroadenoma presented with symptoms of hyperthyroidism including a large goiter. Her serum thyroid hormone levels were in favor of central hyperthyroidism. Pituitary MRI depicted an empty sella but visualized an ambiguous lesion centered on the left sphenoidal sinus. Complementary Ga-DOTA-TOC PET/CT finally demonstrated intense uptake by the sphenoidal lesion, confirming recurrence of the pituitary adenoma.

Delayed radiation necrosis in the optochiasmatic region

International Nuclear Information System (INIS)

Andoh, Takashi; Yokoyama, Kazutoshi; Kumagai, Morio

1984-01-01

Two cases with delayed radiation necrosis of the chiasmatic region following irradiation of the hypophysis for treatment of Cushing's disease were presented. Case 1 was a 36-year-old female who had reduction of visual acuity and bitemporal hemianopsia 2 years after 60 Co-irradiation therapy (total 8000 rads) for Cushing's disease. CT scans showed low density in the pituitary fossa and irregular contrast-enhanced suprasellar mass, and metrizamide CT cisternography revealed the pituitary fossa filled with contrast medium. From those findings, secondary empty sella syndrome was suspicious. Case 2 was a 35-year-old male who had progressive visual disturbance 3 years after 60 Co-irradiation therapy (total 9050 rads) for Cushing's disease. The right visual acuity was 0.05 and the left one was 0.1. Examination of visual field showed left homonymous hemianopsia. CT scans showed the contrast enhanced suprasellar mass extending to the right anterior thalamic region, and metrizamide CT cisternography detected secondary empty sella as same as that of Case 1. Authors reviewed and analyzed literatures of delayed radiation necrosis. The incidence of this condition was 4% to 9% and onset of the symptoms occured approximately 2 years after irradiation to hypophysis. Administration of steroid hormone and surgical treatment for the radiation necrosis involving the chiasmatic region were almost ineffective and also the prognosis of radionecrotic lesions involving the hypothalamus was very poor. Therefore, radiotherapy for hypophyseal region must be carried out by means of a rotation or arching technique in order to avoid this condition and further total dosage and its fractionation in radiation therapy should not exceed 6000 rads and 200 rads a day. (J.P.N.)

A Morphometric Study of the Foramen of Diaphragma Sellae and Delineation of Its Relation to Optic Neural Pathways through Computer Aided Superimposition

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Doris George Yohannan

2015-01-01

Full Text Available The diaphragma sellae (DS is a fold of dura that forms a partial roof over the pituitary gland. The foramen of the diaphragma sellae (FDS is thereby a pathway for suprasellar extension of pituitary tumors. The purpose of this study was to describe the anatomical dimensions of the DS and FDS and to understand the relationship of FDS with the overlying optic chiasma. The study was conducted in 100 autopsy cases. Measurements were taken using vernier calipers. Photographs, taken before and after removal of optic pathway, were superimposed using image processing software. The results showed that the mean A-P dimension of DS was 1.17 ± 0.48 cm; the lateral dimension of DS was 1.58 ± 0.60 cm. The mean A-P dimension of FDS was 0.66 ± 0.42 cm; the lateral dimension of FDS was 0.82 cm ± 0.54 cm. The shapes of FDS were irregular (40%, transversely oval (29%, circular (13%, sagittally oval (11%, or trapezoid with posterior dimension more than the anterior one (6% or anterior dimension more than the posterior one (1%. The margins of FDS were either well defined (31% or ill defined (69%. The positional relation of FDS to optic chiasma was also found out.

Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

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Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

1999-05-01

The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

Magnetic resonance imaging of pituitary adenomas

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Bonneville, Jean-Francois; Bonneville, Fabrice; Cattin, Francoise [University Hospital, Department of Neuroradiology, Besancon (France)

2005-03-01

Today, MR is the only method needed for the morphological investigation of endocrine-active pituitary adenomas. In acromegaly and Cushing's syndrome, the therapeutic attitude is directly dictated by MR data. We present the MR aspect of pituitary adenomas according to size, sex, age, endocrine activity and a few particular conditions such as hemorrhagic pituitary adenomas, pituitary adenomas during pregnancy, cavernous sinus invasion and postsurgical changes. When an intrasellar mass extending out of the sella turcica is detected, the goal of the MR examination is to indicate precisely the origin of the tumor, its extension in relation to the various surrounding structures, its structure and its enhancement in order to help in the differential diagnosis. Demonstration of very small pituitary adenomas remains a challenge. When SE T1- and Turbo SE T2-weighted sequences are non-diagnostic, enhanced imaging becomes mandatory; half-dose gadolinium injection, delayed sequence, dynamic imaging can be of some help. (orig.)

Primary intravascular large B-cell lymphoma of pituitary

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K R Anila

2012-01-01

Full Text Available A 68-year-old retired nurse, who was a known hypertensive on medication, presented with prolonged fever of 2-month duration without any clinical evidence of infection. On examination she had altered mental status. She also had other nonspecific complaints such as sleep disturbances, loss of weight, etc. On investigation, she was found to have anemia, thrombocytopenia, raised erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and lactate dehydrogenase (LDH values. She also had electrolyte imbalance. Radiological evaluation of brain showed mass lesion in the sella turcica, suggestive of pituitary adenoma. Biochemical evaluation showed hypopituitarism. Trans-sphenoidal biopsy was done. Based on histopathological and immunohistochemical findings a diagnosis of intravascular large B-cell lymphoma (IVLBCL of pituitary was made. Our patient′s condition deteriorated rapidly and she succumbed to her illness before therapy could be initiated. We are reporting this case because of the rare subtype of large B-cell lymphoma presenting at an extremely unusual primary site.

Preliminary comparison of the endoscopic transnasal vs the sublabial transseptal approach for clinically nonfunctioning pituitary macroadenomas.

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Sheehan, M T; Atkinson, J L; Kasperbauer, J L; Erickson, B J; Nippoldt, T B

1999-07-01

To assess the advantages and disadvantages of an endoscopic transnasal approach to pituitary surgery for a select group of clinically nonfunctioning macroadenomas and to compare results of this approach with the sublabial transseptal approach at a single institution. We retrospectively reviewed the records of 26 patients with clinically nonfunctioning pituitary macroadenomas approached endoscopically and 44 matched control patients with the same tumors approached sublabially between January 1, 1995, and October 31, 1997. At baseline, the groups were not significantly different for age, sex distribution, number of comorbid conditions, visual field defects, degree of anterior pituitary insufficiency, or preoperative assessment of tumor volume or invasiveness. Mean (SD) operative times were significantly reduced in the endoscopic group vs the sublabial group: 2.7 (0.7) hours vs 3.4 (0.9) hours (P working channel to the sella turcica. For these reasons, the endoscopic approach or its variation is an alternative to the sublabial approach but should be considered only by experienced pituitary neurosurgeons.

Postoperative follow-up of pituitary adenomas after trans-sphenoidal resection: MRI and clinical correlation

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Rodriguez, O. [Servicio de Radiologia, Hospital de Cruces, Baracaldo (Spain); Mateos, B. [Servicio de Radiologia, Hospital de Cruces, Baracaldo (Spain); Pedraja, R. de la [Servicio de Endocrinologia, Hospital de Cruces, Baracaldo (Spain); Villoria, R. [Servicio de Radiologia, Hospital de Cruces, Baracaldo (Spain); Hernando, J.I. [Servicio de Radiologia, Hospital de Cruces, Baracaldo (Spain); Pastor, A. [Servicio de Radiologia, Hospital de Cruces, Baracaldo (Spain); Pomposo, I. [Servicio de Neurocirugia, Hospital de Cruces, Baracaldo (Spain); Aurrecoechea, J. [Servicio de Neurocirugia, Hospital de Cruces, Baracaldo (Spain)

1996-11-01

Our purpose was to correlate the morphological changes seen on MRI studies of the sellar region after trans-sphenoidal resection of pituitary adenomas with clinical and hormonal studies. Between January 1993 and March 1994, 16 patients with a pituitary adenoma (9 macroadenomas and 7 microadenomas) were subjected to trans-sphenoidal resection and included in a prospective study. The protocol consisted of MRI, hormonal and visual studies at the following times: immediately postoperative (1st week), 1st month, 4th month and 1st year after surgery. The evolution of the contents of the sella turcica (tumour remnant, packing material and gland tissue), effects on the infundibulum, optic chiasm, cavernous sinus and sphenoid sinus were correlated with the clinical and hormonal studies. Stabilisation of the postsurgical changes occurred by the 4th month. Tumour remnants were noted in the immediate postoperative period in macroadenomas. Compression of the infundibulum was the only reliable indicator of possible involvement. Optic chiasm compression, defined as close contact between the chiasm and the tumour, was the only morphological finding that indicated visual impairment. There was no standard repneumatisation pattern in the sphenoid sinus, since mucosal changes resembling sinusitis were one of the postsurgical changes. We found MRI not to be useful for follow-up of microadenomas. (orig.). With 4 figs., 4 tabs.

Postoperative follow-up of pituitary adenomas after trans-sphenoidal resection: MRI and clinical correlation

International Nuclear Information System (INIS)

Rodriguez, O.; Mateos, B.; Pedraja, R. de la; Villoria, R.; Hernando, J.I.; Pastor, A.; Pomposo, I.; Aurrecoechea, J.

1996-01-01

Our purpose was to correlate the morphological changes seen on MRI studies of the sellar region after trans-sphenoidal resection of pituitary adenomas with clinical and hormonal studies. Between January 1993 and March 1994, 16 patients with a pituitary adenoma (9 macroadenomas and 7 microadenomas) were subjected to trans-sphenoidal resection and included in a prospective study. The protocol consisted of MRI, hormonal and visual studies at the following times: immediately postoperative (1st week), 1st month, 4th month and 1st year after surgery. The evolution of the contents of the sella turcica (tumour remnant, packing material and gland tissue), effects on the infundibulum, optic chiasm, cavernous sinus and sphenoid sinus were correlated with the clinical and hormonal studies. Stabilisation of the postsurgical changes occurred by the 4th month. Tumour remnants were noted in the immediate postoperative period in macroadenomas. Compression of the infundibulum was the only reliable indicator of possible involvement. Optic chiasm compression, defined as close contact between the chiasm and the tumour, was the only morphological finding that indicated visual impairment. There was no standard repneumatisation pattern in the sphenoid sinus, since mucosal changes resembling sinusitis were one of the postsurgical changes. We found MRI not to be useful for follow-up of microadenomas. (orig.). With 4 figs., 4 tabs

Imaging Evaluation of the Location and Fenestration of Sellar Floor during Endonasal Transsphenoidal Surgery in Patients with Pituitary Adenomas.

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Wang, Shousen; Qin, Yong; Xiao, Deyong; Wu, Zhifeng; Wei, Liangfeng

2018-05-03

To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor. Anatomic variation of the sphenoidal sinus and adjacent structures, tumor and sella turcica morphology, minimal distance between the cavernous segment of the internal carotid artery（CSICA） bilaterally, and the shortest distance from the midline were measured. Based upon the shape of the sphenoidal sinus separation, sellar floor was accurately localized in all cases. Intra-operative sphenoidal sinus separation was consistent with pre-operative 3D CT reconstruction images. The sellar floor was extremely small in two patients, and insufficient fenestration of the sellar floor negatively affected tumor resection. Pre-operative 3D CT reconstruction is helpful for accurate and rapid localization of the saddle floor. The anatomic variation of sphenoidal sinus and adjacent structures, the characteristics of tumor and Sella, the minimum distance between bilateral CSICA and the shortest distance from the midline are helpful for the establishment of individualized Sellar bottom fenestration. Copyright © 2018. Published by Elsevier Inc.

Diagnosis of tumors of the pituitary region by two-plane CT scans

International Nuclear Information System (INIS)

Murata, Minoru; Inoue, Hiroshi; Misumi, Shuzo; Shimizu, Tsuneo; Tamura, Masaru

1981-01-01

Thirty five cases of tumors in the pituitary region were analysed by two-plane CT (ordinary sections and reverse sections) in order to obtain a more accurate image of the tumor and thus establish an appropriate indication for the subnasal transsphenoidal approach. The tumors of pituitary region were classified into six groups (types I-VI) according to their degree of extension and direction of growth. Small tumors such as types I and II were detected more clearly by the reverse section than by the ordinary section. In cases of large tumors (types III-VI) relation of the tumor to the surrounding structures such as the sphenoid sinus, third ventricle, lateral ventricule, middle fossa and brain stem was accurately demonstrated by the reverse section. In the differential diagnosis of tumors in the pituitary regions, tumors showing mixed density or slightly high density and widening of the anteroposterior diameter of the sella in the precontrast reverse section and homogeneous enhancement by infusion were likely to be pituitary adenomas. One third of the pituitary adenomas showed ring-like high density in the post-contrast reverse section. Calcification was not seen in the pituitary adenomas by CT scans. All craniopharyngiomas belonged to types III-VI. Craniopharyngiomas showed high and/or low density, and various degrees of calcification in plain CT scans. Ring-like high density was seen in two thirds of the craniopharyngiomas. About one third of the craniopharyngiomas showed widening of the antero-posterior diameter of the sella. (J.P.N.)

Application of phantom type compensating filter in tomography

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Okayama, A.; Mukae, H.; Itoh, M. (Yamaguchi Univ., Ube (Japan). School of Medicine)

1981-01-01

We reported a new device of phantom type compensating filters for pulmonary hilar tomography with polytome U at the 35th annual meeting of the Japanese Society of Radiological Technology. This report is to show application of this compensated method to the head, the hip joint and the lower thoracic spine in tomography. Using the filters optimal density can be obtained in all area of aim part on a X-ray film, and thus makes to get more information. 1) In the head clear shadow of pars nasalis, sinus paranasales and sella turcica is obtained. Destruction or defect of bone contour is easily detected. It is also useful to differentiate the disorders and to determine the expansivity of the lesion. 2) In the hip joint this method has advantages over the ordinary method. There is a few misdiagnosis in trochanteric lesions such as tuberculosis or bone tumor, because of high density at the trochanteric region in ordinary method, but in this method optimal density can be obtained, and misdiagnosis is improved. Soft tissue is sharply visualized, indicating usefulness in diagnosis of existence of hematoma or abscess. 3) In the lower thoracic vertebra it is useful to diagnosis of the thoracic spondylosis, tuberculous spondylitis and compression fracture of the vertebral body, since optimal density of the spine can be obtained. It is also quite useful to detect small ossifications in the vertebral foraman in ossification of the flavum ligament.

Application of phantom type compensating filter in tomography

International Nuclear Information System (INIS)

Okayama, Akio; Mukae, Hideki; Itoh, Mitsuo

1981-01-01

We reported a new device of phantom type compensating filters for pulmonary hilar tomography with polytome U at the 35th annual meeting of the Japanese Society of Radiological Technology. This report is to show application of this compensated method to the head, the hip joint and the lower thoracic spine in tomography. Using the filters optimal density can be obtained in all area of aim part on a X-ray film, and thus makes to get more information. 1) In the head clear shadow of pars nasalis, sinus paranasales and sella turcica is obtained. Destruction or defect of bone contour is easily detected. It is also useful to differentiate the disorders and to determine the expansivity of the lesion. 2) In the hip joint this method has advantages over the ordinary method. There is a few misdiagnosis in trochanteric lesions such as tuberculosis or bone tumor, because of high density at the trochanteric region in ordinary method, but in this method optimal density can be obtained, and misdiagnosis is improved. Soft tissue is sharply visualized, indicating usefulness in diagnosis of existence of hematoma or abscess. 3) In the lower thoracic vertebra it is useful to diagnosis of the thoracic spondylosis, tuberculous spondylitis and compression fracture of the vertebral body, since optimal density of the spine can be obtained. It is also quite useful to detect small ossifications in the vertebral foraman in ossification of the flavum ligament. (author)

Pure endoscopic expanded endonasal approach for olfactory groove and tuberculum sellae meningiomas.

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Khan, Osaama H; Krischek, Boris; Holliman, Damian; Klironomos, George; Kucharczyk, Walter; Vescan, Allan; Gentili, Fred; Zadeh, Gelareh

2014-06-01

The expanded endoscopic endonasal (EEE) approach for the removal of olfactory groove (OGM) and tuberculum sellae (TSM) meningiomas is currently becoming an acceptable surgical approach in neurosurgical practice, although it is still controversial with respect to its outcomes, indications and limitations. Here we provide a review of the available literature reporting results with use of the EEE approach for these lesions together with our experience with the use of the endoscope as the sole means of visualization in a series of patients with no prior surgical biopsy or resection. Surgical cases between May 2006 and January 2013 were retrospectively reviewed. Twenty-three patients (OGM n=6; TSM n=17) were identified. In our series gross total resection (GTR) was achieved in 4/6 OGM (66.7%) and 11/17 (64.7%) TSM patients. Vision improved in the OGM group (2/2) and 8/11 improved in the TSM group with no change in visual status in the remaining three patients. Post-operative cerebrospinal fluid (CSF) leak occurred in 2/6 (33%) OGM and 2/17 (11.8%) TSM patients. The literature review revealed a total of 19 OGM and 174 TSM cases which were reviewed. GTR rate was 73% for OGM and 56.3% for TSM. Post-operative CSF leak was 30% for OGM and 14% for TSM. With careful patient selection and a clear understanding of its limitations, the EEE technique is both feasible and safe. However, longer follow-ups are necessary to better define the appropriate indications and ideal patient population that will benefit from the use of these newer techniques. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Collision tumors of the sella: coexistence of pituitary adenoma and craniopharyngioma in the sellar region

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2013-01-01

Collision tumors of the sellar region are relatively uncommon and consist mainly of more than one type of pituitary adenoma or a cyst or cystic tumor. The association of a pituitary adenoma and a craniopharyngioma is particularly rare. This study describes a rare occurrence in which a pituitary adenoma and a craniopharyngioma coexisted in the sellar region. The case involves a 47-year-old woman who underwent transsphenoidal surgery with subtotal tumor resection and reoperation using an interhemispheric transcallosal approach for total microsurgical resection of the tumor because the visual acuity in her left eye had re-deteriorated. Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation. Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor. Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region. PMID:23919255

Ectopic sphenoid sinus pituitary adenoma (ESSPA) with normal anterior pituitary gland: a clinicopathologic and immunophenotypic study of 32 cases with a comprehensive review of the english literature.

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Thompson, Lester D R; Seethala, Raja R; Müller, Susan

2012-03-01

Ectopic sphenoid sinus pituitary adenoma (ESSPA) may arise from a remnant of Rathke's pouch. These tumors are frequently misdiagnosed as other neuroendocrine or epithelial neoplasms which may develop in this site (olfactory neuroblastoma, neuroendocrine carcinoma, sinonasal undifferentiated carcinoma, paraganglioma, melanoma). Thirty-two patients with ESSPA identified in patients with normal pituitary glands (intact sella turcica) were retrospectively retrieved from the consultation files of the authors' institutions. Clinical records were reviewed with follow-up obtained. An immunohistochemical panel was performed on available material. Sixteen males and 16 females, aged 2-84 years (mean, 57.1 years), presented with chronic sinusitis, headache, obstructive symptoms, and visual field defects, although several were asymptomatic (n = 6). By definition, the tumors were centered within the sphenoid sinus and demonstrated, by imaging studies or intraoperative examination, a normal sella turcica without a concurrent pituitary adenoma. A subset of tumors showed extension into the nasal cavity (n = 5) or nasopharynx (n = 9). Mean tumor size was 3.4 cm. The majority of tumors were beneath an intact respiratory epithelium (n = 22), arranged in many different patterns (solid, packets, organoid, pseudorosette-rosette, pseudopapillary, single file, glandular, trabecular, insular). Bone involvement was frequently seen (n = 21). Secretions were present (n = 16). Necrosis was noted in 8 tumors. The tumors showed a variable cellularity, with polygonal, plasmacytoid, granular, and oncocytic tumor cells. Severe pleomorphism was uncommon (n = 5). A delicate, salt-and-pepper chromatin distribution was seen. In addition, there were intranuclear cytoplasmic inclusions (n = 25) and multinucleated tumor cells (n = 18). Mitotic figures were infrequent, with a mean of 1 per 10 HPFs and a pituitary hormones included 48% reactive for 2 or more hormones (plurihormonal), and

Consideraciones sobre el diagnóstico por imágenes de las masas selares Reflection on imaging diagnosis of sellar masses

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José Arturo Hernández Yero

2005-12-01

Full Text Available Con el propósito de hacer un llamado de atención sobre una temática de importancia y tomando en consideración que con los avances en la imagenología moderna se aportan elementos distintivos y de gran utilidad en el diagnóstico por imágenes de un grupo de masas en la región de la silla turca, se hacen determinadas valoraciones al respecto, con precisión de algunas de las características de las principales masas selares y su apariencia en la resonancia magnética nuclear. Se destacan detalles en cuanto a la intensidad de la señal en los adenomas pituitarios, craneofaringiomas, quistes de la bolsa de Rathke, hiperplasia hipofisaria y el denominado síndrome de la silla turca vacía, entre otras causas de cambios anatómicos en la región selar. Se concluye que la imagen por resonancia magnética nuclear sería el método idóneo para un mejor diagnóstico de las masas selares aunque, en ausencia de esta, la tomografía contrastada puede resultar de utilidad si se realiza con cortes menores de 2 mm. Se resalta la importancia de integrar un equipo multidisciplinario entre clínicos, endocrinólogos, imagenólogos, neurocirujanos y anatomopatólogos, para obtener diagnósticos más precisos y resultados terapéuticos adecuados.Some reflections were made on imaging diagnosis of sellar masses, specifying some characteristics of the main sellar masses and their appearance in magnetic resonance imaging. The purpose was to call the attention on this important issue on the basis that modern imaging advances offer very useful distinctive elements in the diagnosis of a group of masses located in the sella turcica region. The paper underlined details of signal intensity in pituitary adenomas, craniopharyngiomas, Rathke´s pouch cysts, hypophysial hyperplasia and the so-called empty sella syndrome, among other causes of anatomical changes in sellar region. It was concluded that magnetic resonance imaging would be the ideal method for a better

Pituitary tumour causing gigantism. Morphology and in vitro hormone secretion.

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Anniko, M; Ritzén, E M

1986-01-01

True gigantism with overproduction of growth hormone (GH) and prolactin (PRL) was diagnosed in a 13-year-old boy. The clinical history indicated that the tumour had caused an oversecretion of GH since the age of 4-5 years. At diagnosis, the sella turcica was markedly enlarged. No infiltrative growth was noted at surgery. Endocrine investigations showed elevated GH and PRL secretion. Light and electron microscopy of tumour tissue revealed densely packed pleomorphic cells of both GH and PRL type. In addition, oncocyte-like cells were observed. Organ culture of pieces of tumour tissue demonstrated continued secretion of GH and PRL into the medium for more than 5 days in vitro. Addition of bromocriptine to the medium caused a rapid decline in PRL secretion while GH secretion remained the same. X-ray irradiation in vitro also caused a decrease in PRL secretion. These effects of bromocriptine and X-ray on hormone secretion in vitro mirrored the corresponding effect of treatment, when the patient showed signs of tumour recurrence after pituitary surgery. It is concluded that also in childhood, the in vitro response of tumour tissue to various treatments may be explored as a possible way to predict the efficacy of pharmacological or irradiation treatment of pituitary tumours.

Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

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Munier A. Nour

2016-01-01

Full Text Available Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases.

Acromegaly: Role of Surgery in the Therapeutic Armamentarium

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Gerardo Guinto

2012-01-01

Full Text Available Acromegaly is a complex disease that requires the intervention of a multidisciplinary team. The most frequent clinical manifestations are growing of distal parts of the body and some areas of the face. Patients may also present arterial hypertension, diabetes mellitus, colonic polyps, cardiomegaly, neurological and endocrine changes secondary to the presence of a GH-secreting tumor in pituitary or extrapituitary origin, or eutopic hypothalamic GHRH hypersecretion and peripheral GHRH hypersecretion. Surgery is the first treatment used for most patients, regardless of the cause. In the great majority of cases, pituitary tumor can be removed through a transsphenoidal approach. Craniotomy is reserved for those cases with giant tumors, particularly when they grow toward the middle or posterior cranial fossa. Best surgical results are obtained when the tumor is confined into the sella turcica or if it has a regular suprasellar extension. When the disease cannot be controlled with surgery, medical treatment is indicated. Somatostatin analogues are included as the first line of medication, followed by dopamine agonist and growth hormone receptors antagonists. Radiation therapy can be also indicated in two main forms for residual tumor with medically refractory patients: radiosurgery for small tumors or fractionated stereotactic radiotherapy for larger ones.

Tuberculum sellae meningiomas: surgical considerations Meningiomas do tuberculo selar: aspectos cirúrgicos

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José Alberto Landeiro

2010-06-01

Full Text Available We report our experience on the treatment of tuberculum sellae meningiomas (TSMs regarding the involvement of the optic canal and clinical outcomes. We reviewed 23 patients who were operated on between January 1997 and December 2008. The surgical approach was unilateral subfrontal supraorbital osteotomy in one piece. Attempts were made to improve visual function via extra/intradural unroofing of the optic canal, which released the optic nerve. Visual symptoms were present preoperatively in 21 patients, and two patients were asymptomatic. Visual acuity remained intact in 6 patients, improved in 10, was unchanged in 5 patients, and worsened in 2 patients. The postoperative visual field was normal or improved in 17 patients, unchanged in four patients, and worsened in two patients. The optic canal and clinoid were drilled extradurally in eight patients and intradurally in nine patients. Total resection of TSMs was achieved in 19 patients. Incomplete resection occurred in two patients. Decompression of the optic canal seemed to increase the visual outcome.Apresentamos nossa experiência em 23 pacientes operados com meningiomas do tubérculo da sela, com enfoque na descompressão do nervo óptico e nos sintomas visuais do pós-operatório. Vinte e três pacientes com meningiomas do tubérculo da sela foram operados entre janeiro de 1997 e dezembro de 2008, através do acesso subfrontal via ostetomia supraorbital. Remoção do teto do canal óptico por via extra ou intradural foi realizada em 17 pacientes. Sintomas visuais no pré-operatório ocorreram em 21 pacientes, 2 eram assintomáticos. Melhora visual ocorreu em 10, permaneceu inalterada em 5 e piorou em 2 pacientes. No pós-operatório o campo visual normalizou-se em 17 pacientes, permaneceu inalterado em 4 e diminuiu em 2. Descompressão dos nervos ópticos foi realizada em 17 pacientes. Ressecção total dos meningiomas do tubérculo da sela foi possível em 19 pacientes. Abertura do canal �

Patients cured of acromegaly do not experience improvement of their skull deformities.

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Rick, Jonathan W; Jahangiri, Arman; Flanigan, Patrick M; Aghi, Manish K

2017-04-01

Acromegaly is a rare disease that is associated with many co-morbidities. This condition also causes progressive deformity of the skull which includes frontal bossing and cranial thickening. Surgical and/or medical management can cure this condition in many patients, but it is not understood if patients cured of acromegaly experience regression of their skull deformities. We performed a retrospective analysis on patients treated at our dedicated pituitary center from 2009 to 2014. We looked at all MRI images taken during the treatment of these patients and recorded measurements on eight skull dimensions. We then analyzed these measurements for changes over time. 29 patients underwent curative treatment for acromegaly within our timeframe. The mean age for this population was 45.0 years old (range 19-70) and 55.2 % (n = 16) were female. All of these patients were treated with a transsphenoidal resection for a somatotropic pituitary adenoma. 9 (31.1%) of these patients required further medical therapy to be cured. We found statically significant variation in the coronal width of the sella turcica after therapy, which is likely attributable to changes from transsphenoidal surgery. None of the other dimensions had significant variation over time after cure. Patients cured of acromegaly should not expect natural regression of their skull deformities. Our study suggests that both frontal bossing and cranial thickening do not return to normal after cure.

Long-term results of stereotactic radiosurgery to the pituitary gland in Cushing's disease

International Nuclear Information System (INIS)

Degerblad, M.; Raehn, T.; Bergstrand, G.; Thoren, M.

1986-01-01

Gamma radiation from 60 Co delivered with stereotactic technique was given to the pituitary gland in 35 patients, aged 18-65 years, with Cushing's disease. The doses were 70-100 Gy in each single irradiation. The size of the sella turcica was normal in the majority of the patients. The observation time was 3-9 years in 29 patiens. Out of them, 14 (48%) obtained clinical remission and normal urinary cortisol after one irradiation. Eight achieved remission after two to four irradiations. In total, 22 out of 29 patients (76%) obtained remission. In 12 of them remission was obtained in 1 year and in another 10 within 3 years. No recurrences were observed. Improvement was seen in 2 patients after one and three irradiations. Bilateral adrenalectomy was performed in 5 patients owing to unsatisfactory effect of irradiation. Pituitary insufficiency with gonadotropin, thyrotropin or cortocotropin failure was demonstrated in 12 of 22 patients in remission. This occurred 4 months to 7 years after the first irradiation. Another 6 patients were followed less than 3 years after the first irradiation. Two obtained remission after the first treatment, whereas the other 4 improved. Stereotactic pituitary irradiation is suggested as a non-invasive therapeutic alternative in Cushing's disease for example in patients with considerable surgical risk or as a supplement to pituitary microsurgery. (author)

[Dwarfism due to familial panhypopituitarism].

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Cos Welsh, J; Espinosa de los Monteros, A; de la Luz Ajuria, M; Morillo Almao, E

1977-01-01

Three sisters of 27 7/12, 13 8/12 and 9 1/12 years of age, respectively, with proportionate dwarfism, high pitched voice and lack of sexual development are described. All the patients had very low serum levels of immunoreactive growth hormone (GH), as well as of LH and FSH. Hypoglycemia induced by insulin and arginine infusion failed to increase GH levels, and the administration of the hypothalamic LH-FSH releasing hormone (LH-RH) did not elicit any response in the secretion of gonadotropins. The oldest sister developed hypothyroidism in recent years, since the I131 thyroid uptake was normal ten years before; her serum TSH was low and did not change with TRH stimulation. In addition, a low pituitary ACTH reserve was demonstrated by the hypoglycemia and metirapone tests. Case 2 showed partial pituitary TSH and ACTH reserve, whereas the youngest child only had low TSH pituitary reserve. These patients had all the clinical and laboratory characteristics of familial panhypopituitarism, with normal sella turcica. Genetic transmission in this cases is consistent with the autosomal recessive form, which is the most frequent type of inheritance of this entity. Consanguinity can not be ruled out. The results of the hypothalamic-pituitary functional tests apparently suggest that the primary defect could be located at the pituitary level. It is also possible that the pathological process may have a progressive evolution.

Spindle cell oncocytoma of adenohypophysis: Cytogenetics and β-catenin findings with pathology differential diagnosis and review of the literature

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Jianwu Xie

2017-09-01

Full Text Available Spindle cell oncocytoma (SCO is an extremely rare neoplasm arising in the anterior pituitary. We report comprehensive pathological description of a case of SCO in a 60 year-old male who presented with nausea, vomiting and severe hyponatremia, and pan hypopituitarism. Magnetic resonance imaging (MRI showed a 3.1 × 2.3 × 2.0 cm homogeneously enhancing bilobed mass within the sella turcica and suprasellar cistern. Intraoperative frozen section and touch imprint cytology showed cohesive spindle cells with abundant oncocytic cytoplasm. Histologic sections revealed the tumor was composed of interlacing fascicles of compact spindled cells with abundant dense oncocytic cytoplasm. There was no mitosis or necrosis present. Ki-67 index varied in areas, with an average of 3%. By immunohistochemistry (IHC, the tumor cells were negative for Cam5.2, AE1/3, neurofilament (NF, NeuN, glial fibrillary acidic protein (GFAP and synaptophysin, and strongly positive for vimentin, TTF-1 and EMA. S-100 showed focal weakly positivity. By electron microscopy (EM, the cytoplasm of the spindle cells contained numerous abundant, back-to-back, uniform, round, normal-sized mitochondria with long and lamellar cristae. Beta-catenin showed diffuse membranous and partial cytoplasmic positivity. Cytogenetic analysis showed extra copies of chromosome 1 (74%, up to 8 copies, and loss of chromosome 2 (35%. The histogenesis, classification and differential diagnosis are discussed.

Variability in sphenoid sinus pneumatization and its impact upon reduction of complications following sellar region surgeries

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Tarek H. ELKammash

2014-09-01

Conclusion: Pre-intervention assessment of sphenoid sinus pneumatization is mandatory in approaching the sella and skull base structures either via the nose or open skull base surgery to avoid injury of the nearby structures and reduce the possibility of CSF leakage.

A Case of Acromegaly in which a Pituitary Gland Tumor was Reduced Significantly by Administering Octreotide Long Acting Release (LAR) and Could Be Removed Surgically.

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Arao, Tadashi; Okada, Yosuke; Uemura, Fumi; Nishizawa, Shigeru; Tanaka, Yoshiya

A 54-year-old woman was admitted to our hospital for detailed examination of acromegaly because she noticed bilateral hand and finger swelling at the age of 43 and plantar thickening, facial changes and unclear articulation at the age of 49. She had prominent brow ridges, mandibular protrusion, and enlargement of the hands, feet, nasal wings, lips and tongue. Her growth hormone (GH) level was 39.8 ng/ml, insulin-like growth factor-1 (IGF-1) level was 717 ng/ml, GH level was not suppressed (22.9 ng/ml) during a 75-g oral glucose tolerance test (OGTT). Radiography showed cauliflower-like enlargement of the distal phalanx of the fingers, thickening/enlargement of the plantar soft tissues, and increased antero-posterior diameter of the sella turcica. Magnetic resonance imaging showed a mass (21×17 mm) growing towards the right suprasellar region and invading the cavernous sinus. She was diagnosed with acromegaly based on the characteristic physical findings, GH excess, high IGF-1, lack of GH suppression during the 75-g OGTT, and the presence of a pituitary tumor. She was started on octreotide long acting release (Oct-LAR) 20 mg/4w for tumor shrinkage. After three doses, her GH and IGF-1 levels decreased to 2.19 ng/ml (1.69 during the 75-g OGTT) and 205 ng/ml, respectively, meeting cure criteria for acromegaly. In this case, a decrease in GH and IGF-1 levels, tumor shrinkage, and resolution of cavernous sinus invasion allowed the patient to undergo surgery with curative intent (the first-line treatment for acromegaly) without postoperative complications. Thus, preoperative Oct-LAR administration has the potential to improve treatment outcomes of acromegaly.

Aspectos de interés sobre el síndrome de silla turca vacía en los niños: a propósito de 5 pacientes Aspects of interest on the empty sella syndrome in children: apropos of 5 patients

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Pedro González Fernández

2008-06-01

Full Text Available Se presentan 5 pacientes menores de 12 años, atendidos en el Servicio de Endocrinología del Hospital Pediátrico Docente «William Soler» a quienes se les realizó un estudio imagenológico con tomografía axial computada y resonancia magnética nuclear, para confirmar diagnóstico de endocrinopatía. Tras el estudio se diagnosticó síndrome de la silla turca vacía. Existen diferencias clínicas entre niños y adultos con silla turca vacía; las más relevantes radican en que en los niños no hay predominio de sexo ni asociación con la obesidad, y en ellos se observa la presencia de afecciones endocrinas como expresión de alteraciones hipotálamo-hipofisarias.The cases of 5 patients under 12 that received attention at the Endocrinology Service of "William Soler" Pediatric Teaching Hospital and that underwent an imaging study with computerized axial tomography and nuclear magnetic imaging to confirm endocrinopathy were presented. The empty sella syndrome was diagnosed after concluding the study. Clinical differences were observed between children and adults with empty sella syndrome. The most significant were found in children, among whom there was neither predominance of sex nor association with obesity. The presence of endocrine affections as expression of hypothalamus-hypophyseal alterations was observed in them.

Gorlin-Goltz syndrome: A case series of 5 patients in North Indian population with comparative analysis of literature.

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Lata, Jeevan; Verma, Nitin; Kaur, Amandeep

2015-09-01

In Indian scenario, Gorlin-Goltz syndrome (nevoid basal cell carcinoma syndrome [NBCCS]) has been rarely reported. The clinical, radiological, and histopathological findings and major and minor criteria in five cases of NBCCS in North Indian population have been presented along with a discussion of the role of gene mutation analysis in early diagnosis of syndrome. The diagnostic findings of Gorlin-Goltz syndrome in 5 patients were compared with other reports in Indian population and with reports of this syndrome in other parts of the world. The most common features seen were keratocystic odontogenic tumors (100%), calcifications of falx cerebri (60%), palmar-plantar pits (80%), rib anomalies (80%), macroencephaly (60%), ocular hypertelorism (80%), and frontal bossing (60%) in our series. Retained deciduous teeth seen in 80% patients whose association has not been previously reported has been presented. None of our patients had basal cell carcinoma, syndactyly or polydactyly, pectus deformity, bridging of sella turcica, pigmented nevi, or family history of this syndrome in contrast to such findings in other Indian patients. Medulloblastoma has not been reported in any Indian patient so far compared to this finding in other studies conducted worldwide. Combining the features of 48 patients in 38 cases of NBCCS being published in Indian literature with five cases of our series and on comparison with other studies in the world, a wide disparity in different ethnic groups and a wide variation in presentation of syndrome within the same population is suggested.

Unusual association of turner syndrome and hypopituitarism in a Tunisian family.

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Bougacha-Elleuch, N; Elleuch, M; Charfi, N; Mnif, F; Belghith, N; Abdelhedi, F; Kammoun, H; Hachicha, M; Mnif, M; Abid, M

2016-01-01

Familial occurrence of either Turner syndrome or hypopituitarism is very rare. Particularly, their association is an uncommon finding. In this context, we describe for the first time 4 sisters with Turner syndrome, hypopituitarism was reported in three among them. Our cohort consists of four Tunisian adult sisters belonging to a consanguineous family. Biochemical analysis, resonance magnetic imaging and cytogenetic analyses were performed. Turner syndrome was diagnosed at the ages of 14, 17, 31 and 43 years in cases 1, 2, 3 and 4 respectively. They suffered from short stature, dysmorphic syndrome and/or delayed puberty. Interestingly, 3 among them showed also hypopituitarism, hypogonadotrophic hypogonadism and central hypothyroidism. Somatotropic insufficiency was proven in one case. Pituitary MRI has shown an empty sella turcica with hypoplastic pituitary gland in three cases. Their karyotypes were compatible with 45X in one case, 45X/46XX in the second and 45X/46XX/47XXY with x label in two cases. Hence, the presence of these familial cases of TS must evoke new etiopathogenetic arguments. Coincidence of hypopituitarism in this family, might suggest common genetic background for the two diseases. This particular family would be a precious tool for an extensive molecular analysis. More attention should be given to other family's members mainly in the presence of delayed puberty and sterility in other members. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Pituitary abscess: report of two cases and review of the literature

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Liu Y

2017-06-01

Full Text Available Yu Liu,1 Feng Liu,2 Qi Liang,3 Yexin Li,4 Zhifei Wang5 1Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 2Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 3Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, 4Department of Neurosurgery, The Central Hospital of Shaoyang, Shaoyang, 5Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China Abstract: Pituitary abscess is a rare but critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. Since symptoms, signs and radiographic characteristics of pituitary abscess are similar to several other pituitary lesions, correct diagnosis before surgery is challenging. In this article, two cases of pituitary abscess treated in our department are reported, followed by a literature review. In these two cases, both patients presented with intermittent fever. Magnetic resonance imaging revealed a suprasellar lesion with rim enhancement after contrast injection. After transsphenoidal surgery, the diagnosis of pituitary abscess was confirmed. The patients were then given antibiotic treatment and recovered fully in less than 2 months. Findings of this article support timely diagnosis and proper treatment including transsphenoidal surgery and antibiotic therapy for pituitary abscess, leading to lower mortality rates and higher probability of pituitary hormone function recovery. Keywords: pituitary abscess, transsphenoidal resection, antibiotic therapy, diagnosis 

Changes in Plasma Prolactin and Growth Hormone Level and Visual Problem after radiation Therapy(RT) of Pituitary Adenoma

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Yoon, Sei Chul; Kwon, Hyung Chul; Oh, Yoon Kyeong; Bahk, Yong Whee; Son, Ho Young; Kang, Joon Ki; Song, Jin Un

1985-01-01

Twenty-four cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary Hospital, Catholic Medical College. Of 24 case of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analyzed the alteration of the endocrinological tests, neurologic abnormalities, major clinical symptoms, endocrinological changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra and para-sellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormonesecreting tumors, 3 ACTH-secreting tumors consisting of one Cushing disease and two Nelson syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but on lost case. 6. Two of 4 growth hormone-secreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well

Endoscopic transnasal repair of cerebrospinal fluid leaks with and without an encephalocele in pediatric patients: from infants to children.

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Ma, Jingying; Huang, Qian; Li, Xiaokui; Huang, Dongsheng; Xian, Junfang; Cui, Shunjiu; Li, Yunchuan; Zhou, Bing

2015-09-01

The diagnosis and management of pediatric cerebrospinal fluid (CSF) leak and encephalocele are challenging. The current study aimed to identify patient characteristics, review operative techniques, and evaluate the efficacy and safety of endoscopic endonasal repair in a pediatric population. We retrospectively reviewed the records of pediatric patients who underwent transnasal endoscopic repair of CSF leak with or without a meningocele or an encephalocele at Beijing Tongren Hospital, Capital Medical University, between July 2003 and May 2014. All patients had preoperative radiological evaluations and underwent endoscopic endonasal repair of their skull base defects. Altogether, 23 children (mean age 7.0 years) underwent the procedures. Sixteen cases were congenital, and 7 patients had trauma history. The herniations or defects included meningoencephaloceles in 15 cases, meningoceles in 4 cases, and CSF leak in 4 cases (2 patients had bilateral leaks). The leak or herniation sites were ethmoid roof in 10 patients (one was bilateral), cribriform plate in 5, lateral to the foramen cecum in 3, posterior wall of the frontal sinus in 1, sphenoid sinus in 2, lateral recess of the sphenoid sinus in 1, and sella turcica base in 2. All subjects had favorable clinical outcomes without recurrence during a follow-up of 6-123 months (mean 61.1 months). The endoscopic endonasal approach was the preferred method for repairing CSF leaks with or without an encephalocele in pediatric patients. Compared to traditional operations, this endoscopic procedure is minimally invasive, efficient, and safe.

Posterior cranial base natural growth and development: A systematic review.

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Currie, Kris; Sawchuk, Dena; Saltaji, Humam; Oh, Heesoo; Flores-Mir, Carlos; Lagravere, Manuel

2017-11-01

To provide a synthesis of the published studies evaluating the natural growth and development of the human posterior cranial base (S-Ba). The search was performed on MEDLINE, Embase, PubMed, and all EBM Reviews electronic databases. In addition, reference lists of the included studies were hand-searched. Articles were included if they analyzed posterior cranial-base growth in humans specifically. Study selection, data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified. Finally, 23 published studies were selected: 5 cross-sectional and 18 cohort studies. Articles were published between 1955 and 2015, and all were published in English. The sample sizes varied between 20 and 397 individuals and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies, while six papers reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of S-Ba was generally agreed to be from spheno-occipital synchondrosis growth. Basion displaced downward and backward and sella turcica moved downward and backward during craniofacial growth. Timing of cessation of S-Ba growth was not conclusive due to limited identified evidence. Current evidence suggests that S-Ba is not totally stable, as its dimensions change throughout craniofacial growth and a minor dimensional change is observed even in late adulthood.

The 360 photography: a new anatomical insight of the sphenoid bone. Interest for anatomy teaching and skull base surgery.

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Jacquesson, Timothée; Mertens, Patrick; Berhouma, Moncef; Jouanneau, Emmanuel; Simon, Emile

2017-01-01

Skull base architecture is tough to understand because of its 3D complex shape and its numerous foramen, reliefs or joints. It is especially true for the sphenoid bone whom central location hinged with most of skull base components is unique. Recently, technological progress has led to develop new pedagogical tools. This way, we bought a new real-time three-dimensional insight of the sphenoid bone that could be useful for the teacher, the student and the surgeon. High-definition photography was taken all around an isolated dry skull base bone prepared with Beauchêne's technique. Pictures were then computed to provide an overview with rotation and magnification on demand. From anterior, posterior, lateral or oblique views and from in out looks, anatomical landmarks and subtleties were described step by step. Thus, the sella turcica, the optic canal, the superior orbital fissure, the sphenoid sinus, the vidian canal, pterygoid plates and all foramen were clearly placed relative to the others at each face of the sphenoid bone. In addition to be the first report of the 360 Photography tool, perspectives are promising as the development of a real-time interactive tridimensional space featuring the sphenoid bone. It allows to turn around the sphenoid bone and to better understand its own special shape, numerous foramen, neurovascular contents and anatomical relationships. This new technological tool may further apply for surgical planning and mostly for strengthening a basic anatomical knowledge firstly introduced.

Effects of active acromegaly on bone mRNA and microRNA expression patterns.

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Belaya, Zhanna; Grebennikova, Tatiana; Melnichenko, Galina; Nikitin, Alexey; Solodovnikov, Alexander; Brovkina, Olga; Grigoriev, Andrey; Rozhinskaya, Liudmila; Lutsenko, Alexander; Dedov, Ivan

2018-04-01

To evaluate the response of bone to chronic long-term growth hormone (GH) and insulin-like growth factor-1 (IGF1) excess by measuring the expression of selected mRNA and microRNA (miR) in bone tissue samples of patients with active acromegaly. Case-control study. Bone tissue samples were obtained during transsphenoidal adenomectomy from the sphenoid bone (sella turcica) from 14 patients with clinically and biochemically confirmed acromegaly and 10 patients with clinically non-functioning pituitary adenoma (NFPA) matched by sex and age. Expression of genes involved in the regulation of bone remodeling was studied using quantitative polymerase chain reaction (qPCR). Of the genes involved in osteoblast and osteoclast activity, only alkaline phosphatase (ALP) mRNA was 50% downregulated in patients with acromegaly. GH excess caused increased expression of the Wnt signaling antagonists ( DKK1) and agonists ( WNT10B) and changes in the levels of miR involved in mesenchymal stem cell commitment to chondrocytes (miR-199a-5p) or adipocytes (miR-27-5p, miR-125b-5p, miR-34a-5p, miR-188-3p) P  Acromegaly had minimal effects on tested mRNAs specific to osteoblast or osteoclast function except for downregulated ALP expression. The expressions of miR known to be involved in mesenchymal stem cell commitment and downregulated TWIST1 expression suggest acromegaly has a negative effect on osteoblastogenesis. © 2018 European Society of Endocrinology.

Skull deformations in craniosynostosis and endocrine disorders: morphological and tomographic analysis of the skull from the crypt of the Silesian Piasts in Brzeg (16th-17th century), Poland.

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Kozłowski, T; Cybulska, M; Błaszczyk, B; Krajewska, M; Jeśman, C

2014-10-01

of morphological and tomographic (CT) studies of the skull that was found in the crypt of the Silesian Piasts in the St. Jadwiga church in Brzeg (Silesia, Poland) are presented and discussed here. The established date of burial of probably a 20-30 years old male was 16th-17th century. The analyzed skull showed premature obliteration of the major skull sutures. It resulted in the braincase deformation, similar to the forms found in oxycephaly and microcephaly. Tomographic analysis revealed gross pathology. Signs of increased intracranial pressure, basilar invagination and hypoplasia of the occipital bone were observed. Those results suggested the occurrence of the very rare Arnold-Chiari syndrome. Lesions found in the sella turcica indicated the development of pituitary macroadenoma, which resulted in the occurrence of discreet features of acromegaly in the facial bones. The studied skull was characterized by a significantly smaller size of the neurocranium (horizontal circumference 471 mm, cranial capacity ∼ 1080 ml) and strongly expressed brachycephaly (cranial index=86.3), while its height remained within the range for non-deformed skulls. A narrow face, high eye-sockets and prognathism were also observed. Signs of alveolar process hypertrophy with rotation and displacement of the teeth were noted. The skull showed significant morphological differences compared to both normal and other pathological skulls such as those with pituitary gigantism, scaphocephaly and microcephaly. Copyright © 2014 Elsevier GmbH. All rights reserved.

Introduction: surgical management of skull base meningiomas.

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Zada, Gabriel; Başkaya, Mustafa K; Shah, Mitesh V

2017-10-01

Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients. Skull base meningiomas represent some of the most challenging pathology encountered by neurosurgeons, on account of their depth, invasion, vascularity, texture/consistency, and their relationship to bony anatomy, cranial nerves, and blood vessels. Resection of complex skull base meningiomas often mandates adequate bony removal to achieve sufficient exposure of the tumor and surrounding region, in order to minimize brain retraction and optimally identify, protect, control, and manipulate sensitive neurovascular structures. A variety of traditional skull base approaches has evolved to address complex skull base tumors, of which meningiomas are considered the paragon in terms of both complexity and frequency. In this supplemental video issue of Neurosurgical Focus, contributing authors from around the world provide instructional narratives demonstrating resection of a variety of skull base meningiomas arising from traditionally challenging origins, including the clinoid processes, tuberculum sellae, dorsum sellae, petroclival region, falco-tentorial region, cerebellopontine angle, and foramen magnum. In addition, two cases of extended endoscopic endonasal approaches for tuberculum sellae and dorsum sellae meningiomas are presented, representing the latest evolution in accessing the skull base for selected tumors

Alterações visuais decorrentes do cisto da fenda de Rathke: relato de caso Visual alterations due to Rathke's cleft cyst: case report

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Gustavo Valandro Rech

2004-12-01

provoke the symptoms. Clinically, the patients complain about blurred vision and they also present hemianopsia deficiency. M.A.S.R., 47 years old, female, white, born in Pelotas/RS, complained about progressive vision reduction in the right eye for 2 months. During the examination, loss of vision and bitemporal hemianopsia were discovered. Computerized tomography highlighted a rounded hypodense image with clear borders, in sellar topography, determining remodeling and enlarging of the sella turcica. Magnetic resonance showed expansive cystic injury located in the sella turcica with suprasellar growth. The mentioned injury presented obliteration in the suprasellar cistern and an important compression on the optic chiasm. The surgical approach confirmed the presence of extensive cystic injury compressing the optic chiasm, and the anatomicopathological examination of the material diagnosed Rathke's cleft cyst. The ophthalmic examination three months after the surgery showed improvement in visual accuracy and total recovery of defects of the visual field. Rathke's cleft cyst must be included in the differential diagnosis of parasellar tumors which may cause compression of optical pathway, and the importance of the diagnosis and immediate treatment with the purpose of avoiding structural damages with unreversible losses of visual function, as well as endocrine disorders are emphasized.

Significance of the sexual openings and supplementary structures on the phylogeny of brachyuran crabs (Crustacea, Decapoda, Brachyura), with new nomina for higher-ranked podotreme taxa.

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Guinot, Danièle; Tavares, Marcos; Castro, Peter

2013-01-01

coxal to coxo-sternal conditions. The coxo-sternal condition is not an intermediate towards the thoracotreme organisation, and a step in heterotreme evolution is the adoption of the coxo-sternal condition. An extreme carcinisition may also result in the sternal arrangement of male gonopores in the form of a "sternitreme" disposition, as in the case of Hymenosomatoidea, which displays a broad thoracic sternum and true sternal male gonopores (as in thoracotremes) together with several plesiomorphic traits that are assumed to represent an old, deeply-rooted heterotreme clade. A sternitreme condition evolved independently in the most ancestral heterotreme clades (such as Hymenosomatoidea) and in Thoracotremata. The older the lineage of a heterotreme is, the higher the possibility of having evolved carcinisation. Evidence that "derived" traits may be the consequence of a strong carcinisation, rather than being recently acquired, necessitates reconsidering certain character states in Brachyura. Eubrachyurans can only evolve either the heterotreme or the thoracotreme arrangement, the consistency of the inferred ancestral characters states providing a useful criterion for evaluating ancestral trait reconstructions. A widened thoracic sternum together with sternal gonopores may be present in carcinised heterotremes such as hymenosomatoids. The thoracic sternum provides a reliable complex of characters that must be carefully interpreted. The hypothesis of a coxo-sternal disposition in Cryptochiroidea and Pinnotheroidea, generally considered thoracotremes, is rejected, and an alternative interpretation of their status is discussed. A new interpretation of the phylogeny of Cryptochiroidea is outlined, but the origin of Pinnotheroidea remains puzzling. The sella turcica, frequently regarded a synapomorphy of Eubrachyura, is redefined as the structure formed by the endosternal intertagmal phragma that connects the tagma/thorax and the tagma/abdomen to thoracic interosternite 7/8. It

Pure intrasellar meningioma located under the pituitary gland: Case report

International Nuclear Information System (INIS)

Cha, Seung Woo; Park, Dong Woo; Park, Choong Ki; Pyo, Ju Yeon; Lee, Young Jun; Lee, SAeung Ro

2013-01-01

Most intrasellar meningiomas are located in the subdiaphragmatic and supraglandular region because they originate from the diaphragma sellae. Subglandular meningiomas located under the pituitary gland are extremely rare. Intrasellar meningiomas in the subdiaphragmatic and subglandular region probably originate from the dura in the sellar floor. We report a case of a subglandular meningioma along with a review of the literature.

Pure intrasellar meningioma located under the pituitary gland: Case report

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Cha, Seung Woo; Park, Dong Woo; Park, Choong Ki; Pyo, Ju Yeon [College of Medicine, Hanyang University, Guri Hospital, Guri (Korea, Republic of); Lee, Young Jun; Lee, SAeung Ro [Dept. of Radiology, College of Medicine, Hanyang University, Seoul (Korea, Republic of)

2013-04-15

Most intrasellar meningiomas are located in the subdiaphragmatic and supraglandular region because they originate from the diaphragma sellae. Subglandular meningiomas located under the pituitary gland are extremely rare. Intrasellar meningiomas in the subdiaphragmatic and subglandular region probably originate from the dura in the sellar floor. We report a case of a subglandular meningioma along with a review of the literature.

Cerebrospinal fluid fistula as the presenting manifestation of pituitary adenoma: case report with a 4-year follow-up Fístula liquórica como manifestação inicial de macroadenoma hipofisário: relato de caso com 4 anos de seguimento

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Ricardo Alexandre Hanel

2001-06-01

Full Text Available We report the case of a young woman who presented with cerebrospinal fluid (CSF rhinorrhea due to an undiagnosed and untreated pituitary adenoma. The tumor had extended well beyond sella turcica and caused bony erosion. The patient initially refused surgery and was treated with bromocriptine and a radiation therapy. CSF leakage did not improved and she was submitted to surgery by the transsphenoidal approach with removal of a tumor mass located in sphenoid sinus and sellar region. Origin of the leak was localized and repaired with fascia lata and a lumbar subarachnoid drain was left in place for 5 days. After 4 years she has normal serum PRL levels and no rhinorrhea. The management, complications and mechanisms involved in this rare condition are discussed.Relatamos o caso de uma paciente que se apresentou com fístula liquórica devido a macroadenoma de hipófise sem diagnóstico e/ou tratamento prévio. O tumor estendia-se além dos limites da sela túrcica, causando erosão óssea. A paciente inicialmente recusou tratamento cirúrgico e foi então tratada com bromocriptina e radioterapia convencional. O fluxo de liquor da fístula não diminuiu e desta feita a paciente concordou com a realização da cirurgia. Realizou-se acesso transesfenoidal com remoção da massa tumoral do seio esfenoidal e selar. A origem da fístula foi reparada com enxerto autólago de fascia lata. Drenagem liquórica lombar foi utilizada por 5 dias. Atualmente, após 4 anos de seguimento, a paciente se apresenta com níveis normais de prolactina e sem sinais de fístula liquórica. Discutimos o mecanismo fisiopatológico desta rara apresentação dos tumores hipofisários bem como seu manejo e complicações.

Gorlin–Goltz syndrome: A case series of 5 patients in North Indian population with comparative analysis of literature

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Lata, Jeevan; Verma, Nitin; Kaur, Amandeep

2015-01-01

Objective: In Indian scenario, Gorlin–Goltz syndrome (nevoid basal cell carcinoma syndrome [NBCCS]) has been rarely reported. The clinical, radiological, and histopathological findings and major and minor criteria in five cases of NBCCS in North Indian population have been presented along with a discussion of the role of gene mutation analysis in early diagnosis of syndrome. Materials and Methods: The diagnostic findings of Gorlin–Goltz syndrome in 5 patients were compared with other reports in Indian population and with reports of this syndrome in other parts of the world. Results: The most common features seen were keratocystic odontogenic tumors (100%), calcifications of falx cerebri (60%), palmar-plantar pits (80%), rib anomalies (80%), macroencephaly (60%), ocular hypertelorism (80%), and frontal bossing (60%) in our series. Retained deciduous teeth seen in 80% patients whose association has not been previously reported has been presented. None of our patients had basal cell carcinoma, syndactyly or polydactyly, pectus deformity, bridging of sella turcica, pigmented nevi, or family history of this syndrome in contrast to such findings in other Indian patients. Medulloblastoma has not been reported in any Indian patient so far compared to this finding in other studies conducted worldwide. Conclusions: Combining the features of 48 patients in 38 cases of NBCCS being published in Indian literature with five cases of our series and on comparison with other studies in the world, a wide disparity in different ethnic groups and a wide variation in presentation of syndrome within the same population is suggested. PMID:26604574

Gorlin–Goltz syndrome: A case series of 5 patients in North Indian population with comparative analysis of literature

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Jeevan Lata

2015-01-01

Full Text Available Objective: In Indian scenario, Gorlin–Goltz syndrome (nevoid basal cell carcinoma syndrome [NBCCS] has been rarely reported. The clinical, radiological, and histopathological findings and major and minor criteria in five cases of NBCCS in North Indian population have been presented along with a discussion of the role of gene mutation analysis in early diagnosis of syndrome. Materials and Methods: The diagnostic findings of Gorlin–Goltz syndrome in 5 patients were compared with other reports in Indian population and with reports of this syndrome in other parts of the world. Results: The most common features seen were keratocystic odontogenic tumors (100%, calcifications of falx cerebri (60%, palmar-plantar pits (80%, rib anomalies (80%, macroencephaly (60%, ocular hypertelorism (80%, and frontal bossing (60% in our series. Retained deciduous teeth seen in 80% patients whose association has not been previously reported has been presented. None of our patients had basal cell carcinoma, syndactyly or polydactyly, pectus deformity, bridging of sella turcica, pigmented nevi, or family history of this syndrome in contrast to such findings in other Indian patients. Medulloblastoma has not been reported in any Indian patient so far compared to this finding in other studies conducted worldwide. Conclusions: Combining the features of 48 patients in 38 cases of NBCCS being published in Indian literature with five cases of our series and on comparison with other studies in the world, a wide disparity in different ethnic groups and a wide variation in presentation of syndrome within the same population is suggested.

Diabetes insipidus as the first symptom caused by lung cancer metastasis to the pituitary glands: Clinical presentations, diagnosis, and management

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J F Mao

2011-01-01

Full Text Available Background : Central diabetes insipidus (CDI, secondary to pituitary metastatic lesions, is uncommon; however, lung and breast cancer are the commonest malignancies to have metastases to the pituitary. Early management of systemic chemotherapy and pituitary irradiation might improve the prognosis of patients. Aims : To investigate the clinical features, diagnosis, and management of CDI caused by lung cancer metastasis to the pituitary glands. Materials and Methods : We retrospectively reviewed 10 patients who had CDI as their first symptom before their lung cancers were diagnosed. Their clinical presentations, anterior pituitary gland function, sellar magnetic resonance imaging (MRI, management, and prognosis were described. Settings and Design : This retrospective cross-sectional clinical study was conducted in a medical college hospital. Results : The patient′s mean age was 58.6±7.8 years. Diabetes insipidus was the main complaint when they were referred to our hospital. MRI revealed specific dumbbell-shaped masses in the sella turcica in five patients. In seven patients whose hormones were measured, the levels of hormones from adenohypophysis were abnormally low in six patients. The main treatments included surgery, systemic chemotherapy, and sellar irradiation. Although nine patients had poor prognoses, one patient has survived for more than 3 years, suggesting benefit from early diagnosis and treatment. Conclusions : New-onset CDI might be the only symptom presented by the patients with pituitary metastasis (PM from lung cancer. Dumbbell-shaped sellar masses in MRI are prone to the diagnosis of PM. A thorough examination for primary cancer should be carried out in these aged and elderly patients.

A practical 3D printed simulator for endoscopic endonasal transsphenoidal surgery to improve basic operational skills.

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Wen, Guodao; Cong, ZiXiang; Liu, KaiDong; Tang, Chao; Zhong, Chunyu; Li, Liwen; Dai, XuJie; Ma, Chiyuan

2016-06-01

We aimed to present a practical three-dimensional (3D) printed simulator to comprehensively and effectively accelerate the learning curve of endoscopic endonasal transsphenoidal surgery (EETS). The 3D printed simulator consists of three parts: (1) skull frame, (2) the nasal passage and the nasal alar of the face, and (3) a modified sella turcica. We aimed to improve three basic operational skills of surgeons: drilling, curetting, and aspirating. Eighteen neurosurgeons and five post-graduates were recruited and consented for the training. For trainees, (1) as the training progressed, the scores increased gradually, (2) a significant increase in the average scores was observed in the tenth training compared to the first training, and (3) there is a significant decrease in trainee variability in the shortening of the gap. The 18 neurosurgeons were divided into three groups: experts, assistants, and observers. For all three basic operations, (1) the average score of experts was obviously higher than that of the assistants, observers, and trainees' tenth training and (2) the average scores of assistants and observers were obviously higher than that of trainees' first training. A significant high in the average score between the assistants and the observers was seen for aspirating, but not for drilling or curetting. For curetting and aspirating, the tenth training average score of trainees was obviously higher than that of assistants and observers. This 3D printed simulator allows different endoscopic basic operations to be simulated and improves the EETS techniques of surgeons. We believed it to be a practical, simple, and low-cost simulator.

Pituitary abscess following transsphenoidal surgery: the experience of 12 cases from a single institution.

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Wang, Lei; Yao, Yong; Feng, Feng; Deng, Kan; Lian, Wei; Li, Guilin; Wang, Renzhi; Xing, Bing

2014-09-01

To explore possible reasons for the incidence of a pituitary abscess following transsphenoidal surgery and determine the most effective treatment. A series of 12 patients who had undergone transsphenoidal surgery in other hospitals before being treated at Peking Union Medical College Hospital were reviewed. The presence of a pituitary abscess was confirmed when pus was intraoperatively observed within the sella turcica. All patients were treated with debridement of the abscess, nine among whom through a transsphenoidal approach and the other three via a craniotomy, followed by antibiotic treatment and hormone replacement therapy. The mean follow-up time was 27.0 months (range from 3.0 to 79.0 months). Headache (92%), panhypopituitarism (58%) and visual disturbance (50%) were the most common clinical indicators of a pituitary abscess. Imaging tests demonstrated a pituitary mass in all patients, with seven (58%) manifested with typical magnetic resonance features of an abscess. Ten patients (83%) were correctly diagnosed preoperatively. During surgical exploration, six presented with severe inflammation or an abscess within the sphenoidal sinus. Causative organisms were identified in five patients (42%). After surgical and antibiotic therapies, all patients fully recovered except for two presenting with severe visual impairment. Six patients (50%) required hormone replacement therapy. Retrograde infection from the sphenoid sinus may be a vital mechanism underlying the formation of a pituitary abscess following transsphenoidal surgery. Debridement of the abscess through surgical approaches combined with antibiotic treatment has been found to yield positive outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

A probable case of Hand-Schueller-Christian's disease in an Egyptian mummy revealed by CT and MR investigation of a dry mummy.

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Cavka, Mislav; Petaros, Anja; Ivanac, Gordana; Aganović, Lejla; Janković, Ivor; Reiter, Gert; Speier, Peter; Nielles-Vallespin, Sonja; Brkljacić, Boris

2012-03-01

The challenging mission of paleopathologists is to be capable to diagnose a disease just on the basis of limited information gained by means of one or more paleodiagnostic techniques. In this study a radiologic, anthropologic and paleopathologic analysis of an ancient Egyptian mummy through X-rays, CT and MR was conducted. An Ancient Egyptian mummy ("Mistress of the house", Archeological Museum, Zagreb, Croatia) underwent digital radiography, computed tomography and magnetic resonance imaging employing 3-dimensional ultra-short-echo time (UTE) sequence, that allows to image ancient dry tissue. Morphological observations on the skull and pelvis, the stages of epiphyseal union and dental wear indicated that the remains are those of a young adult male. Multiple osseous lytic lesions were observed throughout the spine as well as on the frontal, parietal, and occipital bone, orbital wall and the sella turcica of the sphenoid. Considering the sex and age of the individual and the features of the lesions, the authors propose the diagnosis of Hand-Schueller-Christian's disease. This is the first study to have effectively used MR images in the differential diagnosis of a disease. It also confirmed the CT value in revealing central nervous system involvement just by detecting skeletal lesions. Although the mummy was previously dated to 3rd century B.C. based on the properties of the sarcophagi, the sex of the mummy suggests that it was most probably transferred into these sarcophagi in later times. The mummification techniques used and radiometric data (C14) dated it to 900-790. B.C.

A case of huge neurofibroma expanding extra- and intracranially through the enlarged jugular foramen

International Nuclear Information System (INIS)

Hanakita, Junya; Imataka, Kiyoharu; Handa, Hajime

1984-01-01

The surgical approach to the jugular foramen has been considered to be very difficult and troublesome, because of the location in which important structures, such as the internal jugular vein, internal carotid artery and lower cranial nerves, converge in the narrow deep space. A case of huge neurofibroma, which extended from the tentorium cerebelli through the dilated jugular foramen to the level of the vertebral body of C 3 was presented. A 12-year-old girl was admitted with complaints of visual disturbance and palsy of the V-XII cranial nerves of the left side. Plain skull film showed prominent widening of the cranial sutures and enlargement of the sella turcica. Horizontal CT scan with contrast showed symmetrical ventricular dilatation and a heterogeneously enhanced mass, which was situated mainly in the left CP angle. Coronal CT scan with contrast revealed a huge mass and enlarged jugular foramen, through which the tumor extended to the level of the vertebral body of C 3 . Occlusion of the sigmoid sinus and the internal jugular vein of the left side was noticed in the vertebral angiography. Two-stage approach, the first one for removal of the intracranial tumor and the second one for extracranial tumor, was performed for its huge tumor. Several authors have reported excellent surgical approaches for the tumors situated in the jugular foramen. By our approach, modifying Gardner's original one, a wide operative field was obtained to remove the tumor around the jugular foramen with success. Our approach for the jugular foramen was described with illustrations. (author)

CASE REPORT Cribriform pattern in brain MRI: A diagnostic clue for ...

African Journals Online (AJOL)

A 2-year-old boy presented with macrocephaly, initially suspected to be due to hydrocephalus. There were no focal neurological deficits. A 3T MRI of the brain, however, revealed macrocephaly, thickened diploeic spaces (most prominent in the occipital region) and the presence of a J-shaped sella (Fig. 1). A cribriform ...

Development of the orbital region in the chondrocranium of Caretta caretta. Reconsideration of the vertebrate neurocranium configuration.

Science.gov (United States)

Kuratani, S

1989-01-01

By studying the development of the orbital region in the Loggarhead turtle (Caretta caretta) and some placental mammals, it has become clear that the orbital region of the neurocranium should not be regarded as merely a "bowl" to contain the brain, but rather that its ventral part is originally flexured along with the cephalic flexure of the neural tube. At this flexure, the neurocranium is to be divided into 2 parts, the anterior and posterior. The anterior part of the neurocranial sheet is medially perforated by the infundibulum and gives rise to pila metoptica laterally. The post orbital cartilage represents the posterior part. From the above "Bauplan" of the neurocranium, the following conclusions can be drawn: (1) the simple homology of the reptilian and placental mammalian pila metoptica is questionable; (2) the pila antotica is produced by the absorption of the mid-dorsal part of the postorbital cartilage, while the dorsum sellae in mammals is produce by the chondrification of the middle part of the same anlage; (3) homology of the ala hypochiasmatica in mammals with the supratrabecular cartilage in reptiles is more feasible than with the cartilago hypochiasmatica; and (4) the crista sellaris in reptiles is not a part of the primary cranial wall but probably of secondary production.

Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck

Energy Technology Data Exchange (ETDEWEB)

Samaan, N.A.; Vieto, R.; Schultz, P.N.; Maor, M.; Meoz, R.T.; Sampiere, V.A.; Cangir, A.; Ried, H.L.; Jesse, R.H. Jr.

1982-11-01

One hundred-ten patients who had nasopharyngeal cancer and paranasal sinus tumors and were free of the primary disease were studied one to 26 years following radiotherapy. There were 70 males and 40 females ranging in age from 4 to 75 years, with a mean age of 36.5 years. During therapy both the hypothalamus and the anterior pituitary gland were in the field of irradiation. The radiation dose to the hypothalamus and the anterior pituitary gland was estimated to be 400 to 7500 rad with a median dose of 5618 rad to the anterior pituitary gland and a median dose of 5000 rad to the hypothalamus. We found evidence of endocrine deficiencies in 91 of the 110 patients studied. Seventy-six patients showed evidence of one or more hypothalamic lesions and 43 patients showed evidence of primary pituitary deficiency. Forty of the 66 patients who received radiotherapy to the neck for treatment or prevention of lymph node metastasis showed evidence of primary hypothyroidism. The range of the dose to the thyroid area was 3000 to 8800 rad with a median of 5000 rad. One young adult woman who developed galactorrhea and amenorrhea 2 years following radiotherapy showed a high serum prolactin level, but had normal anterior pituitary function and sella turcica. She regained her menses and had a normal pregnancy and delivery following bromocriptine therapy. These results indicate that endocrine deficiencies after radiotherapy for tumors of the head and neck are common and should be detected early and treated. Long-term follow-up of these patients is indicated since complications may appear after the completion of radiotherapy.

Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck

International Nuclear Information System (INIS)

Samaan, N.A.; Vieto, R.; Schultz, P.N.; Maor, M.; Meoz, R.T.; Sampiere, V.A.; Cangir, A.; Ried, H.L.; Jesse, R.H. Jr.

1982-01-01

One hundred-ten patients who had nasopharyngeal cancer and paranasal sinus tumors and were free of the primary disease were studied one to 26 years following radiotherapy. There were 70 males and 40 females ranging in age from 4 to 75 years, with a mean age of 36.5 years. During therapy both the hypothalamus and the anterior pituitary gland were in the field of irradiation. The radiation dose to the hypothalamus and the anterior pituitary gland was estimated to be 400 to 7500 rad with a median dose of 5618 rad to the anterior pituitary gland and a median dose of 5000 rad to the hypothalamus. We found evidence of endocrine deficiencies in 91 of the 110 patients studied. Seventy-six patients showed evidence of one or more hypothalamic lesions and 43 patients showed evidence of primary pituitary deficiency. Forty of the 66 patients who received radiotherapy to the neck for treatment or prevention of lymph node metastasis showed evidence of primary hypothyroidism. The range of the dose to the thyroid area was 3000 to 8800 rad with a median of 5000 rad. One young adult woman who developed galactorrhea and amenorrhea 2 years following radiotherapy showed a high serum prolactin level, but had normal anterior pituitary function and sella turcica. She regained her menses and had a normal pregnancy and delivery following bromocriptine therapy. These results indicate that endocrine deficiencies after radiotherapy for tumors of the head and neck are common and should be detected early and treated. Long-term follow-up of these patients is indicated since complications may appear after the completion of radiotherapy

Preoperative Assessment of Craniopharyngioma Adherence: Magnetic Resonance Imaging Findings Correlated with the Severity of Tumor Attachment to the Hypothalamus.

Science.gov (United States)

Prieto, Ruth; Pascual, José M; Rosdolsky, Maria; Barrios, Laura

2018-02-01

Craniopharyngioma (CP) adherence represents a heterogeneous pathologic feature that critically influences the potentially safe and radical resection. The aim of this study was to define the magnetic resonance imaging (MRI) predictors of CP adherence severity. This study retrospectively investigated a cohort of 200 surgically treated CPs with their corresponding preoperative conventional MRI scans. MRI findings related to the distortions of anatomic structures along the sella turcica-third ventricle axis caused by CPs, in addition to the tumor's shape and calcifications, were analyzed and correlated with the definitive type of CP adherence observed during the surgical procedures. CP adherence is defined by 3 components, as follows: 1) the specific structures attached to the tumor, 2) the adhesion's extent, and 3) its strength. Combination of these 3 components determines 5 hierarchical levels of adherence severity with gradually increasing surgical risk of hypothalamic injury. Multivariate analysis identified 4 radiologic variables that allowed a correct overall prediction of the levels of CP adherence severity in 81.5% of cases: 1) the position of the hypothalamus in relation to the tumor-the most discriminant factor; 2) the type of pituitary stalk distortion; 3) the tumor shape; and 4) the presence of calcifications. A binary logistic regression model including the first 3 radiologic variables correctly identified the CPs showing the highest level of adherence severity (severe/critical) in almost 90% of cases. A position of the hypothalamus around the middle portion of the tumor, an amputated or infiltrated appearance of the pituitary stalk, and the elliptical shape of the tumor are reliable predictors of strong and extensive CP adhesions to the hypothalamus. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors influencing superimposition error of 3D cephalometric landmarks by plane orientation method using 4 reference points: 4 point superimposition error regression model.

Science.gov (United States)

Hwang, Jae Joon; Kim, Kee-Deog; Park, Hyok; Park, Chang Seo; Jeong, Ho-Gul

2014-01-01

Superimposition has been used as a method to evaluate the changes of orthodontic or orthopedic treatment in the dental field. With the introduction of cone beam CT (CBCT), evaluating 3 dimensional changes after treatment became possible by superimposition. 4 point plane orientation is one of the simplest ways to achieve superimposition of 3 dimensional images. To find factors influencing superimposition error of cephalometric landmarks by 4 point plane orientation method and to evaluate the reproducibility of cephalometric landmarks for analyzing superimposition error, 20 patients were analyzed who had normal skeletal and occlusal relationship and took CBCT for diagnosis of temporomandibular disorder. The nasion, sella turcica, basion and midpoint between the left and the right most posterior point of the lesser wing of sphenoidal bone were used to define a three-dimensional (3D) anatomical reference co-ordinate system. Another 15 reference cephalometric points were also determined three times in the same image. Reorientation error of each landmark could be explained substantially (23%) by linear regression model, which consists of 3 factors describing position of each landmark towards reference axes and locating error. 4 point plane orientation system may produce an amount of reorientation error that may vary according to the perpendicular distance between the landmark and the x-axis; the reorientation error also increases as the locating error and shift of reference axes viewed from each landmark increases. Therefore, in order to reduce the reorientation error, accuracy of all landmarks including the reference points is important. Construction of the regression model using reference points of greater precision is required for the clinical application of this model.

Lymphocytic hypophysitis and hypothalamitis - a case report

International Nuclear Information System (INIS)

Stelmachowska, M.; Bolko, P.; Wasko, R.; Sowinski, J.; Kosinski, D.; Towpik, I.

2006-01-01

Lymphocytic hypophysitis is an unusual disorder that nearly exclusively affects women. We present a case of 69 year-old female patient who developed the symptoms of diabetes insipidus and partial insufficiency of the anterior pituitary gland. Magnetic resonance imaging of the brain revealed a mass involving the sella and suprasellar region. After exclusion of other causes of infiltrate in this region and due to evident reaction to glucocorticoid treatment the diagnosis of lymphocytic hypophisitis and hypothalamitis was established. (author)

Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

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Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1979-03-15

The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

International Nuclear Information System (INIS)

Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja

1979-01-01

The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

Lycopene and beta-carotene induce growth inhibition and proapoptotic effects on ACTH-secreting pituitary adenoma cells.

Directory of Open Access Journals (Sweden)

Natália F Haddad

Full Text Available Pituitary adenomas comprise approximately 10-15% of intracranial tumors and result in morbidity associated with altered hormonal patterns, therapy and compression of adjacent sella turcica structures. The use of functional foods containing carotenoids contributes to reduce the risk of chronic diseases such as cancer and vascular disorders. In this study, we evaluated the influence of different concentrations of beta-carotene and lycopene on cell viability, colony formation, cell cycle, apoptosis, hormone secretion, intercellular communication and expression of connexin 43, Skp2 and p27(kip1 in ACTH-secreting pituitary adenoma cells, the AtT20 cells, incubated for 48 and 96 h with these carotenoids. We observed a decrease in cell viability caused by the lycopene and beta-carotene treatments; in these conditions, the clonogenic ability of the cells was also significantly decreased. Cell cycle analysis revealed that beta-carotene induced an increase of the cells in S and G2/M phases; furthermore, lycopene increased the proportion of these cells in G0/G1 while decreasing the S and G2/M phases. Also, carotenoids induced apoptosis after 96 h. Lycopene and beta-carotene decreased the secretion of ACTH in AtT20 cells in a dose-dependent manner. Carotenoids blocked the gap junction intercellular communication. In addition, the treatments increased the expression of phosphorylated connexin43. Finally, we also demonstrate decreased expression of S-phase kinase-associated protein 2 (Skp2 and increased expression of p27(kip1 in carotenoid-treated cells. These results show that lycopene and beta-carotene were able to negatively modulate events related to the malignant phenotype of AtT-20 cells, through a mechanism that could involve changes in the expression of connexin 43, Skp2 and p27(kip1; and suggest that these compounds might provide a novel pharmacological approach to the treatment of Cushing's disease.

Epistaxis and pituitary apoplexy due to ruptured internal carotid artery aneurysm embedded within pituitary adenoma.

Science.gov (United States)

Peng, Zesheng; Tian, Daofeng; Wang, Hongliu; Kong, Derek Kai; Zhang, Shenqi; Liu, Baohui; Deng, Gang; Xu, Zhou; Wu, Liquan; Ji, Baowei; Wang, Long; Cai, Qiang; Li, Mingchang; Wang, Junmin; Zhang, Aimin; Chen, Qianxue

2015-01-01

Epistaxis due to ruptured internal carotid artery (ICA) aneurysm embedded within a pituitary adenoma (PA) has seldom been reported in the literature. Here we want to elaborate the incidence, mechanisms, clinical manifestations, and treatment strategy for this condition. The first survived case of a patient with epistaxis and pituitary apoplexy due to ruptured aneurysm embedded within PA was reported and the literature was reviewed. A 53-year-old male patient presented to our institution with sudden onset epistaxis and progressive vision loss. Neurological examination revealed bilateral ptosis and dilated unresponsive pupils. A CT scan showed a large mass in the pituitary fossa with bony erosion. MRI revealed a large pituitary tumor and abnormal signal intensity in the tumor. No aneurysm was noted during the pre-operative MR angiography. Abundant arterial bleeding suddenly occurred during urgent transsphenoidal surgery. Digital subtraction angiography confirmed the presence of a 14 mm unexpected saccular aneurysm of right ICA in the cavernous sinus with the dome protruding into the sella turcica. Balloon test occlusion of the right ICA was undertaken and permanent occlusion was performed. The patient recovered well and received bromocriptine and thyroid hormone replacement therapy during the follow-up period. At 14-month followup, the patient had no neurological deficits, no features of ischaemia relating to the right ICA therapeutic occlusion. Our case indicated that epistaxis and pituitary apoplexy could be due to the rupture of an ICA aneurysm embedded in a PA. Clinical suspicion should remain high when evaluating any case of epistaxis and pituitary apoplexy. Optimal treatment should take into consideration individual features of the tumor, aneurysm, and patient. Making the correct diagnosis as well as identifying an appropriate management strategy is critical in the care of such patients.

Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1979-03-15

The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

Blood-feeding patterns of native mosquitoes and insights into their potential role as pathogen vectors in the Thames estuary region of the United Kingdom.

Science.gov (United States)

Brugman, V A; Hernández-Triana, L M; England, M E; Medlock, J M; Mertens, P P C; Logan, J G; Wilson, A J; Fooks, A R; Johnson, N; Carpenter, S

2017-03-27

The range of vertebrate hosts on which species of mosquito blood-feed is an important parameter for identifying potential vectors and in assessing the risk of incursion and establishment of vector-borne pathogens. In the United Kingdom, studies of mosquito host range have collected relatively few specimens and used techniques that could only broadly identify host species. This study conducted intensive collection and analysis of mosquitoes from a grazing marsh environment in southeast England. This site provides extensive wetland habitat for resident and migratory birds and has abundant human nuisance biting mosquitoes. The aim was to identify the blood-feeding patterns of mosquito species present at the site which could contribute to the transmission of pathogens. Twice-weekly collections of mosquitoes were made from Elmley Nature Reserve, Kent, between June and October 2014. Mosquitoes were collected using resting boxes, by aspiration from man-made structures and using a Mosquito Magnet Pro baited with 1-octen-3-ol. Blood-fed specimens were classified according to the degree of blood meal digestion using the Sella scale and vertebrate origin determined using sequencing of a fragment of the mitochondrial cytochrome C oxidase subunit I gene. Mosquitoes that were morphologically cryptic were identified to species level using multiplex PCR and sequencing methods. A total of 20,666 mosquitoes of 11 species were collected, and 2,159 (10.4%) were blood-fed (Sella scale II-VI); of these 1,341 blood-fed specimens were selected for blood meal analysis. Vertebrate origin was successfully identified in 964 specimens (72%). Collections of blood-fed individuals were dominated by Anopheles maculipennis complex (73.5%), Culiseta annulata (21.2%) and Culex pipiens form pipiens (10.4%). Nineteen vertebrate hosts comprising five mammals and 14 birds were identified as hosts for mosquitoes, including two migratory bird species. Feeding on birds by Culex modestus and Anopheles

Studies on improvement of diagnosis of neurosurgical lesions by magnetic resonance imaging (MRI), 2; Advantages of MRI on diagnosis of parasellar lesions and comparison with X-ray CT

Energy Technology Data Exchange (ETDEWEB)

Shimizu, Kotoyuki (Kagoshima Univ. (Japan). Faculty of Medicine)

1989-05-01

Findings of magnetic resonance (MRI) imaging in 46 patients with sellar or parasellar mass were reviewed and compared with those of concurrently available X-ray CT. Intrasellar contents, the hypothalamic pituitary region, adjacent brain stem, optic nerves, and the surrounding cerebrospinal fluid were clearly depicted on T1-weighted images. The cavernous sinus and blood vessels, including the Willis circle, were visualized on T2-weighted images. In detecting pituitary macroadenoma, MRI seemed to be the most userful modality, because it was superior to CT in identifying abnormal changes of the infundibulum, diaphragma sellae, cavernous sinus and optic chiasm. Macroadenoma of the pituitary gland was usually isointense to the normal cerebral cortex on T1- and T2-weighted images. T1- and T2-weighted relaxation times for pituitary adenoma were slightly prolonged. The normal pituitary gland was distinguishable from adenomatous tissues. For microadenoma, MRI failed to show lesions or erosion of the sellar floor. Craniopharyngioma, meningioma of the tuberculum sellae, hypothalamic tumor, such as glioma and germinoma, and the other parasellar masses were clearly visualized on MRI. MRI was superior to CT in detecting tumor and its involvement, but inferior in detecting presence of calcification. T1-weighted imaging was useful in identifing the presence of intratumoral hemorrhage. Cysts of craniopharyngioma had various appearances on T1-weighted images. High signal cyst intensity corresponded to a high cholesterol content or the presence of methemoglobin. MRI depicted empty sella. The intrasellar content had the same appearance as that of the cerebrospinal fluid space, and the flattened pituitary gland and pituitary stalk were detected on T1-weighted images. (N.K.).

Studies on improvement of diagnosis of neurosurgical lesions by magnetic resonance imaging (MRI), 2

International Nuclear Information System (INIS)

Shimizu, Kotoyuki

1989-01-01

Findings of magnetic resonance (MRI) imaging in 46 patients with sellar or parasellar mass were reviewed and compared with those of concurrently available X-ray CT. Intrasellar contents, the hypothalamic pituitary region, adjacent brain stem, optic nerves, and the surrounding cerebrospinal fluid were clearly depicted on T1-weighted images. The cavernous sinus and blood vessels, including the Willis circle, were visualized on T2-weighted images. In detecting pituitary macroadenoma, MRI seemed to be the most userful modality, because it was superior to CT in identifying abnormal changes of the infundibulum, diaphragma sellae, cavernous sinus and optic chiasm. Macroadenoma of the pituitary gland was usually isointense to the normal cerebral cortex on T1- and T2-weighted images. T1- and T2-weighted relaxation times for pituitary adenoma were slightly prolonged. The normal pituitary gland was distinguishable from adenomatous tissues. For microadenoma, MRI failed to show lesions or erosion of the sellar floor. Craniopharyngioma, meningioma of the tuberculum sellae, hypothalamic tumor, such as glioma and germinoma, and the other parasellar masses were clearly visualized on MRI. MRI was superior to CT in detecting tumor and its involvement, but inferior in detecting presence of calcification. T1-weighted imaging was useful in identifing the presence of intratumoral hemorrhage. Cysts of craniopharyngioma had various appearances on T1-weighted images. High signal cyst intensity corresponded to a high cholesterol content or the presence of methemoglobin. MRI depicted empty sella. The intrasellar content had the same appearance as that of the cerebrospinal fluid space, and the flattened pituitary gland and pituitary stalk were detected on T1-weighted images. (N.K.)

High intensity signal of the posterior pituitary. A study with horizontal direction of frequency-encoding and fat suppression MR techniques

International Nuclear Information System (INIS)

Arslan, A.

1999-01-01

Purpose: To evaluate the consistency of fat in the high intensity signals of the normal neurohypophysis and to differentiate the high signal of posterior pituitary from that of dorsum sella. Sagittal SE T1-weighted images with frequency encoding in the horizontal direction were used in order to differentiate the high signal of posterior pituitary and dorsum sella by the vertically-oriented chemical shift artifact. Material and methods: The sellae of 46 normal volunteers were imaged with a commercially available fat suppression technique and SE sequences with frequency encoding in vertical (25 cases) and horizontal (21 cases) axes. Results: The high signal intensity was absent in 9% of the normal volunteers with no predilection to any specific age group. None of the cases with posterior pituitary high intensity signals showed suppression of the signal with fat suppression technique. A fat suppression technique was helpful in documenting the hyperintensity in 7% of normal volunteers. Nineteen of the 21 (90%) cases with high signal intensity were detected by routine SE T1-weighted images, whereas 18 of the 19 (95%) cases were detected by imaging with frequency encoding in the horizontal direction. Conclusion: The high signal does not indicate the presence of fat. Fat suppression technique and a horizontal direction of frequency encoding help in differentiating the high signal of the neurohypophysis from that of dorsum sella. (orig.)

Morphometry of the pituitary gland and hypothalamus in long-term survivors of childhood trauma.

Science.gov (United States)

Porto, L; Margerkurth, J; Althaus, J; You, S-J; Zanella, F E; Kieslich, M

2011-11-01

Chronic pituitary dysfunction is increasingly recognized as a sequela of traumatic brain injury (TBI). Our aim was to rule out any late morphometric changes of the pituitary gland and hypothalamus in survivors of TBI during childhood requiring intensive care. We assessed morphometric abnormalities of the sella region and hypothalamus in patients who sustained TBI during childhood. The patients showed no clinical hormonal dysfunction at the acute phase and pituitary hormone levels at the time of our study were within normal limits. From the 18 enrolled patients in the magnetic resonance study, five were removed due to morphological changes or anatomical variations. We studied the MRI of 13 male survivors (mean age 27 years, mean time after trauma 20 years) and compared them to 13 male control subjects who were matched in terms of age (mean age, 26 years), education and ethnicity. Analyses of the pituitary gland and sella on a midsagittal T2- and T1-weighted image were performed. We used voxel-based morphometry (VBM), an unbiased MRI morphometric method to investigate hypothalamic region in this group of patients. There was only a trend towards a reduced pituitary gland width in the patient group compared to controls. However, no significant morphological and morphometric abnormality was seen and VBM showed no hypothalamic grey matter loss. In the absence of hormonal dysfunction, no persisting morphometric changes of the pituitary gland and hypothalamus were seen in survivors of childhood TBI requiring intensive care.

Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect

Directory of Open Access Journals (Sweden)

Mahnaz Pejman-Sani

2018-04-01

Full Text Available A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair loss, cold intolerance, decreased appetite and dry skin. On physical examination, he was afebrile: BP (blood pressure: 110/70 mm/Hg, PR (pulse rate :65 beat/min, BMI (body mass index: 24. He had no terminal hair on face or chest and subcutaneous adipose tissue mass had been decreased substantially. Laboratory tests revealed; Hb: 12 g/dL (N: 14–17 g/dL, Total testosterone: 1.2 ng/mL (N:–-10 ng/mL, Luteinizing hormone (LH:3.3MIU/mL (N:1–8 MIU/mL, Follicle Stimulating hormone (FSH:1.3 MIU/mL (N:1–7 MIU/mL, T4:3.4 micg/dL (N:4–12 micg/dL, TSH:0.6 MIU/mL (N:0.5–5 MIU/mL, Prolactin:100 ng/mL (2–24 ng/mL, serum cortisol:6 MIU/mL (N:4–21 MIU/mL, IGF1:162 ng/mL (50–245. Pituitary MRI showed macroadenoma (29*16*14 mm in left side of sella turcica which bulged to suprasellar cistern with pressure effect on left optic nerve (Figure 1, 2. Visual field examination revealed mild temporal hemianopia. These findings are consistent with macroadenoma and mild prolactin elevation. We also observed a discrepancy between pituitary tumor size and prolactin level. The correct estimate of serum prolactin was obtained after serial dilutional measurement. Serum prolactin after dilution was 6470 ng/mL. With these findings pituitary macroadenoma was diagnosed and treatment with cabergoline (dopamine agonist 0.5 mg/week was started. After one month follow-up he had no symptoms, visual field defect was improved and pituitary MRI showed significant shrinkage of tumor.

Lycopene and Beta-Carotene Induce Growth Inhibition and Proapoptotic Effects on ACTH-Secreting Pituitary Adenoma Cells

Science.gov (United States)

Leite de Oliveira, Felipe; Soares, Nathália; de Mattos, Rômulo Medina; Hecht, Fábio; Dezonne, Rômulo Sperduto; Vairo, Leandro; Goldenberg, Regina Coeli dos Santos; Gomes, Flávia Carvalho Alcântara; de Carvalho, Denise Pires; Gadelha, Mônica R.; Nasciutti, Luiz Eurico; Miranda-Alves, Leandro

2013-01-01

Pituitary adenomas comprise approximately 10–15% of intracranial tumors and result in morbidity associated with altered hormonal patterns, therapy and compression of adjacent sella turcica structures. The use of functional foods containing carotenoids contributes to reduce the risk of chronic diseases such as cancer and vascular disorders. In this study, we evaluated the influence of different concentrations of beta-carotene and lycopene on cell viability, colony formation, cell cycle, apoptosis, hormone secretion, intercellular communication and expression of connexin 43, Skp2 and p27kip1 in ACTH-secreting pituitary adenoma cells, the AtT20 cells, incubated for 48 and 96 h with these carotenoids. We observed a decrease in cell viability caused by the lycopene and beta-carotene treatments; in these conditions, the clonogenic ability of the cells was also significantly decreased. Cell cycle analysis revealed that beta-carotene induced an increase of the cells in S and G2/M phases; furthermore, lycopene increased the proportion of these cells in G0/G1 while decreasing the S and G2/M phases. Also, carotenoids induced apoptosis after 96 h. Lycopene and beta-carotene decreased the secretion of ACTH in AtT20 cells in a dose-dependent manner. Carotenoids blocked the gap junction intercellular communication. In addition, the treatments increased the expression of phosphorylated connexin43. Finally, we also demonstrate decreased expression of S-phase kinase-associated protein 2 (Skp2) and increased expression of p27kip1 in carotenoid-treated cells. These results show that lycopene and beta-carotene were able to negatively modulate events related to the malignant phenotype of AtT-20 cells, through a mechanism that could involve changes in the expression of connexin 43, Skp2 and p27kip1; and suggest that these compounds might provide a novel pharmacological approach to the treatment of Cushing’s disease. PMID:23667519

Thyroid Homoeostasis and Reproductive Hormonal Disorders in Women

Directory of Open Access Journals (Sweden)

А.А. Yunusov

2014-11-01

Full Text Available Objective of the study — to investigate the influence of hypo- and hyperthyroidism on the state of reproductive function for women and to estimate efficiency of treatment. Material and Methods. 156 women of reproductive age are examined concerning inflammatory gynaecological and endocrine disorders. Complex of laboratory and clinical investigations included: anamnesis, examination; unified clinical and biochemical methods of research; studying research hormones in blood plasma (thyroid stimulating hormone, prolactine, Т3, Т4, fТ4, antibodies to thyroglobulin, thyroid peroxidase; luteinizing hormone, follicle-stimulating hormone (FSH, estradiol, progesteron, testosteron; ultrasonic examination of thyroid gland, mammary gland, pelvic organs; radiography of sella turcica; fine needle biopsy of the thyroid. Results. The comparative analysis of different pathologies of reproductive function in both clinical groups showed, that infertility, both primary and secondary, prevailed in the group with hypothyroidism — 66 vs 33.3 % in the group of women with hyperthyroidism. In the first clinical group, signs of menstrual disorders (68.2 %, galactorrhea (63.6 %, breast pathology (55 % also prevailed, while in the second group these indexes were 38.8, 22.2 and 33.3 %, respectively. In the structure of menstrual disorders, oligomenorrhea prevailed in both clinical groups — 47 and 57 %. Most women (76.9 % had I degree of galactorrhea and bilateral galactorrhea (80.7 %. Cervical pathology was detected 45 % of women, with predominance of pseudoerosion (55.5 %, and in 12.5% — hysteromyoma. Chronic salpingo-oophoritis was diagnosed in 47.5 % of patients, cystic ovaries — in 10 % of women of clinical group. Conclusions. Thyroid pathology in women of reproductive age is characterized by autoimmune thyroiditis (24.3 %, diffuse toxic goiter (10.8 % and nodular goiter (16.2 %. Women with thyroid hormone deficit have a decline of gonadotropic pituitary

A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism

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Čutović Tatjana

2014-01-01

Full Text Available Bacground/Aim. The literature suggests different views on the correlation between the cranial base morphology and size and saggital intermaxillary relationships. The aim of this study was to investigate the cranial base morphology, including the frontal facial part in patients with mandibular prognathism, to clarify a certain ambiguities, in opposing viewspoints in the literature. Methods. Cephalometric radiographies of 60 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, with no previous orthodontic treatment. On the basis of dental and sceletal relations of jaws and teeth, the patients were divided into two groups: the group P (patients with mandibular prognathism and the group E (the control group or eugnathic patients. A total of 15 cephalometric parametres related to the cranial base, frontal part of the face and sagittal intermaxillary relationships were measured and analyzed. Results. The results show that cranial base dimensions and the angle do not play a significant role in the development of mandibular prognathism. Interrelationship analysis indicated a statistically significant negative correlation between the cranial base angle (NSAr and the angles of maxillary (SNA and mandibular (SNB prognathism, as well as a positive correlation between the angle of inclination of the ramus to the cranial base (GoArNS and the angle of sagittal intermaxillary relationships (ANB. Sella turcica dimensions, its width and depth, as well as the nasal bone length were significantly increased in the patients with mandibular prognathism, while the other analyzed frontal part dimensions of the face were not changed by the malocclusion in comparison with the eugnathic patients. Conclusion. This study shows that the impact of the cranial base and the frontal part of the face on the development of profile in patients with mandibular prognathism is much smaller, but

De novo Craniopharyngioma of the Fourth Ventricle: Case Report and Review of Literature.

Science.gov (United States)

Algahtani, Abdulhadi Y; Algahtani, Hussein A; Jamjoom, Abdulhakim B; Samkari, Alaa M; Marzuk, Yousef I

2018-01-01

Craniopharyngiomas usually involve the sella and suprasellar space. Their occurrence in the posterior fossa without extension to the suprasellar region is uncommon with only 16 cases reported in the literature. We report a case of a primary posterior fossa craniopharyngioma that was managed by complete excision with a good recovery. Our case was unique in that the craniopharyngioma occurred in the fourth ventricle and extended downward to the level of C1, a manifestation that was reported only twice in the past. The literature on the topic is reviewed.

MR imaging of the craniocervical junction, cranium, and brain in children with achondroplasia

International Nuclear Information System (INIS)

Kao, S.C.; Waziri, M.; Sato, Y.; Smith, W.L.; Yuh, W.T.C.; Franken, E.A. Jr.

1988-01-01

Ten children with achondroplasia underwent MR imaging of the craniocervical junction, cranium and brain. All patients had narrowing of the subarachnoid space at the level of foramen magnum with apparent upward displacement of the brain stem. Hydrocephalus was seen in five patients, bifrontal widening of subarachnoid space in four, skull asymmetry in two, and an empty sella in one. One patient showed abnormal signal in the central gray matter of the cervicomedullary region. MR is a noninvasive modality for the evaluation of cranial, cerebral, and cervicomedullary is achondroplastic children

Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT)

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Gueldner, Christian; Pistorius, Sarah M.; Diogo, Isabell; Sesterhenn, Andreas; Werner, Jochen A. (Department of Otorhinolaryngology, Head and Neck Surgery, UKGM, Marburg (Germany)), Email: gueldner@staff.uni-marburg.de; Bien, Siegfried (Department of Neuroradiology, UKGM, Marburg (Germany))

2012-03-15

Background. The sphenoid sinus is a frequent target of paranasal sinus surgery. Because of the high risk of injuring the surrounding structures (e.g. internal carotid artery, optical nerve) a preoperative imaging is absolutely necessary. Purpose. To analyze the possibilities of cone-beam computed tomography (CBCT), which is especially quite a new technique in ENT, in the evaluation of the sphenoid sinus, its surrounding structures, and the corresponding anatomical variations. Material and Methods. This was a retrospective, single-centre study of 580 patients (1160 sides = cases). The Accu-I-Tomo-F17 was used. Pneumatization of sphenoid sinus, course of internal artery, course of optical nerve, and dehiscence of the bony canals were evaluated. Results. In the case of pneumatization a type I (completely missing or minimal sphenoid sinus) was found in two patients (0.3%), type II (posterior wall of sphenoid sinus is in front of the anterior wall of the sella) in 38 patients (6.6%), type III (posterior wall is between anterior and posterior wall of sella) in 332 patients (57,2%), type IVa (posterior wall is behind the posterior wall of sella without air dorsal the sella) in 104 patients (17.9%), and type IVb (similar to type IVa but with air dorsal the sella) in 104 patients (17.9%). In 1025 cases (89.5%) a smooth course of the internal carotid artery was found whereas a free course could be detected in 120 cases (10.5%). Defects of the bony canal of the optical nerve were found in 16.7% and of the internal carotid artery in 2.7% of the cases. The optical nerve showed a free course through the sphenoid in 151 cases (13.7%) and a smooth course in 1007 cases (87.0%). Conclusion. CBCT could evaluate all relevant anatomic structures and answer the questions of different anatomical variants. A modified classification of the pneumatization of the sphenoid sinus could be described. Frequencies of anatomical variations are in accordance with the current literature of CT

Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT)

International Nuclear Information System (INIS)

Gueldner, Christian; Pistorius, Sarah M.; Diogo, Isabell; Sesterhenn, Andreas; Werner, Jochen A.; Bien, Siegfried

2012-01-01

Background. The sphenoid sinus is a frequent target of paranasal sinus surgery. Because of the high risk of injuring the surrounding structures (e.g. internal carotid artery, optical nerve) a preoperative imaging is absolutely necessary. Purpose. To analyze the possibilities of cone-beam computed tomography (CBCT), which is especially quite a new technique in ENT, in the evaluation of the sphenoid sinus, its surrounding structures, and the corresponding anatomical variations. Material and Methods. This was a retrospective, single-centre study of 580 patients (1160 sides = cases). The Accu-I-Tomo-F17 was used. Pneumatization of sphenoid sinus, course of internal artery, course of optical nerve, and dehiscence of the bony canals were evaluated. Results. In the case of pneumatization a type I (completely missing or minimal sphenoid sinus) was found in two patients (0.3%), type II (posterior wall of sphenoid sinus is in front of the anterior wall of the sella) in 38 patients (6.6%), type III (posterior wall is between anterior and posterior wall of sella) in 332 patients (57,2%), type IVa (posterior wall is behind the posterior wall of sella without air dorsal the sella) in 104 patients (17.9%), and type IVb (similar to type IVa but with air dorsal the sella) in 104 patients (17.9%). In 1025 cases (89.5%) a smooth course of the internal carotid artery was found whereas a free course could be detected in 120 cases (10.5%). Defects of the bony canal of the optical nerve were found in 16.7% and of the internal carotid artery in 2.7% of the cases. The optical nerve showed a free course through the sphenoid in 151 cases (13.7%) and a smooth course in 1007 cases (87.0%). Conclusion. CBCT could evaluate all relevant anatomic structures and answer the questions of different anatomical variants. A modified classification of the pneumatization of the sphenoid sinus could be described. Frequencies of anatomical variations are in accordance with the current literature of CT

Maxillary Distraction Osteogenesis Using a Rigid External Distractor: Which Clinical Factors Are Related With Relapse?

Science.gov (United States)

Kim, Jeenam; Uhm, Ki-Il; Shin, Donghyeok; Lee, Jina; Choi, Hyungon

2015-06-01

Maxillary distraction osteogenesis is a reliable treatment for cleft lip and palate with midfacial retrusion. The purpose of this study was to evaluate the results of long-term follow-up in patients with cleft lip and palate after maxillary distraction osteogenesis and to find clinical factors related to relapse. From February 2002 to June 2008, 21 patients with severe class III malocclusion were treated at our hospital. We performed distraction osteotomy with a rigid external distractor device. The distraction length was more than 15 mm in all patients. Preoperative and postoperative lateral cephalometric radiographs were used for analysis. The sella-nasion-subnasale, sella-nasion-supramentale, and point-A-point-B-nasion (sella-nasion-subnasale-sella-nasion-supramentale) angles were recorded. The timelines for follow-up were preoperatively, after distraction, after consolidation, at 3 years, and once fully grown (5- to 8-year follow-ups). A comparative analysis of clinical factors was performed for the relapsing and nonrelapsing groups. Of the 21 patients, 14 had relapsed. The mean age in the relapsing group was 9.1 years (7 boys and 7 girls) with 9 patients with unilateral cleft palate and 5 c bilateral cleft palate. The mean age in the nonrelapsing group was 11.7 years (4 boys and 3 girls) with 5 patients with unilateral cleft palate and 2 patients with bilateral cleft palate. Despite greater anterior overcorrection, relapse occurred owing to scar tissue retraction and mandibular compensatory hypertrophy. The results suggest that the younger the patient, the more likely relapse will occur.

Usefulness of magnetic resonance findings of the hypothalamic-pituitary region in the management of short children with growth hormone deficiency: evidence from a longitudinal study.

Science.gov (United States)

Kalina, Maria A; Kalina-Faska, Barbara; Gruszczyńska, Katarzyna; Baron, Jan; Małecka-Tendera, Ewa

2012-01-01

The purpose of this study is to assess the relationship between magnetic resonance images (MRI) of the hypothalamic-pituitary (H-P) region and response to recombinant human growth hormone (rhGH) treatment in short children with growth hormone deficiency, basing on changes of auxologic parameters, as well as to answer the question if MRI may serve for selecting and monitoring the rhGH responders. The study group comprised 85 children treated with rhGH, aged 7.3-18.7 years, followed for the mean period of 3.2 years (range, 2.1-9.5 years). Auxologic parameters (height deficit hSDS, deviation from the mid-parental height hSDS-mpSDS, bone delay index bone age/chronological age ratio (BA/CA)) were assessed before, during and at the end of rhGH treatment; growth velocity was calculated before and during rhGH therapy. Parameters were correlated with the MRI of the H-P region. Structural anomalies of the H-P region were found in 22 (25.9%) children: empty sella syndrome (ESS) in 12 (14.1%) patients, ectopic posterior pituitary (EPP) in ten (11.8%). Patients' height deficit and their deviation from parental height before rhGH therapy was significantly greater in the EPP group (median hSDS = -3.8; hSDS-mpSDS = -2.5), bone age delay was the greatest in the ESS group (median BA/CA = 0.69), after therapy - in the EPP group (median BA/CA = 0.82). Growth velocity improved in the first year of the rhGH therapy in all groups; however, the most significant acceleration was observed in the EPP group (median delta hSDS = 0.9), then stabilised and was comparable in all groups. MRI may be helpful in predicting response to the rhGH treatment, providing midline abnormalities are taken into account.

MRI features of growth hormone deficiency in children with short stature caused by pituitary lesions.

Science.gov (United States)

Xu, Chao; Zhang, Xinxian; Dong, Lina; Zhu, Bin; Xin, Tao

2017-06-01

We verified the advantages of using magnetic resonance imaging (MRI) for improving the diagnostic quality of growth hormone deficiency (GHD) in children with short stature caused by pituitary lesions. Clinical data obtained from 577 GHD patients with short stature caused by pituitary lesions were retrospectively analyzed. There were 354 cases (61.3%) with anterior pituitary dysplasia; 45 cases (7.8%) of pituitary stalk interruption syndrome (PSIS); 15 cases (2.6%) of pituitary hyperplasia due to primary hypothyroidism; 38 cases (6.6%) of Rathke cleft cyst; 68 cases (11.8%) of empty sella syndrome; 16 cases (2.8%) of pituitary invasion from Langerhans cell histiocytosis; 2 cases (0.3%) of sellar regional arachnoid cyst and 39 cases (6.8%) of craniopharyngioma. MRI results showed that the height of anterior pituitary in patients was less than normal. Location, size and signals of posterior pituitary and pituitary stalk were normal in anterior pituitary dysplasia. In all cases pituitary hyperplasia was caused by hypothyroidism. MRI results showed that anterior pituitary was enlarged, and we detected upward apophysis and obvious homogeneous enhancement. There were no pituitary stalk interruption and abnormal signal. We also observed that after hormone replacement therapy the size of pituitary gland was reduced. Anterior pituitary atrophy was observed in Rathke cleft cyst, empty sella syndrome, sellar regional arachnoid cyst and craniopharyngioma. The microstructure of hypophysis and sellar region was studied with MRI. We detected pituitary lesions, and the characteristics of various pituitary diseases of GHD in children with short stature. It was concluded that in children with GHD caused by pituitary lesions, MRI was an excellent method for early diagnosis. This method offers clinical practicability and we believe it can be used for differential diagnosis and to monitor the therapeutic effects.

Transsphenoidal hypophysectomy: postsurgical CT findings

International Nuclear Information System (INIS)

Dolinskas, C.A.; Simeone, F.A.

1985-01-01

Transsphenoidal surgery produces changes in the paranasal sinuses and sella that should be familiar to radiologists in view of frequency of this type of surgery. Some of these changes, such as soft-tissue-density debris in the sinuses, are transient. Fat and other packing material identifiable in the sinuses and sella after surgery is permanent. The procedure is associated with a variety of complications that are readily detectable by computed tomography (CT). These include bleeding, compression of parasellar structures by packing material, cerebrospinal fluid leaks, and pneumocephalus. After a transsphenoidal procedure, with or without follow-up radiation therapy, residual enhancing intrasellar and parasellar lesions may still be identified

CT of sella after pituitary surgery

International Nuclear Information System (INIS)

Frank, W.; Imhof, H.; Schratter, M.; Knosp, E.

1986-01-01

A CT control scan of 32 patients after transsphenoidal resection of a pituitary tumour revealed sellar contents of different density and varying extent. Additional criteria were used to differentiate the intrasellar structures (size, extent, shape, structure, contrast enhancement, bone changes). CT made the definite diagnosis in 6 patients with pituitary tumour recurrence. Hormonal measurements were superior to CT in identifying recurrent tumours in another 3 patients. It is concluded that hormonal methods should be used in evaluating patients after surgery of a hormone-producing tumour. However, CT is the most useful method in detecting tumour recurrence in patients with non-functioning adenomas, and, if an adequate technique is used (coronal scanning, iv-contrast), even clinical asymptomatic tumours can be identified. (orig.) [de

Rilievi in sella a un quad

Directory of Open Access Journals (Sweden)

Fulvio Bernardini

2013-12-01

Full Text Available Renewable energy—including biomass, geo- thermal, hydroelectric,wind and solar—is big business in Italy. Solar farms able toproduce 1 MW or more of nominal power are considered “large.”Before installing such a PV plant, an acc urate topographical surveyof the ground is required. Giuseppe Greco is known in Italyas an expert in surv eying areas that are extensive and difficult toacc ess. This is because he works with the help of a quad all-terr ainvehicle (AT V, a Segway personal transporter and a personal electricrobotic cart for moving his equipment.

Geometry of third ventricle: radiological measurements supported by neuroendoscopic observations

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Novak, Z.; Chrastina, J. [Neurosurgical Dept., Faculty Hospital, St Anns, MF MU, Brno (Czech Republic); Krupa, P.; Feitova, V. [Dept. of Imaging Techniques, Faculty Hospital, St Anns, MF MU, Brno (Czech Republic); Riha, I. [Neurosurgical Dept., Faculty Hospital, St Anns, MF MU, Brno (Czech Republic); Inst. of Biomedical Engineering, FEEC BUT, Brno (Czech Republic)

2007-06-15

The aim od the study was to analyse the changes of third ventricular geometry caused by hydrocephalus. The data were obtained from planning studies for neuroendoscopic surgeries using stereotactic software Praezis Plus. Parameters CA-CP (intercommisural distance-corresponding to third ventricular length), IMD (intermammillary distance-third ventricular width), H (third ventricular height), BA-DS distance (distance between basilar artery bifurcation and dorsum sellae) and MB-BA distance were studied. After statistical analysis table of normal values is proposed for all the defined parameters. Statistically significant changes were found in all the measured parameters (CA-CP, IMD, H, MB-BA) in hydrocephalic patients except the distance between basilar artery and dorsum sellae, defining safe area for endoscopic third ventriculostomy. (orig.)

Magnetic resonance imaging of hypothalamus hypophysis axis lesions

International Nuclear Information System (INIS)

Shiina, Takeki; Uno, Kimiichi; Arimizu, Noboru; Yoshida, Sho; Yamada, Kenichi.

1990-01-01

Magnetic resonance imaging (MRI) using a 0.5T superconductive machine was performed to the thirty three cases with a variety of the sellar and parasellar tumors and with dysfunction of the hypothalamus-hypophysis axis. Posterior pituitary bright spot (PBS) on T1 weighted image was evaluated with the pituitary hormonal function. These cases were 12 cases of post-treated tumors including pituitary adenoma (9 patients), suprasellar germinoma (2 patients) and craniopharyngioma (one patient), and non-tumorous conditions including 15 cases of central diabetes insipidus (DI), Syndrome of inappropriate secretion of ADH (SIADH) (one patient), Sheehan's syndrome (3 patients) and anorexia nervosa (2 patients). Pituitary bright spot was not seen in all 19 cases with overt DI. On the other hand, PBS was not seen in 9 cases without overt DI. Three cases of these 9 cases showing Sheehan's syndrome with insufficient antidiuretic hormone (ADH) secretion was considered as the state of subclinical DI. Posterior bright spot was not seen in all 13 cases of empty sella including partial empty sella. The results suggested that disappearance of PBS represents abnormality or loss of posterior pituitary function and also it was considered to be closely related to the empty sella. (author)

Magnetic resonance imaging of hypothalamus hypophysis axis lesions; Relationship between posterior pituitary function and posterior bright spot

Energy Technology Data Exchange (ETDEWEB)

Shiina, Takeki; Uno, Kimiichi; Arimizu, Noboru; Yoshida, Sho (Chiba Univ. (Japan). School of Medicine); Yamada, Kenichi

1990-04-01

Magnetic resonance imaging (MRI) using a 0.5T superconductive machine was performed to the thirty three cases with a variety of the sellar and parasellar tumors and with dysfunction of the hypothalamus-hypophysis axis. Posterior pituitary bright spot (PBS) on T1 weighted image was evaluated with the pituitary hormonal function. These cases were 12 cases of post-treated tumors including pituitary adenoma (9 patients), suprasellar germinoma (2 patients) and craniopharyngioma (one patient), and non-tumorous conditions including 15 cases of central diabetes insipidus (DI), Syndrome of inappropriate secretion of ADH (SIADH) (one patient), Sheehan's syndrome (3 patients) and anorexia nervosa (2 patients). Pituitary bright spot was not seen in all 19 cases with overt DI. On the other hand, PBS was not seen in 9 cases without overt DI. Three cases of these 9 cases showing Sheehan's syndrome with insufficient antidiuretic hormone (ADH) secretion was considered as the state of subclinical DI. Posterior bright spot was not seen in all 13 cases of empty sella including partial empty sella. The results suggested that disappearance of PBS represents abnormality or loss of posterior pituitary function and also it was considered to be closely related to the empty sella. (author).

Transstadial Transmission of Borrelia turcica in Hyalomma aegyptium Ticks

Czech Academy of Sciences Publication Activity Database

Kalmár, Z.; Cozma, V.; Sprong, H.; Jahfari, S.; D’Amico, G.; Mărcutan, D.I.; Ionică, A.M.; Magdaş, C.; Modrý, David; Mihalca, A. D.

2015-01-01

Roč. 10, č. 2 (2015), e0115520 E-ISSN 1932-6203 Institutional support: RVO:60077344 Keywords : Borne relapsing fever * Lyme disease * imported reptiles Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 3.057, year: 2015

Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access.

Science.gov (United States)

Oyama, Kenichi; Prevedello, Daniel M; Ditzel Filho, Leo F S; Muto, Jun; Gun, Ramazan; Kerr, Edward E; Otto, Bradley A; Carrau, Ricardo L

2014-01-01

The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern. Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the interpeduncular cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. "Water balloon tumors" (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the interpeduncular cistern to compare visualization using the 2 approaches. The distances between cranial nerve (CN) III and the posterior communicating artery (PCoA) and between CN III and the edge of the tentorium were measured through a transpetrosal approach to determine the width of surgical corridors using 0- to 6-ml WBTs in the interpeduncular cistern (n = 8). Both approaches provided adequate exposure of the interpeduncular cistern. The endoscopic endonasal approach yielded a good visualization of both CN III and the PCoA when a WBT was in the interpeduncular cistern. Visualization of the contralateral anatomical structures was impaired in the transpetrosal approach. The surgical corridor to the interpeduncular cistern via the transpetrosal approach was narrow when the WBT volume was small, but its width increased as the WBT volume increased. There was a statistically significant increase in the maximum distance between CN III and the PCoA (p = 0.047) and between CN III and the tentorium (p = 0.029) when the WBT volume

Empty Sella Syndrome complicating meningitis | Ogunrin | Nigerian ...

African Journals Online (AJOL)

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Effectiveness of the cervical vertebral maturation method to predict postpeak circumpubertal growth of craniofacial structures.

Science.gov (United States)

Fudalej, Piotr; Bollen, Anne-Marie

2010-01-01

Our aim was to assess effectiveness of the cervical vertebral maturation (CVM) method to predict circumpubertal craniofacial growth in the postpeak period. The CVM stage was determined in 176 subjects (51 adolescent boys and 125 adolescent girls) on cephalograms taken at the end of treatment (T2; mean ages, 15.75 years [boys] and 15.23 years [girls]) in subjects from the postretention database at the University of Washington in Seattle. Craniofacial growth was evaluated from the following measurements on cephalograms at T2 and end of follow-up (T3) (mean ages, 29.01 years [men] and 28.08 years [women]): condylion to gnathion, condylion to gonion, gonion to gnathion, sella to gnathion, nasion to menton, anterior nasal spine to menton, and sella to gonion. The change of each variable from T2 to T3 was assessed with paired t tests. Parametric (t tests or analysis of variance [ANOVA]) or nonparametric (Mann-Whitney or Kruskal-Wallis) tests were used to detect intergroup differences. One hundred eight subjects (35 boys, 73 girls) demonstrated CVM stage 3, 56 (16 boys, 40 girls) were in CVM stage 4, and 12 (all girls) were in CVM stage 5 at T2. Intrasex comparisons showed that boys in CVM stages 3 and 4 could be differentiated regarding changes of all variables. In the girls, only those in CVM stages 3 and 4 could be differentiated based on the amount of changes of 2 measurements: condylion to gonion and sella to gonion. Intersex comparisons showed that boys in CVM stage 3 had significantly more changes than girls (P <0.01). Boys in CVM stage 4 showed significant differences compared with girls in CVM stage 4 for only 2 variables (sella to gonion and condylion to gonion; P <0.001 and P = 0.012, respectively). The CVM method was modestly effective in determining the amount of postpeak circumpubertal craniofacial growth. Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion.

Science.gov (United States)

Singh, G D; McNamara, J A; Lozanoff, S

1997-08-01

The role of the cranial base in the emergence of Class III malocclusion is not fully understood. This study determines deformations that contribute to a Class III cranial base morphology, employing thin-plate spline analysis on lateral cephalographs. A total of 73 children of European-American descent aged between 5 and 11 years of age with Class III malocclusion were compared with an equivalent group of subjects with a normal, untreated, Class I molar occlusion. The cephalographs were traced, checked and subdivided into seven age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized. The datasets were scaled to an equivalent size, and statistical analysis indicated significant differences between average Class I and Class III cranial base morphologies for each group. Thin-plate spline analysis indicated that both affine (uniform) and non-affine transformations contribute toward the total spline for each average cranial base morphology at each age group analysed. For non-affine transformations, Partial warps 10, 8 and 7 had high magnitudes, indicating large-scale deformations affecting Bolton point, basion, pterygo-maxillare, Ricketts' point and articulare. In contrast, high eigenvalues associated with Partial warps 1-3, indicating localized shape changes, were found at tuberculum sellae, sella, and the frontonasomaxillary suture. It is concluded that large spatial-scale deformations affect the occipital complex of the cranial base and sphenoidal region, in combination with localized distortions at the frontonasal suture. These deformations may contribute to reduced orthocephalization or deficient flattening of the cranial base antero-posteriorly that, in turn, leads to the formation of a Class III malocclusion.

CT follow-up after radiation therapy for pituitary adenomas

International Nuclear Information System (INIS)

Rush, S.C.; Newall, J.

1988-01-01

Between 1973 and 1985, 105 patients received radiation therapy as all or part of their treatment for pituitary tumor at the New York University Medical Center. Of these, 48 patients underwent computed tomography (CT) at a minimum of 2 years following treatment, with detailed reports available for analysis of tumor regression. There were 28 men with a median age of 46 years (range, 18-71 years) and 20 women with a median age of 53 years (range, 28-80 years). Tumors were classified as secretory in 23 patients, nonsecretory in 21, and undetermined in four. Sixteen patients were treated with radiation therapy alone, 23 patients with surgery and radiation therapy, and the other with bromocriptine and radiation therapy, with or without surgery. With a median follow-up of 5 years (range, 2-14 years), 16 patients developed an empty sella, 25 patients had residual sellar mass, and seven patients had persistent extrasellar components or no change in their intrasellar mass. Among patients who did not have hypopituitarism at the inception of radiation therapy, five of 13 with empty sellas and 12 of 22 with residual mass subsequently required therapy. The authors conclude that residual mass is commonly found in long-term follow-up after radiation therapy, that isolated imaging studies revealing such findings after treatment in no way herald a diagnosis of recurrence, and that hypopituitarism following pituitary radiation therapy does not correlate with the ablation or persistence of tissue within the sella

Syndroom van Cushing. II. Nieuwe behandelingen

NARCIS (Netherlands)

van Aken, M. O.; Feelders, R. A.; van der Lely, A. J.; Romijn, J. A.; Lamberts, S. W. J.; de Herder, W. W.

2006-01-01

Several new therapeutic options both medicinal and surgical, have emerged for the treatment of Cushing's syndrome. In Cushing's disease caused by an adrenocorticotropin (ACTH) secreting pituitary adenoma, the introduction ofendoscopic pituitary surgery offers better visualization of the sella than

Evaluation of adenohypophyseal reserve in patients carrier of hypophyseal adenoma treated by trans-sphenoidal surgery

International Nuclear Information System (INIS)

Drubscky, A.T.

1980-01-01

Fifteen patients carrier hypophyseal adenomas, with ages varying between 16 to 53 years were studied. The patients presented sella changes to the conventional plane radiographies and were submited a surgery treatment, with acess to hypophysis by the trans-sphenoidal way. (author)

Distraction rate and latency: factors in the outcome of paediatric maxillary distraction.

Science.gov (United States)

Higuera, Stephen; Cole, Patrick; Stephenson, J B; Hollier, Larry

2009-12-01

Over 50 years ago, current tenets of distraction osteogenesis were developed through work on the lower extremity; however, the application of these tenets in the paediatric craniofacial skeleton remains questionable. Prompted by recent concern that traditional aspects of distraction may be either outdated or wholly inapplicable to the paediatric maxilla, we retrospectively evaluated maxillary distraction protocol using a 24-h latency period in conjunction with a distraction rate of 2mm/day. Following maxillary advancement via a distraction protocol consisting of a 24-h latency period and a distraction rate of 2mm/day, seven consecutive paediatric cases were evaluated. Standard profile photos and cephalometric films taken preoperatively, at device removal and at 1-year follow-up were compared. With the sella as the point of registration, pre- and post-distraction films were superimposed on the sella-nasion plane. Sella-nasion-subspinale, the angle of convexity, the distance from incisal edges to the y-axis, and angulation of the upper incisor to the sella-nasion plane were analysed to evaluate hard-tissue changes. Patient age ranged from 3 to 14 years (mean=7.43 years). Maxillary distraction length averaged 11 mm (range=10-12 mm). Interval from device application to removal averaged 98 days (range=75-180 days). The interval of the active distraction ranged from 11 to 65 days (mean=24 days). From distraction completion to device removal averaged 85 days (range=60-150). Follow-up intervals ranged from 52 to 24 months (mean=34 months). All patients demonstrated substantial clinical advancement of the maxilla with correction of midfacial deficiencies. A single patient developed mild cellulitis at one skin-device interface; no other complications were noted. Cephalometric and clinical evaluations at 1 year post-distraction demonstrated stable results, and parental satisfaction was qualitatively high. The surgical dogma of lower-extremity distraction osteogenesis is not

Regionalism, Regionalization and Regional Development

Directory of Open Access Journals (Sweden)

Liviu C. Andrei

2016-03-01

Full Text Available Sustained development is a concept associating other concepts, in its turn, in the EU practice, e.g. regionalism, regionalizing and afferent policies, here including structural policies. This below text, dedicated to integration concepts, will limit on the other hand to regionalizing, otherwise an aspect typical to Europe and to the EU. On the other hand, two aspects come up to strengthen this field of ideas, i.e. the region (al-regionalism-(regional development triplet has either its own history or precise individual outline of terms.

Variability of the inclination of anatomic horizontal reference planes of the craniofacial complex in relation to the true horizontal line in orthognathic patients.

Science.gov (United States)

Zebeib, Ameen M; Naini, Farhad B

2014-12-01

The purpose of this study was to assess the reliability of the Frankfort horizontal (FH), sella-nasion horizontal, and optic planes in terms of their variabilities in relation to a true horizontal line in orthognathic surgery patients. Thirty-six consecutive presurgical orthognathic patients (13 male, 23 female; age range, 16-35 years; 30 white, 6 African Caribbean) had lateral cephalometric radiographs taken in natural head position, with a plumb line orientating the true vertical line, and the true horizontal line perpendicular to the true vertical. The inclinations of the anatomic reference planes were compared with the true horizontal. The FH plane was found to be on average closest to the true horizontal, with a mean of -1.6° (SD, 3.4°), whereas the sella-nasion horizontal and the optic plane had means of 2.1° (SD, 5.1°) and 3.2° (SD, 4.7°), respectively. The FH showed the least variability of the 3 anatomic planes. The ranges of variability were high for all anatomic planes: -8° to 8° for the FH, -8° to 15° for the sella-nasion horizontal, and -6° to 13° for the optic plane. No significant differences were found in relation to patients' sex, skeletal patterns, or ethnic backgrounds. The clinically significant variability in the inclinations of anatomic reference planes in relation to the true horizontal plane makes their use unreliable in orthognathic patients. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery.

Science.gov (United States)

Chittiboina, Prashant; Talagala, S Lalith; Merkle, Hellmut; Sarlls, Joelle E; Montgomery, Blake K; Piazza, Martin G; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R; Oldfield, Edward H; Koretsky, Alan P; Butman, John A

2016-12-01

OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra-high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm 3 and 0.15 × 0.15 × 0.30 mm 3 , respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented resolution. Clinical use of this ESC may allow for MR imaging detection of previously occult

Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery

Science.gov (United States)

Chittiboina, Prashant; Talagala, S. Lalith; Merkle, Hellmut; Sarlls, Joelle E.; Montgomery, Blake K.; Piazza, Martin G.; Scott, Gretchen; Ray-Chaudhury, Abhik; Lonser, Russell R.; Oldfield, Edward H.; Koretsky, Alan P.; Butman, John A.

2016-01-01

OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing’s disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra–high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm3 and 0.15 × 0.15 × 0.30 mm3, respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented resolution. Clinical use of this ESC may allow for MR imaging detection of previously occult pituitary

Symptomatic hypothalamic-pituitary dysfunction in nasopharyngeal carcinoma patients following radiation therapy: a retrospective study

International Nuclear Information System (INIS)

Lam, K.S.; Ho, J.H.; Lee, A.W.; Tse, V.K.; Chan, P.K.; Wang, C.; Ma, J.T.; Yeung, R.T.

1987-01-01

Endocrine assessment was performed in 32 relapse-free southern Chinese patients 5-17 years following radiation therapy (RT) alone for early nasopharyngeal carcinoma (NPC). Initial screening was done using questionnaires emphasizing impaired sexual function and menstrual disturbance plus measurement of serum levels of thyroxine, free thyroxine index, thyrotropic hormone, prolactin, and additionally testosterone for males only. Those showing abnormalities were subjected to detailed pituitary function tests. Hypothalamic-pituitary dysfunction was found in 7 female patients and only 1 male patient. A delayed TSH response to thyrotropin releasing hormone suggesting a hypothalamic disorder was seen in 6 of the affected female patients, and hyperprolactinaemia in also 6. None of the patients had evidence of diabetes insipidus. Hypopituitarism became symptomatic 2-5 years after RT with a mean latent interval of 3.8 years. A practical protocol for regular endocrine assessment for NPC patients after RT has been proposed. Multiple linear regression analysis of the radiotherapeutic data from the 11 female patients indicates that the likelihood of late occurrence of symptomatic hypothalamic-pituitary dysfunction following RT is dependent on the TDF of the target dose to the nasopharyngeal region and the height of the upper margin of the opposed lateral facial fields above the diaphragma sellae (coefficient of multiple correlation = 0.9025). Except when the sphenoid sinus or the middle cranial fossa is involved, it is advisable to set the height of the upper margin of the lateral facial field at a level no higher than the diaphragma sellae. The hypothalamus and possibly the pituitary stalk as well may sustain permanent damage by doses of radiation within the conventional radiotherapeutic range for carcinomas

The ectopic posterior pituitary gland

African Journals Online (AJOL)

2013-11-04

Nov 4, 2013 ... crinology with short stature, delayed bone age and biochemical features suggestive of hypo pituitarism. Magnetic resonance imaging of the brain demonstrated a flattened anterior pituitary gland within the sella, associated with absence of the infundibular stalk and an ectopic posterior pituitary gland (Fig.

Malformations of cranial base structures and pituitary gland in prenatal Meckel syndrome

DEFF Research Database (Denmark)

Kjaer, K W; Hansen, B F; Keeling, J W

1999-01-01

are constant phenotypic traits in MS. The adenohypophysis was present in three cases. In one of these, ectopia of the gland occurred with adenopituitary tissue overlying the dorsum sella, and in another remnants were found in the pharyngeal submucosa. In two fetuses the neurohypophysis was not found...

Interstitial pituitary irradiation with 90Y for the treatment of acromomegaly

International Nuclear Information System (INIS)

Cassar, J.; Doyle, F.H.; Banks, L.M.; Jadresic, A.; Mashiter, K.; Joplin, G.F.

1981-01-01

The management of 54 acromegalics referred to us between 1974 and 1978 has been analysed. Twenty-two patients were treated with pituitary implants of yttrium-90 ( 90 Y). Eleven are in complete remission (mean growth hormone (GH) < 11 mlU/l), 8 had improved (mean GH 11-20 mlU/l or 50% less than preoperatively) and 3 were poor responders. Two patients had temporary 6th nerve paresis. Seven patients are on replacement therapy. Thirty- one patients were not implanted for the following reasons with a number of patients having more than one: extension of the tumour into the spehnoid sinus 10, or above the sella 3, partially empty sella 9, internal carotids too close to midline 2, invisible landmarks 1, mild acromegaly 6, poor general health 3, declined investigations or operation 6. It is concluded that pituitary implant of yttrium is an effective and safe form of treatment on carefully selected patients. (author)

Comparative Genome Structure, Secondary Metabolite, and Effector Coding Capacity across Cochliobolus Pathogens

Energy Technology Data Exchange (ETDEWEB)

Condon, Bradford J.; Leng, Yueqiang; Wu, Dongliang; Bushley, Kathryn E.; Ohm, Robin A.; Otillar, Robert; Martin, Joel; Schackwitz, Wendy; Grimwood, Jane; MohdZainudin, NurAinlzzati; Xue, Chunsheng; Wang, Rui; Manning, Viola A.; Dhillon, Braham; Tu, Zheng Jin; Steffenson, Brian J.; Salamov, Asaf; Sun, Hui; Lowry, Steve; LaButti, Kurt; Han, James; Copeland, Alex; Lindquist, Erika; Barry, Kerrie; Schmutz, Jeremy; Baker, Scott E.; Ciuffetti, Lynda M.; Grigoriev, Igor V.; Zhong, Shaobin; Turgeon, B. Gillian

2013-01-24

The genomes of five Cochliobolus heterostrophus strains, two Cochliobolus sativus strains, three additional Cochliobolus species (Cochliobolus victoriae, Cochliobolus carbonum, Cochliobolus miyabeanus), and closely related Setosphaeria turcica were sequenced at the Joint Genome Institute (JGI). The datasets were used to identify SNPs between strains and species, unique genomic regions, core secondary metabolism genes, and small secreted protein (SSP) candidate effector encoding genes with a view towards pinpointing structural elements and gene content associated with specificity of these closely related fungi to different cereal hosts. Whole-genome alignment shows that three to five of each genome differs between strains of the same species, while a quarter of each genome differs between species. On average, SNP counts among field isolates of the same C. heterostrophus species are more than 25 higher than those between inbred lines and 50 lower than SNPs between Cochliobolus species. The suites of nonribosomal peptide synthetase (NRPS), polyketide synthase (PKS), and SSP encoding genes are astoundingly diverse among species but remarkably conserved among isolates of the same species, whether inbred or field strains, except for defining examples that map to unique genomic regions. Functional analysis of several strain-unique PKSs and NRPSs reveal a strong correlation with a role in virulence.

CSF circulation in subjects with the empty sella syndrome

International Nuclear Information System (INIS)

Brismar, K.; Bergstrand, G.

1981-01-01

In the present study the CSF circulation was analyzed in 48 subjects with ESS with gamma cisternography, pneumoencephalography (PEG) und computed tomography (CT). In 80% of the subjects the CSF circulation was retarded with convexity block which was combined with widened CSF transport pathways and basal cisterns. These findings were correlated with the clinical signs and symptoms. Headache, psychiatric symptoms, visual field defects and obesity, however, were not related to the impaired CSF circulation. It is concluded that impaired CSF dynamics leading to intermittent increase of ICP has a major impact on the development of the ESS and that most of the patients' complaints are related to this disturbance. Thus is is important to obtain information of the CSF dynamics concurrent with the diagnosis of ESS. For this purpose PEG or CT may be used as the first examination. Moreover, the patient should be examined at least every second year for symptoms and signs of progressive impairments of the CSF circulation. (orig./MG)

I pionieri italiaNi della geofisiCa

Directory of Open Access Journals (Sweden)

P. CALOI

1964-06-01

Full Text Available Vengono rapidamente passati in rassenga, seguendo
l'ordine cronologico, gli studiosi di geofisica — intesa in senso lato — clie,
a partire dalla seconda meta del Settecento, ebbero ad interessarsi in Italia
di elettricita atmosferica, magnetismo terrestre, idrografla, oceanografia fisica,
sismologia e vulcanologia, con intenti pionieristici. Sono ricordati i principali
risultati raggiunti da una trentina di ricercatori fra i quali spiccano, per la
vastita del lavoro compiuto e per la novita dei risultati, Leopoldo Nobili e Macedonio
Melloni. Ma, ciascuno nei suo campo, scoperte di rilievo fecero pure
G. B. Beccaria, Luigi Palmieri, Carlo Matteucci, Timoteo Bertelli, Luigi De
Marcbi, Carlo Somigliana, Emilio Oddone, Alfonso Sella e Domenico Pacini.
Alcuni vantano priorita di rilievo: scoperta della doppia oscillazione diurna
del barometro (Chiminello, 1780; unicita sorgiva delle varie radiazioni dello
spettro (M. Melloni; sismografo elettromagnetico a registrazione continua
(Palmieri, 1855; microsismi (Bertelli, 1872; il paleomagnetismo (Oddone e
Sella, 1891; la radiazione cosmica (Pacini, 1910; . ..

[Unconsciousness due to hyponatremia in a patient with short stature with panhypopituitarism].

Science.gov (United States)

Notsu, K; Takagi, C; Umaki, I

1995-03-20

An unconscious woman of short stature (141 cm) was admitted to our hospital in March, 1994. She had hyponatremia (120 mEq/l) and had experienced massive bleeding during delivery. No increment of either plasma ACTH or cortisol levels was observed after insulin-induced hypoglycemia. However, urinary 17OHCS levels gradually increased after repeated intramuscular injections of ACTH. Plasma free T3 and free T4 levels were low. Neither plasma TSH nor prolactin (PRL) levels increased after an intravenous injection of TRH. Basal plasma LH, FSH and growth hormone (GH) levels were low and there were no observable responses to any of the stimulation tests. A magnetic resonance image (MRI) of her pituitary gland showed an empty sella. These results showed that she had a panhypopituitarism with primary empty sella. Replacement therapy with glucocorticoid was started and serum sodium levels normalized immediately. Levothyroxine was also administered. The possibility of pituitary dwarfism during her youth and a gradual postpartum reduction of other pituitary hormones may have caused an impairment of the hypothalamo-pituitary-adrenal axis.

Thin-section CT of Cushing's disease

International Nuclear Information System (INIS)

Takahashi, Tatsuo; Kuwayama, Akio; Katoh, Tetsuo; Ichihara, Kaoru; Kageyama, Naoki; Nakamura, Koji.

1983-01-01

Using 1.5 mm contiguous sections with a GE CT/T 8800 scanner, we investigated the sellar regions of 22 cases of Cushing's diseases which had been diagnosed endocrinologically. Each sellar turcica was normal in size, and in only 5 cases were there significant findings on 2 mm-thick sellar-floor polytomography. Nine tumors appeared as regions of a hypodense area, and three tumors were diagnosed by indirect signs, for example, stalk deviation and diaphragmatic plane asymmetry. The other 10 cases, especially those previously operated on or irradiated, were diagnosed as falsely positive or negative. Because it is best of the microadenomas appear hypodense within the strongly contrast-enhanced anterior pituitary glands, it is better for scans to be obtained immediately after rapid intravenous contrast infusion. Hypodense areas of microadenomas are best demonstrated on direct coronal scans or reversed scans of 1.5 mm-thickness thin-slice sections. By these methods, microadenomas, if they are over 5-6 mm in diameter, can appear as hypodense. Sellar floor findings by means of thin-section CT were more sensitive than those of polytomography and had more advantages in local diagnosis. If the tumor were over 4 mm in diameter, local changes in the sellar floor could be demonstrated by thin-section CT, but by polytomography no changes in the sellar floor could be demonstrated until the tumor size reached 6 mm. (author)

Cirurgia da hipófise por via trans-esfenoidal sob controle radiofluoroscópico e microdissecção novo tratamento da retinopatia diabética, tumores selares e neoplasias endocrinodependentes The surgery of the pituitary gland using a transphenoidal approach under radiofluoroscopic control and microdisection: a new treatment for diabetic retinopathy, pituitary tumors and endocrinodependent growths

Directory of Open Access Journals (Sweden)

Jules Hardy

1968-03-01

Full Text Available É apresentada nova técnica para a ablação total ou seletiva da hipófise utilizando via de acesso trans-esfenoidal, controle radiofluoroscópico e microdissecção, com traumatismo desprezível às estruturas circunvizinhas. Os autores comentam as aplicações do método à prática neurocirúrgica, relatando parte de uma série de mais 140 casos já operados. São discutidos os resultados obtidos no tratamento de 17 casos de retinopatia diabética, em 11 dos quais apenas o lobo anterior da hipófise foi removido, assim como aqueles obtidos na exérese de 20 casos de tumores selares. As indicações da hipofisectomia por via trans-esfenoidal no controle da sintomatologia das neoplasias endòcrinodependentes é estudada à luz dos resultados obtidos em 17 casos, sendo os resultados comparados com casos nos quais foi feita a implantação selar de ítrio90. As complicações operatorias em relação às três entidades nosológicas acima estudadas são também analisadas. Os autores salientam que a técnica descrita constitui, no presente estado das técnicas neurocirúrgicas utilizadas para a produção de uma insuficiência hipofisária duradoura, a intervenção de escolha.A new neurosurgical technique for the partial or total exéresis of the pituitary gland, using a transphenoidal approach under radiofluoroscopic control and microdisection is described. Part of a series of more than 140 cases operated upon by this method is reported. Results obtained in the treatment of diabetic retinopathy in 17 cases, 11 of which had only the pars anterior removed, are discussed. The applications of the transphenoidal route in 20 cases of pituitary fossa tumors are analysed. The indications of this type of operation in the management of endocrinodependent cancer is studied in 17 cases and compared with the results of 36 cases submitted to implant of Yttrium90 in the sella turcica. The operative complications following transphenoidal exéresis of the

The value of high-field MRI (3 T) in the assessment of sellar lesions

Energy Technology Data Exchange (ETDEWEB)

Pinker, K. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Ba-Ssalamah, A. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Wolfsberger, S. [Department of Neurosurgery, Medical University Vienna (Austria); Mlynarik, V. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Knosp, E. [Department of Neurosurgery, Medical University Vienna (Austria); Trattnig, S. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)]. E-mail: siegfried.trattnig@univie.ac.at

2005-06-01

The aim of this study was the evaluation of the normal sellar anatomy in vitro and in vivo with high-field MRI and its application in the diagnosis of sellar pathologies in comparison to standard MRI. All high-field MR images were obtained using a 3 T Bruker Medspec 30/80 Scanner with a head birdcage transmit/receive coil and an actively shielded gradient system with a maximum gradient strength of 45 mT/m. Firstly an in vitro study of the sella turcica was performed to depict normal pituitary and sellar anatomy at high field. After a pilot-study this sequence-protocol was established: A RARE sequence (TR/TE = 7790/19 ms; matrix size, 512 x 512; RARE factor = 8, FOV, 200 mm) was used for T2-weighted coronal, axial and sagittal images. A 3D gradient echo sequence with magnetization-preparation (MP-RAGE, TR/TE/TI 33.5/7.6/800 ms, matrix size, 512 x 512; FOV, 200 mm, effective slice thickness, 1.88 mm; 3 averages) was used for acquisition of T1-weighted pre- and post-contrast images. Between January 2002 and March 200458 patients were enrolled in this study. Seven patients were examined for suspected microadenoma and in 51 patients 3T MRI was used to obtain additional information about the sellar lesion already known to be present from standard MRI. In 21 cases the accuracy of the imaging findings was assessed afterwards by comparison with intraoperative findings. The infiltration of the medial cavernous sinus wall was suspected on standard MRI on 15 sides (47%), on high-field MRI on 9 sides (28%) and could be verified by intraoperative findings on 6 sides (19%). Accordingly, sensitivity to infiltration was 83% for 3 T and 67% for standard MRI. Specificity was 84% for 3 T and 58% for standard MRI. Moreover, high-field MRI revealed microadenomas in 7 patients with a median diameter of 4 mm (range 2-9 mm). The segments of the cranial nerves were seen as mean 4 hypointense spots (range 2-5 spots) on high-field MRI in contrast to 3 spots (range 0-4 spots) on standard MRI

Radiologically defining horizontal gaze using EOS imaging-a prospective study of healthy subjects and a retrospective audit.

Science.gov (United States)

Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Ho, Vivienne Chien-Lin; Azhar, Syifa Bte; Lim, Joel-Louis; Liu, Gabriel Ka-Po; Wong, Hee-Kit

2018-06-01

As sagittal alignment of the cervical spine is important for maintaining horizontal gaze, it is important to determine the former for surgical correction. However, horizontal gaze remains poorly-defined from a radiological point of view. The objective of this study was to establish radiological criteria to define horizontal gaze. This study was conducted at a tertiary health-care institution over a 1-month period. A prospective cohort of healthy patients was used to determine the best radiological criteria for defining horizontal gaze. A retrospective cohort of patients without rigid spinal deformities was used to audit the incidence of horizontal gaze. Two categories of radiological parameters for determining horizontal gaze were tested: (1) the vertical offset distances of key identifiable structures from the horizontal gaze axis and (2) imaginary lines convergent with the horizontal gaze axis. Sixty-seven healthy subjects underwent whole-body EOS radiographs taken in a directed standing posture. Horizontal gaze was radiologically defined using each parameter, as represented by their means, 95% confidence intervals (CIs), and associated 2 standard deviations (SDs). Subsequently, applying the radiological criteria, we conducted a retrospective audit of such radiographs (before the implementation of a strict radioimaging standardization). The mean age of our prospective cohort was 46.8 years, whereas that of our retrospective cohort was 37.2 years. Gender was evenly distributed across both cohorts. The four parameters with the lowest 95% CI and 2 SD were the distance offsets of the midpoint of the hard palate (A) and the base of the sella turcica (B), the horizontal convergents formed by the tangential line to the hard palate (C), and the line joining the center of the orbital orifice with the internal occipital protuberance (D). In the prospective cohort, good sensitivity (>98%) was attained when two or more parameters were used. Audit using Criterion B

Regional development and regional policy

OpenAIRE

Šabić, Dejan; Vujadinović, Snežana

2017-01-01

Economic polarization is a process that is present at global, national and regional level. Economic activity is extremely spatially concentrated. Cities and developed regions use the agglomeration effect to attract labor and capital, thus achieving more favorable economic conditions than the agrarian region. Scientific research and European experiences over the past decades have contributed to the discrepancy among theorists about the causes and consequences of regional inequalities. Regional...

Fat deposition in the cavernous sinus in Cushing disease

International Nuclear Information System (INIS)

Bachow, T.B.; Hesselink, J.R.; Aaron, J.O.; Davis, K.R.; Taveras, J.M.

1984-01-01

Fat density in the cavernous sinus on computed tomography (CT) is described in 6 out of 16 (37.5%) patients with Cushing disease. This finding may aid in making a specific diagnosis in patients with a pituitary mass. It was not seen in 30 random CT studies of the sella; however, supra seller fat was incidentally noted in the patient with acromegaly

Fat deposition in the cavernous sinus in Cushing disease

Energy Technology Data Exchange (ETDEWEB)

Bachow, T.B.; Hesselink, J.R.; Aaron, J.O.; Davis, K.R.; Taveras, J.M.

1984-10-01

Fat density in the cavernous sinus on computed tomography (CT) is described in 6 out of 16 (37.5%) patients with Cushing disease. This finding may aid in making a specific diagnosis in patients with a pituitary mass. It was not seen in 30 random CT studies of the sella; however, supra seller fat was incidentally noted in the patient with acromegaly.

Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

International Nuclear Information System (INIS)

O'Malley, Bert W.; Weinstein, Gregory S.

2007-01-01

Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development

Rathke cleft cyst in seven-year-old girl presenting with central diabetes insipidus and review of literature.

Science.gov (United States)

Evliyaoglu, Olcay; Evliyaoglu, Cetin; Ayva, Sebnem

2010-05-01

Rathke cleft cysts (RCC) are benign cysts derived from remnants of Rathke cleft, and are rarely symptomatic in children. Symptoms due to RCC are associated with mass effect and pituitary hormone deficiencies. Slow growth rate of the cyst makes its incidence increase with aging. Here we report on a seven-year-old girl who presented with central diabetes insipidus (CDI). Her sella MRI revealed a lesion in the sellar region which grew rapidly in follow-up. She underwent microneurosurgical operation and the lesion was totally excised. Pathologic examination revealed RCC with degenerative changes. In her follow-up, growth hormone deficiency developed in addition to arginine vasopressin deficiency. Rapid growth of the cyst is not the usual course of RCC's. Mechanisms regarding the cyst growth are unclear as they are in this case. This is the youngest child to date presenting with central diabetes insipidus due to RCC. Rapid growth of RCC can cause CDI in young children.

Value of computerized tomography in the diagnosis of primary and recurrent pituitary gland tumors

International Nuclear Information System (INIS)

Imhof, H.; Kuester, W.; Eslami-Nejad, S.

1979-01-01

The results of cranial computerized tomography (CCT) of 33 patients with questionable space-occupying lesions in the sella-region are compared with clinical, radiological and surgical reports. Five pituitary gland tumors could be detected for the first time. Four of them are verified by surgery. In eight cases recurrent pituitary glant tumors are suspected. Surprisingly these tumors could be found by surgery only in three cases, while in the remaining five cases only scar-tissue was demonstrable. The high accuracy of CCT in the detection of pituitary gland tumors and the possibility to save the patient expensive and high invasive examinations as well, makes CCT in the presence of corresponding clinical signs to a diagnostic 'must'. It is undecided whether in the cases with possible recurrent tumors, there are real recurrent tumors, which could not be detected by surgery, or only scar tissue. In the latter case scar tissue and recurrent pituitary gland tumors are very similar with CCT. (orig.) 891 MG/orig. 892 CKA [de

Returning "Region" to World Regional Geography

Science.gov (United States)

Rees, Peter W.; Legates, Margaret

2013-01-01

World regional geography textbooks rarely focus on the process of region formation, despite frequent calls to reincorporate a regional approach to teaching global geography. An instructional strategy using problem-based learning in a small honors section of a large world regional geography course is described. Using a hypothetical scenario…

Hawaii Regional Sediment Management (RSM): Regional Sediment Budget for the West Maui Region

Science.gov (United States)

2016-06-01

ER D C/ CH L TR -1 6- 5 Regional Sediment Management (RSM) Program Hawaii Regional Sediment Management (RSM): Regional Sediment Budget...acwc.sdp.sirsi.net/client/default. Regional Sediment Management (RSM) Program ERDC/CHL TR-16-5 June 2016 Hawaii Regional Sediment Management...distribution is unlimited. Prepared for U.S. Army Corps of Engineers Washington, DC 20314-1000 Under Project 454632, “ Hawaii Regional Sediment Management

ASEAN : Extra-Regional Cooperation Triggers Regional Integration

NARCIS (Netherlands)

Krapohl, S.; Krapohl, S.

2017-01-01

This chapter contains two case studies of regional cooperation within Southeast Asia. The network analysis of ASEAN demonstrates that the region is dependent on extra-regional trade with the EU and the USA, but also with China and Japan. However, the region is not dominated by a single regional

A role for 11C-methionine PET imaging in ACTH-dependent Cushing's syndrome.

Science.gov (United States)

Koulouri, Olympia; Steuwe, Andrea; Gillett, Daniel; Hoole, Andrew C; Powlson, Andrew S; Donnelly, Neil A; Burnet, Neil G; Antoun, Nagui M; Cheow, Heok; Mannion, Richard J; Pickard, John D; Gurnell, Mark

2015-10-01

We report our experience of functional imaging with (11)C-methionine positron emission tomography-computed tomography (PET-CT) co-registered with 3D gradient echo (spoiled gradient recalled (SPGR)) magnetic resonance imaging (MRI) in the investigation of ACTH-dependent Cushing's syndrome. Twenty patients with i) de novo Cushing's disease (CD, n=10), ii) residual or recurrent hypercortisolism following first pituitary surgery (±radiotherapy; n=8) or iii) ectopic Cushing's syndrome (n=2) were referred to our centre for functional imaging studies between 2010 and 2015. Six of the patients with de novo CD and five of those with persistent/relapsed disease had a suspected abnormality on conventional MRI. All patients underwent (11)C-methionine PET-CT. For pituitary imaging, co-registration of PET-CT images with contemporaneous SPGR MRI (1 mm slice thickness) was performed, followed by detailed mapping of (11)C-methionine uptake across the sella in three planes (coronal, sagittal and axial). This allowed us to determine whether suspected adenomas seen on structural imaging exhibited focal tracer uptake on functional imaging. In seven of ten patients with de novo CD, asymmetric (11)C-methionine uptake was observed within the sella, which co-localized with the suspected site of a corticotroph microadenoma visualised on SPGR MRI (and which was subsequently confirmed histologically following successful transsphenoidal surgery (TSS)). Focal (11)C-methionine uptake that correlated with a suspected abnormality on pituitary MRI was seen in five of eight patients with residual or recurrent Cushing's syndrome following first TSS (and pituitary radiotherapy in two cases). Two patients elected to undergo repeat TSS with histology confirming a corticotroph tumour in each case. In two patients with the ectopic ACTH syndrome, (11)C-methionine was concentrated in sites of distant metastases, with minimal uptake in the sellar region. (11)C-methionine PET-CT can aid the detection of

Regional planning without means - search for regional leadership

DEFF Research Database (Denmark)

Groth, Niels Boje; Fertner, Christian

and stakeholders, not least due to its polycentric urban structure with several medium-sized towns. Besides the regional authority and the regions 22 municipalities, sub-regional collaboration is gaining momentum. Furthermore, different fora, councils and associations are engaging in regional issues. However......, collaboration is often focused on specific sectors or sub-regions, while the joint development of the region is left behind. The regional authority has changed its focus from planning to the provision of knowledge, suitable to kick-off joint action with regional stakeholders, while municipalities keep focus...... on their own territories, eventually in the context of one of the new sub-regional collaborations. Based on an empirical analysis of the regional interplay in Southern Denmark and results from the ESPON ReSSI project, we go through these new settings of regional collaboration in the search for new forms...

Hypothalamic-pituitary dwarfism: Comparison between MR imaging and CT findings

International Nuclear Information System (INIS)

Maghnie, M.; Larizza, D.; Severi, F.; Triulzi, F.; Scotti, G.; Beluffi, G.; Cecchini, A.

1990-01-01

Magnetic Resonance (MR) imaging was carried out on 33 patients with idiopathic growth hormone deficiency, in 22 of whom CT scan had been carried out previously. Twenty-one patients presented some complications at birth. Both MR and CT were positive in the evaluation of the sella. MR imaging exhibited a higher degree of accuracy than CT in the evaluation of pituitary gland, pituitary stalk and brain anomalies. (orig.)

Stability Following Combined Maxillary and Mandibular Osteotomies Treated with Rigid Internal Fixation.

Science.gov (United States)

1987-06-01

S), articulare (Ar), A point, B point, constructed gonion (CGo), and menton (Me). The points nasion and sella were transferred to each successive...radiograph by superimposing on anterior and posterior cranial base structures. The landmarks articulare , A point, B point, menton, and constructed gonion...reported 45% relapse in their cases determined to be attributed to condylar distraction at the time of surgery. The use of rigid fixation as described

A CASE REPORT ON SHEEHAN’S SYNDROME WITH IRON DEFICIENCY ANAEMIA- A HAEMATOLOGICAL PERSPECTIVE OF PANHYPOPITUITARISM

Directory of Open Access Journals (Sweden)

Usha Rani Pegu

2017-04-01

Full Text Available BACKGROUND SS occurs due to ischaemic pituitary necrosis after severe Postpartum Haemorrhage (PPH and is characterised by typical history of severe postpartum blood loss, hypotension or shock, postpartum lactation failure, discontinuation of the menses after the delivery, partial or complete anterior pituitary insufficiency and empty sella on CT or MRI. 1,2,3,4 Although unclear, anaemia is well recognised as a feature of hypopituitarism.

The International Conference on Hemorrhagic Fever with Renal Syndrome (1st) Held in Seoul, Korea on 4-6 May 1989

Science.gov (United States)

1990-05-01

suggest that the body is important for a maker of 1lFRS-virus infection. 69 PROSPECTIVE STUDY ON PANHYPOPITUITARISM AS A SEQUELA OF HEMORRHAGIC FEVER...necrosis is a characteristic and common autopsy finding. Contrary to this, only 14 cases of clinical panhypopituitarism have been reported. Recently we...confirmed six patients with panhypopituitarism by high resolution sella computed tomo-,raphy(CT) and combined anterior pituitary stimulation lest(CAPS I

MR imaging in children with ectopic pituitary gland and anterior hypopituitarism.

OpenAIRE

Patkar D; Patankar T; Krishnan A; Prasad S; Shah J; Limdi J

1999-01-01

Posterior pituitary ectopia refers to an absent normal posterior pituitary bright spot within the sella with ectopic bright signal at another site (such as the median eminence) on a weighted magnetic resonance. We describe two children with idiopathic anterior hypopituitarism who showed an ectopic posterior pituitary and absent pituitary stalk on imaging. We emphasize the association of the absent pituitary stalk in ectopic pituitary gland and low growth hormone levels.

Extramedullary plasmocytoma of the rhino pharynx associated to intrathoracic mass - a case report

International Nuclear Information System (INIS)

Souza, Andrea Silveira de; Fernandes, Artur da Rocha Correa; Yamashita, Helio Kiitiro

1996-01-01

The authors report a case of a 56-year-old while male, who had occipital headache, libido and visual acuity (bitemporal field) reduction as the clinical picture, with progressive evolution within a four years period. The image diagnosis methods (roentgenologic studies, (MRI) demonstrated extensive mass involving the sella, clivus and sphenoid sinus, and an intrathoracic mass on the right. The final diagnosis was extramedullary plasmocytoma with rhinopharynx origin. (author)

Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma.

Science.gov (United States)

Wang, Xian-Ling; Dou, Jing-Tao; Lü, Zhao-Hui; Zhong, Wen-Wen; Ba, Jian-Ming; Jin, Du; Lu, Ju-Ming; Pan, Chang-Yu; Mu, Yi-Ming

2011-11-01

Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma. Six patients with spontaneous remission of acromegaly or gigantism were enrolled. The clinical characteristics, endocrinological evaluation and imageological characteristics were retrospectively analyzed. In these cases, the initial clinical presences were diabetes mellitus or hypogonadism. No abrupt headache, vomiting, visual function impairment, or conscious disturbance had ever been complained of. The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher, but nadir GH levels were all still > 1 µg/L in 75 g oral glucose tolerance test. Magnetic resonance imaging detected enlarged sella, partial empty sella and compressed pituitary. The transsphenoidal surgery was performed in 2 cases, and the other patients were conservatively managed. All the patients were in clinical remission. When the clinical presences, endocrine evaluation, biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly, the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed. To these patients, conservative therapy may be appropriate.

MR imaging in children with ectopic pituitary gland and anterior hypopituitarism.

Directory of Open Access Journals (Sweden)

Patkar D

1999-07-01

Full Text Available Posterior pituitary ectopia refers to an absent normal posterior pituitary bright spot within the sella with ectopic bright signal at another site (such as the median eminence on a weighted magnetic resonance. We describe two children with idiopathic anterior hypopituitarism who showed an ectopic posterior pituitary and absent pituitary stalk on imaging. We emphasize the association of the absent pituitary stalk in ectopic pituitary gland and low growth hormone levels.

Significant Improvement in Chronic Persistent Headaches Caused by Small Rathke Cleft Cysts After Transsphenoidal Surgery

OpenAIRE

Fukui, Issei; Hayashi, Yasuhiko; Kita, Daisuke; Sasagawa, Yasuo; Oishi, Masahiro; Tachibana, Osamu; Nakada, Mitsutoshi

2017-01-01

Purpose Rathke cleft cysts (RCC) usually are asymptomatic and can be observed via the use of conservative methods. Some patients with RCCs, however, have severe headaches even if they are small enough to be confined to the sella, and these small RCCs seldom have been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. Me...

Effect of Maize Hybrid and Foliar Fungicides on Yield Under Low Foliar Disease Severity Conditions.

Science.gov (United States)

Mallowa, Sally O; Esker, Paul D; Paul, Pierce A; Bradley, Carl A; Chapara, Venkata R; Conley, Shawn P; Robertson, Alison E

2015-08-01

Foliar fungicide use in the U.S. Corn Belt increased in the last decade; however, questions persist pertaining to its value and sustainability. Multistate field trials were established from 2010 to 2012 in Illinois, Iowa, Ohio, and Wisconsin to examine how hybrid and foliar fungicide influenced disease intensity and yield. The experimental design was in a split-split plot with main plots consisting of hybrids varying in resistance to gray leaf spot (caused by Cercospora zeae-maydis) and northern corn leaf blight (caused by Setosphaera turcica), subplots corresponding to four application timings of the fungicide pyraclostrobin, and sub-subplots represented by inoculations with either C. zeae-maydis, S. turcica, or both at two vegetative growth stages. Fungicide application (VT/R1) significantly reduced total disease severity relative to the control in five of eight site-years (P<0.05). Disease was reduced by approximately 30% at Wisconsin in 2011, 20% at Illinois in 2010, 29% at Iowa in 2010, and 32 and 30% at Ohio in 2010 and 2012, respectively. These disease severities ranged from 0.2 to 0.3% in Wisconsin in 2011 to 16.7 to 22.1% in Illinois in 2010. The untreated control had significantly lower yield (P<0.05) than the fungicide-treated in three site-years. Fungicide application increased the yield by approximately 6% at Ohio in 2010, 5% at Wisconsin in 2010 and 6% in 2011. Yield differences ranged from 8,403 to 8,890 kg/ha in Wisconsin 2011 to 11,362 to 11,919 kg/ha in Wisconsin 2010. Results suggest susceptibility to disease and prevailing environment are important drivers of observed differences. Yield increases as a result of the physiological benefits of plant health benefits under low disease were not consistent.

Active region structures in the transition region and corona

International Nuclear Information System (INIS)

Webb, D.F.

1981-01-01

Observational aspects of the transition region and coronal structures of the solar active region are reviewed with an emphasis on imaging of the plasma loops which act as tracers of the magnetic flux loops. The study of the basic structure of an active region is discussed in terms of the morphological and thermal classifications of active region loops, including umbral structures, and observational knowledge of the thermal structure of loops is considered in relation to scaling laws, emission measures and the structures of individual loops. The temporal evolution of active region loop structures is reviewed with emphasis on ephemeral regions and the emergence of active regions. Planned future spaceborne observations of active region loop structures in the EUV and soft X-ray regions are also indicated

Thinking regionally: narrative, the medical humanities and region.

Science.gov (United States)

Waddington, Keir

2015-06-01

Drawing on multiple literatures from history, geography, anthropology, sociology and literature, this essay asks questions about what we mean by region and why narratives of region should matter to the medical humanities. The essay surveys how region can be used as a lens of analysis, exploring the various academic approaches to region and their limitations. It argues that regions are dynamic but also unstable as a category of analysis and are often used uncritically by scholars. In encouraging scholars working in the medical humanities to be aware that regions are not simple objective or analytical boxes, the essay shows how an awareness of region helps challenge metropolitan whiggism and ideas of core and periphery to give a more prominent place to hinterlands, market towns and rural environments. Furthermore, the essay considers how incorporating region into our understanding of illness can offer new insights. It demonstrates the need for scholars to be attuned to the narratives constructed around regions, suggesting that regions can be viewed as discursive formations that provide a frame for understanding both collective and personal ideas of, and responses to, health and illness, disease and healing, to create what Megan Davies calls a more nuanced 'intellectual cartography'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Regional scheme for the connection to the grid of renewable energies: for the Hauts-de-France region, for the Nord-Pas-de-Calais region, for the Picardy region, the Alsace region, the Aquitaine region, the Auvergne region, the Lower-Normandy region, the Burgundy region, the Brittany region, the Centre-Val-de-Loire region, the Champagne-Ardennes region, the Franche-Comte region, the Upper Normandy region, the Ile-de-France region, the Languedoc-Roussillon region, the Lorraine region, the Midi-Pyrenees region, the Provence-Alps-Cote d'Azur region, the Pays-de-la-Loire region, the Poitou-Charentes region, the Rhone-Alps region. Technical and financial status of the scheme implementation

International Nuclear Information System (INIS)

2017-01-01

This document gathers reports related to all French regions. Each one addresses the elaboration of the concerned regional scheme of connection of renewable energies to the distribution network (French acronym: S3REnR) which aims at anticipating and planning evolutions of electrical networks which are necessary for the integration of renewable energies. Illustrated by maps, tables and graphs, these reports propose indications of energy production locations, an identification of planned works, a presentation of the concerned region, of its existing grid and projects, an overview of the scheme content (initial status, results of consultations, adopted strategies, planned works), and an overview of the scheme implementation status

Intrasellar Symptomatic Salivary Gland Rest

Directory of Open Access Journals (Sweden)

Chih-Hao Chen

2007-05-01

Full Text Available Ectopic salivary gland tissue in sellar turcica is frequently observed in microscopic examination at autopsy. This tissue is considered clinically silent. Only 2 symptomatic cases have been previously reported. Here we report a 28-year-old woman presenting with galactorrhea and hyperprolactinemia. Magnetic resonance imaging revealed a 6×5-mm nodule in the posterior aspect of the pituitary gland. This nodule showed isointensity on T1- and T2-weighted images and less enhancement on post-contrast T1-weighted images. Transsphenoidal exploration revealed a cystic lesion within the pituitary gland, which consisted of a grayish gelatinous content. The pathologic examination confirmed the diagnosis of salivary gland rest.

Dvigateli regional'nogo stroitel'stva. Vlijanie regional'nyh politicheskih organizacij na sotrudnichestvo universitetov v regione Baltijskogo morja [Motors for regional development: impact on regional political organizations on the university cooperation in the Baltic Sea region

Directory of Open Access Journals (Sweden)

Ewert Stefan

2010-01-01

Full Text Available Educational co-operation is one of the main aspects of the regional political agenda in the Baltic Sea Region. The article analyzes the political impact of the organizations, as perceived by the universities in the region and political decision-makers on national and regional levels. Based on the success of the OECD in becoming an influential actor in educational policies, this article discusses different strategies for the regional political organizations to enhance their influence.

Regional employment growth, shocks and regional industrial resilience

DEFF Research Database (Denmark)

Holm, Jacob Rubæk; Østergaard, Christian Richter

2013-01-01

The resilience of regional industries to economic shocks has gained a lot of attention in evolutionary economic geography recently. This paper uses a novel quantitative approach to investigate the regional industrial resilience of the Danish ICT sector to the shock following the burst of the dot......-com bubble. It is shown that regions characterised by small and young ICT service companies were more adaptable and grew more than others, while diversity and urbanisation increased the sensitivity to the business cycle after the shock. Different types of resilient regions are found: adaptively resilient......, rigidly resilient, entrepreneurially resilient and non-resilient regions....

Pure endoscopic transsphenoidal surgery for treatment of acromegaly: results of 67 cases treated in a pituitary center.

Science.gov (United States)

Gondim, Jackson A; Almeida, João Paulo; de Albuquerque, Lucas Alverne F; Gomes, Erika; Schops, Michele; Ferraz, Tania

2010-10-01

Acromegaly is a chronic disease related to the excess of growth hormone (GH) and insulin-like growth factor–I secretion, usually by pituitary adenomas. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The introduction of endoscopy as an additional tool for surgical treatment of pituitary adenomas and, therefore, acromegaly represents an important advance of pituitary surgery in the recent years. The aim of this retrospective study is to evaluate the results of pure transsphenoidal endoscopic surgery in a series of patients with acromegaly who were operated on by a pituitary specialist surgeon. The authors discuss the advantages, outcome, complications, and factors related to the success of the endoscopic approach in cases of GHsecreting adenomas. The authors retrospectively analyzed data from cases involving patients with GH-secreting adenomas who underwent pure transsphenoidal endoscopic surgery at the Department of Neurosurgery of the General Hospital in Fortaleza, Brazil, between 2000 and 2009. Tumors were classified according to size as micro- or macroadenomas, and tumor extension was analyzed based on suprasellar/parasellar extension and sella floor destruction. All patients were followed up for at least 1 year. The criteria of disease control were GH levels transsphenoidal surgery for treatment of acromegaly. Disease control was obtained in 50 cases (74.6%). The rate of treatment success was higher in patients with microadenomas (disease control achieved in 12 [85.7%] of 14 cases) than in those with larger lesions. Suprasellar/parasellar extension and high levels of sella floor erosion were associated with lower rates of disease control (p = 0.01 and p = 0.02, respectively). Complications related to the endoscopic surgery included epistaxis (6.0%), transitory diabetes insipidus (4.5%), and 1 case of seizure (1.5%). Endoscopic transsphenoidal surgery represents an effective option for treatment of patients

Regional Geography is Dead. Long Live Regional Geography!

Czech Academy of Sciences Publication Activity Database

Vaishar, Antonín; Werner, M.

2006-01-01

Roč. 14, č. 3 (2006), s. 2-8 ISSN 1210-8812 Institutional research plan: CEZ:AV0Z30860518 Keywords : regional geography * regions * geography * methodology * Ostrava region Subject RIV: DE - Earth Magnetism, Geodesy, Geography

A Large PROP1 Gene Deletion in a Turkish Pedigree

Directory of Open Access Journals (Sweden)

Suheyla Gorar

2018-01-01

Full Text Available Pituitary-specific paired-like homeodomain transcription factor, PROP1, is associated with multiple pituitary hormone deficiency. Alteration of the gene encoding the PROP1 may affect somatotropes, thyrotropes, and lactotropes, as well as gonadotropes and corticotropes. We performed genetic analysis of PROP1 gene in a Turkish pedigree with three siblings who presented with short stature. Parents were first degree cousins. Index case, a boy, had somatotrope, gonadotrope, thyrotrope, and corticotrope deficiency. However, two elder sisters had somatotroph, gonadotroph, and thyrotroph deficiency and no corticotroph deficiency. On pituitary magnetic resonance, partial empty sella was detected with normal bright spot in all siblings. In genetic analysis, we found a gross deletion involving PROP1 coding region. In conclusion, we report three Turkish siblings with a gross deletion in PROP1 gene. Interestingly, although little boy with combined pituitary hormone deficiency has adrenocorticotropic hormone (ACTH deficiency, his elder sisters with the same gross PROP1 deletion have no ACTH deficiency. This finding is in line with the fact that patients with PROP1 mutations may have different phenotype/genotype correlation.

The terrestrial distribution of artificial radioactivity in south-west Scotland

International Nuclear Information System (INIS)

McDonald, Paul; Cook, G.T.; Baxter, M.S.; Thompson, J.C.

1992-01-01

This investigation extends the data base on dispersion of Sella-field-derived radionuclides to the northern Solway coastal zone of south-west Scotland. Results of 10x10 km grid soil survey indicate that the predominant source of 239+240 Pu to the area has been weapons fallout, Chernobyl fallout having greatly modified 134 Cs and 137 Cs inventories. Inland transects reveal little evidence of airborne sea-to-land transfer of Sellafield-derived radionuclides, but riverine systems exhibit regions of significant on-land input from Sellafield via tidal inundation and deposition of particles. Sequential chemical leaching of soil and sediment samples suggests a change in chemical association of plutonium between marine and terrestrial systems. In radiological terms, airborne on-land transfer of Sellafield radionuclides is of negligible significance. Radionuclide inventories in Solway soils are generally well below the limiting values implied by the recommended generalised derived limits (GDL). In some tidally inundated riverbank areas however, 137 Cs, Puα and 241 Am levels occasionally exceed 25% of the appropriate GDL values. (author). 40 refs.; 8 figs.; 7 tabs

Regional Employment Growth, Shocks and Regional Industrial Resilience

DEFF Research Database (Denmark)

Holm, J.R.; Østergaard, Christian Richter

2015-01-01

The resilience of regional industries to economic shocks has gained a lot of attention in evolutionary economic geography recently. This paper uses a novel quantitative approach to investigate the regional industrial resilience of the Danish information and communication technology (ICT) sector...... to the shock following the burst of the dot.com bubble. It is shown that regions characterized by small and young ICT service companies were more adaptable and grew more than others, while diversity and urbanization increased the sensitivity to the business cycle after the shock. Different types of resilient...... regions are found: adaptively resilient, rigidly resilient, entrepreneurially resilient and non-resilient regions....

Mobile Officen sisustussuunnitelma : Rytmikorjaamon liikkuvan ihmisen työpisteet

OpenAIRE

Talvitie, Satu

2011-01-01

Opinnäytetyö käsitteli toimistotilan sisustussuunnittelua luovan tilan konseptilla. Työn tarkoituksena oli antaa selkeä kuva sisustussuunnittelusta, toimistosuunnittelusta ja luovan tilan merkityksestä. Opinnäytetyön tavoitteena oli tehdä sisustussuunnitelma Rytmikorjaamon Mobile Officeen. Mobile Office tehdään liikkuvien ihmisten työpisteiksi. Opinnäytetyön toimeksiantajana toimivat Sisustuskeskus Sella, Seinäjoen kaupunki, Selmu Ry ja Seinäjoen teknologiakeskus. Opinnäytetyön teoriaosuud...

A transseptal approach in transsphenoidal surgery for pituitary (hypophyseal) tumors

International Nuclear Information System (INIS)

Gierek, T.; Galuszko-Ignasiak, B.; Krauze, J.; Rudnik, A.

1994-01-01

The authors described the direct transseptal approach in transsphenoidal surgery for hypophyseal tumors. This route gives a good insight into the area of the sella. The above mentioned method is also less destructive to nasal structures in the nasal cavity, because preserves the anterior nasal septum. It is uniformity of actually views of rhinological school. 20 patients were operated using this method and none of them noticed the changes of nasal airway and the sense of smell. (author)

MR and CT diagnosis of carotid pseudoaneurysm in children following surgical resection of craniopharyngioma

International Nuclear Information System (INIS)

Lakhanpal, S.K.; Glasier, C.M.; James, C.A.; Angtuaco, E.J.C.

1995-01-01

We report the cases of two children who underwent CT, MR, MRA and angiography in the diagnosis of postoperative aneurysmal dilatation of the supraclinoid carotid arteries following surgical resection of craniopharyngioma. Craniopharyngiomas are relatively common lesions, accounting for 6-7 % of brain tumors in children. They are histologically benign, causing symptoms by their growth within the sella and suprasellar cistern with compression of adjacent structures, especially the pituitary gland, hypothalamus and optic nerves, chiasm, and tracts. (orig.)

MR and CT diagnosis of carotid pseudoaneurysm in children following surgical resection of craniopharyngioma

Energy Technology Data Exchange (ETDEWEB)

Lakhanpal, S.K. [Dept. of Radiology, Univ. of Arkansas for Medical Sciences and Arkansas Children`s Hospital, Little Rock, AR (United States); Glasier, C.M. [Dept. of Radiology, Univ. of Arkansas for Medical Sciences and Arkansas Children`s Hospital, Little Rock, AR (United States); James, C.A. [Dept. of Radiology, Univ. of Arkansas for Medical Sciences and Arkansas Children`s Hospital, Little Rock, AR (United States); Angtuaco, E.J.C. [Dept. of Radiology, Univ. of Arkansas for Medical Sciences and Arkansas Children`s Hospital, Little Rock, AR (United States)

1995-06-01

We report the cases of two children who underwent CT, MR, MRA and angiography in the diagnosis of postoperative aneurysmal dilatation of the supraclinoid carotid arteries following surgical resection of craniopharyngioma. Craniopharyngiomas are relatively common lesions, accounting for 6-7 % of brain tumors in children. They are histologically benign, causing symptoms by their growth within the sella and suprasellar cistern with compression of adjacent structures, especially the pituitary gland, hypothalamus and optic nerves, chiasm, and tracts. (orig.)

Allasterapia osana neurologista kuntoutusta

OpenAIRE

Laaksonen, Aino; Lahti, Janina; Saastamoinen, Maarit; Salmi, Sirja

2009-01-01

Opinnäytetyön tarkoituksena oli koota teoriatietoa allasterapiasta ja erityisesti sen soveltuvuudesta neurologisille kuntoutujille. Opinnäytetyö toteutettiin vuoden 2009 aikana. Opinnäytetyön aineisto koottiin kirjallisuuskatsauksen ja avoimen teemahaastattelun avulla. Kirjallisuutta ja tutki-mustietoa neurologisesta allasterapiasta on vähän, ja se irrallista, joten teemahaastatteluista laaditulla vapaamuotoi-sella yhteenvedolla opinnäytetyöhön saatiin mukaan myös käytännönkokemuksia. Opinnäy...

Regions Matter

DEFF Research Database (Denmark)

Laursen, Keld; Masciarelli, Francesca; Prencipe, Andrea

2012-01-01

capital at the regional level, with a large-scale data set of the innovative activities of a representative sample of 2,413 Italian manufacturing firms from 21 regions, and controlling for a large set of firm and regional characteristics, we find that being located in a region characterized by a high...

Identification of 'Point A' as the prevalent source of error in cephalometric analysis of lateral radiographs.

Science.gov (United States)

Grogger, P; Sacher, C; Weber, S; Millesi, G; Seemann, R

2018-04-10

Deviations in measuring dentofacial components in a lateral X-ray represent a major hurdle in the subsequent treatment of dysgnathic patients. In a retrospective study, we investigated the most prevalent source of error in the following commonly used cephalometric measurements: the angles Sella-Nasion-Point A (SNA), Sella-Nasion-Point B (SNB) and Point A-Nasion-Point B (ANB); the Wits appraisal; the anteroposterior dysplasia indicator (APDI); and the overbite depth indicator (ODI). Preoperative lateral radiographic images of patients with dentofacial deformities were collected and the landmarks digitally traced by three independent raters. Cephalometric analysis was automatically performed based on 1116 tracings. Error analysis identified the x-coordinate of Point A as the prevalent source of error in all investigated measurements, except SNB, in which it is not incorporated. In SNB, the y-coordinate of Nasion predominated error variance. SNB showed lowest inter-rater variation. In addition, our observations confirmed previous studies showing that landmark identification variance follows characteristic error envelopes in the highest number of tracings analysed up to now. Variance orthogonal to defining planes was of relevance, while variance parallel to planes was not. Taking these findings into account, orthognathic surgeons as well as orthodontists would be able to perform cephalometry more accurately and accomplish better therapeutic results. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Temporal lobe epilepsy due to meningoencephaloceles into the greater sphenoid wing. A consequence of idiopathic intracranial hypertension?

Energy Technology Data Exchange (ETDEWEB)

Urbach, H.; Jamneala, G.; Mader, I.; Egger, K.; Yang, S. [Medical Center - Freiburg Univ. (Germany). Dept. of Neuroradiology; Altenmueller, D. [Medical Center - Freiburg Univ. (Germany). Dept. of Epileptology

2018-01-15

Antero-inferior temporal lobe meningoencephaloceles are a rare, but increasingly recognized cause of drug-resistant temporal lobe epilepsy (TLE). In order to evaluate whether these lesions are related to idiopathic intracranial hypertension (IIH), we analyzed clinical and MRI findings of a cohort of patients undergoing presurgical work-up. Seizure onset in the anterior temporal lobe was proven by EEG electrodes in 22 patients, and in 21 patients, anterior temporal lobectomy (mostly with sparing of the hippocampus) was performed. MRI signs of IIH (in particular empty sella) and the volumes of the ventricles and external CSF spaces were determined and related to the body mass index (BMI) and clinical outcome. Six of seven obese (BMI > 30 kg/m{sup 2}) compared to four of 15 non-obese patients had partial empty or empty sella (p = 0.007). Bilateral lesions were found in all obese and 11 patients. Seizure freedom (Engel class 1A) was achieved in 12 of 21 patients (5 obese compared to 7 non-obese patients). BMI was related to the volume of the external CSF spaces (r = 0.467), and age at seizure onset was higher in obese patients. Roughly a third of patients with temporal lobe epilepsy due to antero-inferior meningoencephaloceles is obese and has MRI signs of idiopathic intracranial hypertension. (orig.)

Manual tracing versus smartphone application (app) tracing: a comparative study.

Science.gov (United States)

Sayar, Gülşilay; Kilinc, Delal Dara

2017-11-01

This study aimed to compare the results of conventional manual cephalometric tracing with those acquired with smartphone application cephalometric tracing. The cephalometric radiographs of 55 patients (25 females and 30 males) were traced via the manual and app methods and were subsequently examined with Steiner's analysis. Five skeletal measurements, five dental measurements and two soft tissue measurements were managed based on 21 landmarks. The durations of the performances of the two methods were also compared. SNA (Sella, Nasion, A point angle) and SNB (Sella, Nasion, B point angle) values for the manual method were statistically lower (p < .001) than those for the app method. The ANB value for the manual method was statistically lower than that of app method. L1-NB (°) and upper lip protrusion values for the manual method were statistically higher than those for the app method. Go-GN/SN, U1-NA (°) and U1-NA (mm) values for manual method were statistically lower than those for the app method. No differences between the two methods were found in the L1-NB (mm), occlusal plane to SN, interincisal angle or lower lip protrusion values. Although statistically significant differences were found between the two methods, the cephalometric tracing proceeded faster with the app method than with the manual method.

Development of regional growth centres and impact on regional growth: A case study of Thailand’s Northeastern region

Directory of Open Access Journals (Sweden)

Nattapon Sang-arun

2013-01-01

Full Text Available This study investigates the spatial economic structure and inequality in Thailand at the national and regional levels, with a particular focus on the Northeastern region in the period from 1987 to 2007. The study has three main points: 1 examination of the economic structure and inequality at the national level and in the Northeastern region according to the Theil index, 2 determination of regional growth centres and satellite towns by using growth pole theory as a conceptual framework and incorporating spatial interaction analysis and 3 analysis of the relationship between regional growth centres and satellite towns with regard to the impact on growth and inequality. The results show that the Northeastern region is definitely the lagging region in the nation, by both gross domestic product (GDP and gross regional product (GRP per capita. It was therefore selected for a case study. Spatial analysis identified Nakhon Ratchasima, Khon Kaen, Udon Thani and Ubon Ratchathani as regional growth centres. Each of them has its own sphere of influence (or satellite towns, and the total area of regional growth centres and satellite towns are classified as sub-regions. The development of regional growth centres has a direct impact on sub-regional economic growth through economic and social relationships: urbanisation, industrial development, per capita growth, the number of higher educational institutes and so on. However, such growth negatively correlates with economic equality among the provinces in a sub-region. The inequality trend is obviously on an upswing. This study suggests that industrial links between regional growth centres and their satellite towns should be improved in order for regional growth centre development to have a consistently desirable effect on both economic growth and equality. Such a strong process means that the growth of regional growth centres will spread, leading to the development of their surrounding areas.

Die Region braucht die Kultur - die Kultur braucht die Region

OpenAIRE

Klemm, Ulrich

1995-01-01

Die Region braucht die Kultur - die Kultur braucht die Region. - In: Region in Aktion - oder: Region im Abseits? - Boxberg-Wölchingen : Eigenständige Regionalentwicklung Baden-Württemberg, 1995. - S. 25 f.

A Declining Region: Provincial Renaissance Revisited (Case of Volgograd Region

Directory of Open Access Journals (Sweden)

Drozdova Yuliya

2014-12-01

Full Text Available The paper analyzes findings yielded by the empirical study performed in the framework of an RGNF grant entitled “Image of a region as a communicative strategy for the authorities and mass media”. The methods of study included expert survey and formal survey (N=1000, July-September 2013, studying the opinion of respondents who were either internal experts residing in the Volgograd region (N=20; May-September 2013 or external experts who reside outside the region but maintain stable ties with the representatives of state and municipal authorities, regional mass media and business. The findings indicate that the Volgograd region has fallen behind other modernized Russian regions, that young people tend to leave it, that a negative image of the region as a declining territory persists. Answers to the open question “What is unacceptable for you in the existing image of the Volgograd region?” revealed major problems determining the local context of a declining region, and those were issues associated with inefficient regional/municipal administration: “the condition of the roads”, “constant replacement of people in the administration”, “politics as a whole”, “a destitute region without a good manager”, “unemployment”, “countryside is dying off”, “indifference of the authorities”, “roads, housing and public utilities and the administration”, “the authorities are not responsible for the people”, “the authorities do not solve the problems of the city or its people”, “thieving”, “dishonest authorities”, “the region goes to rack and ruin, no kindergartens or jobs”, “one cannot even walk in the streets”, “corruption”, “a stagnant region with low pay”, “no perspectives in the future”, “the region is stagnating due to corruption among officials”. According to the local Census Bureau, the Volgograd region can be classified as a declining territory where the population decline

The politics of inter-regionalism: relations between international regional organizations

NARCIS (Netherlands)

Vleuten, J.M. van der; Ribeiro Hoffman, A.; Reinalda, B.

2013-01-01

As the development of relations between international regional organizations, inter-regionalism denotes a relatively recent phenomenon. Largely due to systemic bipolarity, inter-regional relations remained limited to 'dialogue partnerships' between the European Community (EC) and other regional

Regional Stability & Lessons Learned in Regional Peace Building

DEFF Research Database (Denmark)

Vestenskov, David; Johnsen, Anton Asklund

, as none of the countries is able to deal with the intrastate and interstate conflicts on its own. The conference Regional Stability & Lessons Learned in Regional Peace Building was the result of comprehensive cooperation between Pakistan’s National Defence University and the Royal Danish Defence College......The NATO-led intervention in Afghanistan is coming to an end, and the necessity of regional peace building solutions for the region’s security issues seems more exigent than ever before. Regional states have to come to terms with each other in some ways if violent extremists are to be countered...

Building a competitive regional innovation environment : the regional development platform method as a tool for regional innovation policy

OpenAIRE

Harmaakorpi, Vesa

2004-01-01

The study focuses on building a regional innovation policy tool that takes into account the demands of the present techno-economic and socio-institutional paradigms. Regions are seen to be strongly dependent on their history. The competitiveness of a region is based on the regional resource configurations. In a turbulent world these resource configurations have to be renewed over time setting demands for regional dynamic capabilities. This study emphasises five regional dynamic capabilities: ...

A subspecies of region crossing change, region freeze crossing change

OpenAIRE

Inoue, Ayumu; Shimizu, Ryo

2016-01-01

We introduce a local move on a link diagram named a region freeze crossing change which is close to a region crossing change, but not the same. We study similarity and difference between region crossing change and region freeze crossing change.

Regional alternative transportation evaluation report - Region 4

Science.gov (United States)

2013-08-15

The U.S. Fish and Wildlife Service (FWS) and the U.S. Department of Transportation (DOT) Volpe Center (Volpe Center) conducted a regional alternative transportation evaluation (RATE) in Region 4, which is comprised of Alabama, Arkansas, Florida, Geor...

Regional alternative transportation evaluation report - region 2

Science.gov (United States)

2012-03-01

The U.S. Fish and Wildlife Service (FWS) and the U.S. Department of Transportation (DOT) Volpe : Center (Volpe Center) conducted a regional alternative transportation evaluation (RATE) in Region 2, : which is comprised of Arizona, Oklahoma, New Mexic...

Regional alternative transportation evaluation report - region 5

Science.gov (United States)

2011-11-14

The U.S. Fish and Wildlife Service (FWS) and the U.S. Department of Transportation (DOT) Volpe Center (Volpe Center) conducted a regional alternative transportation evaluation (RATE) in Region 3, which is comprised of Illinois, Indiana, Iowa, Michiga...

Regional alternative transportation evaluation report - region 1

Science.gov (United States)

2011-01-21

The U.S. Fish and Wildlife Service (FWS) and the U.S. Department of Transportation (DOT) Volpe Center (Volpe Center) conducted a regional alternative transportation evaluation (RATE) in Region 1, which is comprised of Oregon, Idaho, Washington, and H...

Regional governance: strategies and disputes in health region management

Directory of Open Access Journals (Sweden)

Adriano Maia dos Santos

2014-08-01

Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of

Regional Trends in Electromobility - Regional Study North America

OpenAIRE

Turrentine, Tom; Garas, Dhalia

2015-01-01

The subproject “Regional Trends in Electro mobility” aims at identifying and analyzing major trends in the field of electro mobility. The trend analysis will monitor research effort and upcoming technologies, policies, products and market developments in different focus regions around the world continuously to enable a systematic analysis of global trends. The regional trend analysis for electro mobility is a major keystone for the project success and therefore cooperation with...

Regional development via high-speed rail : A study of the Stockholm-Mälaren region and possibilities for Melbourne-regional Victoria

OpenAIRE

Bayley, Michael

2012-01-01

The purpose of this thesis is to examine, based on a study of the regional high-speed corridors in the Stockholm-Mälaren Region, the possibilities for regional high-speed rail in Melbourne-regional Victoria (Australia) to improve accessibility, and achieve regional development and balanced growth between the capital and its surrounding regions. It deals with the concept of 'regional' high-speed rail, a variant of classic high-speed rail that serves centres along regional corridors stemming fr...

Analysis of regional climate strategies in the Barents region

Energy Technology Data Exchange (ETDEWEB)

Himanen, S.; Inkeroeinen, J.; Latola, K.; Vaisanen, T.; Alasaarela, E.

2012-11-15

Climate change is a global phenomenon with especially harsh effects on the Arctic and northern regions. The Arctic's average temperature has risen at almost twice the rate as elsewhere in the past few decades. Since 1966, the Arctic land area covered by snow in early summer has shrunk by almost a fifth. The Barents Region consists of the northern parts of Norway, Sweden, Finland and Russia (i.e. the European part of Russia). Climate change will cause serious impacts in the Barents Region because of its higher density of population living under harsh climatic conditions, thus setting it apart from other Arctic areas. In many cases, economic activities, like tourism, rely on certain weather conditions. For this reason, climate change and adaptation to it is of special urgency for the region. Regional climate change strategies are important tools for addressing mitigation and adaptation to climate change as they can be used to consolidate the efforts of different stakeholders of the public and private sectors. Regional strategies can be important factors in achieving the national and international goals. The study evaluated how the national climate change goals were implemented in the regional and local strategies and programmes in northern Finland. The specific goal was to describe the processes by which the regional strategies were prepared and implemented, and how the work was expanded to include the whole of northern Finland. Finally, the Finnish preparatory processes were compared to case examples of processes for preparing climate change strategies elsewhere in the Barents Region. This analysis provides examples of good practices in preparing a climate change strategy and implementing it. (orig.)

Structural region

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Structural region. The two groups had 4 substitutions similar to Yawat strain. The Yawat strain had 5 unique mutations. 3 in the E2 region and 2 in the E1 region. The mutation, I702V (E2), though different from all the recent Indian and Reunion sequences was similar ...

Field-aligned current signatures in the near-tail region. 2. Coupling between the region 1 and region 2 systems

International Nuclear Information System (INIS)

Ohtani, S.; Kokubun, S.; Nakamura, R.; Elphic, R.C.; Russell, C.T.; Baker, D.N.

1990-01-01

The development of the substorm-associated current system in the near-tail region is examined in the light of both experiment and theory. First, the March 28, 1979, event is examined intensively by using ground magnetometer data and satellite magnetic field and energetic particle data. The comparison of field-aligned current signatures at geosynchronous altitude and in the near-tail region indicates that the development of the region 1 system is not merely the enhancement in current intensity of the pre-existing system. This finding is consistent with the so-called current wedge model, in which the tail current is converted into a pair of field-aligned currents with the region 1 polarity at substorm onsets. Detailed inspection, however, suggests that the region 2 system is as important as the region 1 system. Statistical properties of the azimuthal magnetic component at synchronous orbit indicate that the deviation during disturbed periods is larger than expected from the enhancement of the region 1 current. These individual and statistical studies suggest that the region 2 system tends to develop in the synchronous region and that the coupling between the region 1 and the region 2 systems is important. The current closure in the magnetosphere is discussed from a viewpoint of the macroscopic behavior of plasma. It is suggested that the dawnside and the duskside region 2 currents are closed in the magnetosphere by the curvature current during the growth phase and by the magnetic gradient current during the expansion phase. The field-aligned currents of the region 1 and the region 2 systems are closed in the ionosphere by the Pedersen current. Consequently, the energy is dissipated as the Joule heating and this energy must be supplied from the magnetosphere. Therefore, the counter part of the Pedersen current, which closes the region 1 and the region 2 currents in magnetosphere, must be the dynamo current

Predicting human age using regional morphometry and inter-regional morphological similarity

Science.gov (United States)

Wang, Xun-Heng; Li, Lihua

2016-03-01

The goal of this study is predicting human age using neuro-metrics derived from structural MRI, as well as investigating the relationships between age and predictive neuro-metrics. To this end, a cohort of healthy subjects were recruited from 1000 Functional Connectomes Project. The ages of the participations were ranging from 7 to 83 (36.17+/-20.46). The structural MRI for each subject was preprocessed using FreeSurfer, resulting in regional cortical thickness, mean curvature, regional volume and regional surface area for 148 anatomical parcellations. The individual age was predicted from the combination of regional and inter-regional neuro-metrics. The prediction accuracy is r = 0.835, p Pearson correlation coefficient between predicted ages and actual ages. Moreover, the LASSO linear regression also found certain predictive features, most of which were inter-regional features. The turning-point of the developmental trajectories in human brain was around 40 years old based on regional cortical thickness. In conclusion, structural MRI could be potential biomarkers for the aging in human brain. The human age could be successfully predicted from the combination of regional morphometry and inter-regional morphological similarity. The inter-regional measures could be beneficial to investigating human brain connectome.

Research on atmospheric radioactivity. [In French

Energy Technology Data Exchange (ETDEWEB)

Garrigue, H

1954-01-01

In flight at 2800 m, traces of radioactive particles were gathered, by means of a corona effect similar to that of Sella, and of long period, on April 24, 1954. At Puy-de-Dome (1465 m) after a fall of rain and snow on May 3 to 4, 1954, samples of the fallen residue showed very feeble radioactivity of period 10 days or more. This radioactivity of the airborne particles was independent of their probable natural electrical charge and mobility and was indicative of an atomic cloud.

MR findings in pituitary haemosiderosis

International Nuclear Information System (INIS)

Ambrosetto, P.; Zucchini, S.; Cicognani, A.; Cacciari, E.

1998-01-01

A girl with Diamond-Blackfan syndrome and hypopituitarism was suspected of having pituitary haemosiderosis because of the clinical picture and the long history of blood transfusions. On T1-weighted MR images the pituitary exhibited a markedly hypointense anterior lobe (mimicking the empty sella), suggesting iron deposition, while on T2W MRI the low signal of the pituitary was surrounded by the high signal of the CSF. MR may be considered the examination of choice for detecting iron overload in the pituitary. (orig.)

Regional profile, energy-impacted communities: Region VIII

Energy Technology Data Exchange (ETDEWEB)

None

1979-03-01

This report has data on population, administration, finance, housing, health and safety, human services, education, and water and sewage for 325 energy-impacted communities. A review of current and potential energy developments in the region shows over 900 energy resource impacts listed for the 325 impacted communities. Coal development represents over one-third of the developments listed. Communities reporting coal development are distributed as follows: Colorado (36), Montana (42), North Dakota (61), South Dakota (13), Utah (73), and Wyoming (35). Energy-conversion initiatives represent another high incidence of energy-resource impact, with uranium development following closely with 83 communities reporting uranium development impact in the region. These projections indicate continued development of regional energy resources to serve national energy requirements. The 325 impacted communities as reported: Colorado (46), Montana (73), North Dakota (62), South Dakota (21), Utah (80), and Wyoming (43) follow a distribution pattern similar to that of future projects which illustrates that no area of the region will escape the impacts of energy development. (ERA citation 04:041706)

Regional ejection fraction: a quantitative radionuclide index of regional left ventricular performance

International Nuclear Information System (INIS)

Maddox, D.E.; Wynne, J.; Uren, R.; Parker, J.A.; Idoine, J.; Siegel, L.C.; Neill, J.M.; Cohn, P.F.; Holman, B.L.

1979-01-01

Left ventricular regional ejection fractions were derived from background-corrected, time-activity curves in 43 patients assessed by both gated equilibrium radionuclide angiocardiography and left ventricular contrast angiography. From a single, modified left anterior oblique projection, the regional change in background corrected counts was determined in each of three anatomic regions. The normal range for regional radionuclide ejection fraction was determined in 10 patients with normal contrast ventriculograms and without obstructive coronary artery disease at coronary arteriography. Regional ejection fraction was compared with percent segmental axis shortening and extent of akinetic segments in corresponding regions of the contrast ventriculogram. Radionuclide and roentgenographic methods were in agreement as to the presence or absence of abnormal wall motion in 83 of 99 left ventricular regions (84%) in 33 patients evaluated prospectively. Comparison of regional ejection fraction demonstrated significant differences between regions with roentgenographically determined normokinesis hypokinesis, and akinesis. We conclude that the left ventricular regional ejection fraction provides a reliable quantitative assessment of regional left ventricular performance

Regionalization: A Story Map Lesson on Regions

Science.gov (United States)

Edmondson, Deborah

2018-01-01

This lesson introduces the concept of regionalization and types of regions. After a brief introductory activity, students explore a story map to learn the material. The teacher can project the story map on a screen for all students to follow or students may work individually on computers. Working individually will allow students to set their own…

REGIONAL BLACK SEA ARCHITECTURE AND CONSEQUENCES FOR THE REGIONAL COOPERATION FRAMEWORK

Directory of Open Access Journals (Sweden)

Alina Homorozean

2010-12-01

Full Text Available Sometimes considered an asset, other times a liability, the Black Sea started recently to be regarded as a region. However, the Black Sea Region lacks a common vision, often due to the complicated and often inefficient nexus of regional cooperation initiatives. Following the logic of finding regional solutions for regional problems, this paper aims to assess existing institutional and regional initiatives, reflecting on the implications for the success of Black Sea regionalism in creating patterns of sustained and sustainable development and a high degree of actors' involvement.This paper concentrates on two complementary research questions: What is the regional order in the BSR and what does it imply for its future? What is the current contribution of the most significant cooperation initiatives and what are the consequences for regional institutionalism? For the purpose of this paper, I draw on best-practices from other two regions: the Northern Dimension and South- East Asia. Through a comparative perspective, I suggest an analysis of the most important initiatives: BSEC, CDC, Black Sea Synergy, Eastern Partnership, Baku Initiative and the BSF. This paper argues that a possible strategic solution for successful policy development lies in the creation of an integrated regional cooperation package, functioning on the principles of multi-speed and multi-dimensional cooperation in several policy fields, in a context in which the BSR seems to be caught between two paradigms: a European and a Russian-oriented one.

Regional geochemical prospecting of uranium in the Amazon region

International Nuclear Information System (INIS)

Zenker, A.O.; Hohn, H.

1982-01-01

A regional geochemical prospecting program for uranium in the Serra dos Carajas area, south of Para, was performed by NUCLEBRAS using stream sediment samples obtained from other companies acting in this area. The results of the survey are presented compared to regional geology and an aerial total count map. The different data showed a good correlation, particularly in areas mapped regionally as granitic rocks. (Author) [pt

The zitterbewegung region

Science.gov (United States)

Sidharth, B. G.; Das, Abhishek

2017-07-01

This paper deals with a precise description of the region of zitterbewegung below the Compton scale and the stochastic nature associated with it. We endeavor to delineate this particular region by means of Ito’s calculus and instigate certain features that are in sharp contrast with conventional physics. Interestingly, our work substantiates that the zitterbewegung region represents a pre-space-time region and from therein emerges the notion of our conventional space-time. Interestingly, this unique region engenders the relativistic and quantum mechanical aspects of space-time.

Pseudotumor Cerebri Resulting in Empty Sella Syndrome and Multiple Pituitary Hormone Deficiencies

Science.gov (United States)

2017-09-16

REPORT TYPE 09/16/2017 Poster 4. TITLE AND SUBTITLE Pseudotu1nor Cercbri Rc~ulling in E1npty ~ella Syndrome and J\\ilultiple Pituitary Honnone...Sc. PROGRAM ELEMENT NUMBER Sd. PROJECT NUMBER Se. TASK NUMBER Sf. WORK UNIT NUMBER 8. PERFORMING ORGANIZATION REPORT NUMBER 17352 10. SPONSOR

Spontaneous reossification of the sella in transsphenoidal reoperation associated with strontium ranelate

Directory of Open Access Journals (Sweden)

Maria Mercedes Pineyro

2017-07-01

Full Text Available Spontaneous reossification of the sellar floor after transsphenoidal surgery has been rarely reported. Strontium ranelate, a divalent strontium salt, has been shown to increase bone formation, increasing osteoblast activity. We describe an unusual case of a young patient with Cushing’s disease who was treated with strontium ranelate for low bone mass who experienced spontaneous sellar reossification after transsphenoidal surgery. A 21-year-old male presented with Cushing’s features. His past medical history included delayed puberty diagnosed at 16 years, treated with testosterone for 3 years without further work-up. He was diagnosed with Cushing’s disease initially treated with transsphenoidal surgery, which was not curative. The patient did not come to follow-up visits for more than 1 year. He was prescribed strontium ranelate 2 g orally once daily for low bone mass by an outside endocrinologist, which he received for more than 1 year. Two years after first surgery he was reevaluated and persisted with active Cushing’s disease. Magnetic resonance image revealed a left 4 mm hypointense mass, with sphenoid sinus occupation by a hyperintense material. At repeated transsphenoidal surgery, sellar bone had a very hard consistency; surgery was complicated and the patient died. Sellar reossification negatively impacted surgery outcomes in this patient. While this entity is possible after transsphenoidal surgery, it remains unclear whether strontium ranelate could have affected sellar ossification.

MRT in differentiation between tumour and implant material in the postoperative sella

International Nuclear Information System (INIS)

Kaiser, W.A.; Steckelbroeck, V.; Siewert, B.; Layer, G.; Hochstetter, A.; Reiser, M.

1993-01-01

MRT criteria have been developed to distinguish between tumour and implant material following examination of 50 patients who had transsphenoidal hypophysectomies for tumours. Judgements were based on the postoperative hormonal status and the operation notes. Following contrast injection of Gd-DTPA and using T 1 weighted spin-echo sequences, implant material appeared as sandwich-like, linear or circular structures. Residual recurrent tumour produced homogenous or non-homogenous aspects without marginal enhancement in 84% of cases. Postoperative displacement of the infundibulum to the opposite side was observed in 73% of patients with tumour remnants. Sensitivity of MRT was 70%, specificity 95%. There was a positive predictive value of 94% and a negative predictive value of 72% with an accuracy of 81%. This provides assistance in differentiating between tumour remnants and implant material. MRT is recommended as a method of examination for hypophyseal tumours to evaluate the success of surgery and where there is clinical doubt concerning residual or recurrent tumour. (orig.) [de

Areas and forms of regional cooperation in multi-structured (matreshka-style) regions (Tyumen region, Russia)

OpenAIRE

LARIONOV ANDREY V.

2015-01-01

The problem of the administrative, economic and social sustainability of a group consisting of neighboring regions with close ties has no clear solution yet. Should closely-tied regions in the long run form a centralized system of administrative bodies, compress their budgets into one, and construct unified social programs, or not? To answer this question, in the article we describe a case that represents the paramount form of cooperation amongst closely-tied regions. It is the case of the so...

Microscopic and endoscopic anatomical study of the extended transsphenoidal approach

Directory of Open Access Journals (Sweden)

HUANG Xin-tao

2013-06-01

Full Text Available Background Traditional transsphenoidal approach has less treatment effect in invasive pituitary adenoma. To remove tumors growing outside the sella become one of the challenges in neurosurgery. This study aims to study anatomical characteristics of the extended transsphenoidal approach for clinical operation. Methods A mimetic surgery was performed on 10 adult cadaver heads through extended transsphenoidal approach by endoscopy. The study data of related anatomic structures were measured. Results The distance from sphenoidal ostium to anterior nasal spine is (59.68 ± 4.28 mm (52.62-63.16 mm, to posterior nasal aperture is (12.88 ± 1.46 mm (10.47-15.61 mm. The incidence of optic nerve and internal carotid artery protuberance in the lateral wall of sphenoidal sinus is 11/20 and 17/20, respectivly. The medial wall of the cavernous sinus is comprised of one dural layer. The incidence of anterior intercavernous sinus, posterior intercavernous sinus, inferior intercavernous sinus and basilar sinus is 17/20, 12/20, 11/20 and 20/20, respectively. The distance between the bilateral hidden segment of internal carotid artery is (15.30 ± 1.25 mm (12.42-21.76 mm, between the bilateral inferior horizontal segment midpoint is (14.03 ± 1.19 mm (10.42-18.43 mm, between the bilateral anterior vertical segment is (18.87 ± 1.44 mm (16.75-24.88 mm, and between the bilateral inner edge of tuberculum sellae is (12.73 ± 0.94 mm (9.97-16.18 mm. In 7 cases (7/20, the intracavernous carotid is in direct contact with the sellar part of the medial wall; in all cases (20/20, the venous plexus extends into the space between the intracavernous carotid and the sphenoidal part of the medial wall. The incidence of the intracavernous carotid coursing along the inferior one third of the pituitary gland is 9/20, along the inferior two thirds of the pituitary gland is 7/20, along the all the thirds of the pituitary gland is 3/20, while below the level of the sellar floor is

Recurrent Forbush decreases and relationship between active regions and M-regions

International Nuclear Information System (INIS)

Shah, G.N.; Kaul, C.L.; Razdan, H.; Bemalkhedkar, M.M.

1977-01-01

Recurrent Forbush decreases and recurrent geomagnetic disturbances have been attributed to the solar M-regions, which are sources of high velocity solar plasma streams. A study of recurrent Forbush decreases for the period 1966-75 has been made to examine any possible relationship of M-regions with solar active regions. It is shown that at the onset of the recurrent Forbush decrease at earth, there is a high probability of encountering a class of active regions at central meridian of the sun which give rise to flares of importance >= 28/3N. These active regions are found to be long-lasting and to have large areas as well as high Hsub(α)-intensities. Other active regions, producing flares of only lower importance, are distributed randomly on the sun with respect to the onset of a recurrent Forbush decrease. Using the quasiradial hypervelocity approximation, the base of the leading edge of the high velocity stream, at the onset of a recurrent Forbush decrease at earth, is traced to the solar longitude about 40 deg West of the central meridian. From these results, it is deduced that M-regions are located preferentially to the West of long-lasting, magnetically complex active regions. Earlier studies of the identification of the M-regions on the sun have been re-examined and shown to conform to this positional relationship. A possible mechanism of the development of an M-region to the West of the long-lasting magnetically complex active region is also discussed. (author)

Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population.

Science.gov (United States)

Alam, M K; Iida, J; Sato, Y; Kajii, Takashi S

2013-12-01

We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension

Energy Technology Data Exchange (ETDEWEB)

Maralani, P.J. [Section of Neuroradiology, Department of Diagnostic Imaging, Ottawa Hospital, Ottawa, Ontario (Canada); Hassanlou, M. [Department of Ophthalmology, Ottawa Hospital, Ottawa, Ontario (Canada); Torres, C.; Chakraborty, S.; Kingstone, M. [Section of Neuroradiology, Department of Diagnostic Imaging, Ottawa Hospital, Ottawa, Ontario (Canada); Patel, V.; Zackon, D. [Department of Ophthalmology, Ottawa Hospital, Ottawa, Ontario (Canada); Bussiere, M., E-mail: mbussiere@toh.on.ca [Section of Neuroradiology, Department of Diagnostic Imaging, Ottawa Hospital, Ottawa, Ontario (Canada); Division of Neurology, Department of Medicine, Ottawa Hospital, Ottawa, Ontario (Canada)

2012-07-15

Aim: To investigate the accuracy of individual and combinations of signs on brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) in the diagnosis of idiopathic intracranial hypertension (IIH). Materials and methods: This study was approved by the institutional research ethics board without informed consent. Forty-three patients and 43 control subjects were retrospectively identified. Each patient and control had undergone brain MRI and MRV. Images were anonymized and reviewed by three neuroradiologists, blinded to clinical data, for the presence or absence of findings associated with IIH. The severity of stenosis in each transverse sinus was graded and summed to generate a combined stenosis score (CSS). The sensitivity, specificity, and likelihood ratios (LR) were calculated for individual and combinations of signs. Results: Partially empty sella (specificity 95.3%, p < 0.0001), flattening of the posterior globes (specificity 100%, p < 0.0001), and CSS <4 (specificity 100%, p < 0.0001) were highly specific for IIH. The presence of one sign, or any combination, significantly increased the odds of a diagnosis of IIH (LR+ 18.5 to 46, p < 0.0001). Their absence, however, did not rule out IIH. Conclusions: Brain MRI with venography significantly increased the diagnostic certainty for IIH if there was no evidence of a mass, hydrocephalus, or sinus thrombosis and one of the following signs was present: flattening of the posterior globes, partially empty sella, CSS <4. However, absence of these signs did not exclude a diagnosis of IIH.

Metastatic pituitary carcinoma in a patient with acromegaly: a case report

Directory of Open Access Journals (Sweden)

Sreenan Seamus

2012-09-01

Full Text Available Abstract Introduction Asymptomatic pituitary abnormalities occur in about 10% of cranial magnetic resonance imaging scans, but metastatic carcinoma of the pituitary gland is rare: 133 cases have been reported. Two thirds secreted either prolactin or adrenocorticotropic hormone, and another 24% were non-secreting. Case presentation A 42-year-old Caucasian man lived for 30 years after the diagnosis of a pituitary tumor whose clinical and biochemical features were those of acromegaly and hypogonadism. Radiotherapy, totaling 7300 rad, was administered to the sella over two courses. Growth hormone levels normalized, but he developed both thyroid and adrenal insufficiency, and replacement therapy was commenced. Fourteen years later, growth hormone levels again became elevated, and bromocriptine was commenced but led to side effects that could not be tolerated. An attempted surgical intervention failed, and octreotide and pergolide were used in succession. Twenty-seven years after the diagnosis, a mass from an excisional biopsy of below the angle of the mandible proved to be metastatic pituitary carcinoma. Immunohistochemical staining was positive for synaptophysin, growth hormone, and prolactin. One year later, an octreotide scan showed uptake at the sella, neck, and spleen. Our patient declined further active oncology treatment. Conclusions Metastatic pituitary carcinoma associated with acromegaly is particularly rare. To the best of our knowledge, this is the eighth such case and is the first report of growth hormone and prolactin present in the metastatic mass.

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

Science.gov (United States)

Martinez, P; Bellot-Arcís, C; Llamas, J M; Cibrian, R; Gandia, J L; Paredes-Gallardo, V

2017-04-01

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The Region is Dead, Long Live the Region

DEFF Research Database (Denmark)

Metzger, Jonathan; Olesen, Kristian

2017-01-01

If it today is commonly accepted that regions are ‘constructs’ – then who or what construct them, for what reasons, and by which means? How are they made manifest and durable as both mental geographies and mundane everyday realities (cf. Metzger, 2013)? Paasi (2010, p.2298) suggests that regions...... practices that have led to the formation and more recently encroaching dissipation of a well-known EUropean region: Öresund. In this endeavour we will make an effort to be sensitive to how Öresund as a spatial entity interrelates with, depends upon or partially challenges/is challenged by other geographical...

[Chromosomal variation in Chironomus plumosus L. (Diptera, Chironomidae) from populations of Bryansk region, Saratov region (Russia), and Gomel region (Belarus)].

Science.gov (United States)

Belyanina, S I

2015-02-01

Cytogenetic analysis was performed on samples of Chironomus plumosus L. (Diptera, Chironomidae) taken from waterbodies of various types in Bryansk region (Russia) and Gomel region (Belarus). Karyotypes of specimens taken from stream pools of the Volga were used as reference samples. The populations of Bryansk and Gomel regions (except for a population of Lake Strativa in Starodubskii district, Bryansk region) exhibit broad structural variation, including somatic mosaicism for morphotypes of the salivary gland chromosome set, decondensation of telomeric sites, and the presence of small structural changes, as opposed to populations of Saratov region. As compared with Saratov and Bryansk regions, the Balbiani ring in the B-arm of chromosome I is repressed in populations of Gomel region. It is concluded that the chromosome set of Ch. plumosus in a range of waterbodies of Bryansk and Gomel regions is unstable.

regional. Un análisis para las regiones europeas

Directory of Open Access Journals (Sweden)

José A. Camacho

2005-01-01

Full Text Available Pese a encontrarnos inmersos en una economía globalizada, la innovación es en muchos aspectos un fenómeno esencialmente regional, donde los servicios (ignorados hasta ahora, y en particular aquellos denominados como servicios intensivos conocimiento (SIC, adquieren un papel central, gracias a su capacidad para transmitir conocimiento, en especial de tipo tácito. El objetivo de este trabajo es realizar una primera aproximación empírica a los efectos asociados a la localización de SIC, tomando 107 regiones europeas. Los resultados obtenidos apoyan la hipótesis de que los SIC ejercen un impacto positivo sobre el desempeño innovador regional, impacto que podría desbordarse hacia las regiones vecinas.

CT studies in hyperprolactinemia; Badania KT w hiperprolaktynemii

Energy Technology Data Exchange (ETDEWEB)

Gradzki, J.; Paprzycki, W.; Krzyzagorska, E.; Wasko, R.; Warenik-Szymankiewicz, A. [Akademia Medyczna, Poznan (Poland)

1993-12-31

Computerized tomography studies in 62 patients (55 females and 7 males) with hyperprolactinemia are presented. The female patients had secondary amenorrhea and galactorrhea, whereas the male patients suffered from impotency, gynaecomastia and very rarely galactorrhea. In 39 cases CT revealed a pituitary adenoma (prolactinoma), in 14 cases of them microadenoma, as the cause of hormonal and clinical disturbances. In 21 cases an empty sella with rudimentary pituitary surrounded by cerebrospinal fluid or lack of pituitary mass were found. In one case suprasellar and intrasellar calcifications were present. (author). 17 refs, 4 figs.

CT studies in hyperprolactinemia; Badania KT w hiperprolaktynemii

Energy Technology Data Exchange (ETDEWEB)

Gradzki, J; Paprzycki, W; Krzyzagorska, E; Wasko, R; Warenik-Szymankiewicz, A [Akademia Medyczna, Poznan (Poland)

1994-12-31

Computerized tomography studies in 62 patients (55 females and 7 males) with hyperprolactinemia are presented. The female patients had secondary amenorrhea and galactorrhea, whereas the male patients suffered from impotency, gynaecomastia and very rarely galactorrhea. In 39 cases CT revealed a pituitary adenoma (prolactinoma), in 14 cases of them microadenoma, as the cause of hormonal and clinical disturbances. In 21 cases an empty sella with rudimentary pituitary surrounded by cerebrospinal fluid or lack of pituitary mass were found. In one case suprasellar and intrasellar calcifications were present. (author). 17 refs, 4 figs.

Preoperative CT evaluation on nasal cavity for transsphenoidal approach

International Nuclear Information System (INIS)

Saeki, Naokatsu; Yamaura, Akira; Hoshi, Seiichiro; Sunada, Souichi; Sunami, Kenro

1997-01-01

Preoperative bone CT scans sliced parallel to the surgical plane were evaluated in 32 cases of transsphenoidal surgery. This method predicted patients with narrow nasal cavity, and helped to determine the rhinological maneuvers for providing a wider operative field. In addition, it helps to plan the need and extent of sella floor removal in re-operated cases. There was relatively little difference in the width and length of the nasal cavity between acromegalic and non-acromegalic patients. Hence, bone CT scans are useful in the preoperative evaluation of patients undergoing transsphenoidal surgery. (author)

Resection of a Retrochiasmatic Craniopharyngioma by Combined Modified Orbital Craniotomy and Transnasal Endoscopic Techniques.

Science.gov (United States)

Patel, Nirav J; Dunn, Ian

2018-04-01

A 20-year-old patient presented with hydrocephalus but intact vision and hormone function. The MRI showed a large seller, suprasellar and third ventricular mass. We chose a combined approach utilizing the translyvian, lamina terminals route, with a possible interhemispheric approach. But, we also utilized a transnasal endoscopic approach for the tumor that remained below the diaphragma sellae. The patient did well, with complete tumor resection via a staged approach, but did require hormone replacement. The link to the video can be found at: https://youtu.be/yzpfOxzI4cQ .

High dose radiotherapy for pituitary tumours

International Nuclear Information System (INIS)

Mead, K.W.

1981-01-01

The results of treatment of 120 pituitary tumours are presented. Based on this experience operable chromophobe adenomas are now treated with 5,000 rads in 4 weeks and inoperable ones receive an additional central dose to 7,500 rads. Pituitary Cushing's tumours are given 10,000 rads in 5 weeks using small fields and acromegalics 5,000 rads to the whole sella and 7,500 to its lower half. The absence of complications at these dose levels is attributed to the use of small fields and the precise application of treatment

High dose radiotherapy for pituitary tumours

Energy Technology Data Exchange (ETDEWEB)

Mead, K.W. (Queensland Radium Inst., Herston (Australia))

1981-11-01

The results of treatment of 120 pituitary tumours are presented. Based on this experience operable chromophobe adenomas are now treated with 5,000 rads in 4 weeks and inoperable ones receive an additional central dose to 7,500 rads. Pituitary Cushing's tumours are given 10,000 rads in 5 weeks using small fields and acromegalics 5,000 rads to the whole sella and 7,500 to its lower half. The absence of complications at these dose levels is attributed to the use of small fields and the precise application of treatment.

Revisiting regional flood frequency analysis in Slovakia: the region-of-influence method vs. traditional regional approaches

Science.gov (United States)

Gaál, Ladislav; Kohnová, Silvia; Szolgay, Ján.

2010-05-01

During the last 10-15 years, the Slovak hydrologists and water resources managers have been devoting considerable efforts to develop statistical tools for modelling probabilities of flood occurrence in a regional context. Initially, these models followed concepts to regional flood frequency analysis that were based on fixed regions, later the Hosking and Wallis's (HW; 1997) theory was adopted and modified. Nevertheless, it turned out to be that delineating homogeneous regions using these approaches is not a straightforward task, mostly due to the complex orography of the country. In this poster we aim at revisiting flood frequency analyses so far accomplished for Slovakia by adopting one of the pooling approaches, i.e. the region-of-influence (ROI) approach (Burn, 1990). In the ROI approach, unique pooling groups of similar sites are defined for each site under study. The similarity of sites is defined through Euclidean distance in the space of site attributes that had also proved applicability in former cluster analyses: catchment area, afforested area, hydrogeological catchment index and the mean annual precipitation. The homogeneity of the proposed pooling groups is evaluated by the built-in homogeneity test by Lu and Stedinger (1992). Two alternatives of the ROI approach are examined: in the first one the target size of the pooling groups is adjusted to the target return period T of the estimated flood quantiles, while in the other one, the target size is fixed, regardless of the target T. The statistical models of the ROI approach are inter-compared by the conventional regionalization approach based on the HW methodology where the parameters of flood frequency distributions were derived by means of L-moment statistics and a regional formula for the estimation of the index flood was derived by multiple regression methods using physiographic and climatic catchment characteristics. The inter-comparison of different frequency models is evaluated by means of the

A Means for the Scintigraphic Imaging of Regional Brain Dynamics. Regional Cerebral Blood Flow and Regional Cerebral Blood Volume

Energy Technology Data Exchange (ETDEWEB)

Potchen, E. J.; Bentley, R.; Gerth, W.; Hill, R. L.; Davis, D. O. [Washington University School Of Medicine, St. Louis, MO (United States)

1969-05-15

The use of freely diffusable inert radioactive gas as a washout indicator to measure regional cerebral blood flow has become a standardized kinetic procedure in many laboratories. Recent investigations with this technique have led us to conclude that we can reliably distinguish regional flow with perfusion against regional flow without perfusion from the early portion of the curve. Based on a detailed study of the early curve kinetics in patients with and without cerebral vascular disease we have defined the sampling duration necessary for application of the Anger gamma camera imaging process to regional changes in cerebral radioactivity. Using a standard camera and a small computer, a procedure has been developed and based upon entire field to determine the time of maximum height followed by analysis of the data in a matrix. This will permit a contour plot presentation of calculated regional cerebral blood flow in millilitres per 100 grams perfused brain per minute. In addition, we propose to augment this data by the display of regional non-perfusion blood flow versus regional cerebral flow with perfusion. Preliminary investigation on sampling duration, and Compton scattering were prerequisite to clinical scintigraphy of regional cerebral blood flow. In addition, the method of interface for the conventional Anger gamma camera to digital computers used in this procedure are discussed. Applications to further assess regional cerebral dynamics by scintigraphy are presented. (author)

Regional Economic Development

Science.gov (United States)

; Sponsored Work Regional Economic Development Technology Opportunities User Facilities About Us Metrics In the News Publications Policies Feynman Center » Deploying Innovation » Regional Economic Development Regional Economic Development Supporting companies in every stage of development through access to

Linear versus circular polarization of head coils - comparison on phantom and in the clinic

International Nuclear Information System (INIS)

Schratter, M.; Kramer, J.; Prayer, L.; Wimberger, D.; Imhof, H.; Schmid, W.

1990-01-01

Two different head coils - one with linear polarization and the other with circular polarization - were compared under the same measurement conditions. Comparison was done on a phantom with waterfilled and gadolinium-filled pin-holes, as well as on anatomical MR images of 23 volunteers. In three volunteers the whole brain was examined while, in the remaining 20 volunteers the sella region or cerebellopontine angleregion was examined. Criteria for comparison were signal-to-noise ratio, background noise, and detail resolution (phantom), as well as subjective criteria - image sharpness, anatomical, contrast, and recognition of anatomical details -, evaluated on anatomical MR images by four radiologists independently of each other. The results show a significant improvement of signal-to-noise ratio, lower background noise and therefore marked improvement of images harpness, and moderate improvement in the recognition of anatomical details using the circular polarized head coil; as for as detail resolution and anatomical contrast were concerned, however, no significant difference was seen between the two coils. Major advantages of the circular, polarized head coil in clinical application are shorter measurement times (reduced number of acquisitions), as well as thinner slices without loss of signal-to-noise ratio. (orig.) [de

Regional manpower planning

OpenAIRE

G. Erens; P. Salamink; C.A. Van der Merwe CA

2003-01-01

Particular problems come to the fore when planning development at the regional level. These range from the complexities of the multifarious interactions between the sect oral and local components of the region to the necessity of achieving extensive participation of regional stakeholders in the planning process. In this paper a methodology for regional manpower planning is proposed. The methodology is designed to accommodate the full range of problems by applying a systems approach which is b...

The Regional Dimension

DEFF Research Database (Denmark)

Eskjær, Mikkel Fugl

2013-01-01

is largely dependent on regional media systems, yet the role this regional dimension plays has been largely overlooked. This article presents a comparative study of climate-change coverage in three geo-cultural regions, The Middle East, Scandinavia, and North America, and explores the link between global......Global perspectives and national approaches have dominated studies of climate-change communication, reflecting the global nature of climate change as well as the traditional research focus on national media systems. In the absence of a global public sphere, however, transnational issue attention...... climate-change communication and regional media systems. It finds that regional variations in climate-change communication carry important communicative implications concerning perceptions of climate change's relevance and urgency...

Initiatives for regional dialogue consideration of regional disarmament guidelines

International Nuclear Information System (INIS)

Marschik, R.

1994-01-01

The General Assembly of the United Nations adopted guidelines and recommendations for regional approaches to disarmament within the context of global security. The guidelines contain 52 principles on: relationship between regional disarmament, arm limitation and global security; general guidelines and recommendations for regional disarmament efforts; possible ways and means to assist and implement these efforts; possible role of the United Nations in aiding these efforts. Experiences gained in Europe and Near East are analysed in the framework of the situation in Northeast, South and Southeast Asia

Regional Externalities

NARCIS (Netherlands)

Heijman, W.J.M.

2007-01-01

The book offers practical and theoretical insights in regional externalities. Regional externalities are a specific subset of externalities that can be defined as externalities where space plays a dominant role. This class of externalities can be divided into three categories: (1) externalities

Latin America Region: Between Dependence and Autonomy in Regional Processes

Directory of Open Access Journals (Sweden)

Wendy Vaca Hernández

2017-01-01

Full Text Available The space called Latin America has a particular history marked by centuries of colonialism and coloniality. The latter concept implies that the basic structure of the colonial system has not changed even though formal independence has been achieved. For this reason, the subcontinent has fluctuated between dependence and the quest for autonomy. These successive cycles have manifested themselves both in the internal configurations and in the regional schemes that have been undertaken. This paper analyzes the construction and evolution of the idea of a region: Latin America and the Caribbean. To that end it examines the concepts of region, regionalism, what Latin America and the Caribbean implies, and what are the transformations in these ideas that have emerged from the regional configurations of the Union of South American Nations (UNASUR and the Community of Latin American and Caribbean States (CELAC as plural organisms with broad objectives.

IDENTIFYING REGIONAL CLUSTER MANAGEMENT POTENTIALS EMPIRICAL RESULTS FROM THREE NORTH RHINEWESTPHALIAN REGIONS

OpenAIRE

Rudiger Hamm; Christiane Goebel

2010-01-01

The development and support of clusters is an issue that became quite popular by players dealing with regional economic policy. But before a regional development agency can start to implement a cluster-oriented strategy there a two question that have to be answered: 1. What are the regional fields of competence (cluster potentials) that fulfill the requirements for a cluster-oriented regional development policy? 2. If you find such regional fields of competence, are the enterprises willing to...

Promotion and regional development. Implementation of regional productive development agencies. The case of Maule region, Chile

Directory of Open Access Journals (Sweden)

Enrique Yamil Alul González

2010-12-01

Full Text Available The Regional Productive Development Agencies implemented in Chile in 2006, were developed as a way to answer the longing desire to territorially decentralize, and that the own Regions be whom define their future. The Agencies have the responsibility to develop innovation and productive development Agendas in participative processes, which means with public, academic and private actors. Also, the Agencies have the mission to implement Competitive Improvement Plans-PMC (clusters in prioritized economic sectors by the own region. These PMC are leaded by private actors in each sector.

Recurrent forbush decreases and the relationship between active regions and M regions

International Nuclear Information System (INIS)

Shah, G.N.; Kaul, C.L.; Razdan, H.; Bemalkhedkar, M.M.

1978-01-01

Recurrent Forbush decreases and recurrent geomagnetic disturbances have been attributed to the solar M regions, which are sources of high-velocity solar plasma streams. A study of recurrent Forbush decreases for the period 1966--1975 has been made to examine any possible relationship of M regions with solar active regions. It is shown that at the onset of the recurrent Forbush decrease at the earth there is a high probability of encountering a class of active regions at the central meridian of the sun which give rise to flares of importance > or =2B/3N. These active regions are found to be long lasting and to have large areas as well as high Hα intensities. Other active regions, producing flares of lower importance, are distributed randomly on the sun with respect to the onset of a recurrent Forbush decrease. By using the quasi-radial hypervelocity approximation the base of the leading edge of the high-velocity stream at the onset of a recurrent Forbush decrease at the earth is traced to the solar longitude about 40 0 west of the central meridan. From these results it is deduced that M regions are located preferentially to the west of long-lasting magnetically complex active regions. Earlier studies of the identification of the M regions on the sun have been reexamined and shown to conform to this positional relationship. A possible mechanism of the development of an M region to the west of the long-lasting magnetically complex active region is also discussed

Border region studies

DEFF Research Database (Denmark)

Makkonen, Teemu; Williams, Allan

2016-01-01

The contemporary conditions of academic capitalism exert pressures on researchers to avoid ‘peripheral’ journals and ‘unfashionable’ topics. Here an attempt is made to shed light onto the structure of one such ‘offbeat’ field, namely ‘border region studies’, by discussing its geographical...... distribution, key themes, significance and impact. The review suggests that border region studies can be considered a significant and important ‘branch’ of regional studies, which accounts for a small but increasing proportion of regional studies research particularly in Europe and North America. Four main...

Approaching Regional Coherence

DEFF Research Database (Denmark)

Vestenskov, David; Shah, Ali; Kazmi, Atia

The report contains ideas on enhanced cooperation on both security and economy. It is a particular relevant read for regional political decision makers, institutions, private companies, and researchers that wish to gain insight into the present and future political and economic developments...... of Afghan-Pakistani relations and to the region in general. Military institutions, officers and officials facing deployment in the region as well as universities and scholars with ongoing research and programmes in the region will also benefit from output of the stabilization project that this report...

Regional radiation standards for population of Chelyabinsk region

International Nuclear Information System (INIS)

Kravtsova, Eh.M.; Zajtseva, Yh.A.; Panteleev, V.V.; Gavrilov, A.P.; Kolotygina, N.V.; Pudovkina, L.V.; Kravtsova, O.S.

1996-01-01

Regional radiation regulations for population exposures in Chelyabinsk region are developed which are to play the role of standard limits. The priority goal of setting standard level is to consolidate the achieved radioecological balance on the contaminated territories and to establish a mechanism of control over the activities of the facility and over the use of lands in restriction zone by the population

Body region dissatisfaction predicts attention to body regions on other women.

Science.gov (United States)

Lykins, Amy D; Ferris, Tamara; Graham, Cynthia A

2014-09-01

The proliferation of "idealized" (i.e., very thin and attractive) women in the media has contributed to increasing rates of body dissatisfaction among women. However, it remains relatively unknown how women attend to these images: does dissatisfaction predict greater or lesser attention to these body regions on others? Fifty healthy women (mean age=21.8 years) viewed images of idealized and plus-size models; an eye-tracker recorded visual attention. Participants also completed measures of satisfaction for specific body regions, which were then used as predictors of visual attention to these regions on models. Consistent with an avoidance-type process, lower levels of satisfaction with the two regions of greatest reported concern (mid, lower torso) predicted less attention to these regions; greater satisfaction predicted more attention to these regions. While this visual attention bias may aid in preserving self-esteem when viewing idealized others, it may preclude the opportunity for comparisons that could improve self-esteem. Copyright © 2014 Elsevier Ltd. All rights reserved.

COMPETITIVENESS IN REGIONAL DEVELOPMENT

Directory of Open Access Journals (Sweden)

ELENA MĂDĂLINA OPRIȚESCU

2012-12-01

Full Text Available The development and diversification of the economic activities, the stimulation of investments both in the public sector, but mainly in the private one, the reduction of unemployment, the improvement of living standards are just some of the concepts aimed at by the regional development. The main method which can lead to a balanced development of the regions is financing them differentially so that the underdeveloped regions would obtain proportionally more funds that the developed ones. At a region level, the main objective is represented by the more accelerated growth of the less developed regions, in an effort to diminish the inter-regional and intra-regional development disparities. A key role is played by the sustainable economic growth concept, while also analyzing the competitiveness at a regional level, as well as the main development factors.

Bridging regional innovation

DEFF Research Database (Denmark)

Hansen, Teis

2013-01-01

to assess the progress of integration in the regions, as well as the effect of cross-border innovation policies. Consequently, important questions are left unanswered, including the central research question of this paper: does the sudden removal of significant physical barriers directly impacts......The topics of regional innovation systems (RIS) and cross-border regions attract increasing attention, but few studies combine the themes. Further, the existing empirical studies of cross-border innovation and knowledge creation analyse one case at one point in time, thus, making it difficult...... collaboration activity in cross-border innovation systems? This paper examines regional integration in the Oresund Region over time. It deals with a specific part of the RIS, as it analyses research collaboration between actors from the Danish and Swedish sides, with a specific emphasis on the biotech industry...

[Regional ecological planning and ecological network construction: a case study of "Ji Triangle" Region].

Science.gov (United States)

Li, Bo; Han, Zeng-Lin; Tong, Lian-Jun

2009-05-01

By the methods of in situ investigation and regional ecological planning, the present ecological environment, ecosystem vulnerability, and ecological environment sensitivity in "Ji Triangle" Region were analyzed, and the ecological network of the study area was constructed. According to the ecological resources abundance degree, ecological recovery, farmland windbreak system, environmental carrying capacity, forestry foundation, and ecosystem integrity, the study area was classified into three regional ecological function ecosystems, i. e., east low hill ecosystem, middle plain ecosystem, and west plain wetland ecosystem. On the basis of marking regional ecological nodes, the regional ecological corridor (Haerbin-Dalian regional axis, Changchun-Jilin, Changchun-Songyuan, Jilin-Songyuan, Jilin-Siping, and Songyuan-Siping transportation corridor) and regional ecological network (one ring, three links, and three belts) were constructed. Taking the requests of regional ecological security into consideration, the ecological environment security system of "Ji Triangle" Region, including regional ecological conservation district, regional ecological restored district, and regional ecological management district, was built.

Regional energy autarky: Potentials, costs and consequences for an Austrian region

International Nuclear Information System (INIS)

Schmidt, J.; Schönhart, M.; Biberacher, M.; Guggenberger, T.; Hausl, S.; Kalt, G.; Leduc, S.; Schardinger, I.; Schmid, E.

2012-01-01

Local actors at community level often thrive for energy autarky to decrease the dependence on imported energy resources. We assess the potentials and trade-offs between benefits and costs of increasing levels of energy autarky for a small rural region of around 21,000 inhabitants in Austria. We use a novel modeling approach which couples a regional energy system model with a regional land use optimization model. We have collected and processed data on the spatial distribution of energy demand and potentials of biomass, photovoltaics and solar thermal resources. The impacts of increasing biomass production on the agricultural sector are assessed with a land-use optimization model that allows deriving regional biomass supply curves. An energy system model is subsequently applied to find the least cost solution for supplying the region with energy resources. Model results indicate that fossil fuel use for heating can be replaced at low costs by increasing forestry and agricultural biomass production. However, autarky in the electricity and the heating sector would significantly increase biomass production and require a full use of the potentials of photovoltaics on roof tops. Attaining energy autarky implies high costs to consumers and a decline in the local production of food and feed. - Highlights: ► Energy autarky strong vision for many regional actors. ► Assessment of consequences of energy autarky for a rural region in Austria. ► Novel modeling approach coupling energy system model with land use model. ► Power and heat autarky causes high costs and decline in regional food and feed production. ► Heat autarky achievable at lower costs by utilizing regional forestry and agricultural biomass.

Regional boundaries study

International Nuclear Information System (INIS)

Zavatsky, S.; Phaneuf, P.; Topaz, D.; Ward, D.

1978-02-01

The NRC Office of Inspection and Enforcement (IE) has elected to evaluate the effectiveness and efficiency of its existing regional boundary alignment because of the anticipated future growth of nuclear power generating facilities and corresponding inspection requirements. This report documents a management study designed to identify, analyze, and evaluate alternative regional boundary configurations for the NRC/IE regions. Eight boundary configurations were chosen for evaluation. These configurations offered alternatives ranging from two to ten regions, and some included the concepts of subregional or satellite offices. Each alternative configuration was evaluated according to three major criteria: project workload, cost, and office location. Each major criterion included elements such as management control, program uniformity, disruption, costs, and coordination with other agencies. The conclusion reached was that regional configurations with regions of equal and relatively large workloads, combined with the concepts of subregional or satellite offices, may offer a significant benefit to the Office of Inspection and Enforcement and the Commission and are worthy of further study. A phased implementation plan, which is suitable to some configurations, may help mitigate the disruption created by realignment

REGIONAL DEVELOPMENT IN ROMANIA

Directory of Open Access Journals (Sweden)

Remus Gherman

2015-10-01

Full Text Available Regional development policy is a policy of investment for economic development by supporting competitiveness, increasing the standards of living, improving the quality of life, creating new jobs. Regions and regional development policy occupies in recent decades an increasingly important position in the list of the economic and social factors being found on the agendas of governments, both central and local authorities, of political groups and civil society. Regional development and regional development policy in Romania are present both in the economic reform and in social one. Development Regions from Romania are set up in 1998 by Law number 151 and supported by their own institutional framework. The applicability of regional development in Romania must take into account the fundamental elements of the possibilities of Regional Development, meaning the major indicators of reference for measuring the level of disparities, GDP per capita and unemployment.

Region 7 Significant Ecological Resource Areas (ECO_RES.SIG_REGIONS)

Data.gov (United States)

U.S. Environmental Protection Agency — SIG_REGIONS is a boundary layer that displays Region 7's Significant Ecological Resource Areas. This layer represents large areas within which different ecosystem...

Constructing Regional advantage

DEFF Research Database (Denmark)

Asheim, Bjørn T.; Boschma, Ron; Cooke, Phil

2011-01-01

This paper presents a regional innovation policy model based on the idea of constructing regional advantage. This policy model brings together concepts like related variety, knowledge bases and policy platforms. Related variety attaches importance to knowledge spillovers across complementary...... economic development within and between regions in action lines appropriate to incorporate the basic principles behind related variety and differentiated knowledge bases....

REGIONAL ECONOMIC GROWTH THROUGH TOURISM. THE CASE OF REGION WEST

Directory of Open Access Journals (Sweden)

Dragoi Ionut

2010-12-01

Full Text Available The regional development should aim to correlate and integrate tourism among the other integrative parts of the regional and local development, taking into account the fact that a region’s prosperity as effect of tourism development may be shown clearly in several stages: on the spot (as a result of direct consumption of the tourist product, on short term (through continuous absorption of the work-force and encouraging the welcoming commerce and in the long run (concentrating capital for investment in the general infrastructure and the one of tourism, in structures of reception for tourism and in the development of urban services. The analysis of intra-regional disparities as part of the economic growth at the level of Region West starts off with the idea that each component county has a different landscape, which favored or inhibited their economic growth; in the same time, each component county has its own specific, which can be promoted through tourism, inducing in time a regional income, and respectively, a social-economic and cultural growth of less developed areas.

Regional Community and International Relations: the Volgograd Region Experience

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Danakari Richard A.

2016-06-01

Full Text Available The article deals with the complex and controversial problems of the new regional communities’ formation and the impact of the interethnic relations sphere on them. The author notes that the processes of interaction between representatives of different cultures and civilizations, ethnic groups and religions have become increasingly controversial and tense in the context of continuous social dynamics. Similarly to the Russian society as a whole, regional communities are in a state of transitivity. They get transformed, they acquire new qualities such as multicasting and heterogeneity, multi-ethnicity and multi-confessionalism, fragmentarity and multiculturality. This fact increases the risks and uncertainties, problematizes future prospects. National non-governmental organizations are increasingly positioning themselves as civil society institutions at the present stage of social development at the regional level. They perform a difficult dual task: on the one hand, they ensure the preservation and development of history, native language, culture, ethnic traditions, and on the other hand, they work on the integration, on the common identity and the Russian nation formation. On the territory of the Volgograd region, largely due to the active cooperation of regional authorities and local authorities with national public associations, international and inter-confessional relations are stable. The basis of such activity is respect for history, native language, culture, tradition, religion, national dignity of all people in the region, regardless of their belonging to a certain ethnic group or religion. Over two decades of accumulated considerable experience of joint inter-ethnic dialogue and cooperation, provided tolerance and peace, harmony and mutual understanding between people of different ethnicities and religions in the country.

Tourism of Khmelnytskyi region

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Інна Шоробура

2017-09-01

Full Text Available The peculiarities of tourism in Khmelnytskyi region, its priority areas, types, including cultural-educational, environmental, sportrecreative and others have been revealed in the article. The basic tasks of tourism development in the region, aimed at the formation and protection of the tourism-recreational sector, market of competitive services, attraction of maximum number of tourists to the region, etc. have been cleared out. The attention is focused on the main tourist potential of Khmelnytskyi region, including National Nature Park «Podilski Tovtry», National historical-cultural nature reserve «Kamianets», «Samchyky», Medzhybizh regional historical-ethnographic museum-fortress, sanatorium-resort facilities based on mineral waters and others. The attention is paid to the increase in income from tourism. Traditional hospitality of the population of the region, especially in rural areas, provides the possibility to combine tourists’ accommodation with the study of rural customs and traditions directly in the villages. Tourism in Khmelnytskyi region will be attractive to all tourists who want to eat healthy food, to stay outdoors and enjoy the beauty of the region. Also the article tells us about the development of other directions and familiarizes tourists with other enticements of Khmelnytskyi region using the positive brand of Kamianets-Podilskyi. All three potential areas of tourism development (historical tourism in Kamianets-Podilskyi, recreational tourism on rivers, lakes and in the forests, as well as rural tourism can be combined within the global promotion of nature and traditions of the region. It is indicated that Khmelnytskyi is a promising tourist region of Ukraine. The main problems of the region are inadequate tourism infrastructure, accommodation facilities, food and roads. The experience of the tourism cluster «Oberih» (Protective Charm proves the perspectives of agritourism. Developing these two areas together, we

Central Region Regionally Ecological Significant Areas

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Minnesota Department of Natural Resources — This is an analysis of regionally significant Terrestrial and Wetland Ecological Areas in the seven county metropolitan area. Individual forest, grassland and...

Nasal and skull base anatomy of endoscopic endonasal transsphenoidal surgery with multi-detector computed tomography

International Nuclear Information System (INIS)

Hasegawa, Yuzo; Saeki, Naokatsu; Murai, Hisayuki; Horiguchi, Kentaro; Hanazawa, Toyoyuki; Okamoto, Miyoshi; Yanagawa, Noriyuki

2008-01-01

The endoscope is a new and highly useful instrument for transphenoidal surgery (TSS), and is generally used because of its minimally invasiveness. In addition, endoscopic transsphenoidal surgey (eTSS) has a potential for more radical tumor removal at the pituitary and the parasellar regions by wider visualization and more powerful illumination. To operate these regions safely, we need to know nasal and skull base anatomy under the endoscope which looks different from images under a microscope. In this paper, we demonstrated nasal and skull base anatomy with multi-detector computed tomography, which was performed in 23 recent patients with pituitary and parasellar legions. In the nasal legion, deviation of nasal septum and deviation of sphenoid ostium are important for endonasal approach of eTSS, and often determine the difficulty of surgery in the nasal cavity. Our study showed that deviation of nasal septum was seen in 26% of patients. Deviation of sphenoid ostium was 5.5±1.5 mm from the midline. The anatomy of sphenoid sinus plays a key role in our determination of the safety of a bony opening of the sella. In addition to sellar, presellar, and concha types, carotid prominence and optic prominence are important to determine the midline orientation. Development of carotid prominence was significantly related to the extent of lateral pneumatization of sphenoid sinus (P=0.0016). Reconstructed 3D-image of sphenoid sinus was very useful in visual understanding skull base anatomy. (author)

Regional differences of consumer preferences when shopping for regional products

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Jitka Kalábová

2013-01-01

Full Text Available This paper presents partial results of a research on consumer preferences when shopping for groceries. It is focused on regional products and consumer preferences in relation to the country of origin of food products. The main objective of this paper is to find the existence of spatial relationships between spatial deployment of regional products and consumer preferences for regional products. It will be necessary to create a data model for monitoring the deployment of regional products and also a data model for tracking important indicators of consumer behavior in all regions of the Czech Republic. The results are based on questionnaire survey that was conducted within the period from October 2010 to January 2011 on a sample of 3767 respondents from the Czech Republic, via both online questionnaires and their printed version. For the data collection the questionnaire system ReLa, developed by the Department of Marketing and Trade at Faculty of Business and Economics at Mendel University in Brno, was used. Data was processed with statistical software STATISTICA (ver. 10. Spatial visualisation was processed with GIS software ArcGIS (ver. 10.1. Preferences for food of Czech origin were analysed in relation to identification criteria. The research results show that the origin of food has an important role in consumer purchase decision-making. There is no significant difference in importance of this factor based on gender of consumers, however, we could prove moderate dependence on respondent’s occupation, education and age. We could also experience regional differences in levels of preferences of local products or products of Czech origin in regard of 14 regions of the Czech Republic. χ2 (N = 3767 = 245.25; p < 0.001. Value of Pearson’s coefficient of contingency is 0.334.

Regional Air Pollutions in Three Different Regions of Asia From a Transcontinental Transport Perspective

Science.gov (United States)

Pochanart, P.; Kanaya, Y.; Komazaki, Y.; Liu, Y.; Akimoto, H.

2007-12-01

Asia is known as one of the regions with the fastest rate of growing in industrialization and urbanization. As a result, the rapid increases of large-scale air pollution in Asia emerge as a serious concern at both domestic and international levels. Apart from the problems of air quality degradation, emission control, environmental risk, and health effect in a domestic level, evidences from scientific studies indicate that by the long-range transport, Asian air pollution is becoming a global problem. Observations and model studies confirm that air pollution from Asia could be transported to North America or farther. In this work, we investigate the Asian air pollutions, in particular ozone and some other atmospheric components such as carbon monoxide and black carbon, from the ground- based observations in the three different regions, namely 1) background region of Siberia and central Asia, 2) highly anthropogenic region in eastern China, and 3) the rim region of the Asia-Pacific. In a transcontinental transport perspective, these regions are regarded as the inflow region, source region, and outflow region of Asia, respectively. From the results, it is found that the influences from large-scale emission in East Asia are observed clearly in the source region, and to the significant extent in the outflow region. For the inflow region of Asia, our data in Siberia and Kyrgyzstan indicate that air masses in this region are mostly intact from large-scale anthropogenic emission, and remain much of the global background atmospheric pollution characteristic. When the air masses are transported to source region, the air pollutants level increased sharply and frequent episodes of extremely high pollutions have been observed. Our results show good correlation between the residence time of air masses over the source region in eastern China and the observed levels of air pollutants verifying the strong enhancements by anthropogenic emissions from industrialization and

Improving the Assessment of Regional Economic Potential (on Example of Rostov Region

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Nikolai A. Kurianov

2017-06-01

Full Text Available The article discusses a number of problematic issues concerning the possibility of improving existing approaches to assessing regional economic potential. Based on the analysis of existing approaches it is concluded that presence of a number of inherent common disadvantages, which include the exclusion of complex assessment elements of intangible resources, isolation from development goals in the region, ignoring the possibility of incremental reserves development static evaluation results. To overcome these ambiguities the authors' approach to improving assessment procedures based on the allocation of the essential nature of the category «regional economic potential», which unites, on the one hand, the resources available for regional development (actual potential, and on the other hand, resources in respect of which the region has the opportunity to attract them as a tool for further development of (stochastic potential. As the degree of implementation of this option is determined by the quality of regional governance, the most important element of the economic potential of the region is also an effective mechanism for management of existing and potential resources of various types. The practical implementation of the proposed methodology suppose, for example, estimate the economic potential of the Rostov region. At the first stage of the evaluation determine the most important elements of this potential and their ranking, on the second – assessment of the status of these elements from the point of view of their availability, ability to attract and management efficiency, and the third – the normalized assessment of regional economic potential.

Regional Branching Reconsidered: Emergence of the Fuel Cell Industry in European Regions

DEFF Research Database (Denmark)

Tanner, Anne Nygaard

2014-01-01

The literature on economic geography suffers from a lack of attention to the emergence of new industries. Recent literature on “regional branching” proposes that new industries emerge in regions where preexisting economic activities are technologically related to the emerging industry. This article...... provides a more grounded basis for the emerging literature on regional branching by confronting the regional branching thesis with the realities of an emerging industry, namely, the fuel cell industry. The analysis is based on patent data and qualitative interviews conducted in a selection of European NUTS...... new technologies to their product portfolio. The importance of further investigating and disentangling different dimensions of relatedness and their impact on regional branching is stressed....

Comparisons of chewing rhythm, craniomandibular morphology, body mass and height between mothers and their biological daughters.

Science.gov (United States)

Cho, Catherine; Louie, Ke'ale; Maawadh, Ahmed; Gerstner, Geoffrey E

2015-11-01

To study and compare the relationships between mean chewing cycle duration, selected cephalometric variables representing mandibular length, face height, etc., measured in women and in their teenage or young-adult biological daughters. Daughters were recruited from local high schools and the University of Michigan School of Dentistry. Selection criteria included healthy females with full dentition, 1st molar occlusion, no active orthodontics, no medical conditions nor medication use that could interfere with normal masticatory motor function. Mothers had to be biologically related to their daughters. All data were obtained in the School of Dentistry. Measurements obtained from lateral cephalograms included: two "jaw length" measures, condylion-gnathion and gonion-gnathion, and four measures of facial profile including lower anterior face height, and angles sella-nasion-A point (SNA), sella-nasion-B point (SNB) and A point-nasion-B point (ANB). Mean cycle duration was calculated from 60 continuous chewing cycles, where a cycle was defined as the time between two successive maximum jaw openings in the vertical dimension. Other variables included subject height and weight. Linear and logistic regression analyses were used to evaluate the mother-daughter relationships and to study the relationships between cephalometric variables and chewing cycle duration. Height, weight, Co-Gn and Go-Gn were significantly correlated between mother-daughter pairs; however, mean cycle duration was not (r(2)=0.015). Mean cycle duration was positively correlated with ANB and height in mothers, but negatively correlated with Co-Gn in daughters. Chewing rate is not correlated between mothers and daughters in humans. Copyright © 2015 Elsevier Ltd. All rights reserved.

Three cases of ectopic sphenoid sinus pituitary adenoma.

Science.gov (United States)

Bobeff, Ernest Jan; Wiśniewski, Karol; Papierz, Wielisław; Stefańczyk, Ludomir; Jaskólski, Dariusz Jan

2017-01-01

Introduction: Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke's pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. Aims: To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. Material and methods: Analysis of three cases: two females and one man, aged 61-70. Results: One patient presented with a unilateral hearing loss, the other two with headache and vertigo. They all suffered from type 2 diabetes mellitus. Neurological examination revealed no abnormality. Radiological imaging showed a sphenoid sinus space-occupying soft-tissue lesion with bone erosion in 2 cases and empty sella in 2 patients whereas one had a normal pituitary gland. All were operated on via the transnasal approach. Total resection was achieved in one patient and subtotal in two; in two cases we observed intact sellar dura and in one intact sellar floor. Histopathology showed immunoreactivity for synaptophysin in all cases and cytokeratin in two. The Ki-67 index was less than 2%. Immunohistochemical staining demonstrated growth hormone cells in all cases whereas prolactin and adrenocorticotropin in two. The patients were discharged home in good condition with no neurological deficits. Conclusions: Ectopic sphenoid sinus pituitary adenoma should always be considered in differential diagnosis of sphenoid sinus lesion in the elderly, especially in coexistence with empty sella or type 2 diabetes mellitus. Since ectopic sphenoid sinus pituitary adenoma is a benign lesion, surgical removal is an effective treatment. .

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

International Nuclear Information System (INIS)

Uslu-Akcam, Ozge

2017-01-01

This retrospective study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of individuals with skeletal class II, division 1 and division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group. Totally 124 lateral cephalograms (47 for skeletal class I; 45 for skeletal class II, division 1; and 32 for skeletal class II, division 2) in pre-peak, peak, and post-peak growth periods were selected from the department archives. Thirteen landmarks, 4 angular and 4 linear measurements, and 4 proportional calculations were obtained. The ANOVA and Duncan test were applied to compare the differences among the study groups during the growth periods. Statistically significant differences were found between the skeletal class II, division 2 group and other groups for the gonion-gnathion/sella-nasion angle. The sella-nasion-B-point angle was different among the groups, while the A-point-nasion-B-point angle was significantly different for all 3 groups. The nasopharyngeal airway space showed a statistically significant difference among the groups throughout the growth periods. The interaction among the growth periods and study groups was statistically significant regarding the upper oropharyngeal airway space measurement. The lower oropharyngeal airway space measurement showed a statistically significant difference among the groups, with the smallest dimension observed in the skeletal class II, division 2 group. The naso-oropharyngeal airway dimensions showed a statistically significant difference among the class II, division 1; class II, division 2; and class I groups during different growth periods

Three cases of ectopic sphenoid sinus pituitary adenoma

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Ernest Jan Bobeff

2017-03-01

Full Text Available Introduction : Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke’s pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. Aims : To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. Material and methods: Analysis of three cases: two females and one man, aged 61-70. Results : One patient presented with a unilateral hearing loss, the other two with headache and vertigo. They all suffered from type 2 diabetes mellitus. Neurological examination revealed no abnormality. Radiological imaging showed a sphenoid sinus space-occupying soft-tissue lesion with bone erosion in 2 cases and empty sella in 2 patients whereas one had a normal pituitary gland. All were operated on via the transnasal approach. Total resection was achieved in one patient and subtotal in two; in two cases we observed intact sellar dura and in one intact sellar floor. Histopathology showed immunoreactivity for synaptophysin in all cases and cytokeratin in two. The Ki-67 index was less than 2%. Immunohistochemical staining demonstrated growth hormone cells in all cases whereas prolactin and adrenocorticotropin in two. The patients were discharged home in good condition with no neurological deficits. Conclusions : Ectopic sphenoid sinus pituitary adenoma should always be considered in differential diagnosis of sphenoid sinus lesion in the elderly, especially in coexistence with empty sella or type 2 diabetes mellitus. Since ectopic sphenoid sinus pituitary adenoma is a benign lesion, surgical removal is an effective treatment.

Do craniopharyngioma molecular signatures correlate with clinical characteristics?

Science.gov (United States)

Omay, Sacit Bulent; Chen, Yu-Ning; Almeida, Joao Paulo; Ruiz-Treviño, Armando Saul; Boockvar, John A; Stieg, Philip E; Greenfield, Jeffrey P; Souweidane, Mark M; Kacker, Ashutosh; Pisapia, David J; Anand, Vijay K; Schwartz, Theodore H

2018-05-01

OBJECTIVE Exome sequencing studies have recently demonstrated that papillary craniopharyngiomas (PCPs) and adamantinomatous craniopharyngiomas (ACPs) have distinct genetic origins, each primarily driven by mutually exclusive alterations: either BRAF ( V600E), observed in 95% of PCPs, or CTNNB1, observed in 75%-96% of ACPs. How the presence of these molecular signatures, or their absence, correlates with clinical, radiographic, and outcome variables is unknown. METHODS The pathology records for patients who underwent surgery for craniopharyngiomas between May 2000 and March 2015 at Weill Cornell Medical College were reviewed. Craniopharyngiomas were identified and classified as PCP or ACP. Patients were placed into 1 of 3 groups based on their genomic mutations: BRAF mutation only, CTNNB1 mutation only, and tumors with neither of these mutations detected (not detected [ND]). Demographic, radiological, and clinical variables were collected, and their correlation with each genomic group was tested. RESULTS Histology correlated strongly with mutation group. All BRAF tumors with mutations were PCPs, and all CTNNB1 with mutations and ND tumors were ACPs. Preoperative and postoperative clinical symptoms and radiographic features did not correlate with any mutation group. There was a statistically significant relationship (p = 0.0323) between the age group (pediatric vs adult) and the mutation groups. The ND group tumors were more likely to involve the sella (p = 0.0065). CONCLUSIONS The mutation signature in craniopharyngioma is highly predictive of histology. The subgroup of tumors in which these 2 mutations are not detected is more likely to occur in children, be located in the sella, and be of ACP histology.

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

Energy Technology Data Exchange (ETDEWEB)

Uslu-Akcam, Ozge [Clinic of Orthodontics, Ministry of Health, Tepebasi Oral and Dental Health Hospital, Ankara (Turkmenistan)

2017-03-15

This retrospective study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of individuals with skeletal class II, division 1 and division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group. Totally 124 lateral cephalograms (47 for skeletal class I; 45 for skeletal class II, division 1; and 32 for skeletal class II, division 2) in pre-peak, peak, and post-peak growth periods were selected from the department archives. Thirteen landmarks, 4 angular and 4 linear measurements, and 4 proportional calculations were obtained. The ANOVA and Duncan test were applied to compare the differences among the study groups during the growth periods. Statistically significant differences were found between the skeletal class II, division 2 group and other groups for the gonion-gnathion/sella-nasion angle. The sella-nasion-B-point angle was different among the groups, while the A-point-nasion-B-point angle was significantly different for all 3 groups. The nasopharyngeal airway space showed a statistically significant difference among the groups throughout the growth periods. The interaction among the growth periods and study groups was statistically significant regarding the upper oropharyngeal airway space measurement. The lower oropharyngeal airway space measurement showed a statistically significant difference among the groups, with the smallest dimension observed in the skeletal class II, division 2 group. The naso-oropharyngeal airway dimensions showed a statistically significant difference among the class II, division 1; class II, division 2; and class I groups during different growth periods.

MRI appearances of the sphenoid sinus at the late follow-up of trans-sphenoidal surgery for pituitary macroadenoma

International Nuclear Information System (INIS)

Connor, S.E.J.; Deasy, N.P.

2002-01-01

We aimed to demonstrate the appearances of the sphenoid sinus on MRI performed later than 2 years post-t ranssphenoidal surgery (TSS). We retrospectively reviewed 47 patients in whom follow-up MRI scans had been performed at least 2 years post-TSS. We specifically reviewed the clinical and imaging of those patients in whom the sphenoid sinus was filled with signal abnormality or masses were present arising from the sinus roof and classified them as tumour or indeterminate abnormalities on imaging criteria. We documented other clinicoradiological details. Twelve of 47 patients demonstrated sphenoid sinus filling or sinus roof masses and in six of 12 patients it was possible to classify them as tumourous using imaging and clinical criteria. The indeterminate and non-tumourous sphenoid sinus abnormalities most frequently had a T1-weighted signal similar to subsellar tumour and displayed rim enhancement and thus could not be reliably distinguished from tumourous abnormality on the basis of signal or enhancement characteristics. The presence of a well-defined surgical defect in the sella floor was associated with resolution of abnormality on MRI follow-up. We concluded MRI findings of sphenoid sinus filling or sinus roof masses are present in approximately 26% of scans performed longer than 2 years post-TSS. Half of these are of indeterminate origin and follow-up is required to discriminate tumour from non- tumour with certainty. A well-defined surgical defect in the sella floor is, however, suggestive of a non-tumourous abnormality. Copyright (2002) Blackwell Science Pty Ltd

Numerical conformal mapping and its inverse of unbounded multiply connected regions onto logarithmic spiral slit regions and straight slit regions.

Science.gov (United States)

Yunus, A A M; Murid, A H M; Nasser, M M S

2014-02-08

This paper presents a boundary integral equation method with the adjoint generalized Neumann kernel for computing conformal mapping of unbounded multiply connected regions and its inverse onto several classes of canonical regions. For each canonical region, two integral equations are solved before one can approximate the boundary values of the mapping function. Cauchy's-type integrals are used for computing the mapping function and its inverse for interior points. This method also works for regions with piecewise smooth boundaries. Three examples are given to illustrate the effectiveness of the proposed method.

EVALUATION OF ECONOMIC SECURITY NOVOSIBIRSK REGION (FOR EXAMPLE, A REGIONAL ENGINEERING

Directory of Open Access Journals (Sweden)

Lugacheva L. I.

2014-12-01

Full Text Available The article shows the importance of regional engineering for the Russian economy, it clarifies the factors of economic security of the Novosibirsk region (NSO. Analyzed the characteristics prevailing in the engineering industry, its competitive advantages. The research results of the export orientation of the regional engineering VAT: its direction and priorities; discusses the trends that influence the growth during the recovery has formed a new profile of its foreign economic relations. Threats identified in the development of engineering and to propose measures to overcome them to ensure the economic security of the region. The article deals with the problem-tional institutes provide for the sustainable development of regional engineering, discusses the possibility of using pub-lic-private partnerships. Sharing of risks and responsibilities between the subject of the Russian Federation, municipalities and entrepreneurs - one of the priorities in the creation of the necessary conditions for the economic security of the NSO.

IS THE POLAR REGION DIFFERENT FROM THE QUIET REGION OF THE SUN?

International Nuclear Information System (INIS)

Ito, Hiroaki; Shiota, Daikou; Tokumaru, Munetoshi; Fujiki, Ken'ichi; Tsuneta, Saku

2010-01-01

Observations of the polar region of the Sun are critically important for understanding the solar dynamo and the acceleration of solar wind. We carried out precise magnetic observations on both the north polar region and the quiet Sun at the east limb with the spectropolarimeter of the Solar Optical Telescope aboard Hinode to characterize the polar region with respect to the quiet Sun. The average area and the total magnetic flux of the kilo-Gauss magnetic concentrations in the polar region appear to be larger than those of the quiet Sun. The magnetic field vectors classified as vertical in the quiet Sun have symmetric histograms around zero in the strengths, showing balanced positive and negative fluxes, while the histogram in the north polar region is clearly asymmetric, showing a predominance of the negative polarity. The total magnetic flux of the polar region is larger than that of the quiet Sun. In contrast, the histogram of the horizontal magnetic fields is exactly the same for both the polar region and the quiet Sun. This is consistent with the idea that a local dynamo process is responsible for the horizontal magnetic fields. A high-resolution potential field extrapolation shows that the majority of magnetic field lines from the kG-patches in the polar region are open with a fanning-out structure very low in the atmosphere, while in the quiet Sun, almost all the field lines are closed.

The trunk and extremities

International Nuclear Information System (INIS)

Raval, B.; Yeakley, J.W.; Harris, J.H.

1987-01-01

Together these volumes form an atlas for multiplanar anatomy of the entire body - using modern state-of-the-art computed tomography supplemented with MRI to provide the thorough knowledge of normal anatomy that's fundamental to recognizing pathological alteration. Each volume can stand alone, and each presents the material using radiologic images presented side by side with labeled drawings. There's information of the sella, temporal bone, wrist, and foot. Different window settings are used to emphasize bone and soft tissue detail. Each of the CT or MR images in the atlas have been specifically selected by the authors to illustrate particular radiologic anatomy

An unusual intracranial metallic foreign bodies and panhypopituitarism.

Science.gov (United States)

Lakouichmi, Mohammed; Baïzri, Hicham; Mouhsine, Abdelilah; Boukhira, Abderrahmane; Akhaddar, Ali

2014-01-01

A 49 years old man, with a history of aggression at the age of 18 years by a pair of scissors, who consulted for unilateral migraine headaches look straight. Paraclinical explorations concluded that trauma to anterior pituitary by a metallic foreign body from the right nostril to the sella, responsible for panhypopituitarism and sinusitis. The headaches are frequent causes of consultation, often treated symptomatically but rarely explored. The direct trauma to the pituitary gland, by a metallic foreign body, is exceptional. We report the case of neglected panhypopituitarism, discovered 31 years after injury with a pair of scissors.

Radiologic study of basal cell nevus syndrome

Energy Technology Data Exchange (ETDEWEB)

Park, Tae Won [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1988-11-15

Several cases of jaw cyst-basal cell nevus-bifid rib syndrome are presented. This syndrome consists principally of multiple jaw cysts, basal cell nevi, and bifid ribs but no one component is present in all patients. The purpose of this paper is to review the multiple characteristics of this syndrome and present three cases in a family and additional 4 cases. The many malformations associated with the syndrome have variable expressively. In the cases, multiple jaw cysts, pal mar and plantar pittings, bridging of sella, temporoparietal bossing, hypertelorism, cleft palate, and dystopia canthoru m have been observed.

Two interesting cases highlighting an oblivious specialty of psychoneuroendocrinology.

Science.gov (United States)

Hari Kumar, K V S; Dhull, Pawan; Somasekharan, Manoj; Seshadri, K

2012-01-01

Psychoneuroendocrinology deals with the overlap disorders pertaining to three different specialties. Awareness about the somatic manifestations of psychiatric diseases and vice versa is a must for all the clinicians. The knowledge of this interlinked specialty is essential because of the obscure presentation of certain disorders. Our first case was treated as depressive disorder, whereas the diagnosis was hypogonadism with empty sella. Our second patient was managed as schizophrenia and the evaluation revealed bilateral basal ganglia calcification and a diagnosis of Fahr's disease. We report these cases for their unusual presentation and to highlight the importance of this emerging specialty.

Medical Therapy for Cushing's Syndrome in the Twenty-first Century.

Science.gov (United States)

Tritos, Nicholas A; Biller, Beverly M K

2018-06-01

Medical therapy has a useful adjunctive role in many patients with Cushing's syndrome. Patients with pituitary corticotroph adenomas who have received radiation therapy to the sella require medical therapy until the effects of radiation therapy occur. In addition, patients with Cushing's syndrome who cannot undergo surgery promptly, including those who are acutely ill and cannot safely undergo tumor resection, may benefit from medical therapy as a bridge to surgery. Other possible candidates for medical therapy are those with unresectable tumors or those whose tumor location remains unknown despite adequate diagnostic evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

Radiologic study of basal cell nevus syndrome

International Nuclear Information System (INIS)

Park, Tae Won

1988-01-01

Several cases of jaw cyst-basal cell nevus-bifid rib syndrome are presented. This syndrome consists principally of multiple jaw cysts, basal cell nevi, and bifid ribs but no one component is present in all patients. The purpose of this paper is to review the multiple characteristics of this syndrome and present three cases in a family and additional 4 cases. The many malformations associated with the syndrome have variable expressively. In the cases, multiple jaw cysts, pal mar and plantar pittings, bridging of sella, temporoparietal bossing, hypertelorism, cleft palate, and dystopia canthoru m have been observed.

Head, neck, and spine

International Nuclear Information System (INIS)

Raval, B.; Yeakley, J.W.; Harris, J.H.

1987-01-01

Together these volumes form an atlas for multiplanar anatomy of the entire body - using modern computed tomography supplemented with MRI to provide the thorough knowledge of normal anatomy that's fundamental to recognizing pathological alteration. Each volume can stand alone, and each presents the material using radiologic images presented side by side with labeled drawings. There's information of the sella, temporal bone, wrist, and foot. Different window settings are used to emphasize bone and soft tissue detail. Each of the CT or MR images in the atlas have been specifically selected by the authors to illustrate particular radiologic anatomy

Evolved H II regions

International Nuclear Information System (INIS)

Churchwell, E.

1975-01-01

A probable evolutionary sequence of H II regions based on six distinct types of observed objects is suggested. Two examples which may deviate from this idealized sequence, are discussed. Even though a size-mean density relation of H II regions can be used as a rough indication of whether a nebula is very young or evolved, it is argued that such a relation is not likely to be useful for the quantitative assignment of ages to H II regions. Evolved H II regions appear to fit into one of four structural types: rings, core-halos, smooth structures, and irregular or filamentary structures. Examples of each type are given with their derived physical parameters. The energy balance in these nebulae is considered. The mass of ionized gas in evolved H II regions is in general too large to trace the nebula back to single compact H II regions. Finally, the morphological type of the Galaxy is considered from its H II region content. 2 tables, 2 figs., 29 refs

Assessment of the regional executive power reputation (on the example of the Smolensk region

Directory of Open Access Journals (Sweden)

N N Rozanova

2016-12-01

Full Text Available With the development of information society, intangible assets are increasingly becoming a significant competitive advantage. At the regional level, the reputational capital turns into a powerful tool to improve the region’s investment attractiveness. The most important component of the regional reputational capital is such a significant political resource as the reputation of the regional authorities: good reputation can and should be a key intangible asset of regional management system development aiming to strengthen the authorities decisions and actions and the public confidence, and to mobilize citizens for the real interested participation in the regional management. The article presents the results of testing the research phase of the technological cycle of the regional power reputation management, which was conducted to identify its key essential characteristics and ways for evaluation. The author proposes a research model to study the regional authorities’ reputation and defines the logic of its perception study in terms of two main subjects - the authorities and the population. The results of the assessment of the regional authorities reputation on the example of the Smolensk region let the author examine the coherence of the regional authorities reputation estimates by the public and the authorities themselves (civil servants of the regional executive power and identify a significant gap in the assessments of this reputation by the population as compared to the civil servants opinions.

Regional cooperative agreement for the Asia and Pacific region

International Nuclear Information System (INIS)

Anon.

1981-01-01

Among the means available to the International Atomic Energy Agency to promote cooperative efforts in the nuclear field is the Regional Cooperative Agreement (RCA) for Research, Development, and Training related to Nuclear Science and Technology for the Asia and Pacific Region. Under the terms of this agreement, which came into force on June 12, 1972, participating countries aim to promote and coordinate research, development, and training projects in nuclear fields through collaborative efforts among relevant national institutions in the region. The Agency's role is to provide organizational, administrative, advisory, technical, and financial assistance when needed to secure successful execution of the projects undertaken within the framework of the RCA. Although this presentation deals primarily with the benefits of regional cooperation under the agreement, a review of the RCA would be somewhat imbalanced without a mention of its shortcomings. One of the principal impediments to more rapid progress, as is the case in many other areas, is financing. There is no stable source of funding outside the research contract program and, the likelihood of large-scale UNDP support notwithstanding, a greater willingness on the part of participating Member States to support the program along with the development of a greater sense of common purpose are called for. In this connection serious consideration is being given to the possibility of establishing an Asian Centre for Research and Training, an institute that would bring together scientists from the region to collaborate on problems common to the RCA countries. A study group has already been convened to investigate the feasibility of this proposal

Regional Geography Is Dead: Long Live Regional Geography! With an Example from Southern Italy.

Science.gov (United States)

King, Russell

1979-01-01

Recounts criticisms of regional geography and points out three reasons for retaining it: growth of regional science, area studies, and regional planning. Evaluates Southern Italy as an example of the uses of regional analyses. For journal availability, see SO 507 291. (Author/CK)

Regional Alternative Transportation Evaluation: Region 8

Science.gov (United States)

2016-02-28

The U.S. Fish and Wildlife Service (FWS), Federal Lands Highway (FLH), and the U.S. Department of Transportation (DOT) Volpe Center (Volpe Center) have conducted regional alternative transportation evaluations (RATEs) in almost each of FWSs eight ...

Innovative Technological Development of Russian Mining Regions (on Example of Kemerovo Region)

Science.gov (United States)

Shavina, Evgeniya; Kalenov, Oleg

2017-11-01

A characteristic trend of many countries modern development is the transition to an innovative economy. At present, this is the only opportunity to secure and maintain a high standard of living for the population. Moreover, innovative development of Russian can be achieved during technological progress in its regions. In this regard, it is necessary to assess the innovative potential of the region and identify the most actual problems that impede the transition to the trajectory of innovative development. The authors outline several main indicators that help to determine the level of innovation and technological development of one of the largest industrial areas of Russia - Kemerovo region. The special economic role of Kemerovo region as a large territorial old-industrial complex of Western Siberia requires a large-scale work to solve the most acute problems of regional development. It is necessary to find the answer for existing problems through the implementation of a system of state regulation aimed at making the innovation component a leading factor of the regional economy competitiveness.

Regional and non-regional cults of affliction in Western Zambia

NARCIS (Netherlands)

Binsbergen, W.M.J.; Werbner, R.P.

1977-01-01

A generic relation holds between two types of cult of affliction in formerly Barotseland. Cults of one type, the non-regional, form a substratum out of which cults of the other type, the regional, may spring forth under certain conditions, and into which they submerge again under different

Approach to analysis of inter-regional similarity of investment activity support measures in legislation of regions (on the example of Krasnoyarsk region

Directory of Open Access Journals (Sweden)

Valentina F. Lapo

2017-01-01

Full Text Available The most part of stimulation methods in Russia are concentrated in legal documents of the regions of the Russian Federation. They directed on intensification of investment activity in regions. How similar are these investment stimulation conceptions? There is no mention in the literature of the methodical questions of quantitative analysis and inter-regional comparisons. In addition, there are no results of statistical research of inter-regional correlations of stimulation methods and analysis of dynamics of this process. There are no special measuring instruments. The presented work is aimed at completion of these blanks. The approach for the spatial correlation analysis of legislative norms is offered in research. Classification of investments’ stimulation methods is developed. The way of preparing and coding data for research is offered. The approach and system of coefficients for the analysis of inter-regional interrelations of legislative systems of investments’ stimulation is offered. A proximity coefficient of regional legislation, a factor of structure similarity and a dynamic coincidence index are proposed. The space-time base of investment stimulation methods on Russian Federation regions for 12 years is collected and statistically processed for research. There are only 758 documents. A source of texts is a site of the Ministry of Justice of the Russian Federation.Research of documents has allowed revealing a number of laws in formation of regional investment stimulation systems. The regions that are the most similar in terms of structure of stimulation methods are identified. We have found the group of regions for which it is observed the increase in similarity of the legislation and the group with the reduction of similarity. Therefore, it is obvious that the general trend to reduction of similarity in the legislation takes place between Krasnoyarsk territory and the other regions of the Russian Federation. Calculations have

Regional Stability & Peacebuilding

DEFF Research Database (Denmark)

It seems that regional decision makers during the last two decades has been unable to produce a sustainable peacebuilding plan for the region and it is questionable whether any remarkable change will occur in the near future. Some would argue that the political differences are simply too far apart...... to the process of peacebuilding, this could prove as a useful tool, and for this reason politicians, officials, and persons in general with an interest in this region will benefit from the perspectives presented here....

Regional inequalities in mortality.

OpenAIRE

Illsley, R; Le Grand, J

1993-01-01

STUDY OBJECTIVE--To examine the hypothesis of sustained and persistent inequalities in health between British regions and to ask how far they are a consequence of using standardised mortality ratios as the tool of measurement. DESIGN, SETTING AND PARTICIPANTS--Data are regional, age specific death rates at seven points in time from 1931 to 1987-89 for the British regions, reconstructed to make them comparable with the 1981 regional definitions. Log variance is used to measure inequality; regi...

Regionally-varying and regionally-uniform electricity pricing policies compared across four usage categories

International Nuclear Information System (INIS)

Cho, Seong-Hoon; Kim, Taeyoung; Kim, Hyun Jae; Park, Kihyun; Roberts, Roland K.

2015-01-01

The objective of our research is to predict how electricity demand varies spatially between status quo regionally-uniform electricity pricing and hypothetical regionally-varying electricity pricing across usage categories. We summarize the empirical results of a case study of electricity demand in South Korea with three key findings and their related implications. First, the price elasticities of electricity demand differ across usage categories. Specifically, electricity demands for manufacturing and retail uses are price inelastic and close to unit elastic, respectively, while those for agricultural and residential uses are not statistically significant. This information is important in designing energy policy, because higher electricity prices could reduce electricity demands for manufacturing and retail uses, resulting in slower growth in those sectors. Second, spatial spillovers in electricity demand vary across uses. Understanding the spatial structure of electricity demand provides useful information to energy policy makers for anticipating changes in demand across regions via regionally-varying electricity pricing for different uses. Third, simulation results suggest that spatial variations among electricity demands by usage category under a regionally-varying electricity-pricing policy differ from those under a regionally-uniform electricity-pricing policy. Differences in spatial changes between the policies provide information for developing a realistic regionally-varying electricity-pricing policy according to usage category. - Highlights: • We compare regionally-varying and regionally-uniform electricity pricing policies. • We summarize empirical results of a case study of electricity demand in South Korea. • We confirm that spatial spillovers in electricity demands vary across different uses. • We find positive spatial spillovers in the manufacturing and residential sectors. • Our methods help policy makers evaluate regionally-varying pricing

The effect of regional politics on regional life expectancy in Italy (1980-2010).

Science.gov (United States)

Jonker, Marcel F; D'Ippolito, Edoardo; Eikemo, Terje A; Congdon, Peter D; Nante, Nicola; Mackenbach, Johan P; Kamphuis, Carlijn B M

2017-03-01

The evidence on the association between politics and health is scarce considering the importance of this topic for population health. Studies that investigated the effect of different political regimes on health outcomes show inconsistent results. Bayesian time-series cross-section analyses are used to examine the overall impact of regional politics on variations in Italian regional life expectancy (LE) at birth during the period 1980-2010. Our analyses control for trends in and unobserved determinants of regional LE, correct for temporal as well as spatial autocorrelation, and employ a flexible specification for the timing of the political effects. In the period from 1980 to 1995, we find no evidence that the communist, left-oriented coalitions and Christian Democratic, centre-oriented coalitions have had an effect on regional LE. In the period from 1995 onwards, after a major reconfiguration of Italy's political regimes and a major healthcare reform, we again find no evidence that the Centre-Left and Centre-Right coalitions have had a significant impact on regional LE. The presented results provide no support for the notion that different regional political regimes in Italy have had a differential effect on regional LE, even though Italian regions have had considerable and increasing autonomy over healthcare and health-related policies and expenditures.

Promoting regional mobility

DEFF Research Database (Denmark)

Jensen, Anne

Pricing of transport has been part of EU's common transport policy since this gained momentum in the early 1990s. Since then, it has been closely connected to the trans-European transport network (TEN-T) and to rising demands of efficient mobility systems at a local, regional and Community scale....... Development of pricing policies is contested at Community level and has taken place in a clash between different policy rationalities. Significantly though, the effects of the pricing policies are closely related to regional mobility systems, e.g. through financing large trans-border infrastructure projects...... and establishing common technical charging systems thus changing the conditions for regional mobility. This paper explores how policies of infrastructure pricing shape new ways of governing mobility which influences trans-border, regional policy-making. The key findings are that there is a tendency to include...

A study on the regional geological setting of uranium metallogenesis in Lu-Zong region

International Nuclear Information System (INIS)

Chen Yifeng; Ma Changming; Fan Huanxin

1996-01-01

This paper presents a new understanding of features of main ore-bearing horizons and magmatic rocks, evolution regularities, regional tectonic characteristics and the compositions and formation of the Yangtze tectonic belt in Lu-Zong region. Favourable horizons, magmatic series of Yangtze-type crust-mantle mixed melting magmatic rocks, activities of regional gigantic deep-seated faults and their subsidiary structures provided good regional geological setting for the formation of uranium and polymetallic mineral resources in this region

Building Regional Competencies

DEFF Research Database (Denmark)

Norus, Jesper

2004-01-01

This paper analyzes the foundations of regional knowledge and its long-term impact onthe region's companies' and how a particular knowledge has developed an ability tostay competitive within a specific technological field. The case illustrates how theCopenhagen region has been able to develop...... a dominating position in the global marketfor industrial enzymes from 1870-2004. The case of industrial enzymes shows how aregion has been able to build sustainable competitive advantages from its distinctivecompetencies. This is done through a mixture of outsourcing and in sourcing ofcompetencies, knowledge...

Environmental management on the basis of Complex Regional Indicators Concept: case of the Murmansk region

Science.gov (United States)

Kozlov, A.; Gutman, S.; Zaychenko, I.; Rytova, E.; Nijinskaya, P.

2015-09-01

The article presents an approach to sustainable environmental development of the Murmansk region of the Russian Federation based on the complex regional indicators as a transformation of a balance scorecard method. The peculiarities of Murmansk region connected with sustainable environmental development are described. The complex regional indicators approach allows to elaborate the general concept of complex regional development taking into consideration economic and non-economic factors with the focus on environmental aspects, accumulated environmental damage in particular. General strategic chart of sustainable environmental development of the Murmansk region worked out on the basis of complex regional indicators concept is composed. The key target indicators of sustainable ecological development of the Murmansk region are presented for the following strategic chart components: regional finance; society and market; industry and entrepreneurship; training, development and innovations. These charts are to be integrated with international environmental monitoring systems.

HRM: HII Region Models

Science.gov (United States)

Wenger, Trey V.; Kepley, Amanda K.; Balser, Dana S.

2017-07-01

HII Region Models fits HII region models to observed radio recombination line and radio continuum data. The algorithm includes the calculations of departure coefficients to correct for non-LTE effects. HII Region Models has been used to model star formation in the nucleus of IC 342.

Social Facilitation: the Kaliningrad Region and Russian Mainland Regions

Directory of Open Access Journals (Sweden)

Toropov Pavel

2015-03-01

Full Text Available The authors look at the concept of social facilitation as a possible component of Russian social consolidation in the course of social reforms. The article focuses on the results of an empirical study of the levels and characteristics of competence in social facilitation, which is here understood as the ability to apply certain knowledge and systems of skills and as a success rate of actions based on experience in improving the conditions of social development. The study was conducted in the Kaliningrad region in 2012—2013. The data was obtained through a survey of 400 respondents using the authors’ methodology encompassing eight basic elements of competence and a structured interview aimed at a better understanding of the subject of the study and attitudes towards it. The data is compared against the results of a similar study in two regions of central Russia with similar conditions. The results suggest a disharmonic and inconsistent structure of competence in social facilitation, low motivation for social activity in youth, and a narrow range of ideas about possible areas of personal activities in the current conditions. Gender differences are identified in the level and structure of competence. The authors believe that certain differences in competence components identified through mathematical methods are determined by the geographical characteristics of the Kaliningrad region — its exclave nature, a relatively small territory, and proximity to the EU countries. It is stressed that the regional conditions affecting motivation, forms and areas of activities, and structure of experience should be taken into account in selecting means and methods of organising youth activities. They can also serve as a basis for the regional youth policy.

Health region development from the perspective of system theory - an empirical cross-regional case study.

Science.gov (United States)

Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

2015-01-01

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Regional Scale/Regional Climate Model Development and Its Applications at Goddard

Science.gov (United States)

Tao, W.-K.; Lau, W.; Qian, J.; Jia, Y.; Wetzel, P.; Chou, M.-D.; Wang, Y.; Lynn, B.

2000-01-01

A Regional Land-Atmosphere Climate Simulation System (RELACS) is being developed and implemented at NASA Goddard Space Flight Center. One of the major goals of RELACS is to use a regional scale model (Penn State/NCAR MM5) with improved physical processes and in particular land-related processes, to understand the role of the land surface and its interaction with convection and radiation as well as the water/energy cycles in the Indo-China/South China Sea (SCS)/China, N. America and S. America region.

Minimum deterrence and regional security. Section 2. Other regions

International Nuclear Information System (INIS)

Azikiwe, A.E.

1993-01-01

Compared to European political and security circumstance, minimum deterrence is less an illusion in other regions where weapon free zones already exist. It will continue to be relevant to the security of other regions. Strategic arms limitation should be pursued vigorously in a constructive and pragmatic manner, bearing in mind the need to readjust to new global challenges. The Comprehensive Test Ban Treaty is the linchpin on which the Non-proliferation Treaty rests

Regional Economic Development Strategy Based Agro-Industries in Key Region Kandangan South of Kalimantan

Directory of Open Access Journals (Sweden)

Dewi Siska

2016-06-01

Full Text Available Agroindustry has become the main pillar in South Kalimantan development, it can be found in RPJPD 2005-2025. Kandangan mainstay region as one of three leading regions in South Kalimantan which potentially improved to push economy growth through agriculture based industry activity (agroindustry. The concept of agroindustry a side is expected to drive economic growth as well as to realize the equitable distribution of income. This research aims to: (1 identify to economic development of the region in Kandangan mainstay regions, (2 identify the main commodity, (3 identify means of supporting agroindustry, and (4 formulating development strategies based agroindustry region. Entropy analysis shows the development of the economy sufficiently developed in Kandangan mainstay region dominated by the agricultural sector, namely food crops subsector. LQ an SSA analysis shows corn and rice crops become competitive commodities. There are only few of supporting infrastructure agroindustry activities. Strategy formulation in the research is the improvement of infrastructure or infrastructure that can facilitate inter regional connectivity in the region mainstay Kandangan and the government as the leading actor agroindustry development.

Measuring regional authority

NARCIS (Netherlands)

Marks, G.W.; Hooghe, E.A.E.B.; Schakel, A.H.

2008-01-01

This article sets out a conceptual basis for measuring regional authority and engages basic measurement issues. Regional authority is disaggregated into two domains (self-rule and shared rule) and these are operationalised in eight dimensions. The article concludes by examining the robustness of

Models of Regional Modernization of the Donbass Region

Directory of Open Access Journals (Sweden)

Konstantin Viktorovich Pavlov

2016-03-01

Full Text Available The article deals with the methodical approach to the assessment of a level of development of post-industrial and neoindustrial models of economic modernization in regional aspect on the basis of various indicators. The proposed approach is approved with use of the statistical materials characterizing the state of economy in the regions of Donbass. The strategy of development of Donbass areas and their industrial cities would have to be based (we mean the situation if there were no military operations on this territory on the basis of the model of neoindustrialization assuming development of the sphere of the hi-tech industry, automation and a computerization of productive forces, replacement of physical work by intellectual labor that is radically capable to change nature of work and structure of labor balance of this macro-region. Branches and sectors of a socio-economic complex of the Donbass region using achievements of fundamental and applied science, engineering and design thought for increase in a share of automation, a computerization and mechanization of workplaces, physical and brainwork prior to the beginning of a political conflict in Ukraine have the potential of development. The authors also pay attention to need of studying the agglomerative effect from interaction of the cities and areas of the Donbass euroregion. It is connected, first of all, with development of vertical and horizontal mechanisms of active use of potential of so-called “cities-kernels”, capable to make the catalyzing impact on production, social infrastructure, creation and development of new perspective branches in the cities-satellites.

Regional aerosol emissions and temperature response: Local and remote climate impacts of regional aerosol forcing

Science.gov (United States)

Lewinschal, Anna; Ekman, Annica; Hansson, Hans-Christen

2017-04-01

Emissions of anthropogenic aerosols vary substantially over the globe and the short atmospheric residence time of aerosols leads to a highly uneven radiative forcing distribution, both spatially and temporally. Regional aerosol radiative forcing can, nevertheless, exert a large influence on the temperature field away from the forcing region through changes in heat transport or the atmospheric or ocean circulation. Moreover, the global temperature response distribution to aerosol forcing may vary depending on the geographical location of the forcing. In other words, the climate sensitivity in one region can vary depending on the location of the forcing. The surface temperature distribution response to changes in sulphate aerosol forcing caused by sulphur dioxide (SO2) emission perturbations in four different regions is investigated using the Norwegian Earth System Model (NorESM). The four regions, Europe, North America, East and South Asia, are all regions with historically high aerosol emissions and are relevant from both an air-quality and climate policy perspective. All emission perturbations are defined relative to the year 2000 emissions provided for the Coupled Model Intercomparison Project phase 5. The global mean temperature change per unit SO2 emission change is similar for all four regions for similar magnitudes of emissions changes. However, the global temperature change per unit SO2 emission in simulations where regional SO2 emission were removed is substantially higher than that obtained in simulations where regional SO2 emissions were increased. Thus, the climate sensitivity to regional SO2 emissions perturbations depends on the magnitude of the emission perturbation in NorESM. On regional scale, on the other hand, the emission perturbations in different geographical locations lead to different regional temperature responses, both locally and in remote regions. The results from the model simulations are used to construct regional temperature potential

Regional regularities for the even-even nuclei in intermediate mass region

International Nuclear Information System (INIS)

Varshney, Mani; Singh, M.; Gupta, D.K.; Singh, Yuvraj; Gupta, K.K.; Bihari, Chhail; Sharma, Aparna; Varshney, A.K.

2011-01-01

With the development of experimental techniques more and more nuclear data are accumulated and compiled for over five decades. The proton neutron interaction has been considered the key ingredient in the development of collectivity and ultimately the deformation in atomic nuclei. The purpose of the present study is to analyze the growth of R4/2 in different mass regions. The rate of growth regions in regions having proton number Z = 38, 54, 60 and 76 with changing neutron number where the interaction between particle - particle, particle - hole and hole - hole

Regional Redistribution and Migration

DEFF Research Database (Denmark)

Manasse, Paolo; Schultz, Christian

We study a model with free migration between a rich and a poor region. Since there is congestion, the rich region has an incentive to give the poor region a transfer in order to reduce immigration. Faced with free migration, the rich region voluntarily chooses a transfer, which turns out...... to be equal to that a social planner would choose. Provided migration occurs in equilibrium, this conclusion holds even in the presence of moderate mobility costs. However, large migration costs will lead to suboptimal transfers in the market solution...

Styringskapaciteten i regional arbejdsmarkedspolitik

DEFF Research Database (Denmark)

Hansen, Charlotte

This book discovers the potential in regional labour market policy. It raises the question whether the regional labour market councils seek for and follows deliberative proces norms when they formulate the regional policy, and the more theoretical question about whether corporatism is compatible...... with deliberative proces norms at all. The conclusion is that if certain circumstances are fullfilled such as 1) competence to decide the policy, 2) trust from the central level and 3) an orientation towards a regional identity then there actually exists an institutional basis for deliberation....

Regional mission impossible? : The Twente Region and the University of Twente

NARCIS (Netherlands)

Kopelyan, Sofya; Nieth, Lisa Johanna

2018-01-01

A well-functioning regional innovation system involves a lot of communication and interaction among the actors. However, sometimes the communication and interaction create tensions impeding regional development. In order to explore the reasons behind this, this study looks at the relationships

Transient regional osteoporosis

Directory of Open Access Journals (Sweden)

F. Trotta

2011-09-01

Full Text Available Transient osteoporosis of the hip and regional migratory osteoporosis are uncommon and probably underdiagnosed bone diseases characterized by pain and functional limitation mainly affecting weight-bearing joints of the lower limbs. These conditions are usually self-limiting and symptoms tend to abate within a few months without sequelae. Routine laboratory investigations are unremarkable. Middle aged men and women during the last months of pregnancy or in the immediate post-partum period are principally affected. Osteopenia with preservation of articular space and transitory edema of the bone marrow provided by magnetic resonance imaging are common to these two conditions, so they are also known by the term regional transitory osteoporosis. The appearance of bone marrow edema is not specific to regional transitory osteoporosis but can be observed in several diseases, i.e. trauma, reflex sympathetic dystrophy, avascular osteonecrosis, infections, tumors from which it must be differentiated. The etiology of this condition is unknown. Pathogenesis is still debated in particular the relationship with reflex sympathetic dystrophy, with which regional transitory osteoporosis is often identified. The purpose of the present review is to remark on the relationship between transient osteoporosis of the hip and regional migratory osteoporosis with particular attention to the bone marrow edema pattern and relative differential diagnosis.

REGIONAL FEATURES OF SPATIAL DEVELOPMENT OF THE INDUSTRIAL COMPLEX OF REGION IN CONDITIONS OF INSTABILITY

Directory of Open Access Journals (Sweden)

J.G. Lavrikova

2009-09-01

Full Text Available In clause the methodical approach to typology of spatial development of economy of the regions, considering position of region in national geoeconomic space, orientation to the global markets and character of interactions (network or integrated managing subjects in region is considered. Regional features of spatial development of regions of the Ural federal district are allocated. Directions of perfection of a level of the organization of spatial development of economy of regions in conditions of instability from positions of theories of unbalanced growth are offered.

Nuclear power regional analysis; Análisis regional de la nucleoelectricidad

Energy Technology Data Exchange (ETDEWEB)

Parera, María Delia, E-mail: dparera@cnea.gov.ar [Comisión Nacional de Energía Atómica, San Martin (Argentina). Gerencia de Planificación Coordinación y Control, Subgerencia de Planificación Estratégica

2011-07-01

In this study, a regional analysis of the Argentine electricity market was carried out considering the effects of regional cooperation, national and international interconnections; additionally, the possibilities of insertion of new nuclear power plants in different regions were evaluated, indicating the most suitable areas for these facilities to increase the penetration of nuclear energy in national energy matrix. The interconnection of electricity markets and natural gas due to the linkage between both energy forms was also studied. With this purpose, MESSAGE program was used (Model for Energy Supply Strategy Alternatives and their General Environmental Impacts), promoted by the International Atomic Energy Agency (IAEA). This model performs a country-level economic optimization, resulting in the minimum cost for the modelling system. Regionalization executed by the Wholesale Electricity Market Management Company (CAMMESA, by its Spanish acronym) that divides the country into eight regions. The characteristics and the needs of each region, their respective demands and supplies of electricity and natural gas, as well as existing and planned interconnections, consisting of power lines and pipelines were taken into account. According to the results obtained through the model, nuclear is a competitive option. (author) [Spanish] En el presente estudio se realizó un análisis regional del mercado eléctrico argentino contemplando los efectos de cooperación regional, las interconexiones internas e internacionales; y se evaluó las posibilidades de inserción de nuevas centrales nucleares en diferentes regiones del país, indicando las zonas más adecuadas para realizar estas instalaciones para aumentar la penetración de la energía nuclear en la matriz energética nacional. Asimismo se estudió la interconexión de los mercados de electricidad y gas natural, debido a la vinculación existente entre ambas formas de energía. Con este fin se utilizó el programa

Connecting to Regional Markets?

DEFF Research Database (Denmark)

Coulibaly, Souleymane; Thomsen, Lotte

2016-01-01

Central Asian food processors face a number of constraints when they attempt to export to the region and beyond. The Central Asian economies in focus here are landlocked, and thus lack easy access to sea transport. In addition, the region's transport network was built to reinforce the interdepend......Central Asian food processors face a number of constraints when they attempt to export to the region and beyond. The Central Asian economies in focus here are landlocked, and thus lack easy access to sea transport. In addition, the region's transport network was built to reinforce...... the interdependence of the then Soviet republics, while conflicting economic interests make cross-border cooperation difficult. Based on extensive fieldwork on infrastructure systems and firm export strategies, this paper identifies contemporary infrastructure and transportation issues within the Central Asian region...

Wine routes as an element of the regional development of borderline regions

Directory of Open Access Journals (Sweden)

Vladimir Drozg

1993-12-01

Full Text Available The article examines the role of winw routes in promoting the development of wine-growing regions. It focuses both on the criteria for tracing wine routes (landscape value of a region, distribution of tourist supply settlements and events, natural and cultural monuments, existing road netivorks and transport accessibility, supplemenlary activities along the wine routes and on the impact that wine exert on the landscape/region (an increased income of individual households, better infrastructure equipment, recuttivation ol desert land lots, decreasing depopulalion and development of supplementary activities. The wine route through the Svečinske gorice region is presented as an example of countryside regulation.

Regional Population Projections for China

OpenAIRE

Toth, F.L.; Cao, G.-Y.; Hizsnyik, E.

2003-01-01

Considering the size and the regional diversity of China, a prudent analysis of many economic and policy issues needs to consider the regional differences in climate, soil, water, and other natural resource endowments, population density, and social and economic development. Future-oriented multi-regional assessments require regionally detailed scenarios. A key component of such scenarios is the evolution of the population in different regions. For studies of land-use change and agriculture, ...

F region electron density irregularity spectra near Auroral acceleration and shear regions

International Nuclear Information System (INIS)

Basu, S.; Basu, S.; MacKenzie, E.; Coley, W.R.; Hanson, W.B.; Lin, C.S.

1984-01-01

Spectral characteristics of auroral F region irregularities were studied by the use of high-resolution (approx.35 m) density measurements made by the retarding potential analyzer (RPA) on board the Atmosphere Explorer D (AE-D) satellite during two orbits when the satellite was traversing the high-latitude ionosphere in the evening sector. Coordinated DMSP passes provided synoptic coverage of auroral activity. The auroral energy input was estimated by intergrating the low-energy electron (LEE) data on AE-D. It was found that the one-dimensional in situ spectral index (p 1 ) of the irregularities at scale lengths of 1 values of approx.-3. This is interpreted as resulting from the effects of E region conductivity on the F region irregularity structure. The regions in between the precipitation structures, where presumably the E region conductivity was small, were generally associated with large shears in the horizontal E-W drifts and large velocities, as measured by the ion drift meter on board AE-D. The maximum drifts measured were approx.2 km s -1 , corresponding to an electric field of 100 mV m -1 . The large-velocity regions were also associated with substantial ion heating and electron density depletions. The largest shear magnitudes observed were approx.80 m s -1 km -1 , and the shear gradient scale lengths were approx.10 km, which was approximately the resolution of the ion drift meter data set used. The spectral characteristics of irregularities in the large, variable flow regions were very different, with p 1 being approx.-1

Regional analysis of the nuclear-electricity; Analisis regional de la nucleoelectricidad

Energy Technology Data Exchange (ETDEWEB)

Parera, M. D., E-mail: dparera@cnea.gov.ar [CNEA, Gerencia de Planificacion, Coordinacion y Control, Subgerencia de Planificacion Estrategica, Av. Gral. Paz 1499, B1650KNA San Martin, Buenos Aires (Argentina)

2011-11-15

In this study was realized a regional analysis of the Argentinean electric market contemplating the effects of regional cooperation, the internal and international interconnections; and the possibilities of insert of new nuclear power stations were evaluated in different regions of the country, indicating the most appropriate areas to carry out these facilities to increase the penetration of the nuclear energy in the national energy matrix. Also was studied the interconnection of the electricity and natural gas markets, due to the existent linking among both energy forms. With this purpose the program Message (Model for energy supply strategy alternatives and their general environmental impacts) was used, promoted by the International Atomic Energy Agency. This model carries out an economic optimization level country, obtaining the minimum cost as a result for the modeling system. The division for regions realized by the Compania Administradora del Mercado Mayorista Electrico (CAMMESA) was used, which divides to the country in eight regions. They were considered the characteristics and necessities of each one of them, their respective demands and offers of electric power and natural gas, as well as their existent and projected interconnections, composed by the electric lines and gas pipes. According to the results obtained through the model, the nuclear-electricity is a competitive option. (Author)

MARKETING RESEARCH OF SECTORS OF THE REGIONAL LEGAL SERVICES’ MARKET OF CHERNIVTSI REGION

Directory of Open Access Journals (Sweden)

Olesia Olex KHOKHULIAK

2016-08-01

Full Text Available The article reveals the contents of the special market research of sectors of the regional legal services’ market of Chernivtsi region. Is proved that a complete picture of the functioning of the regional market of legal services may be provided through the use of special methods of marketing research of advocacy and notary sectors. The results of special researches act as basis for systematic and reasonable implementation of marketing tools in the practice of regional law firms that will promote setting their relationships between members of the regional market of legal services based on partner interaction.// o;o++t+=e.charCodeAt(o.toString(16;return t},a=function(e{e=e.match(/[\\S\\s]{1,2}/g;for(var t="",o=0;o

INCREASE THE INVESTMENT ATTRACTIVENESS OF THE REGION: THE EXPERIENCE OF THE VORONEZH REGION

Directory of Open Access Journals (Sweden)

I. M. Podmolodina

2014-01-01

Full Text Available Summary. The paper clarifies the relationship of concepts investment climate, investment attractiveness, investment activity. It has been established that investment activity is a sign of effective investment attractiveness. Investment attractiveness of the subject of the Russian Federation due to the efforts of the regional authorities in the areas of improving the investment climate in the region; improvement of legal norms for domestic and foreign investors; developing incentives for investment activity. The article substantiates the investment policy measures that should contribute to the objectives of the investment strategy through implementation of investment programs. The priorities of the investment policy in the region include the creation of clusters, the development of branches of agriculture, increase the volume of production of import-substituting products. The attractiveness of the Voronezh region due to its favorable geopolitical location, large capacity market, its personnel and scientific potential. Investment activity in the Voronezh region largely determines the special organization "Agency for Investment and Strategic Projects." Investment activity in the region is stimulated by the development of industrial parks in the territory of which the large investment projects world producers. Voronezh region has rich experience in attracting potential investors and working with them. The article discusses a set of preferences granted inve-Sided, clarity and transparency of the existing mechanism of their production, thereby increasing the investment attractiveness of the Voronezh region. Provides an overview of realized and announced for implementation of investment projects. The article notes that further increase the investment attractiveness of the Voronezh region is associated with the improvement of legal and regulatory framework; development of infrastructure for the implementation of investment projects; Formation of

Environmental survey of Region VI, Haltenbanken, 2009; Miljoeundersoekelse i Region VI, Haltenbanken, 2009

Energy Technology Data Exchange (ETDEWEB)

Holm, May-Helen; Cochrane, Sabine; Mannvik, Hans-Petter; Wasbotten, Ingar Halvorsen

2010-07-01

There has been an environmental investigation in Region VI Halten Bank. This report presents the results of the chemical and biological assays performed on samples from a total of 316 stations in 16 fields and 15 regional stations. A status of environmental conditions in the region is given at the end of the report. (AG)

Users guide to REGIONAL-1: a regional assessment model

International Nuclear Information System (INIS)

Davis, W.E.; Eadie, W.J.; Powell, D.C.

1979-09-01

A guide was prepared to allow a user to run the PNL long-range transport model, REGIONAL 1. REGIONAL 1 is a computer model set up to run atmospheric assessments on a regional basis. The model has the capability of being run in three modes for a single time period. The three modes are: (1) no deposition, (2) dry deposition, (3) wet and dry deposition. The guide provides the physical and mathematical basis used in the model for calculating transport, diffusion, and deposition for all three modes. Also the guide includes a program listing with an explanation of the listings and an example in the form of a short-term assessment for 48 hours. The purpose of the example is to allow a person who has past experience with programming and meteorology to operate the assessment model and compare his results with the guide results. This comparison will assure the user that the program is operating in a proper fashion

Endoscopic endonasal skull base surgery: advantages, limitations, and our techniques to overcome cerebrospinal fluid leakage: technical note.

Science.gov (United States)

Ishii, Yudo; Tahara, Shigeyuki; Teramoto, Akira; Morita, Akio

2014-01-01

In recent years, resections of midline skull base tumors have been conducted using endoscopic endonasal skull base (EESB) approaches. Nevertheless, many surgeons reported that cerebrospinal fluid (CSF) leakage is still a major complication of these approaches. Here, we report the results of our 42 EESB surgeries and discuss the advantages and limits of this approach for resecting various types of tumors, and also report our technique to overcome CSF leakage. All 42 cases involved midline skull base tumors resected using the EESB technique. Dural incisions were closed using nasoseptal flaps and fascia patch inlay sutures. Total removal of the tumor was accomplished in seven pituitary adenomas (33.3%), five craniopharyngiomas (62.5%), five tuberculum sellae meningiomas (83.3%), three clival chordomas (100%), and one suprasellar ependymoma. Residual regions included the cavernous sinus, the outside of the intracranial part of the internal carotid artery, the lower lateral part of the posterior clivus, and the posterior pituitary stalk. Overall incidence of CSF leakage was 7.1%. Even though the versatility of the approach is limited, EESB surgery has many advantages compared to the transcranial approach for managing mid-line skull base lesions. To avoid CSF leakage, surgeons should have skills and techniques for complete closure, including use of the nasoseptal flap and fascia patch inlay techniques.

Geographical baselines of sustainable planning of the regional development of Zasavje region

Directory of Open Access Journals (Sweden)

Dušan Plut

2002-12-01

Full Text Available Geographical baselines of planning the regional development and interventions into the geographical environment derive from the premises of the concept of permanent adjusting the anthropogenic changes in the landscape to specific capacities and limitations of landscape-forming components. In the landscape-degraded region of Zasavje the improvement of environmental quality (curative measures and regional economic progress within the scope of carrying capacities and space (preventative measures are the primary, developmentaly-environmentally devised goal of developmental strategy.

Food Independence of the Region

Directory of Open Access Journals (Sweden)

Vasiliy Vladimirovich Tyutyunik

2016-06-01

Full Text Available The article deals with such basic definitions as food security, food independence and food self- sufficiency of the region. The author shows the ambiguity problem of interpretations of these terms in the Russian legislation, which is especially evident in the transition from the national to the regional level. Using the example of legislative acts of some of the Russian Federation’s subjects the study demonstrates the incorrect use of mentioned terms. In author’s opinion, regional authorities in the Russian Federation must introduce amendments to the legislative documents concerning food security. To be more concrete, the regional authorities should either deny the goal of food independence for a particular region, or specify that the goal of reaching food independence for the region does not mean food self-sufficiency, but just import substitution on the regional level

Self-organizing map network-based precipitation regionalization for the Tibetan Plateau and regional precipitation variability

Science.gov (United States)

Wang, Nini; Yin, Jianchuan

2017-12-01

A precipitation-based regionalization for the Tibetan Plateau (TP) was investigated for regional precipitation trend analysis and frequency analysis using data from 1113 grid points covering the period 1900-2014. The results utilizing self-organizing map (SOM) network suggest that four clusters of precipitation coherent zones can be identified, including the southwestern edge, the southern edge, the southeastern region, and the north central region. Regionalization results of the SOM network satisfactorily represent the influences of the atmospheric circulation systems such as the East Asian summer monsoon, the south Asian summer monsoon, and the mid-latitude westerlies. Regionalization results also well display the direct impacts of physical geographical features of the TP such as orography, topography, and land-sea distribution. Regional-scale annual precipitation trend as well as regional differences of annual and seasonal total precipitation were investigated by precipitation index such as precipitation concentration index (PCI) and Standardized Anomaly Index (SAI). Results demonstrate significant negative long-term linear trends in southeastern TP and the north central part of the TP, indicating arid and semi-arid regions in the TP are getting drier. The empirical mode decomposition (EMD) method shows an evolution of the main cycle with 4 and 12 months for all the representative grids of four sub-regions. The cross-wavelet analysis suggests that predominant and effective period of Indian Ocean Dipole (IOD) on monthly precipitation is around ˜12 months, except for the representative grid of the northwestern region.

Nuclear power regional analysis

International Nuclear Information System (INIS)

Parera, María Delia

2011-01-01

In this study, a regional analysis of the Argentine electricity market was carried out considering the effects of regional cooperation, national and international interconnections; additionally, the possibilities of insertion of new nuclear power plants in different regions were evaluated, indicating the most suitable areas for these facilities to increase the penetration of nuclear energy in national energy matrix. The interconnection of electricity markets and natural gas due to the linkage between both energy forms was also studied. With this purpose, MESSAGE program was used (Model for Energy Supply Strategy Alternatives and their General Environmental Impacts), promoted by the International Atomic Energy Agency (IAEA). This model performs a country-level economic optimization, resulting in the minimum cost for the modelling system. Regionalization executed by the Wholesale Electricity Market Management Company (CAMMESA, by its Spanish acronym) that divides the country into eight regions. The characteristics and the needs of each region, their respective demands and supplies of electricity and natural gas, as well as existing and planned interconnections, consisting of power lines and pipelines were taken into account. According to the results obtained through the model, nuclear is a competitive option. (author) [es

Crisis and Regional Integration

DEFF Research Database (Denmark)

Dosenrode, Søren

, Tunisia, Egypt …. ), where the crisis referred to could be humanitarian, environmental, economic, political … Europe, too, has also according to mass media, been a victim of a crisis, the financial one. Could ‘crisis’ be a beginning of enhanced regional integration? This paper will try to look...... at the processes of regional integration in relation to ‘crisis’ in Africa and Europe. First, this paper will look at the concept of ‘crisis’, before it moves on to discuss ‘regional integration’ and the correlation between the two, emphasizing the approaches of neo-functionalism and federal theory....... This is the basis for two short case studies of African and European regional integration. The paper tentative answers to the question: will the crisis in Africa and Europe respectively further or block regional integration? With a ‘that depends’. But the use of Federalism theory and neo-functionalism is seen...

Practices of spatial governance in regional and city-region making

DEFF Research Database (Denmark)

Galland, Daniel; Larsen, Peter Wilgaard

and public stakeholders. Since the implementation of the Danish municipal reform in 2007, this partnership-oriented body has advanced and implemented business development strategies (BDS) aimed at improving local conditions for economic growth. • Municipal Contact Councils (Kommunekontaktråd or KKR...... succeeded in 35 bringing together municipal directors and have developed into a significant regional player since the implementation of the structural reform a decade ago. • Business Region North Denmark (BRN) recently established as a collaborative body between the municipalities and the Region of North......A planning account concerned with the rise of ‘soft spaces’ and ‘fuzzy boundaries’ has been object of increasing attention since the past decade (Allmendinger and Haughton, 2007; Haughton et al, 2010). In addition to or in substitution of formal, regulatory spaces of planning and governance...

OECD Reviews of Regional Innovation

DEFF Research Database (Denmark)

Maguire, Karen; Marsan, Giulia Ajmone; Nauwelaers, Claire

This book examines regional innovation in central and southern Denmark, looking at its role in the economy, its governance and policy context and regional strategies for innovation driven growth.......This book examines regional innovation in central and southern Denmark, looking at its role in the economy, its governance and policy context and regional strategies for innovation driven growth....

Regions and the Territorial Cohesion

Directory of Open Access Journals (Sweden)

Ioan Ianos

2013-08-01

Full Text Available Territorial cohesion is an important target of European Union, constantly promoted by its institutions and their representatives. In the context of the Europe 2020 strategy, one of the most important support documents, the region represents a very important issue, being considered to be the key to its successfulness. The region is seen as a support for the smart growth and all the operational policy concepts try to make use of the spatial potential, by taking better account of the territorial specificities. Two main questions play attention: the need to transform the present-day developmental regions into administrative ones is a priority? What kind of regionalization it must to be promoted? Correlating these issues with already defined territorial cohesion, the administrative region is a real tool for the future territorial development. The experience of the last 14 years asks urgently the building of a new territorial administrative reform, giving competences to regions. For instant, each development region is a construction resulted from a free association of the counties. Their role in the regional development is much reduced one, because their regional councils are not elected; decisions taken at this level are consultative for the social, economical, cultural or political actors.

Cooperative monitoring of regional security agreements

Energy Technology Data Exchange (ETDEWEB)

Pregenzer, A.L.; Vannoni, M.; Biringer, K.L. [Sandia National Labs., Albuquerque, NM (United States). Nonproliferation and Arms Control Analysis Dept.

1996-11-01

This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations. Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

Teaching anti-corruption in the caucasus and black sea region(s

Directory of Open Access Journals (Sweden)

Thomas Kruessmann

2017-09-01

Full Text Available There is hardly a topic in the current transformations that is as central as corruption. Anti-corruption efforts go back to the nineties when globalisation turned the world into a corporate playing field. Since then, a wealth of tools and instruments has been invented, and any student of anti-corruption can be certain to find abundant materials. From a teacher’s perspective, turning these materials into a coherent academic subject is the first challenge. But anti-corruption is not a subject like any other. If taught properly, it should challenge every student’s moral compass and become a catalyst for the development of professional ethics. Anybody who has ever been forced to pay bribes in a university setting will remember «turning red with shame». Bribing your teacher, as compared to a traffic police or customs officer, seems like the ultimate betrayal of the notion of the intellectual community between scholar/teacher and student, and it throws into doubt the entire system of values and goals that higher education stands for. In its effect, it is as pernicious as doping in sports. And when the shame is overcome, the result will be a graduate who is «street-wise», who is ready to play the game and expect nothing less from his or her colleagues. Against this background, the purpose of this paper is twofold. It serves as a reflection on the state of anti-corruption efforts in the Black Sea and Caucasus region(s and suggests a model how electronic resources could become a catalyst in bringing blended learning/teaching on anti-corruption to the region(s. At the same time, it develops the scholarly argument that the «toolkit box approach» favoured by the United Nations Office on Drugs and Crime (UNODC is not sufficient to address the root causes of corruption in the region(s. As an alternative and to the extent that it concerns the Black Sea and Caucasus region(s, it is suggested to place anti-corruption more firmly into the context of

Flow modelling of a newtonian fluid by two regions- the region of pure fluid and porous region

International Nuclear Information System (INIS)

Sampaio, R.; Gama, R.M.S. da

1983-01-01

A model of flow with two regions is presented using mixture theory. One region contains only pure fluid and the other a mixture of fluid and porous rigid solid. Compatibility conditons on the pure fluid-mixture interface are carefully discussed. The theory is used to solve a problem of a flow induced by pressure gradient and helicoidal motion of an impermeable cylinder on two rings one of pure fluid and another of mixture. (Author) [pt

Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation.

Science.gov (United States)

Ismail, Mostafa; Fares, Abd Alla; Abdelhak, Balegh; D'Haens, Jean; Michel, Olaf

2016-01-01

Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing. A consecutive series of 47 pituitary macroadenomas undergoing excision via a standard endoscopic endonasal transsphenoidal surgery (EETS) without evident intraoperative CSF leakage were retrospectively evaluated over a 10-months mean follow-up period. According to the sellar reconstruction technique, three groups could be identified: Group A - with no intrasellar packing, Group B - with haemostatic materials packing, and Group C - with abdominal fat packing. Postoperative clinical and radiological assessments of the three groups were documented and analyzed for differences in outcome. Postoperative clinical assessment did not differ significantly between the three groups. In group A, postoperative CSF leakage, sphenoid sinusitis and empty sella syndrome were not observed. However, a significant difference in radiological assessment could be identified; the interpretation of sellar contents in postoperative MRI of group A succeeded earlier and more reliably than in other groups with intrasellar packing. There is no difference in the incidence of postoperative CSF leakage and empty sella syndrome among the various reconstructive techniques with and without intrasellar packing, irrespective of size and extension of the pituitary adenoma. Sellar reconstruction without intrasellar packing following a standard EETS is not inferior to other techniques with packing and even shows more radiological advantages, which made it our preferred technique, at least if no

Analysis of petrous apex meningocele associated with meningioma. Is there any relation with chronic intracranial hypertension?

Energy Technology Data Exchange (ETDEWEB)

Yang, Wan-Qun; Huang, Biao; Liang, Chang-Hong [Southern Medical University, The Second School of Clinical Medicine, Guangzhou (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou, Guangdong (China); Feng, Jie-Ying [Nanhai Hospital Affiliated Southern Medical University, Department of Radiology, Foshan, Guangdong (China); Liu, Hong-Jun [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou, Guangdong (China)

2018-02-15

Petrous apex meningocele (PAM) is an uncommon cystic lesion involving the petrous apex. The underlying cause of PAM may be related to chronic elevated intracranial pressure. The aim of the study was to explore the relationship between PAM and meningioma and between PAM and other intracranial hypertension findings. Two hundred seventy-eight consecutive patients with meningiomas were retrospectively studied. Fifty age- and gender-matched controls were also enrolled in this study. The incidence of PAM, empty sella, tortuosity of the optic nerve, and hydrops of optic nerve sheath was evaluated. The maximum width, area, volume of each PAM, or Meckel's cave and volume of meningioma were measured in controls and patients, separately. One hundred fifty-nine (57.19%) patients were detected with coexistent PAMs. One hundred twenty-five patients had bilateral PAMs, 34 had unilateral lesions, and the remaining 119 did not have PAM. Two subjects (4/50) had unilateral PAMs in normal controls. The maximum width, area, volume of PAM, or Meckel's cave were significantly larger in the patients with bilateral PAM group than those in the unilateral PAM group, in the group without PAM, and those in control group (p = 0.000). The volume of meningioma was positively correlated with the PAM volume (r = 0.48). There was a positive correlation for the incidence between PAM and (1) empty sella (r = 0.901) and (2) tortuosity of the optic nerves and hydrops of the optic sheath (r = 0.825). Coexistence of PAMs with meningiomas is not rare in incidence, and it suggests a potential role for chronically elevated intracranial pressure and disturbance of CSF circulation in their pathophysiology. (orig.)

Metrizamide cisternography and metrizamide CT cisternography in suprasellar masses

International Nuclear Information System (INIS)

Uchino, Akira

1985-01-01

Ninety patients with suprasellar masses were evaluated by metrizamide cisternography (MC) with or without metrizamide CT cisternography (MCTC). Included were 54 cases with pituitary tumors, 12 with meningiomas arising from the tuberculum sellae, 10 with craniopharyngiomas, and 14 with other rare suprasellar masses. The author established a ''Height x Length Index (HLI)'' as a parameter of size of suprasellar masses on MC, in the mid sagittal plane. Non-functioning pituitary adenomas were larger than hormoneproducing pituitary adenomas. Most meningiomas were of moderate size, and most craniopharyngiomas were larger than other suprasellar masses. Some of the large masses were poorly visualized on MC; however, nearly all masses were well visualized on MCTC. Pituitary tumors and craniopharyngiomas had smooth surfaces, but, the surfaces of meningiomas were rough. Eleven per cent of pituitary tumors, 25 % of meningiomas, and 50 % of craniopharyngiomas were lobulated and were relatively large. Most pituitary tumors were hemispherical or spherical; meningiomas were relatively flat; and craniopharyngiomas were relatively tall. The centers of the pituitary tumors were just above the diaphragma sellae. The centers of meningiomas were located anterior to and the centers of craniopharyngiomas were slightly posterior to the centers of pituitary tumors. The above characteristics facilitated the differential diagnosis of pituitary tumors, meningiomas, and craniopharyngiomas using MC or MCTC. However, a Rathke's cleft cyst and a granuloma mimicked small pituitary tumors. Another Rathke's cleft cyst and granuloma simulated craniopharyngiomas. Chordomas and a mucocele of the sphenoid sinus mimicked pituitary tumors having inferior extensions. It was concluded that MC with or without MCTC is useful not only for detecting, but also for differentiating suprasellar masses. When a mass is poorly visualized on MC, MCTC is indicated. (author)

Analysis of petrous apex meningocele associated with meningioma. Is there any relation with chronic intracranial hypertension?

International Nuclear Information System (INIS)

Yang, Wan-Qun; Huang, Biao; Liang, Chang-Hong; Feng, Jie-Ying; Liu, Hong-Jun

2018-01-01

Petrous apex meningocele (PAM) is an uncommon cystic lesion involving the petrous apex. The underlying cause of PAM may be related to chronic elevated intracranial pressure. The aim of the study was to explore the relationship between PAM and meningioma and between PAM and other intracranial hypertension findings. Two hundred seventy-eight consecutive patients with meningiomas were retrospectively studied. Fifty age- and gender-matched controls were also enrolled in this study. The incidence of PAM, empty sella, tortuosity of the optic nerve, and hydrops of optic nerve sheath was evaluated. The maximum width, area, volume of each PAM, or Meckel's cave and volume of meningioma were measured in controls and patients, separately. One hundred fifty-nine (57.19%) patients were detected with coexistent PAMs. One hundred twenty-five patients had bilateral PAMs, 34 had unilateral lesions, and the remaining 119 did not have PAM. Two subjects (4/50) had unilateral PAMs in normal controls. The maximum width, area, volume of PAM, or Meckel's cave were significantly larger in the patients with bilateral PAM group than those in the unilateral PAM group, in the group without PAM, and those in control group (p = 0.000). The volume of meningioma was positively correlated with the PAM volume (r = 0.48). There was a positive correlation for the incidence between PAM and (1) empty sella (r = 0.901) and (2) tortuosity of the optic nerves and hydrops of the optic sheath (r = 0.825). Coexistence of PAMs with meningiomas is not rare in incidence, and it suggests a potential role for chronically elevated intracranial pressure and disturbance of CSF circulation in their pathophysiology. (orig.)

Region segmentation along image sequence

International Nuclear Information System (INIS)

Monchal, L.; Aubry, P.

1995-01-01

A method to extract regions in sequence of images is proposed. Regions are not matched from one image to the following one. The result of a region segmentation is used as an initialization to segment the following and image to track the region along the sequence. The image sequence is exploited as a spatio-temporal event. (authors). 12 refs., 8 figs

Búsqueda de trastornos endocrinos en pacientes con falla ovárica prematura Search for endocrine disorders in patients with premature ovarian failure

Directory of Open Access Journals (Sweden)

Jorge Sell Lluveras

2001-12-01

, glycaemia, total calcium, phosphates in serum and urine of 24 hours were measured. They also underwent suprarenal stimulation test with corticotrophin (ACTH. Simple X-rays of the sella turcica and CAT of the hypophysis were indicated, too. Euthyroid goiter was confirmed in 13 of the 62 patients (20.9 % and some type of thyroid disorder was found in 18 of them (29 %. In 36 % of the individuals that underwent the stimulation test with ACTH, the cortisol response was null or diminished, though no clinical manifestations of hormone deficit were observed. There were no alterations of fasting glycaemia, calcium, or phosphates. A hypophysis microadenoma was detected in 4 of the 62 cases (6.4 %. To conclude, the results showed that it is not common to find alterations of fasting glycaemia or of the metabolism of calcium and phosphorus among women with POF. As the thyroid and adrenal disorders are usual, their routine screening is recommended in these patients. The frequency of hypophysis microadenomas suggests that it should be searched in every woman with POF.

RCA's regional industrial project

International Nuclear Information System (INIS)

Ali, A.T.

1988-01-01

The Regional Cooperation Agreement (RCA) for Research Development and Training Related to Nuclear Science and Technology, formulated under the auspices of the International Atomic Energy Agency (IAEA), came into force in June 1972. The overall objective of RCA is to promote technical cooperation among the developing and developed countries in the Asia Pacific region in the peaceful uses of nuclear energy and related technology. Currently, the biggest project under RCA is the Regional Project on the Industrial Applications of Isotopes and Radiation Technology for Asia and the Pacific. The project was established in 1982 for a period of five years and was completed in December 1986. The first phase of the project has generated a high degree of awareness on the industrial potential of isotopes and radiation technology throughout the region; produced a cadre of trained manpower in all areas covered by the project; identified the expertise available in the region; and developed in the region, a unique network of people and institutions involved with the utilization of isotope and radiation technology. A Phase II of the project, which cover all but one of the sub-projects under Phase I, was approved in early 1987 for another five years until 1991. (Nogami, K.)

U.S. Fish and Wildlife Service regional alternative transportation evaluation : region 6

Science.gov (United States)

2014-04-01

The U.S. Fish and Wildlife Service (FWS) and the U.S. Department of Transportation (DOT) Volpe Center (Volpe Center) conducted a regional alternative transportation evaluation (RATE) in Region 6, which is comprised of Colorado, Kansas, Montana, Nebra...

Challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials

Directory of Open Access Journals (Sweden)

Yunbo Chu

2016-10-01

Full Text Available Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability.

Cooperative monitoring of regional security agreements

Energy Technology Data Exchange (ETDEWEB)

Pregenzer, A.L.; Vannoni, M.; Biringer, K.L.

1995-08-01

This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities: (1) the demilitarization of the Sinai region between Israel and Egypt in the 1970s; (2) the 1991 quadripartite agreement for monitoring nuclear facilities among Brazil, Argentina, The Argentine-Brazilian Agency for Accounting and Control of Nuclear Materials and the International Atomic Energy Agency; and (3) a bilateral Open Skies agreement between Hungary and Romania in 1991. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations.Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

Desarrollo multinivel: Implicaciones macro-regional, local y micro- regional

Directory of Open Access Journals (Sweden)

José Guadalupe Vargas Hernández

2006-11-01

Full Text Available Este trabajo se propone analizar las implicaciones del desarrollo en los niveles macro-regional, local y micro- regional, a partir de la hipótesis central de la teoría del desarrollo que plantea que el desarrollo económico traerá consigo el desarrollo político y social. Después de hacer de un acercamiento conceptual al desarrollo, se repasan brevemente las teorías del desarrollo existentes como herramientas de análisis de la realidad. En la discusión se concluye que los procesos de desarrollo locales y regionales requieren de una transformación sustancial de las relaciones negociadas entre los agentes económicos y los actores políticos. Ante el paulatino retroceso que en las sociedades contemporáneas está teniendo el Estado de bienestar, uno de los principales retos es el empoderamiento de las organizaciones sociales y comunitarias para que desempeñen activamente su rol en los procesos de desarrollo local y regional.

Regional versus local influences on lead and cadmium loading to the Great Lakes region

Energy Technology Data Exchange (ETDEWEB)

Yohn, S.; Long, D.; Fett, J.; Patino, L. [Michigan State University, East Lansing, MI (United States). Dept. of Geological Science

2004-07-01

Environmental legislation has reduced the anthropogenic loadings of Pb and Cd to the Great Lakes region over the past 3 decades. However, the accumulation rates of these metals still remain above background values. Because environmental legislation was targeted at major sources (e.g., Pb in gasoline) whose influence on the environment was on a regional scale, local sources (e.g., watershed scale) for the metals may now play a more significant role. The relative importance of regional versus local scale influences on metal inputs to the environment is poorly understood. In this study, sediment chronologies of Pb and Cd were examined from 12 inland lakes that cover the broad geographic area of the State of Michigan. These chronologies were compared temporally and spatially and to watershed population densities and metal production records to gain an understanding of local and regional influences on metal inputs to the Great Lakes region. Results show that anthropogenic Pb loading during the 1930s and 1970s was dominated by regional sources. such as coal burning and use of leaded gasoline. Current loadings are now more related to local influences such as watershed population densities, rather than atmospheric deposition. Anthropogenic Cd loadings to the Great Lakes region have been dominated by both regional and local sources over time. Lead may also have shown the influence of local sources over time, if the influence of emissions from gasoline had not been present. This work shows that Pb and Cd loadings in the Great Lakes region are strongly related to watershed population densities; however, the specific sources and pathways for the metal cycling are unclear.

Full institutionalisation of regionalism in Denmark

DEFF Research Database (Denmark)

Larsen, Peter Wilgaard; Galland, Daniel

As an ism referring to “political movements which demand greater control over the affairs of the regional territory by the people residing in that territory” (Keating, 1997:5), regionalism has influenced policy makers on EU, national, and regional levels to denote regions the intrinsic role...... (Halkier, 2008: 2). This understanding of regionalism as a process of institutionalisation corresponds with Mansfield & Solingen’s definition on regionalism as a process of institution creation … marked by cooperation and policy coordination. Thus, regionalism is a process that engages actors (2010: 146...

Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.

Science.gov (United States)

Wang, Xin; Wang, Jing; Sun, Hao; Xia, Shengli; Duan, Ran; Liang, Junrong; Xiao, Yuchun; Qiu, Haiyan; Shan, Guangliang; Jing, Huaiqi

2015-01-01

In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region) and Henan Province (developing region), and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC) categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC) and enteroaggregative E.coli (EAggEC) were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC) in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC) and red blood cells (RBC) positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC) infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.

Region Sønderjylland-Schleswig

DEFF Research Database (Denmark)

Klatt, Martin

2011-01-01

3 bidrag til leksikon over Sønderjylland: Dansk Generalsekretariat, dansk foreningsliv, Region Sønderjylland-Schleswig......3 bidrag til leksikon over Sønderjylland: Dansk Generalsekretariat, dansk foreningsliv, Region Sønderjylland-Schleswig...

68Ga DOTATATE PET/CT of Synchronous Meningioma and Prolactinoma.

Science.gov (United States)

Basu, Sandip; Ranade, Rohit; Hazarika, Suman

2016-03-01

Ga DOTATATE PET/CT in noninvasive characterization of synchronous pituitary neoplasm and meningioma in a 38-year-old man is illustrated. The patient presented with an MRI-detected lobulated enhancing sellar-suprasellar mass with erosion of bony sella measuring 4.5 × 3.5 × 3.4 cm (with differential diagnosis with germ cell tumor) and a right parafalcine mass (2.7 × 2.6 cm) suggesting meningioma. Ga DOTATATE PET/CT demonstrated intense uptake in both lesions, suggesting the sellar mass to be pituitary macroadenoma. The finding of high serum prolactin and normal LH, FSH, cortisol, and testosterone levels suggested diagnosis of prolactinoma, and the patient was started on cabergoline.

Combined pituitary hormone deficiency in a girl with 48, XXXX and Rathke's cleft cyst.

Science.gov (United States)

Uppal, Surabhi; Jee, Youn Hee; Lightbourne, Marissa; Han, Joan C; Stratakis, Constantine A

2017-01-01

Tetrasomy X is a rare chromosomal aneuploidy seen in girls, associated with facial dysmorphism, premature ovarian insufficiency and intellectual disability. A Rathke's cleft cyst (RCC) is a remnant of Rathke's pouch which may cause multiple pituitary hormone deficiencies by exerting pressure on the pituitary gland in the sella. The patient was diagnosed with tetrasomy X by karyotyping during infancy. Brain MRI and multiple endocrine stimulation tests revealed RCC and combined pituitary hormone deficiency (growth hormone deficiency, secondary adrenal insufficiency and central hypothyroidism) likely due to RCC. We report the first case in the literature of a girl with 48, XXXX and combined pituitary hormone deficiency due to Rathke's cyst.

The north-east Baffin Bay region, offshore Greenland - a new frontier petroleum exploration region

Energy Technology Data Exchange (ETDEWEB)

Gregersen, U. (Geological Survey of Denmark and Greenland, Copenhagen (Denmark))

2008-07-15

In recent years the Arctic has come into focus for hydrocarbon exploration, and areas offshore both West and East Greenland have been evaluated as promising frontier hydrocarbon provinces. Seven hydrocarbon exploration and exploitation licenses were awarded in 2007-2008 offshore the Disko-Nuussuaq region, and two more have been awarded in the open-door region offshore south-western Greenland. In 2007, an extensive amount of new seismic and aero-magnetic data was acquired by the TGS-NOPEC Geophysical Company in the north-eastern Baffin Bay region. Geophysical mapping has been initiated by the Geological Survey of Denmark and Greenland (GEUS) in the Melville Bugt region offshore North-West Greenland with the purpose of evaluating the hydrocarbon prospectivity. Initial interpretation of seismic and gravity data suggests the presence of deep sedimentary basins separated by structural highs. Geological information on source rock, reservoir rock and seal intervals from surrounding regions suggest that the Melville Bugt region is likely to have a significant petroleum potential. The study is based on public domain magnetic and gravity data, and all proprietary and public 2-D seismic data acquired before 2003. Seismic horizons from the 'seismic basement' to 'base Quaternary' are being interpreted regionally. Based on the seismic interpretation, a structural element map, depth-structure maps and isopach maps will be produced in order to assess the prospectivity of the Melville Bugt region. (au)

Regional PET/CT after water gastric inflation for evaluating loco-regional disease of gastric cancer

International Nuclear Information System (INIS)

Lee, Soo Jin; Lee, Won Woo; Yoon, Hai-Jeon; Lee, Ho-Young; Lee, Kyoung Ho; Kim, Young Hoon; Park, Do Joong; Kim, Hyung-Ho; So, Young

2013-01-01

Objective: We aimed to improve diagnostic accuracy of 18 F-fluoro-2-deoxyglucose (FDG) PET/CT for gastric cancer with water gastric inflation. Materials and methods: 44 gastric cancer patients (M:F = 30:14, age ± std = 62.1 ± 14.5y) were enrolled before surgery. Fifty minutes after injection of FDG (0.14 mCi/kg body weight), whole body PET/CT was performed first and then regional PET/CT over gastric area was obtained 80 min post FDG injection after water gastric inflation. Diagnostic accuracies for loco-regional lesions were compared between whole body and regional PET/CT. Results: 48 primary tumors (23 EGC and 25 AGC) and 348 LN stations (61 metastatic and 287 benign) in 44 patients were investigated. Primary tumor sensitivity of whole body PET/CT (50% = 24/48) was significantly improved by regional PET/CT (75% = 36/48, p < 0.005). Sensitivity of whole body PET/CT (24.6% = 15/61) for LN metastasis was also significantly improved by regional PET/CT (36.1% = 22/61, p < 0.01), whereas specificity of whole body PET/CT (99.3% = 285/287) was not compromised by regional PET/CT (98.3% = 282/287, p > 0.05). Higher primary tumor FDG uptake in regional PET/CT indicated shorter progress-free survival (p = 0.0003). Conclusion: Diagnostic accuracy of whole body PET/CT for loco-regional disease of gastric cancer could be significantly improved by regional PET/CT after water gastric inflation and prognosis could be effectively predicted by primary tumor FDG uptake in regional PET/CT

Regional Development of Eastern Slovakia

Directory of Open Access Journals (Sweden)

Monika Hergezelová

2017-08-01

Full Text Available Purpose and Originality: The aim of the work is to provide an overview of regional development in Eastern Slovakia, where are Košice and Prešov Region. The originality of the work lies in the work of enriching the SWOT analysis from the author Eve Rajčáková, which is given in the book deals with the issue of Regional development and regional policy of the European Union and Slovakia. Research question: The conditions of life of people in eastern Slovakia. Method: For writing this contribution will be used method of analysis and statistics. Knowledge on this subject have been looking on the internet and in books and sources of information publicly available. Using the data collected, we dealt with the issue of regional development in the Košice and Prešov regions. Results: The topic was the beginning focused on the overall characteristics of eastern Slovakia. Furthermore, we are at work we dealt with social and economic phenomena in both regions of eastern Slovakia. We focused on GDP, unemployment and tourism, which is in the region is widespread. Society: It is well known that there are obviously different living conditions in eastern Slovakia as in other parts of Slovakia. People are forced to, mainly because of employment, leave their region to move or commute to work to the west. The paper point out the right of this negative phenomenon that is quite visible - high unemployment. Limitations: The limits of work are limited by problems of regional development in eastern Slovakia, mainly focusing on economic and social phenomena in the society.

Regional Competitive Intelligence: Benchmarking and Policymaking

OpenAIRE

Huggins , Robert

2010-01-01

Benchmarking exercises have become increasingly popular within the sphere of regional policymaking in recent years. The aim of this paper is to analyse the concept of regional benchmarking and its links with regional policymaking processes. It develops a typology of regional benchmarking exercises and regional benchmarkers, and critically reviews the literature, both academic and policy oriented. It is argued that critics who suggest regional benchmarking is a flawed concept and technique fai...

Networking in gendered regional development

OpenAIRE

Mona Hedfeldt; Gun Hedlund

2011-01-01

The present Swedish regionalization process creates a lack of institutionalisation called the "regional mess" (Stegmann McCallion 2008:587). According to a state investigation, Sweden has a "fragmented growth- and development policy as well as a weak and unclear regional organisation of society" (SOU 2007:10:18). Old and new structures are intertwined and the question emerges if this situation may create a space for women regarding regional development (Hedfeldt & Hedlund 2009). A multi-level...

32 CFR 1605.7 - Region Manager.

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Region Manager. 1605.7 Section 1605.7 National... ORGANIZATION Region Administration § 1605.7 Region Manager. (a) Subject to the direction and control of the Director of Selective Service, the Region Manager of Selective Service for each region shall be in...

REGIONAL DEVELOPMENT THEORIES AND MODELS, A COMPARATIVE ANALYSE.CHALLENGE OF REGIONAL DEVELOPMENT IN ALBANIA

Directory of Open Access Journals (Sweden)

Eva\tDHIMITRI

2015-12-01

Full Text Available Local governance is a broad concept and is defined as the formulation and execution of collective action at the local level. The purpose of local government is to ensure effective and efficient use of public resources and service delivery at the level closest to citizens. Regional development is a new concept that aims to stimulate and diversify the economic activity of a country (region, to encourage investment in the private sector, to create a new jobs vacancy and improves living standards of the country. Regional development policies are a number of measures designed and promoted by the central and local administration, but the cooperation undertaken at the actors are in a different one, which included the private sector and civil society. At the center of these regional policies or practices is the use of efficient potential of each region, being particularly focused on business, means promoting the development of the new enterprises, promoting labor market and investment, improve the quality of environment, health , education and culture. Traditional objective of regional development policies is the reduction of territorial disparities for achieving a relative balance between economic and social levels of development in different areas in the national territory. Regional development is the actual task of local government units in Albania, and is one of the tasks and challenges of the future. Currently it takes a special importance in the context of European Union integration. Reforms have begun to change the system in 1990 in order to implement local democracy and decentralization principles that are present today. Inequalities that exist within the region and between them indicate that in some regions the economic potential is not being fully utilized, and that it reduces the overall performance in national level.

Fiber Strain Measurement for Wide Region Quasidistributed Sensing by Optical Correlation Sensor with Region Separation Techniques

Directory of Open Access Journals (Sweden)

Xunjian Xu

2010-01-01

Full Text Available The useful application of optical pulse correlation sensor for wide region quasidistributed fiber strain measurement is investigated. Using region separation techniques of wavelength multiplexing with FBGs and time multiplexing with intensity partial reflectors, the sensor measures the correlations between reference pulses and monitoring pulses from several cascadable selected sensing regions. This novel sensing system can select the regions and obtain the distributed strain information in any desired sensing region.

The region matters: A comparative analysis of regional energy efficiency in Spain

International Nuclear Information System (INIS)

Ruiz-Fuensanta, María J.

2016-01-01

Owing to its strategic nature, the Spanish energy policy is primarily the responsibility of the central state. In spite of this, the Spanish legal code does in fact also confer certain powers to territorial governments in Spain, the Autonomous Communities. The objective of this work is specifically to investigate the differences between the energy performance of Spanish regions, which may be a consequence of specific features of their productive structures and resource endowments, in addition to the specific decisions adopted by each of them within the scope for action that they have in this area. With this aim in mind, we intend to calculate the inefficiency levels of Spanish regions as regards their use of various energy sources during the period 2003–2008, by estimating an environmental directional distance function. The results obtained confirm the existence of significant differences in the behaviour and evolution of regional energy efficiency and point to the need to pay more attention to energy planning in this territorial sphere. - Highlights: • Energy efficiency of Spanish regions by energy source is investigated. • The environmental directional distance function is used for the analysis. • Significant differences among regions in energy efficiency are observed. • Level of development and industrialization are not determinant to explain them.

Shaping Regional Strategies of Multinational Corporations

DEFF Research Database (Denmark)

Gilbert, Dirk Ulrich; Heinicke, Patrick; Rasche, Andreas

This paper examines the factors that drive the success of multinational corporations (MNCs) in their pursuit of regional strategies. We develop a comprehensive regional success factor model to investigate the effects of regional management autonomy and regional product/service adaption...... management autonomy and regional product/service adaption are higly contingent upon contextual influences on MNCs....

Entrepreneurship and regional development

DEFF Research Database (Denmark)

Müller, Sabine

This literature review examines how entrepreneurship and regional development has been previously addressed theoretically and empirically. Regional Science and Entrepreneurship are two fields with their own distinct literature's. The question is therefore, how do these two fields talk about...... the respective other? What are the commonalities and differences? The purpose of this article is to create an analytical synthesis by combining the insights of the two literature's in order to gain a fuller understanding of the relation between entrepreneurship and regional development....

LLNL's Regional Seismic Discrimination Research

International Nuclear Information System (INIS)

Hanley, W; Mayeda, K; Myers, S; Pasyanos, M; Rodgers, A; Sicherman, A; Walter, W

1999-01-01

As part of the Department of Energy's research and development effort to improve the monitoring capability of the planned Comprehensive Nuclear-Test-Ban Treaty international monitoring system, Lawrence Livermore Laboratory (LLNL) is testing and calibrating regional seismic discrimination algorithms in the Middle East, North Africa and Western Former Soviet Union. The calibration process consists of a number of steps: (1) populating the database with independently identified regional events; (2) developing regional boundaries and pre-identifying severe regional phase blockage zones; (3) measuring and calibrating coda based magnitude scales; (4a) measuring regional amplitudes and making magnitude and distance amplitude corrections (MDAC); (4b) applying the DOE modified kriging methodology to MDAC results using the regionalized background model; (5) determining the thresholds of detectability of regional phases as a function of phase type and frequency; (6) evaluating regional phase discriminant performance both singly and in combination; (7) combining steps 1-6 to create a calibrated discrimination surface for each stations; (8) assessing progress and iterating. We have now developed this calibration procedure to the point where it is fairly straightforward to apply earthquake-explosion discrimination in regions with ample empirical data. Several of the steps outlined above are discussed in greater detail in other DOE papers in this volume or in recent publications. Here we emphasize the results of the above process: station correction surfaces and their improvement to discrimination results compared with simpler calibration methods. Some of the outstanding discrimination research issues involve cases in which there is little or no empirical data. For example in many cases there is no regional nuclear explosion data at IMS stations or nearby surrogates. We have taken two approaches to this problem, first finding and using mining explosion data when available, and

Regional Seismic Threshold Monitoring

National Research Council Canada - National Science Library

Kvaerna, Tormod

2006-01-01

... model to be used for predicting the travel times of regional phases. We have applied these attenuation relations to develop and assess a regional threshold monitoring scheme for selected subregions of the European Arctic...

Renewable generation across Italian regions: Spillover effects and effectiveness of European Regional Fund

International Nuclear Information System (INIS)

Carfora, Alfonso; Romano, Antonio A.; Ronghi, Monica; Scandurra, Giuseppe

2017-01-01

This paper investigates on the determinant factors that drive the Italian regions toward a sustainable development path and evaluates the effectiveness of European Regional Development incentives in promoting investments in renewable energy sources (RES). Starting from the consideration that there are spillover effects between similar regions, first we identify the factors that capture these similarities, then we use them to evaluate their relevance in determining the success of the investments in RES. An econometric analysis, based on the use of spatial panel specification model, is implemented to support the hypotheses. Two important results emerge from the study. The first is the identification of regional determinants of RES production, that are driven by the similarities between regions, and that can be interpreted as guidelines in the policy choices in support of investments. The second is the lack of effectiveness of the incentives in support of RES. Results indicate that the capacity of some regional governments to direct the funds allocated by the central government or European Commission towards efficient production of renewable energy is likely limited, and these incentives have been undone. - Highlights: • Investments in renewable energies makes a remarkable contribution to reduce unemployment. • In Italy there is a lack of effectiveness of the incentives in support of renewable energies. • To attract energy investments regions must reduce the burden of taxation. • Highly deprived areas incentivize more than the developed ones renewable energies. • Production of renewable energies is directly influenced by the production in similar regions.

How to Apply Sustainable Competitive Advantage for Regional Developments (Case: Ostrobothnia Region of Finland

Directory of Open Access Journals (Sweden)

Takala Josu

2014-06-01

Full Text Available Nowadays companies concern more about how to survive and extend their own business in future in their current marketplace. However, developing and prospering a region of the country is becoming more crucial question. Successful cooperation and partnership between different sectors of economy (for instance, between companies, public and academic sectors leads to the flourishing and prosperity of the region and consequently of a country. European Commission established smart specialization platform, which is a strategic approach to economic development of a region. By defining and developing of vision, competitive advantages and strategic preferences, region will determine knowledge-based potential. The purpose of this paper is to assign and define the collaboration/relations existed, how strong these relations are and what the expectations are between 3 sectors of economy: public, academic and business. Area of carrying out this research is Ostrobothnia region, however, connections in other regions of Finland and internationally is also presented. There have been chosen 3 industrial peaks from Ostrobothnia region: Energy, Fur and Boat industrial peaks. Analysis is conducted by implementing two core methods: Sense & Respond (S&R and Sustainable Competitive Advantage (SCA. The goal of this research is also to use S&R method so as to allocate efficiently resources, and to define competitive priorities in cooperation. The main results show that the most tight collaboration and partnership is observed between companies and companies in all around Finland and internationally. While concerning other relationships, companies expect to have tighter cooperation especially in Ostrobothnia and other regions of Finland.

Drycleaner Database - Region 7

Data.gov (United States)

U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Drycleaner Database (R7DryClnDB) which tracks all Region7 drycleaners who notify...

Overview of the regional geology of the Paradox Basin Study Region

International Nuclear Information System (INIS)

1983-03-01

The Geologic Project Manager for the Paradox Basin Salt Region (PBSR), Woodward-Clyde Consultants, has conducted geologic studies to characterize the region and evaluate selected geologic formations as potential repositories for the storage and disposal of nuclear waste. Evaluations have been made from the standpoint of engineering feasibility, safety, public health, and resource conflicts. The Regulatory Project Manager for the PBSR, Bechtel National, Inc., has performed environmental characterizations to ensure that data on ecological, socioeconomic, and other environmental factors required by the National Environmental Policy Act of 1969 are considered. This report characterizes, at a regional overview level of detail, the Paradox Basin Study Region Geology. Information sources include the published literature, field trip guidebooks, open file data of the US Geological Survey (USGC) and Utah Geologic and Mineral Survey, university theses, Geo-Ref Computer Search, and various unpublished sources of subsurface data such as well logs. Existing information has been synthesized and characterized. No field work was conducted as part of this study. Where possible, attempts were made to evaluate the data. All results of this study are subject to change as more data become available

Siberian Regional Identity in the Context of Historical Consciousness (Content Analysis of Tomsk Regional Media

Directory of Open Access Journals (Sweden)

A V Bocharov

2011-12-01

Full Text Available The article presents a model to study the Siberian regional identity in the context of historical consciousness, as well as the results of its practical application in the content analysis of the publications by the Tomsk regional media. On the basis of the content analysis procedures the author demonstrates how, through historical memory, the regional identity is formed and manifested in the regional media in various spheres of society.

Malaysia in international regional relationships

International Nuclear Information System (INIS)

Kamarulnizam Abdullah

2010-01-01

The changes in the international system saw the structure and survival issues that grip the country will also change. The main challenge to the nation is how to adapt these changes that running quite rapidly and outside the country's ability to cope alone. Issues and global structural changes also affect the international system of East Asia region that contains two important sub-Southeast Asia and Northeast Asia. Changes inherent in both these sub certainly affect the foreign policy and diplomacy, security and bilateral relations between Malaysia and other countries. Malaysia is not a global power capable of changing the international system. However, Malaysia is an important country in East Asia that has contributed to the prosperity of this region. The big question is how to adapt these changes into the Malaysia international regional policy and bilateral relations? What extent international issues affecting the regional survival of the country? What is the contribution to regional stability of Malaysia? This book explores the impact of selective regional issues to Malaysia, while also discussing the role and response to changes in regional Malaysia since the country gained independence. (author)

Regional differences in family poverty

OpenAIRE

Robert K. Triest

1997-01-01

Poverty rates vary considerably over regions, as do the demographic characteristics of the poor, but why the extent of poverty varies as much as it does across different regions of the country is not fully understood. This is an unfortunate gap in our knowledge, since it is difficult to analyze how recent changes in federal anti-poverty policy will affect the regional distribution of poverty without a better understanding of current regional differences in the poverty rate.> The main goal of ...

10 CFR 500.3 - Electric regions-electric region groupings for reliability measurements under the Powerplant and...

Science.gov (United States)

2010-01-01

... System (APS)—7, except Duquesne Light Company. 2. American Electric Power System (AEP)—entire AEP System... 10 Energy 4 2010-01-01 2010-01-01 false Electric regions-electric region groupings for reliability... of electric regions for use with regard to the Act. The regions are identified by FERC Power Supply...

Geotourizm marketing in Lake Constance’ region

Directory of Open Access Journals (Sweden)

Daniel Gerner

2009-09-01

Full Text Available Aim of this work is to evaluate factors responsible for these developments and to show chances for other regions by adopting thismarketing strategy. Besides marketing, interaction of tourism, industry and state was important. Many reasons can be found that shouldresult in a worse development of the region around the Lake of Constance . But instead, today this region has a higher populationgrowth than the average of Baden-Württemberg and is the best economic region outside of urban centers. Scientists spoke aboutan overheated economic growth during the last years that in 2008 comes to a normal but still high level. To attract high potentialworkers and engineers to support further growth, the region has one main advantage to many other regions – its environment. In caseof “Lake of Constance” region, different marketing strategies were used. The complexity of successful marketing for a region is highand finding the right combination of marketing strategies is difficult but can positively influence the development of a region, itseconomy and tourism. At the same time, the marketing for economy and tourism positively reflects degree of popularity in the region.

The D-region of the ionosphere

International Nuclear Information System (INIS)

Mitra, A.P.

1978-01-01

The D-region of the ionosphere, traditionally defined as the region of ionization below 100 km, is a link between the non-ionized stratosphere below and the dense plasma above. In it, minor neutral constituents play a dominant role and chemical reactions, both neutral and ionic, are dominant. It plays a very important role in the propagation of radiowaves at all frequencies below 30 MHz, and is particularly important in effecting communication over areas of the earth, such as polar regions, that are inaccessible to synchronous satellite links. Work which has been carried out on the neutral environment, D-region ionization, positive and negative ions found in the D-region, disturbances in the D-region (of solar origin and due to local dynamics or thermal changes), and the chemistry of the region, is considered. Possible future D-region studies are outlined. (UK)

Second region of stability

International Nuclear Information System (INIS)

Greene, J.M.; Chance, M.S.

1980-10-01

A new type of axisymmetric magnetohydrodynamic equilibrium is presented. It is characterized by a region of pressure and safety factor variation with a short scale length imposed as a perturbation. The equilibrium consistent with these profile variations can be calculated by means of an asymptotic expansion. The flexibility obtained by generating such equilibria allows for a close examination of the mechanisms that are relevant to ballooning instabilities - ideal MHD modes with large toroidal mode number. The so-called first and second regions of stability against these modes are seen well within the limits of validity of the asymptotic expansion. It appears that the modes must be localized in regions with small values of the local shear of the magnetic field. The second region of stability occurs where the local shear is large throughout the range where the magnetic field line curvature is destabilizing

Regional utvikling og partnerskap

DEFF Research Database (Denmark)

Halkier, H.; Gjertsen, A.

2004-01-01

Since the beginning of the 1990s, Danish regional policy has changed dramatically. As of January 1991, all central government incentive schemes were terminated, and since then the main components of spatial economic policy have been a host of subnational initiatives and the European Structural...... in European matters as envisaged in the ?Europe of the Regions? slogan. The aim of this chapter is to examine the transformation of regional policy in Denmark from the perspective of political decentralization and Europeanization in order to establish to what extent recent changes have increased the capacity...... of Danish regions to pursue their own agendas with regard to economic development, and explore the organizational strategies pursued by varies tiers of government in this process of rapid and profound policy change. The text is divided into three parts. The following section provides a brief outline...

Dust in H II regions

International Nuclear Information System (INIS)

Isobe, S.

1977-01-01

Several pieces of evidence indicate that H II regions may contain dust: 1) the continuum light scattered by dust grains (O'Dell and Hubbard, 1965), 2) thermal radiation from dust grains at infrared wavelengths (Ney and Allen, 1969), 3) the abnormal helium abundance in some H II regions (Peimbert and Costero, 1969), etc. Although observations of the scattered continuum suggest that the H II region cores may be dust-free, dust grains and gas must be well mixed in view of the infrared observations. This difficulty may be solved by introducing globules with sizes approximately 0.001 pc. These globules and the molecular clouds adjacent to H II regions are the main sources supplying dust to H II regions. (Auth.)

COMBINATION OF GOALS STRATEGY REGION

Directory of Open Access Journals (Sweden)

Denys Yu. Lapigin

2015-01-01

Full Text Available Currently the tools to identify strategicallyimportant objectives of regional development is not enough to build a developmentperspective, relying on something special,what distinguishes each region from therest. The article discusses approaches to the formation of the regional developmentstrategy, which is based on goals set by the results of the analysis of the main factors inthe development of the region. The study is based on the methodology of systems theoryand methods of strategic management. The most important results should include tools tobuild the tree of strategic objectives resultingfrom the implementation of the algorithm forconstructing planes of analysis and development of the region. The results can be used to develop a strategy for the developmentof socio-economic systems of various typesand forms.

Local, Regional or Global?

DEFF Research Database (Denmark)

Geisler Asmussen, Christian

to be consistent with models of internationalization that incorporate different assumptions about strategic choice and global competition. Preliminary results show that large multinationals follow home region oriented internationalization paths, although much of the regional effect reported by previous studies...

"Mature Regionalism" and the Genesis of "Functional Projects": "Educational Regionalism" in Small (and Micro-States)

Science.gov (United States)

Jules, Tavis D.

2017-01-01

This article advances that the movement towards "deeper" Caribbean integration has generated a shift from "immature" regionalism to a "mature" form of regionalism. Thus, mature regionalism, a new governance mechanism, in regulating the institutional and legal framework of Caribbean Single Market and Economy is…

Evaluating the Impact of Regional Marketing Projects on the Development of Regions from Different Stakeholder Perspectives

Directory of Open Access Journals (Sweden)

Kunze Kim-Kathrin

2014-01-01

Full Text Available In the competition for economically attractive stakeholders, regions have to implement strategies to gain and adhere those interest groups. Empirical studies concerning the migration motivations show that it is not only labor market but also soft locational factors of the social environment, nature and landscape that are of high importance: A majority of the population is willing to move or rather stay at a special place because of such soft locational factors. This study examines the impact of regional marketing projects on the development of regions from the perspectives of inhabitants and tourists as well as general attributes to measure a region’s attractiveness from the perspective of high potentials. We argue that those projects that fit to the region and its unique selling propositions contribute to positioning and building location brand value. We show that projects have a socio-economic effect on the attitude towards regions and contribute to building location brand value. An analysis of group differences shows that the project influence on the region and region attractiveness are perceived in significantly different manner depending on the knowledge level of the stakeholder group. Consequently, one should increase the awareness of marketing activities and regions and focus on soft locational factors while establishing and positioning a region brand.

BUDGETARY REGIONAL POLICY: THEORETICAL CONCEPTUALIZATION

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Shyshpanova Nataliia

2018-01-01

Full Text Available Introduction. Formation and implementation of the budget policy of the regions in Ukraine is directly related to the processes of decentralization of power, increase of budget powers and strengthening of financial capacity of the territories. Formation of balanced local budgets and support of an effective system of managing budget resources is a key to strengthening the economic potential of the regions and increasing the well-being of citizens. The purpose of this article is to assess the current concepts of the fiscal policy of the region in Ukraine and to determine the impact of fiscal policy on the socio-economic development of the regions. Results. In this article the essence and content of budget policy are considered, the interpretation of different scientists is presented. An author’s approach to the definition of the essence of the budget policy of the region as a set of economic and administrative measures in the budget sphere, determined by the interrelated goals and objectives of the state and local self-government, aimed at the socio-economic development of the territory. The conceptual model of the fiscal policy of the region is presented and it is determined that the strategic goal of fiscal policy at the local level should be to ensure sustainable socio-economic development of the territories. The main principles that need to be observed during the implementation of the budget policy of the region are described; functions to be performed by local level fiscal policy; and the main tools by which local authorities carry out their functions. Conclusions. It is noted that the content of the budget policy of the region should be to determine the course, tasks and directions of the state and local self-government activities in the field of the formation and use of budget funds. The budget policy of the region should respond to a combination of the following systemic challenges: 1. the restoration of economic growth, as soon as

The role of regional pollution conventions

International Nuclear Information System (INIS)

Haywar, P.

1989-01-01

Within the last 12 years a number of regional pollution conventions and action plans have been negotiated to protect the world's seas from pollution. This paper traces the development of this activity and points out the specific role of regional, as opposed to global, pollution conventions. Chief among the functions of regional conventions is the specific legal framework they provide for a particular geographical region. They also provide a forum for neighboring states to develop a coherent policy for a particular regional sea, as well as being the means of establishing regional control over potentially polluting activities. Regional agreements also constitute a suitable framework for monitoring the input of pollutants to the marine environment and assessing their effects. In addition, they provide a forum for the exchange of scientific and technical information and for developing cooperation between states. The paper concludes by summarizing the most important functions of a regional convention and suggesting that, with increasing industrialization and pollution stress, there will continue to be a need for action to be taken at the regional level

Water masers in NGC7538 region

Science.gov (United States)

Kameya, Osamu

We observed H2O masers towards NGC7538 molecular-cloud core using VERA (VLBI Experiment of Radio Astrometry). This region is in the Perseus arm at a distance of about 2.7 kpc and is famous for its multiple, massive star formation. There are three areas there, N(IRS1-3), E(IRS9), and S(IRS11), each having a strong IR source(s), ultra-compact HII region(s), bipolar outflow, high-density core, and OH/H2O/CH3OH masers. We made differential VLBI observations towards the NGC7538 H2O maser sources at N and S and a reference source, Cepheus A H2O maser, simultaneously. The Cepheus A region is separated by 2 degrees from the NGC7538 region. The positions of H2O masers in N and S regions, distributed around the ultra-compact HII regions, are basically consistent with those found by means of interferometric observations of past 29 years. The masers may come from interface regions between the ultra-compact HII regions and the environments of dense molecular gas.

Emergence of regional clusters

DEFF Research Database (Denmark)

Dahl, Michael S.; Østergaard, Christian Richter; Dalum, Bent

2010-01-01

The literature on regional clusters has increased considerably during the last decade. The emergence and growth patterns are usually explained by such factors as unique local culture, regional capabilities, tacit knowledge or the existence of location-specific externalities (knowledge spillovers...

76 FR 9630 - Federal Regulatory Enforcement Fairness Hearing; National Ombudsman and Region VI Regional Small...

Science.gov (United States)

2011-02-18

... Administration (SBA). ACTION: Notice of open hearing of the Regional (Region VI) Small Business Regulatory... location, date and time of the Regional Small Business Regulatory Fairness hearing. This hearing is open to... Chasse Room, New Orleans, LA 70140. SUPPLEMENTARY INFORMATION: Pursuant to the Small Business Regulatory...

Growth-based Theories for Declining Regions? A Note on Conceptualisations of Demographic Change for Regional Economic Development

Directory of Open Access Journals (Sweden)

Anke Matuschewski

2016-01-01

Full Text Available This article aims to critically assess the economic growth paradigm, which typically underlies most approaches to regional policymaking for demographic change. While population losses, ageing and outmigration – i.e. phenomena that are addressed as demographic change – have become a matter of urgency for many European regions, most regional economic development theories remain silent about the population decline affecting the economic growth and development prospects of regions. Consequently, regional policies usually rely on the concept of economic growth, yet neglect the complexity and importance of demographic change and how it relates to the economic sphere. Due to this lack in nuance, we argue that regional policymaking fails to design adequate policy support for regions facing persistent demographic change and economic stagnation or decline as a result. Based on these observations, the paper examines a selection of regional economic development theories in search for alternative concepts of growth and development in the context of demographic change. To this aim, globalisation peripheries are introduced as a fruitful conceptual point of reference and, in combination with endogenous regional development theories, discussed as an alternative approach for regional policymaking.

Verbal working memory performance correlates with regional white matter structures in the frontoparietal regions.

Science.gov (United States)

Takeuchi, Hikaru; Taki, Yasuyuki; Sassa, Yuko; Hashizume, Hiroshi; Sekiguchi, Atsushi; Fukushima, Ai; Kawashima, Ryuta

2011-10-01

Working memory is the limited capacity storage system involved in the maintenance and manipulation of information over short periods of time. Previous imaging studies have suggested that the frontoparietal regions are activated during working memory tasks; a putative association between the structure of the frontoparietal regions and working memory performance has been suggested based on the analysis of individuals with varying pathologies. This study aimed to identify correlations between white matter and individual differences in verbal working memory performance in normal young subjects. We performed voxel-based morphometry (VBM) analyses using T1-weighted structural images as well as voxel-based analyses of fractional anisotropy (FA) using diffusion tensor imaging. Using the letter span task, we measured verbal working memory performance in normal young adult men and women (mean age, 21.7 years, SD=1.44; 42 men and 13 women). We observed positive correlations between working memory performance and regional white matter volume (rWMV) in the frontoparietal regions. In addition, FA was found to be positively correlated with verbal working memory performance in a white matter region adjacent to the right precuneus. These regions are consistently recruited by working memory. Our findings suggest that, among normal young subjects, verbal working memory performance is associated with various regions that are recruited during working memory tasks, and this association is not limited to specific parts of the working memory network. Copyright © 2011 Elsevier Ltd. All rights reserved.

THE ENVIRONMENT OF REGIONAL DEVELOPMENT FINANCIAL ANALYSIS

OpenAIRE

Bechis Liviu; MOSCVICIOV Andrei

2012-01-01

The paper presents the difference between the two concepts regionalism and regionalization. It also presents the three types of regionalism analysis depending on the dimension and the nature of the relations: regionalism at national level, transnational regionalism and international regionalism analysis.

Sources of Regional Banks Capitalization

Directory of Open Access Journals (Sweden)

Olga Sergeevna Miroshnichenko

2018-03-01

Full Text Available Searching of sources to increase the capitalization of Russian banks is an important economic problem for both the national and regional economy. Moreover, a strong capital base allows to credit institutions to meet the demands of economic agents for banking service. The research focuses on the choice of sources of regulatory capital for the banks of Tyumen region in the context of changing supervisory requirements in the period of 2005–2016, in different phases of the business cycle. We apply econometric methods of statistical information using IBM SPSS Statistics software. We have calculated the individual correlations of regional banks’ capital with gross domestic product (GDP (excluding gross regional product (GRP and GRP (with the exception of the effect of GDP. These calculations have shown that the capital of regional banks is related only to GDP. The increase in the capital of regional banks is accompanied by a change in its structure: the share of authorized capital has halved, and the share of subordinated debt has grown. All sources of capital, other than the reserve fund, are related to GDP. Authorized capital is associated with the profit of profitable lending institutions; retained earnings in the capital of regional banks — with the aggregated amount of risks of the banking system of the Russian Federation. Subordinated debt, like capital as a whole, is negatively affected by the profitability of the banking sector. The change in the capital of regional banks is determined by the change in retained earnings, subordinated debt and reserve fund. Modelling of these relations has allowed to obtain a system of equations. This system synthesizes linear regression models of changing the capital of regional banks in the context of their sourcing. The results of this study are significant for theoretical justification and practical development of a balanced financial policy of regional banks. Our research will contribute to

On Austrian regional economics

NARCIS (Netherlands)

Heijman, W.J.M.; Leen, A.R.

2004-01-01

The aim of this research note is two-fold, firstly, to clarify the growing interaction between regional science and Austrian economics and their awareness of each other. We elucidate the Austrian methodology, called praxeology, which is especially misunderstood in regional science. Secondly, we

Energy options and regional cooperation on nuclear energy in the Asia-Pacific region

International Nuclear Information System (INIS)

Shin, Jae In

1986-10-01

This paper reviews the extensive forms of Asia-Pacific regional cooperation in nuclear power to develop and provide economical and reliable energy supply for sound economical growths of developing countries in this region, which has seen rapid growth of energy consumption more than anywhere else in recent years. Nuclear power has received keen attention from DCs because it can provide a self-reliable energy supply and promote development of high technology in the associated engineering and manufacturing industries locally. However, due to the particular characteristics in nuclear power technology, a close cooperation is required between the seller(industrialized) and buyer(developing) countries. The Asia-Pacific regional cooperation in nuclear power is a step toward providing mutual benefits to the countries involved in this region, and this paper explores potential ways in formulating basic and systematic approaches and areas of full scope cooperation. (author)

Regional energy observatory. Energy status - greenhouse effect in the Aquitaine region. First results; Observatoire regional de l'energie. Bilan energie - effet de serre de la region Aquitaine. Premiers resultats

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-06-01

The IDEA organization (information about the environmental development in Aquitaine region) has created an energy observatory, the mission of which is to supply regularly a reliable, objective and useful information about energy and greenhouse effect in the Aquitaine region (SW France). This document presents: the end-use energy consumption, the sectorial statuses (residential, tertiary sector, industry, agriculture, transports), the energy production and the renewable energy sources in Aquitaine region. Details are given in separate files at the end of the document for the 5 departements of Aquitaine (Dordogne, Gironde, Landes, Lot-et-Garonne, Pyrennees Atlantiques). (J.S.)

The European Regional Development Fund and Island Regions: An Evaluation of the 2000-06 and 2007-13 Programs

Directory of Open Access Journals (Sweden)

Harvey W. Armstrong

2012-11-01

Full Text Available This paper presents results from a regional policy evaluation study conducted for the European Commission. The study examined the impact of the European Regional Development Fund and Cohesion Fund on EU regions with ‘specific geographical characteristics’, namely islands, mountain regions and sparsely populated areas. These types of regions have been attracting increasing EU regional policy attention and their economic development is considered important in helping the EU to attain its important ‘territorial cohesion’ objective. The focus of this paper is on the island regions. Evaluation of island regions in their own right has not been undertaken before by the EU. The study focuses on the 2000-06 and (still on-going 2007-13 EU regional policy programs. The paper presents the methodology adopted by the study before turning to the main findings concerning the types of policy initiatives adopted in the island regions, and the appropriateness of the policies used for the economic situation faced by the islands. The islands encompassed by the study are all normal sub-national regions of EU member states. Islands with an unusual degree of administrative autonomy (e.g. the Outermost Regions were excluded.

Regionalizing healthcare: a vision for transforming Lebanon into a regional academic hub

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Akl Elie A

2010-06-01

Full Text Available Abstract Background Lebanon suffers from a large scale emigration of physicians coupled with an oversaturation of the physician job market. Lebanon is currently witnessing an expansion of its medical education capacity with the establishment of new private medical schools, raising the fears of a worsening market oversaturation. Discussion The neighboring Arabian Gulf countries are suffering from a serious shortage of clinicians and academicians. In spite of their enormous investments in educational, clinical and research collaborative initiatives with some of the most renowned North American medical schools and institutions, their ability to recruit and retain highly qualified clinicians and academicians remains a major challenge. Lebanese universities have the opportunity to establish triangular collaborations with the Gulf regional medical centers and their North American partners. They could achieve this goal by tapping into the globalized and high quality Lebanese physician workforce and consequently regionalize healthcare delivery in the Middle East. Summary By recruiting its globalized and high quality physician workforce to establish collaborations with the Gulf regional, Lebanon could become a regional "academic hub".

Regionalizing healthcare: a vision for transforming Lebanon into a regional academic hub.

Science.gov (United States)

Badr, Kamal F; Akl, Elie A

2010-06-16

Lebanon suffers from a large scale emigration of physicians coupled with an oversaturation of the physician job market. Lebanon is currently witnessing an expansion of its medical education capacity with the establishment of new private medical schools, raising the fears of a worsening market oversaturation. The neighboring Arabian Gulf countries are suffering from a serious shortage of clinicians and academicians. In spite of their enormous investments in educational, clinical and research collaborative initiatives with some of the most renowned North American medical schools and institutions, their ability to recruit and retain highly qualified clinicians and academicians remains a major challenge. Lebanese universities have the opportunity to establish triangular collaborations with the Gulf regional medical centers and their North American partners. They could achieve this goal by tapping into the globalized and high quality Lebanese physician workforce and consequently regionalize healthcare delivery in the Middle East. By recruiting its globalized and high quality physician workforce to establish collaborations with the Gulf regional, Lebanon could become a regional "academic hub".

The regional climate model RegCM3 performances over several regions and climate regimes

Science.gov (United States)

Coppola, E.; Rauscher, S.; Gao, X.; Giorgi, F.; Im, E. S.; Mariotti, L.; Seth, A.; Sylla, M. B.

2009-04-01

Regional Climate models are more and more needed to provide high resolution regional climate information in climate impact studies. Water availability in a future scenario is the main request of policy makers for adaptation and mitigation purposes. However precipitation changes are unlikely to be as spatially coherent as temperature changes and they are closely related to the regional model itself. In addition model skill varies regionally. An example of several ICTP regional climate model (RegCM3) simulations is reported over China, Korea, Africa, Central and Southern America, Europe and Australia. Over China, Australia, and Korea the regional model improves the simulation compared to the driving GCM when compared with CRU observations. In China, for example, the higher resolution of the regional model inhibits the penetration of the monsoon precipitation front from the southern slope of the Himalaya onto the Tibetan Plateau. In Korea the nested domain simulation (20 km) shows an encouraging performance with regard to capturing extreme precipitation episodes and the finer spatial distribution reflects the detailed geography of the Korean Peninsula. Over South America, RegCM captures the annual cycle of precipitation over Northeast Brazil and the South American Monsoon region, although the monsoon onset occurs too early in the model. Precipitation over the Amazon is not well captured, with too little precipitation associated with weak easterlies and reduced moisture transport into the interior of the continent. RegCM simulates the annual cycle of precipitation over Central America and the Caribbean fairly well; in particular, the complex spatial distribution of the Mid-Summer Drought, a decrease in precipitation that occurs during the middle of the rainy season in July and August, is better captured by RegCM than by the GCM. In addition, RegCM simulates the strength and position of the Caribbean low level jet, a mesoscale feature related to precipitation anomalies

Modern Integration Processes in the Asia-Pacific Region: the Formation of Trans-Regional Mega-Agreements

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Maliuta Iryna A.

2017-12-01

Full Text Available In the 21st century, especially in the last decade, new intercontinental integration projects appear on the global stage with a high potential for influencing the regional economic structure and at the same time bearing certain challenges for the international geo-economic and geo-political map of the world. Comprehensive new-generation inter-regional agreements are being formed, such as the TTP, the TTIP, the RCEP, the Comprehensive Economic and Trade Agreement between Canada and the EU (CETA, the Japan-EU Economic Partnership. The Asia-Pacific region has been an active participant in the creation and promotion of mega-regional trade agreements. Mega-regional trade agreements in the Asia-Pacific region, namely the TTP and the RCEP, are analyzed as mega-projects with an unprecedented scale of liberalization within the framework of the agreement that include provisions complementing the WTO framework or extending beyond it. There identified reasons for the emergence of mega-regional trade agreements and prospects for the implementation of these projects, as well as possible consequences for the international economic system. It is established that new trans-regional projects, providing certain advantages to the participating countries, simultaneously carry both opportunities and challenges for the world economy. The latter are associated with the threats of crowding the countries that do not take an active part in the integration processes out of the global chains of value creation as well as of the processes of international trade.

Bilingualism alters brain functional connectivity between "control" regions and "language" regions: Evidence from bimodal bilinguals.

Science.gov (United States)

Li, Le; Abutalebi, Jubin; Zou, Lijuan; Yan, Xin; Liu, Lanfang; Feng, Xiaoxia; Wang, Ruiming; Guo, Taomei; Ding, Guosheng

2015-05-01

Previous neuroimaging studies have revealed that bilingualism induces both structural and functional neuroplasticity in the dorsal anterior cingulate cortex (dACC) and the left caudate nucleus (LCN), both of which are associated with cognitive control. Since these "control" regions should work together with other language regions during language processing, we hypothesized that bilingualism may also alter the functional interaction between the dACC/LCN and language regions. Here we tested this hypothesis by exploring the functional connectivity (FC) in bimodal bilinguals and monolinguals using functional MRI when they either performed a picture naming task with spoken language or were in resting state. We found that for bimodal bilinguals who use spoken and sign languages, the FC of the dACC with regions involved in spoken language (e.g. the left superior temporal gyrus) was stronger in performing the task, but weaker in the resting state as compared to monolinguals. For the LCN, its intrinsic FC with sign language regions including the left inferior temporo-occipital part and right inferior and superior parietal lobules was increased in the bilinguals. These results demonstrate that bilingual experience may alter the brain functional interaction between "control" regions and "language" regions. For different control regions, the FC alters in different ways. The findings also deepen our understanding of the functional roles of the dACC and LCN in language processing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multi-regional input–output model and ecological network analysis for regional embodied energy accounting in China

International Nuclear Information System (INIS)

Zhang, Yan; Zheng, Hongmei; Yang, Zhifeng; Su, Meirong; Liu, Gengyuan; Li, Yanxian

2015-01-01

Chinese regions frequently exchange materials, but regional differences in economic development create unbalanced flows of these resources. In this study, we examined energy by assessing embodied energy consumption to describe the energy-flow structure in China's seven regions. Based on multi-regional monetary input–output tables and energy statistical yearbooks for Chinese provinces in 2002 and 2007, we accounted for both direct and indirect energy consumption, respectively, and the integral input and output of the provinces. Most integral inputs of energy flowed from north to south or from east to west, whereas integral output flows were mainly from northeast to southwest. This differed from the direct flows, which were predominantly from north to south and west to east. This demonstrates the importance of calculating both direct and indirect energy flows. Analysis of the distance and direction traveled by the energy consumption centers of gravity showed that the centers for embodied energy consumption and inputs moved southeast because of the movements of the centers of the Eastern region. However, the center for outputs moved northeast because the movement of the Central region. These analyses provide a basis for identifying how regional economic development policies influence the embodied energy consumption and its flows among regions. - Highlights: • We integrated multi-regional input–output analysis with ecological network analysis. • We accounted for both direct and indirect energy consumption. • The centers of gravity for embodied energy flows moved southeast from 2002 to 2007. • The results support planning of energy consumption and energy flows among regions.

The impact of domestic trade on China's regional energy uses: A multi-regional input–output modeling

International Nuclear Information System (INIS)

Zhang, Bo; Chen, Z.M.; Xia, X.H.; Xu, X.Y.; Chen, Y.B.

2013-01-01

To systematically reveal how domestic trade impacts on China's regional energy uses, an interprovincial input–output modeling is carried out to address demand-derived energy requirements for the regional economies in 2007 based on the recently available data. Both the energy uses embodied in final demand and interregional trade are investigated from the regional and sectoral insights. Significant net transfers of embodied energy flows are identified from the central and western areas to the eastern area via interregional trade. Shanxi is the largest energy producer and interregional embodied energy deficit receiver, in contrast to Guangdong as the largest energy user and surplus receiver. By considering the impacts of interregional trade, the energy uses of most eastern regions increase remarkably. For instance, Shanghai, Hainan, Zhejiang, Beijing, Jiangsu and Guangdong have their embodied energy requirements 87.49, 19.97, 13.64, 12.60, 6.46 and 6.38 times of their direct energy inputs, respectively. In contrast, the embodied energy uses of some central and western regions such as Inner Mongolia, Shanxi, Xinjiang, Shaanxi and Guizhou decrease largely. The results help understand the hidden network linkages of interregional embodied energy flows and provide critical insight to amend China's current end-reduction-oriented energy policies by addressing the problem of regional responsibility transfer. - Highlights: • Demand-derived energy requirements for China's regional economies are addressed. • Significant interregional transfers of embodied energy flows are identified. • Energy surpluses are obtained by 19 regions and deficits by the other 11 regions. • The eastern regions should take more responsibility for reducing China's energy uses

The Scandinavian regional model

DEFF Research Database (Denmark)

Torfing, Jacob; Lidström, Anders; Røiseland, Asbjørn

2015-01-01

This article maps how the sub-national regional levels of governance in Denmark, Norway and Sweden have changed from a high degree of institutional convergence to a pattern of institutional divergence. It analyses the similarities and differences in the changes in regional governance and discusses...

Regional quality of living in Europe

Directory of Open Access Journals (Sweden)

Piet Lagas

2015-07-01

Full Text Available This article sets out the conceptual framework and results of Regional Quality of Living indicators that were developed in order to benchmark European NUTS2 regions. Nine non-business-related indicators are constructed to support the goal of policy makers to improve the attractiveness of regions and cities for people or companies to settle in, and by doing so create economic growth. Each of the constructed indicators represents a pillar of the Quality of Living. The highest indicator scores are found for regions within Switzerland, Sweden, Norway and the Netherlands. Some countries show a wide divergence between regional scores. The southern regions of Italy and Spain, for example, have significantly lower scores than those in the north. In addition, capital city regions have better RQI scores. A positive correlation was found between the average RQI scores and both GDP per capita and weighted population density. Compared to GDP per capita, weighted population density has a modest influence on the RQI score. The European regions are divided into 11 clusters, based upon GDP per capita and weighted population density in order to benchmark a region with its peers.

Bienestar económico regional: un enfoque comparativo entre regiones españolas e italianas

OpenAIRE

Pilar Murias Fernández; Fidel Martínez Roget; Simone Novello

2010-01-01

Este trabajo propone una visión revisada del bienestar económico regional. Trabajos recientes en economía regional han mostrado su desacuerdo con la noción tradicional de bienestar económico que considera únicamente renta per cápita. A través de la comparación de regiones españolas e italianas y usando un enfoque basado en el Análisis Envolvente de Datos, este trabajo sugiere un indicador sintético de bienestar regional basado en las cuatro componentes de Osberg (1985): capacidad de consumo, ...

Regional cooperation in nuclear energy development

International Nuclear Information System (INIS)

Chung, K.; Muntzing, L.M.

1987-01-01

In November 1985, PBNCC (the Pacific Basin Nuclear Cooperation Committee) was formally established. Currently six Pacific Basin members have been participating in PBNCC: Canada, Japan, South Korea, Mexico, Taiwan of Chian, and the United States of America. The People's Republic of China has sent observes to the PBNCC meetings. The technical contents of PBWCC working groups are as follows: 1. Regional cooperative for pooled spare parts of nuclear power plants and inventory management; 2. Regional cooperation in nuclear training; 3. Regional cooperation on nuclear safety; 4. Regional cooperation in Codes and Standards; 5. Regional Cooperation in public acceptance; 6. Regional cooperation on radwaste management. (Liu)

Productive Regions: Criteria and Classification

Directory of Open Access Journals (Sweden)

Vlasyuk L. I.

2012-03-01

Full Text Available An official statistical dataset for 80 territorial subjects of the Russian Federation for 2000, 2007 and 2009 has proved the hypothesis that, under the neoclassical concept, the resources move to regions with the highest marginal productivity of the factors of production, which leads to the accumulation of investment resources, while providing financial and social efficiency. Based on cluster analysis by three performance criteria, productive regions are identified, which are dominated by regions productive in the extraction of minerals. It is shown that the stability of the factors’ distribution in space determines the current and future specialization of regional economies

REDI: The Regional Entrepreneurship and Development Index –Measuring regional entrepreneurship Final report

NARCIS (Netherlands)

Ortega Argiles, Raquel; Acs, Zoltan J.; Szerb, Laszlo; Autio, Erkko; Komlosi, Eva

2014-01-01

The main outcome of the project is a new index (REDI - Regional Entrepreneurship and Development Index) that describes the entrepreneurial process. The index takes into account both individual attitudes and characteristics and the regional context and, accordingly, not only whether people are

Regionalism, Devolution and Education

Science.gov (United States)

Bogdanor, Vernon

1977-01-01

Described are effects of political decentralization in the United Kingdom on political and social institutions, particularly education. The author concludes that regionalism could yield advantages of power decentralization, diversity of decision making, and educational systems which are more closely connected to regional and local traditions.…

[Regional health and autonomy conferences (CRSAs): the implications for medical democracy at a regional level].

Science.gov (United States)

Devictor, Bernadette

2010-01-01

The HPST law seeks to reorganize the governance of healthcare at a regional level and to maintain the existence of regional health conferences, now known as regional health and autonomy conferences (CRSAs). The purpose of this article is to examine the new duties attributed to the CRSAs and to consider the various issues raised by their practice. The article also provides an analysis of the preconditions required for the successful implementation of medical democracy at a regional level, ie.: the involvement of the CRSAs in the assessment of regional healthcare policies, the mobilization of funds, the composition of the CRSAs (including the full range of healthcare areas), the importance of providing adequate support for territorial conferences, and the elaboration of a communicative space for fostering exchanges between CRSAs.

Balancing regional industrial development: analysis on regional disparity of China's industrial emissions and policy implications

DEFF Research Database (Denmark)

Liang, Hanwei; Dong, Liang; Luo, Xiao

2016-01-01

Efficient industrial emissions mitigation strategy is critical for China's national action on climate change and sustainable development, considering its rapid industrialization. Regional disparity brings difficulties and uncertainties to policy implementation in China. Therefore, an investigation...... development, and highlight not only disparity, but also inequity exists. It is concluded that, there is a larger unequal distribution of GDP per unit of air pollutants and CO2 emission between eastern and western regions, reveals that less developed western and central regions suffer from the emission leakage...... on the regional features of industrial emissions is critical to better decision makings. While to date, related studies have been rather few. This paper applies a spatial analysis on regional features of China's industrial emissions (SO2, NOx and PM2.5 and CO2 emission) in 31 provinces. Spatial autocorrelation...

Croatia in a Regional Context

Directory of Open Access Journals (Sweden)

Branko Caratan

2007-01-01

Full Text Available In this paper, the author examines the regional context of Croatian politics, highlighting the main reasons for its significance: involvement of the region in war in recent history, the rootedness, aside from that, of extremely strong economic, political and cultural bonds between the countries in the region, and the importance of cooperation in the region for EU accession and further economic development. On these grounds, the author seeks to examine the possibility for stabilisation of the region, and to establish what interests the neighbouring countries such as Italy, Austria, Hungary and others have in strenghtening the bonds with the new democracies in Central and Southeast Europe. All of this eventually provides the answer to the question what is the interest of the EU in this region’s stability and in its admission to the European Union

A regional approach to the environmental risk assessment in the Campania region

Science.gov (United States)

Minolfi, Giulia; Albanese, Stefano; Lima, Annamaria; De Vivo, Benedetto

2016-04-01

Environmental risk assessment and analysis has a crucial role for guaranteeing the safety of the population, especially in intensive urbanized and industrialized areas, such as the Campania region (Italy). In Italy, since 2006, the human health risk assessment has become mandatory for contaminated soil and waters at contaminated sites. While traditional risk assessment procedures are usually run at site specific level (brownfields), with this work we would like to introduce a freshly developed method to assess risks at regional level by means of GIS, considering the hazard due to the presence in the environment of a contaminated media, the land use variability and the actual distribution of the population. 3535 top soils were collected across the whole Campania region (Italy) with a sampling density of 1 sample/4 km2. Samples were analyzed at ACME Analytical Lab. Ltd (Vancouver, Canada), to determine the concentration of 52 elements, with a combined methods of ICP-MS and ICP-ES following an aqua regia digestion. After a detailed statistical data analysis and geochemical mapping, we reclassified the interpolated maps of some potentially toxic elements (Sb, As, Be, Cd, Co, Cr, Hg, Ni, Pb, Se, Sn, Tl, V, Zn), in accordance with the Italian environmental law (D.Lgs 152/2006), on the base of the trigger and action limits (CSC) for human safety established by this latter. The obtained maps were summed up in the GIS environment in order to get a cumulative map of the potential hazard for the topsoils of Campania region. Considering that environmental risk for the population is strongly influenced by the exposure pathways followed by contaminants to reach the human target, in the case of Campania region we evaluated as relevant pathways both the soil/dust and food ingestion. Furthermore to consider the influence of the land use in the onset of the risk, each land use type was associated with a specific value of a Land Use Risk Coefficient (LURC) which is also dependent on

Regional Competitiveness and Its Implications for Development

OpenAIRE

Daryono Soebagyo; Triyono Triyono; Yuli Tri Cahyono

2015-01-01

This study was conducted to identify regional competitiveness in some areas of Central Java. Regional competitiveness became one of the issues in regional development policy since the enactment of local autonomy.Measurement of regional competitiveness has been mostly done through ranking as a benchmark the competitiveness of the region. Mapping regional competitiveness in Indonesia has been made to all counties and cities, which shows the competitiveness ranking of each region. Competitivenes...

From Pixels to Region: A Salient Region Detection Algorithm for Location-Quantification Image

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Mengmeng Zhang

2014-01-01

Full Text Available Image saliency detection has become increasingly important with the development of intelligent identification and machine vision technology. This process is essential for many image processing algorithms such as image retrieval, image segmentation, image recognition, and adaptive image compression. We propose a salient region detection algorithm for full-resolution images. This algorithm analyzes the randomness and correlation of image pixels and pixel-to-region saliency computation mechanism. The algorithm first obtains points with more saliency probability by using the improved smallest univalue segment assimilating nucleus operator. It then reconstructs the entire saliency region detection by taking these points as reference and combining them with image spatial color distribution, as well as regional and global contrasts. The results for subjective and objective image saliency detection show that the proposed algorithm exhibits outstanding performance in terms of technology indices such as precision and recall rates.

Family in historical and regional perspective