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Sample records for miembro inferior postruptura

  1. Inferior vestibular neuritis.

    PubMed

    Kim, Ji-Soo; Kim, Hyo Jung

    2012-08-01

    Vestibular neuritis (VN) mostly involves the superior portion of the vestibular nerve and labyrinth. This study aimed to describe the clinical features of VN involving the inferior vestibular labyrinth and its afferents only. Of the 703 patients with a diagnosis of VN or labyrinthitis at Seoul National University Bundang Hospital from 2004 to 2010, we retrospectively recruited 9 patients (6 women, age range 15-75) with a diagnosis of isolated inferior VN. Diagnosis of isolated inferior VN was based on torsional downbeating spontaneous nystagmus, abnormal head-impulse test (HIT) for the posterior semicircular canal (PC), and abnormal cervical vestibular-evoked myogenic potentials (VEMP) in the presence of normally functioning horizontal and anterior semicircular canals, as determined by normal HIT and bithermal caloric tests. All patients presented with acute vertigo with nausea, vomiting, and imbalance. Three patients also had tinnitus and hearing loss in the involved side. The rotation axis of torsional downbeating spontaneous nystagmus was best aligned with that of the involved PC. HIT was also positive only for the involved PC. Cervical VEMP was abnormal in seven patients, and ocular VEMP was normal in all four patients tested. Ocular torsion and subjective visual vertical tests were mostly within the normal range. Since isolated inferior VN lacks the typical findings of much more prevalent superior VN, it may be mistaken for a central vestibular disorder. Recognition of this rare disorder may help avoid unnecessary workups in patients with acute vestibulopathy.

  2. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

    PubMed Central

    Prasad, G. Raghavendra; Billa, Srikar; Bhandari, Pavaneel; Hussain, Aijaz

    2013-01-01

    Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI) bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric – inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up. PMID:23798814

  3. Simulation of the Inferior Mirage

    NASA Astrophysics Data System (ADS)

    Branca, Mario

    2010-09-01

    A mirage can occur when a continuous variation in the refractive index of the air causes light rays to follow a curved path. As a result, the image we see is displaced from the location of the object. If the image appears higher in the air than the object, it is called a "superior" mirage, while if it appears lower it is called an "inferior" mirage.2 The most common example of an inferior mirage is when, on a hot day, a stretch of dry road off in the distance appears to be wet (see Fig. 1). Many lab activities have been described that simulate the formation of superior mirages. In these demonstrations light beams curve downward as they pass through a nonuni-form fluid.3-6 Much less common are laboratory demonstrations of upward-curving light rays of the kind responsible for inferior mirages. This paper describes a simple version of such a demonstration.

  4. Simulation of the Inferior Mirage

    ERIC Educational Resources Information Center

    Branca, Mario

    2010-01-01

    A mirage can occur when a continuous variation in the refractive index of the air causes light rays to follow a curved path. As a result, the image we see is displaced from the location of the object. If the image appears higher in the air than the object, it is called a "superior" mirage, while if it appears lower it is called an "inferior"…

  5. INTERDEPENDENT SUPERIORITY AND INFERIORITY FEELINGS

    PubMed Central

    Ingham, Harrington V.

    1949-01-01

    It is postulated that in neurotic persons who have unrealistic feelings of superiority and inferiority the two are interdependent. This is a departure from the concept of previous observers that either one or the other is primary and its opposite is overcompensation. The author postulates considerable parallelism, with equal importance for each. He submits that the neurotic person forms two logic-resistant compartments for the two opposed self-estimates and that treatment which makes inroads of logic upon one compartment, simultaneously does so upon the other. Two examples are briefly reported. The neurotic benefits sought in exaggeration of capability are the same as those sought in insistence upon inferiority: Presumption of superiority at once bids for approbation and delivers the subject from the need to prove himself worthy of it in dreaded competition; exaggeration of incapability baits sympathy and makes competition unnecessary because failure is conceded. Some of the characteristics of abnormal self-estimates that distinguish them from normal are: Preoccupation with self, resistance to logical explanation of personality problems, inconsistency in reasons for beliefs in adequacy on the one hand and inadequacy on the other, unreality, rationalization of faults, and difficulty and vacillation in the selection of adequate goals. PMID:15390573

  6. Shape recognition and inferior temporal neurons.

    PubMed Central

    Schwartz, E L; Desimone, R; Albright, T D; Gross, C G

    1983-01-01

    Inferior temporal cortex plays an important role in shape recognition. To study the shape selectivity of single inferior temporal neurons, we recorded their responses to a set of shapes systematically varying in boundary curvature. Many inferior temporal neurons were selective for stimuli of specific boundary curvature and maintained this selectivity over changes in stimulus size or position. The method of describing boundary curvature was that of Fourier descriptors. PMID:6577453

  7. Inferior vena caval masses identified by echocardiography

    NASA Technical Reports Server (NTRS)

    Sun, J. P.; Asher, C. R.; Xu, Y.; Huang, V.; Griffin, B. P.; Stewart, W. J.; Novick, A. C.; Thomas, J. D.

    1999-01-01

    The most common cause of an inferior vena caval mass is renal cell carcinoma that extends through the lumen, occurring in 47 of 62 patients (85%). Detection of an inferior vena caval mass affects the surgical approach requiring cardiopulmonary bypass for resection when the mass extends to the heart.

  8. Bilateral inferior petrosal sinus sampling.

    PubMed

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  9. Bilateral inferior petrosal sinus sampling

    PubMed Central

    Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo

    2016-01-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  10. Inferior alveolar nerve block: Alternative technique

    PubMed Central

    Thangavelu, K.; Kannan, R.; Kumar, N. Senthil

    2012-01-01

    Background: Inferior alveolar nerve block (IANB) is a technique of dental anesthesia, used to produce anesthesia of the mandibular teeth, gingivae of the mandible and lower lip. The conventional IANB is the most commonly used the nerve block technique for achieving local anesthesia for mandibular surgical procedures. In certain cases, however, this nerve block fails, even when performed by the most experienced clinician. Therefore, it would be advantageous to find an alternative simple technique. Aim and Objective: The objective of this study is to find an alternative inferior alveolar nerve block that has a higher success rate than other routine techniques. To this purpose, a simple painless inferior alveolar nerve block was designed to anesthetize the inferior alveolar nerve. Materials and Methods: This study was conducted in Oral surgery department of Vinayaka Mission's dental college Salem from May 2009 to May 2011. Five hundred patients between the age of 20 years and 65 years who required extraction of teeth in mandible were included in the study. Out of 500 patients 270 were males and 230 were females. The effectiveness of the IANB was evaluated by using a sharp dental explorer in the regions innervated by the inferior alveolar, lingual, and buccal nerves after 3, 5, and 7 min, respectively. Conclusion: This study concludes that inferior alveolar nerve block is an appropriate alternative nerve block to anesthetize inferior alveolar nerve due to its several advantages. PMID:25885503

  11. [Inferior vestibular neuritis: diagnosis using VEMP].

    PubMed

    Walther, L E; Repik, I

    2012-02-01

    Vestibular evoked myogenic potentials (VEMP) are a new method to establish the functional status of the otolith organs. The sacculocollic reflex of the cervical VEMP to air conduction (AC) reflects predominantly saccular function due to saccular afferents to the inferior vestibular nerve. We describe a case of inferior vestibular neuritis as a rare differential diagnosis of vestibular neuritis. Clinical signs were a normal caloric response, unilaterally absent AC cVEMPs and bilaterally preserved ocular VEMPs (AC oVEMPs).

  12. Lateralization Technique and Inferior Alveolar Nerve Transposition

    PubMed Central

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  13. Inferior Vena Cava Filters for Recurrent Thrombosis

    PubMed Central

    Patel, Salil H.; Patel, Rima

    2007-01-01

    Inferior vena cava filters are often used as alternatives to anticoagulant therapy for the prevention of pulmonary embolism. Many of the clinical data that support the use of these devices stem from relatively limited retrospective studies. The dual purpose of this review is to examine the incidence of thrombotic complications associated with inferior vena cava filters and to discuss the role of anticoagulant therapy concurrent with filter placement. Device-associated morbidity and overall efficacy can be considered only in the context of rates of vena cava thrombosis, insertion-site thrombosis, recurrent deep venous thrombosis, and recurrent pulmonary embolism. PMID:17622366

  14. Efferent pathways modulate hyperactivity in inferior colliculus.

    PubMed

    Mulders, Wilhelmina Henrica A M; Seluakumaran, Kumar; Robertson, Donald

    2010-07-14

    Animal models have demonstrated that mild hearing loss caused by acoustic trauma results in spontaneous hyperactivity in the central auditory pathways. This hyperactivity has been hypothesized to be involved in the generation of tinnitus, a phantom auditory sensation. We have recently shown that such hyperactivity, recorded in the inferior colliculus, is still dependent on cochlear neural output for some time after recovery (up to 6 weeks). We have now studied the capacity of an intrinsic efferent system, i.e., the olivocochlear system, to alter hyperactivity. This system is known to modulate cochlear neural output. Anesthetized guinea pigs were exposed to a loud sound and after 2 or 3 weeks of recovery, single-neuron recordings in inferior colliculus were made to confirm hyperactivity. Olivocochlear axons were electrically stimulated and effects on cochlear neural output and on highly spontaneous neurons in inferior colliculus were assessed. Olivocochlear stimulation suppressed spontaneous hyperactivity in the inferior colliculus. This result is in agreement with our earlier finding that hyperactivity can be modulated by altering cochlear neural output. Interestingly, the central suppression was generally much larger and longer lasting than reported previously for primary afferents. Blockade of the intracochlear effects of olivocochlear system activation eliminated some but not all of the effects observed on spontaneous activity, suggesting also a central component to the effects of stimulation. More research is needed to investigate whether these central effects of olivocochlear efferent stimulation are due to central intrinsic circuitry or to coactivation of central efferent collaterals to the cochlear nucleus.

  15. Identificación de los miembros del cúmulo NGC 2516

    NASA Astrophysics Data System (ADS)

    de Elía, G. C.; Orellana, R. B.

    El cúmulo abierto NGC 2516 (α = 7h 58m y δ = -60o 45') tiene una edad de, aproximadamente, 150 Myr. El análisis de este sistema es particularmente importante en el Hemisferio Sur debido a su abundancia de estrellas peculiares y muy estudiado aplicando técnicas fotométricas, pero muy poco analizado desde el punto de vista astrométrico. A partir de una placa obtenida en el Observatorio Astronómico de La Plata y observaciones más actuales, nos hemos abocado al estudio de los movimientos propios de este cúmulo con el fin de determinar la pertenencia al mismo de las estrellas del campo de dicho cúmulo. Luego de llevar a cabo la determinación de los movimientos propios de todas las estrellas a partir de las posiciones obtenidas de la placa existente en el Observatorio de La Plata de 1914 y leídas con la MAMA en París, las observaciones realizadas con el círculo meridiano de San Fernando que se encuentra en el Observatorio Félix Aguilar de San Juan y las posiciones existentes en los catálogos AC 2000, Tycho, USNO y UCAC, programamos el método de Vasilevsky y Sanders para determinar la pertenencia de las estrellas de la región al cúmulo en cuestión. En un paso posterior, se realizó una modificación al método anterior para la determinación de los miembros. En esta modificación se consideró la densidad de las estrellas del cúmulo y la densidad de estrellas de campo. Esto permitió evaluar la pertenencia, no sólo a partir del movimiento propio de las estrellas, sino también a partir de la posición de las mismas con respecto al centro del cúmulo. También se consideró la dependencia de los parámetros con la magnitud. Los resultados así obtenidos fueron comparados con otras investigaciones de movimientos propios de la región del cúmulo. El movimiento propio absoluto del cúmulo fue comparado con el obtenido a partir de los catálogos estelares. Se encontró que los resultados coincidían para estrellas brillantes (magnitud más brillante que

  16. Leiomyosarcoma arising from the inferior mesenteric vein

    PubMed Central

    Clemente, Gennaro; Sarno, Gerardo; Barbaro, Brunella; Nuzzo, Gennaro

    2009-01-01

    Leyomiosarcomas arising from the portal/mesenteric venous system are very rare tumours, and only a few cases have been reported in the global literature. As the other leyomiosarcomas of vascular origin, they are associated with a poor prognosis. The present report describes the case of a 66-year-old woman with a leyomiosarcoma of the inferior mesenteric vein, unexpectedly found during a CT scan performed for another indication. A brief review of the literature is also given. The patient underwent radical surgical excision and enjoys a good health, without radiological signs of recurrence, 24 months after surgery. In this case, an early incidental diagnosis determined an early treatment and, probably, a favourable prognosis. This is the second case of leyomiosarcoma of the inferior mesenteric vein reported in the literature. PMID:21686492

  17. Leiomyosarcoma of the Inferior Vena Cava

    PubMed Central

    Sadri, Ben Abid; Amine, Attaoui Mohamed; Zeineb, Mzoughi; Nizar, Miloudi; Lassad, Gharbi; Khalfallah, Mohamed Tahar

    2013-01-01

    Vascular leiomyosarcoma (LMS) are unique. The inferior vena cava (IVC) is the most affected organ (about 38% cases). We report the observation of a 50-year old woman who consulted for right upper quadrant pain. Imaging studies revealed a retroperitoneal mass that mimic a LMS of the IVC. The patient was operated. A resection of the IVC along with the tumor was performed without reconstruction. The management of LMS is surgical and depends upon the location and tumor characteristics. PMID:24765501

  18. Non-inferiority trials: are they inferior? A systematic review of reporting in major medical journals

    PubMed Central

    Morris, Tim P; Fielding, Katherine; Carpenter, James R; Phillips, Patrick P J

    2016-01-01

    Objective To assess the adequacy of reporting of non-inferiority trials alongside the consistency and utility of current recommended analyses and guidelines. Design Review of randomised clinical trials that used a non-inferiority design published between January 2010 and May 2015 in medical journals that had an impact factor >10 (JAMA Internal Medicine, Archives Internal Medicine, PLOS Medicine, Annals of Internal Medicine, BMJ, JAMA, Lancet and New England Journal of Medicine). Data sources Ovid (MEDLINE). Methods We searched for non-inferiority trials and assessed the following: choice of non-inferiority margin and justification of margin; power and significance level for sample size; patient population used and how this was defined; any missing data methods used and assumptions declared and any sensitivity analyses used. Results A total of 168 trial publications were included. Most trials concluded non-inferiority (132; 79%). The non-inferiority margin was reported for 98% (164), but less than half reported any justification for the margin (77; 46%). While most chose two different analyses (91; 54%) the most common being intention-to-treat (ITT) or modified ITT and per-protocol, a large number of articles only chose to conduct and report one analysis (65; 39%), most commonly the ITT analysis. There was lack of clarity or inconsistency between the type I error rate and corresponding CIs for 73 (43%) articles. Missing data were rarely considered with (99; 59%) not declaring whether imputation techniques were used. Conclusions Reporting and conduct of non-inferiority trials is inconsistent and does not follow the recommendations in available statistical guidelines, which are not wholly consistent themselves. Authors should clearly describe the methods used and provide clear descriptions of and justifications for their design and primary analysis. Failure to do this risks misleading conclusions being drawn, with consequent effects on clinical practice. PMID:27855102

  19. Decompression of inferior alveolar nerve: case report.

    PubMed

    Marques, Tiago Miguel Santos; Gomes, Joana Marques

    2011-01-01

    Paresthesia as a result of mechanical trauma is one of the most frequent sensory disturbances of the inferior alveolar nerve. This case report describes surgical treatment for paresthesia caused by a compressive phenomenon within the mandibular canal. The cause of the compression, a broken instrument left in the patient's mouth during previous endodontic therapy, was identified during routine radiography and computed tomography. Once the foreign object was removed by surgery, the paresthesia resolved quickly. This case highlights the potential for an iatrogenic mechanical cause of paresthesia.

  20. Partial breast reconstruction with mini superficial inferior epigastric artery and mini deep inferior epigastric perforator flaps.

    PubMed

    Spiegel, Aldona J; Eldor, Liron

    2010-08-01

    In this study, partial breast reconstruction was undertaken after breast conservation therapy using mini abdominal free flaps on both an immediate and delayed basis.Patient demographics, oncologic status, reconstructive data, and complications were collected from medical records.Twelve patients (age range 39-60) were included in this study with a mean follow-up time of 5 years. Ten mini superficial inferior epigastric artery flaps and 2 mini deep inferior epigastric perforator flaps were used (7 immediate and 5 delayed reconstructions). No flap lost, 1 minor abdominal wound dehiscence, and no local or distant recurrences were noted. Good to excellent results were reported by 91% of the women.In properly selected patients with high motivation toward breast conservation, tailored abdominal mini-free flaps can safely and satisfactorily be implemented for the reconstruction of partial mastectomy defects. Patients should be comprehensively educated on the potential future implications of using the abdominal donor site for partial breast reconstruction.

  1. Uses of the Inferior Oblique Muscle in Strabismus Surgery

    PubMed Central

    Stager, David; Dao, Lori M.; Felius, Joost

    2015-01-01

    Inferior oblique muscle weakening is typically performed for overaction of the muscle. In this article, we review inferior oblique muscle anatomy, different weakening procedures, and recent surgical techniques that take advantage of the muscle's unique anatomy for the treatment of additional indications such as excyclotorsion and hypertropia in primary gaze. PMID:26180466

  2. Complications of inferior vena cava filters

    PubMed Central

    Grewal, Simer; Chamarthy, Murthy R.

    2016-01-01

    Inferior vena cava (IVC) filter placement is a relatively low risk alternative for prophylaxis against pulmonary embolism in patients with pelvic or lower extremity deep venous thrombosis who are not suitable for anticoagulation. There is an increasing trend in the number of IVC filter implantation procedures performed every year. There are many device types in the market and in the early 2000s, the introduction of retrievable filters brought an additional subset of complications to consider. Modern filter designs have led to decreased morbidity and mortality, however, a thorough understanding of the limitations and complications of IVC filters is necessary to weight the risks and benefits of placing IVC filters. In this review, the complications associated with IVC filters are divided into procedure related, post-procedure, and retrieval complications. Differences amongst the device types and retrievable filters are described, though this is limited by a significant lack of prospective studies. Additionally, the clinical presentation as well as prevention and treatment strategies are outlined with each complication type. PMID:28123983

  3. Progressive limb ataxia following inferior olive lesions

    PubMed Central

    Horn, K M; Deep, A; Gibson, A R

    2013-01-01

    Cerebellar climbing fibres originate in the inferior olive (IO). Temporary IO inactivation produces movement deficits. Does permanent inactivation produce similar deficits and, if so, do they recover? The excitotoxin, kainic acid, was injected into the rostral IO of three cats. Behaviour was measured during reaching and locomotion. Two cats were injected during the reaching task. Within minutes, grasping became difficult and the trajectories of the reaches showed higher arcing than normally seen. During locomotion, both cats showed head and trunk deviation to the injected side, walking paths curved to the injected side, and the paws were lifted higher than normal. Limbs contralateral to the injections became rigid. Within 1 day, posture had normalized, locomotion was unsteady and high lifting of the paws had reversed to a tendency to drag the dorsum of the paws. Passive body movement produced vestibular signs. Over a few days, locomotion normalized and vestibular signs disappeared. Reach trajectories were normal but grasping deficits persisted. Over the first week, the amplitude of limb lift during reaching and locomotion began to increase. The increase continued over time and, after several months, limb movements became severely ataxic. The effects followed the somatotopy of the rostral IO: a loss of cells in medial rostral IO only affected the forelimb, whereas a loss of cells in medial and lateral IO affected both forelimb and hindlimb. Deficits produced by IO lesions involve multiple mechanisms; some recover rapidly, some appear stable, and some worsen over time. The nature of the progressive deficit suggests a gradual loss of Purkinje cell inhibition on cerebellar nuclear cells. PMID:23027819

  4. [Combined resection of liver and inferior vena cava].

    PubMed

    Sherba, A E; Efimov, D Iu; Rummo, O O

    2014-01-01

    It was analyzed the results of treatment of 8 patients. Combined resection of liver and inferior vena cava was done in all cases. All resections of inferior vena cava were performed in combination with right-sided hemihepatectomy. Circular resection of inferior vena cava was done in 6 cases, tangential-in 2 cases. Allograft of donor inferior vena cava was used in 3 cases for reconstruction of inferior vena cava. Average duration of combined resection of liver and inferior vena cava was 675±189 min, average hemorrhage - 1800±1402 ml. The need for transfusion of packed red blood cells was 270±723 ml, the need for transfusion of fresh frozen plasma was 1105±636 ml. Post-resection liver failure according to criteria ISGLS developed in 3 patients (37.5%). Biliary complications such as biliary fistula and inconsistency of hepatico-jejunal anastomosis developed in 2 patients (25%). Hospital mortality was 12.5%. It is considered that resection of liver with inferior vena cava demands an experience in hepatobiliary surgery and/or liver transplantation. Surgeon must be ready to use total vascular isolation, hypothermic preservation and veno-venous bypass grafting. It allows to dilate an opportunity of resection liver surgery.

  5. Spatial selectivity in the temporoparietal junction, inferior frontal sulcus, and inferior parietal lobule

    PubMed Central

    Hansen, Kathleen A.; Chu, Carlton; Dickinson, Annelise; Pye, Brandon; Weller, J. Patrick; Ungerleider, Leslie G.

    2015-01-01

    Spatial selectivity, as measured by functional magnetic resonance imaging (fMRI) activity patterns that vary consistently with the location of visual stimuli, has been documented in many human brain regions, notably the occipital visual cortex and the frontal and parietal regions that are active during endogenous, goal-directed attention. We hypothesized that spatial selectivity also exists in regions that are active during exogenous, stimulus-driven attention. To test this hypothesis, we acquired fMRI data while subjects maintained passive fixation. At jittered time intervals, a briefly presented wedge-shaped array of rapidly expanding circles appeared at one of three contralateral or one of three ipsilateral locations. Positive fMRI activations were identified in multiple brain regions commonly associated with exogenous attention, including the temporoparietal junction, the inferior parietal lobule, and the inferior frontal sulcus. These activations were not organized as a map across the cortical surface. However, multivoxel pattern analysis of the fMRI activity correctly classified every pair of stimulus locations, demonstrating that patterns of fMRI activity were correlated with spatial location. These observations held for both contralateral and ipsilateral stimulus pairs as well as for stimuli of different textures (radial checkerboard) and shapes (squares and rings). Permutation testing verified that the obtained accuracies were not due to systematic biases and demonstrated that the findings were statistically significant. PMID:26382006

  6. [Congenital anomalies of the inferior vena cava: role of imaging].

    PubMed

    Manfredi, R; Cotroneo, A R; Pirronti, T; Macis, G; Marano, P

    1995-10-01

    In recent years, clinics and radiology of congenital anomalies of the inferior vena cava have increased in importance in planning abdominal surgery, liver or kidney transplantation, or new interventional or diagnostic procedures such as the positioning of inferior vena cava filters to prevent pulmonary embolism, varicocel sclerotherapy and renal venous sampling. In the past, the radiologic assessment of these rare anomalies was performed only with angiography, which remains the most accurate diagnostic method. Today, besides angiography, less invasive examinations can be performed, e.g., US, CT and MRI, with MRA. In the last two years, 5 patients with inferior vena cava anomalies were examined: 3 had double inferior vena cava and 2 azygos continuation. All of them were submitted to US, CT, MRI and MRA and 3 patients underwent also angiography, two of them with double puncture. US can suggest the diagnosis but may be limited by technical factors and in the assessment of the whole inferior vena cava. Enhanced CT can depict anomaly extent, but uses contrast agents and ionizing radiations. Angiography better depicts craniocaudal spread and collateral networks but is an invasive procedure and sometimes needs a double puncture (double inferior vena cava). MRI, with MRA, yields the same information as the other modalities, but without contrast agents or ionizing radiations. The development of velocity encoded sequences will probably make this technique the method of choice in the study of inferior vena cava anomalies. Our study was aimed at reviewing the embryo-genesis of inferior vena cava anomalies and to assess the relative importance of different diagnostic procedures in the diagnosis and staging of these anomalies.

  7. Auditory scene analysis following unilateral inferior colliculus infarct.

    PubMed

    Champoux, François; Paiement, Philippe; Vannasing, Phetsamone; Mercier, Claude; Gagné, Jean-Pierre; Lepore, Franco; Lassonde, Maryse

    2007-11-19

    Event-related potentials in the form of mismatch negativity were recorded to investigate auditory scene analysis capabilities in a person with a very circumscribed haemorrhagic lesion at the level of the right inferior colliculus. The results provide the first objective evidence that processing at the level of the inferior colliculus plays an important role in human auditory frequency discrimination. Moreover, the electrophysiological data suggest that following this unilateral lesion, the auditory pathways fail to reorganize efficiently.

  8. Glucose utilization in the inferior cerebellar vermis and ocular myoclonus.

    PubMed

    Yakushiji, Y; Otsubo, R; Hayashi, T; Fukuchi, K; Yamada, N; Hasegawa, Y; Minematsu, K

    2006-07-11

    In a patient with symptomatic ocular myoclonus, the authors observed the regional cerebral metabolic rate of glucose use (rCMRGlu) before and after successful treatment with clonazepam. Even after the symptoms resolved, the rCMRGlu in the hypertrophic olive increased persistently, whereas that in the inferior cerebellar vermis contralateral to the hypertrophic olive decreased. The inferior cerebellar vermis, belonging to the vestibulocerebellar system, may be associated with the generation of symptomatic ocular myoclonus.

  9. Inferior ectopic pupil and typical ocular coloboma in RCS rats.

    PubMed

    Tsuji, Naho; Ozaki, Kiyokazu; Narama, Isao; Matsuura, Tetsuro

    2011-08-01

    Ocular coloboma is sometimes accompanied by corectopia in humans and therefore ectopic pupil may indicate ocular coloboma in experimental animals. The RCS strain of rats has a low incidence of microphthalmia. We found that inferior ectopic pupil is associated exclusively with small-sized eyes in this strain. The objective of the current study was to evaluate whether inferior ectopic pupil is associated with iridal coloboma and other types of ocular coloboma in RCS rats. Both eyes of RCS rats were examined clinically, and those with inferior ectopic pupils underwent morphologic and morphometric examinations. In a prenatal study, coronal serial sections of eyeballs from fetuses at gestational day 16.5 were examined by using light microscopy. Ectopic pupils in RCS rats were found exclusively in an inferior position, where the iris was shortened. Fundic examination revealed severe chorioretinal coloboma in all cases of inferior ectopic pupil. The morphologic characteristics closely resembled those of chorioretinal coloboma in humans. Histopathologic examination of primordia showed incomplete closure of the optic fissure in 4 eyeballs of RCS fetuses. Neither F(1) rats nor N(2) (progeny of RCS × BN matings) displayed any ocular anomalies, including ectopic pupils. The RCS strain is a suitable model for human ocular coloboma, and inferior ectopic pupil appears to be a strong indicator of ocular coloboma.

  10. Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle.

    PubMed

    Aguirre-Aquino, B I; Riemann, C D; Lewis, H; Traboulsi, E I

    2001-02-01

    Snapping or tearing of an extraocular muscle refers to its rupture across its width, usually at the junction between muscle and tendon several millimeters behind the insertion. Tearing occurs during strabismus or retinal reattachment surgery, or after trauma. If the proximal end of the muscle cannot be located, transposition procedures are necessary to achieve ocular realignment. These surgical procedures carry the risk of anterior segment ischemia, especially in the elderly. Anterior transposition of the inferior oblique muscle has been used for the treatment of inferior oblique overaction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy. We transposed the inferior oblique muscle insertion in a 73-year-old woman with a snapped inferior rectus muscle.

  11. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    PubMed

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (p<0.01). Eighteen (60%) patients had ptosis, six (20%) of whom had bilateral ptosis. Diagnosing myasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected.

  12. The effects of inferior olive lesion on strychnine seizure

    SciTech Connect

    Anderson, M.C.; Chung, E.Y.; Van Woert, M.H. )

    1990-10-01

    Bilateral inferior olive lesions, produced by systemic administration of the neurotoxin 3-acetylpyridine (3AP) produce a proconvulsant state specific for strychnine-induced seizures and myoclonus. We have proposed that these phenomena are mediated through increased excitation of cerebellar Purkinje cells, through activation of glutamate receptors, in response to climbing fiber deafferentation. An increase in quisqualic acid (QA)-displaceable ({sup 3}H)AMPA ((RS)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid) binding in cerebella from inferior olive-lesioned rats was observed, but no difference in ({sup 3}H)AMPA binding displaced by glutamate, kainic acid (KA) or glutamate diethylester (GDEE) was seen. The excitatory amino acid antagonists GDEE and MK-801 ((+)-5-methyl-10,11-dihydro-5H-dibenzo(a,d)cyclo-hepten-5,10 imine) were tested as anticonvulsants for strychnine-induced seizures in 3AP inferior olive-lesioned and control rats. Neither drug effected seizures in control rats, however, both GDEE and MK-801 produced a leftward shift in the strychnine-seizure dose-response curve in 3AP inferior olive-lesioned rats. GDEE also inhibited strychnine-induced myoclonus in the lesioned group, while MK-801 had no effect on myoclonus. The decreased threshold for strychnine-induced seizures and myoclonus in the 3AP-inferior olive-lesioned rats may be due to an increase in glutamate receptors as suggested by the ({sup 3}H)AMPA binding data.

  13. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    SciTech Connect

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.

    1986-12-01

    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% (mean +/- S.E.M.) vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury.

  14. Traumatic neuroma of the inferior alveolar nerve: a case report.

    PubMed

    Arribas-García, Ignacio; Alcalá-Galiano, Andrea; Gutiérrez, Ramón; Montalvo-Moreno, Juan José

    2008-03-01

    Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass within the canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology and immunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence.

  15. Variant Inferior Alveolar Nerves and Implications for Local Anesthesia

    PubMed Central

    Wolf, Kevin T.; Brokaw, Everett J.; Bell, Andrea; Joy, Anita

    2016-01-01

    A sound knowledge of anatomical variations that could be encountered during surgical procedures is helpful in avoiding surgical complications. The current article details anomalous morphology of inferior alveolar nerves encountered during routine dissection of the craniofacial region in the Gross Anatomy laboratory. We also report variations of the lingual nerves, associated with the inferior alveolar nerves. The variations were documented and a thorough review of literature was carried out. We focus on the variations themselves, and the clinical implications that these variations present. Thorough understanding of variant anatomy of the lingual and inferior alveolar nerves may determine the success of procedural anesthesia, the etiology of pathologic processes, and the avoidance of surgical misadventure. PMID:27269666

  16. The Development of Hypertrophic Inferior Olivary Nucleus in Oculopalatal Tremor.

    PubMed

    Jun, Bokkwan

    2016-12-01

    Oculopalatal tremor is an acquired clinical condition resulting from the interruption of the dentato-rubro-olivary neuronal pathway. The signal change in inferior olivary nucleus and its hypertrophy on magnetic resonance imaging (MRI) can be observed prior to the development of symptomatic oculopalatal tremor. This is a case of the fourth cranial nerve palsy followed by oculopalatal tremor, and increased signal intensity in inferior olivary nucleus on MRI was observed in 7 months after damage to the dentate-rubro-olivary pathway and 5 months prior to the development of oscillopsia and oculopalatal tremor.

  17. Calcium Uptake and Release through Sarcoplasmic Reticulum in the Inferior Oblique Muscles of Patients with Inferior Oblique Overaction

    PubMed Central

    Kim, Hee Seon; Chang, Yoon-Hee; Kim, Do Han; Park, So Ra; Han, Sueng-Han

    2006-01-01

    We characterized and compared the characteristics of Ca2+ movements through the sarcoplasmic reticulum of inferior oblique muscles in the various conditions including primary inferior oblique overaction (IOOA), secondary IOOA, and controls, so as to further understand the pathogenesis of primary IOOA. Of 15 specimens obtained through inferior oblique myectomy, six were from primary IOOA, 6 from secondary IOOA, and the remaining 3 were controls from enucleated eyes. Ryanodine binding assays were performed, and Ca2+ uptake rates, calsequestrins and SERCA levels were determined. Ryanodine bindings and sarcoplasmic reticulum Ca2+ uptake rates were significantly decreased in primary IOOA (p<0.05). Western blot analysis conducted to quantify calsequestrins and SERCA, found no significant difference between primary IOOA, secondary IOOA, and the controls. Increased intracellular Ca2+ concentration due to reduced sarcoplasmic reticulum Ca2+ uptake may play a role in primary IOOA. PMID:16642550

  18. Inferior Colliculus Lesions Impair Eyeblink Conditioning in Rats

    ERIC Educational Resources Information Center

    Freeman, John H.; Halverson, Hunter E.; Hubbard, Erin M.

    2007-01-01

    The neural plasticity necessary for acquisition and retention of eyeblink conditioning has been localized to the cerebellum. However, the sources of sensory input to the cerebellum that are necessary for establishing learning-related plasticity have not been identified completely. The inferior colliculus may be a source of sensory input to the…

  19. Inferior vena cava leiomyosarcoma: vascular reconstruction is not always mandatory

    PubMed Central

    Slimane, Maher; Yahia, Nada Belhaj; Bouaziz, Hanene; Bouzaine, Hatem; Benhassouna, Jamel; Dhieb, Tarek Ben; Hechiche, Monia; Gammoudi, Amor; Rahal, Khaled

    2016-01-01

    Leiomyosarcoma (LMS) of inferior vena cava is a rare and aggressive tumor, arising from the smooth muscle cells in the vessel wall. A large complete surgical resection is the essential treatment. The need of vascular reconstruction is not always mandatory. It’s above all to understand the place of the reconstruction with artificial vascular patch prosthetics of vena cave after a large resection of the tumor. We rapport two cases of LMS of inferior vena cava in two women who underwent successful large resection of tumor and lower segment of inferior vena cava. In first case, reconstruction of the inferior vena cava was not performed because of the development of venous collaterals derivation. In the second case reconstruction was done using Dacron interposition graft. The necessity of a large resection in management of primary leiomyosarcoma of vena cave makes sometimes unavoidable the sacrifice of a portion of the vena. Indeed, a better comprehension of the development of venous derivation may render unnecessary the reconstruction. PMID:28154642

  20. Traumatic longitudinal splitting of the inferior rectus muscle

    PubMed Central

    Laursen, Jessica; Demer, Joseph L.

    2011-01-01

    Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus following orbital reconstruction after a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging (MRI) revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers. PMID:21463958

  1. Inferior pancreaticoduodenal artery aneurysm associated with common hepatic artery occlusion.

    PubMed

    Bracale, G; Porcellini, M; Bernardo, B; Selvetella, L; Renda, A

    1996-12-01

    A unique case of true inferior pancreaticoduodenal artery aneurysm (IPDA) associated with occlusion of common hepatic artery is reported. Radiological and MRI findings are described. Because of high risk of visceral ischemia that contraindicated a percutaneous transluminal embolization, a successful tangential resection of aneurysm was performed.

  2. Endodontic-related inferior alveolar nerve and mental foramen paresthesia.

    PubMed

    Morse, D R

    1997-10-01

    Paresthesia is a condition that involves perverted sensations of pain, touch, or temperature. It has a variety of possible causes. This article presents a literature review and case reports of endodontically related inferior alveolar nerve and mental foramen paresthesia. Nondrug prevention methods and the dental uses of dexamethasone are also discussed.

  3. Care of patients with deep inferior epigastric perforator reconstruction.

    PubMed

    Long, Laura; Israelian, Amy

    2013-01-01

    Recent trends reflect greater numbers of women opting for mastectomy for invasive breast cancer. Breast reconstruction, either at the time of mastectomy or later, is increasingly an option patients prefer. Although many women opt for implants, reconstruction using autologous tissue offers several advantages including tissue that feels more natural and will age naturally with the patient. The deep inferior epigastric perforator flap has emerged as an alternative to the transverse rectus abdominis myocutaneous flap and allows for preservation of the underlying abdominal muscle. As greater numbers of surgeons are able to offer this microvascular alternative, nurses will care for these postoperative patients in the intensive care unit and medical/surgical settings. This article reviews the evaluation of patients for deep inferior epigastric perforator reconstruction and the unique complexities of postoperative nursing care for these patients.

  4. Enhanced Modiolar Stimulation Effects in the Inferior Colliculus

    DTIC Science & Technology

    2007-11-02

    stimulation. Keywords: Cochlear Implant , Inferior Colliculus, Modiolar Stimulation I. INTRODUCTION Cochlear implants are used to provide hearing sensation...to the sensoneurally deaf. Bipolar electrical stimulation of a scala tympani cochlear implant produces a localized stimulus which has been measured...to diminish at about 9dB/octave [1]. Blamey et al. (1994) describes both a perceived low frequency shift by cochlear implant patients in response to

  5. Management of the Thrombosed Filter-Bearing Inferior Vena Cava

    PubMed Central

    Sildiroglu, Onur; Ozer, Harun; Turba, Ulku Cenk

    2012-01-01

    Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management. PMID:23449290

  6. Leiomyosarcoma of the inferior vena cava: a case report.

    PubMed

    Nascif, Rafael Lemos; Antón, Ana Graziela Santana; Fernandes, Gabriel Lacerda; Dantas, George Caldas; Gomes, Vinícius de Araújo; Natal, Marcelo Ricardo Canuto

    2014-01-01

    The authors report a case of a 48 year-old female patient with moderate abdominal pain and bulging in the abdomen. Physical examination demonstrated the presence of a palpable abdominal mass. Computed tomography showed a heterogeneously enhancing retroperitoneal mass in close contact with the inferior vena cava. En bloc resection of the mass and of the attached vena cava segment was performed. Histological analysis revealed leiomyosarcoma.

  7. [Aneurysm of the anterior inferior cerebellar artery: case report].

    PubMed

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  8. Truncal ataxia from infarction involving the inferior olivary nucleus.

    PubMed

    Park, Jae Hyun; Ryoo, Sookyung; Moon, So Young; Seo, Sand Won; Na, Duk L

    2012-08-01

    Truncal ataxia in medullary infarction may be caused by involvement of the lateral part of the medulla; however, truncal ataxia in infarction involving the inferior olivary nucleus (ION) has received comparatively little attention. We report a patient with truncal ataxia due to medial medullary infarction located in the ION. A lesion in the ION could produce a contralateral truncal ataxia due to increased inhibitory input to the contralesional vestibular nucleus from the contralesional flocculus.

  9. Bruxism elicited by inferior alveolar nerve injury: a case report.

    PubMed

    Melis, Marcello; Coiana, Carlo; Secci, Simona

    2012-02-01

    The aim of this case report is to describe the history of a patient who received an injury to the right inferior alveolar nerve after placement of a dental implant, with bruxism noted afterward. The symptoms were managed by the use of an occlusal appliance worn at night and occasionally during the day, associated with increased awareness of parafunction during the day to reduce muscle pain and fatigue. Paresthesia of the teeth, gingiva, and lower lip persisted but were reduced during appliance use.

  10. Bayesian approach to non-inferiority trials for normal means.

    PubMed

    Gamalo, M Amper; Wu, Rui; Tiwari, Ram C

    2016-02-01

    Regulatory framework recommends that novel statistical methodology for analyzing trial results parallels the frequentist strategy, e.g. the new method must protect type-I error and arrive at a similar conclusion. Keeping these in mind, we construct a Bayesian approach for non-inferiority trials with normal response. A non-informative prior is assumed for the mean response of the experimental treatment and Jeffrey's prior for its corresponding variance when it is unknown. The posteriors of the mean response and variance of the treatment in historical trials are then assumed as priors for its corresponding parameters in the current trial, where that treatment serves as the active control. From these priors, a Bayesian decision criterion is derived to determine whether the experimental treatment is non-inferior to the active control. This criterion is evaluated and compared with the frequentist method using simulation studies. Results show that both Bayesian and frequentist approaches perform alike, but the Bayesian approach has a higher power when the variances are unknown. Both methods also arrive at the same conclusion of non-inferiority when applied on two real datasets. A major advantage of the proposed Bayesian approach lies in its ability to provide posterior probabilities for varying effect sizes of the experimental treatment over the active control.

  11. Abducens nerve palsy due to inferior petrosal sinus thrombosis.

    PubMed

    Mittal, Shivam Om; Siddiqui, Junaid; Katirji, Bashar

    2017-02-24

    Isolated unilateral abducens nerve palsy is usually due to ischemia, trauma or neoplasm. Dorello's canal is the space between the petrous apex and superolateral portion of the clivus, bound superiorly by Gruber's ligament. The abducens nerve travels with inferior petrosal sinus (IPS) though the Dorello's canal before entering the cavernous sinus. A 31-year-old man presented with neck pain, and binocular horizontal diplopia, worse looking towards left and at distance. He had a history of intravenous drug abuse but no history of hypertension or diabetes. On examination, he had complete left 6th nerve palsy with normal fundi, pupils, and other cranial nerves. Methicillin-resistant Staphylococcus aureus bacteremia was detected with naïve tricuspid valve endocarditis and multiple septic emboli to lungs with infarcts. His cerebrospinal fluid was normal. MRI of the brain was normal. MRV of head and neck showed thrombosis of the left internal jugular vein, left sigmoid sinus and left inferior petrosal sinus with normal cavernous sinus and no evidence of mastoiditis. He was treated with broad spectrum antibiotics. He was not anticoagulated for fear of pulmonary hemorrhage from pulmonary infarcts. Although cerebral venous sinus thrombosis commonly presents with elevated intracranial pressure, isolated ipsilateral 6th nerve palsy from its compression in Dorello's canal due to thrombosis of the ipsilateral inferior petrosal sinus is extremely rare. To our knowledge, only two patients have been reported with isolated abducens palsy due to IPS thrombosis; one caused by septic emboli and the other developed it during IPS cortisol level sampling.

  12. Inferior vestibular neuritis in a fighter pilot: a case report.

    PubMed

    Xie, Su Jiang; Jia, Hong Bo; Xu, Po; Zheng, Ying Juan

    2013-06-01

    Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.

  13. Inferior hip dislocation after falling from height: A case report

    PubMed Central

    Tekin, Ali Çağrı; Çabuk, Haluk; Büyükkurt, Cem Dinçay; Dedeoğlu, Süleyman Semih; İmren, Yunus; Gürbüz, Hakan

    2016-01-01

    Introduction Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. Presentation of case A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15 m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation. No neurovascular impairment was determined. On radiologic examination, a left ischial type inferior hip dislocation was detected. Hemorrhagic shock which developed due to acute blood loss to thoracic and abdominal cavity and patient died at third hour after she was brought to the hospital. Discussion Traumatic hip dislocations have high morbidity and mortality rates due to multiple organ damage, primarily of the extremities, chest and abdomen. In the treatment of traumatic hip dislocation, closed reduction is recommended through muscle relaxation under general anesthesia or sedation. This procedure should be applied before any intervention for concomitant extremity injuries. A detailed evaluation on emergency presentation, a multi-disciplinary approach and early diagnosis with the rapid application of imaging methods could be life-saving for such patients. PMID:27058153

  14. [Inferior vertical nystagmus: is magnetic resonance imaging mandatory?].

    PubMed

    Esteban-Sánchez, Jonathan; Rueda-Marcos, Almudena; Sanz-Fernández, Ricardo; Martín-Sanz, Eduardo

    2016-02-01

    Introduccion. La aparicion de un nistagmo vertical inferior clasicamente obliga a descartar una patologia vascular o de la union craneocervical mediante resonancia magnetica (RM). Estudios recientes demuestran una baja rentabilidad de esta prueba, ya que sugieren que este signo oculomotor puede tener una causa vestibular periferica, sobre todo cuando el paciente presenta un vertigo posicional paroxistico benigno (VPPB) del canal semicircular superior. Objetivo. Comprobar la rentabilidad de la RM en una poblacion de pacientes con nistagmo de posicion vertical inferior. Pacientes y metodos. Estudio retrospectivo de 42 pacientes consecutivos a los que se les realizo una historia clinica, exploracion fisica, y pruebas vestibulares caloricas y rotatorias. A todos ellos se les practico una RM craneal y cervical. Resultados. El 52% de los pacientes con nistagmo de posicion vertical inferior presentaba una clinica y exploracion fisica compatibles con VPPB del canal semicircular superior. La RM fue normal en un 67%, un 26% mostraba datos de espondilopatia y un 5% de microangiopatia cerebral no relacionados con la clinica del paciente. La prevalencia de malformacion de Arnold-Chiari de tipo I fue de un 9% en la poblacion estudiada, sin que nadie tuviera un antecedente reciente de VPPB. Los resultados obtenidos en las pruebas complementarias vestibulares no aportaron informacion adicional para llegar a un diagnostico etiologico. Conclusion. En los pacientes con un VPPB, la RM craneal y las pruebas vestibulares tienen una baja rentabilidad diagnostica, y se debe evaluar la necesidad real de esta prueba con el contexto clinico.

  15. Intraosseous schwannoma originating in inferior alveolar nerve: a case report.

    PubMed

    Suga, Kenichiro; Ogane, Satoru; Muramatsu, Kyotaro; Ohata, Hitoshi; Uchiyama, Takeshi; Takano, Nobuo; Shibahara, Takahiko; Eguchi, Jun; Murakami, Satoshi; Matsuzaka, Kenichi

    2013-01-01

    Schwannomas (neurilemmomas) are benign neoplasms derived from Schwann cells of the neurilemma and appear most frequently on the auditory nerve or peripheral nerves of the skin. They arise in the oral and maxillofacial region infrequently, and very rarely in the center of the jaw. We herein present a case of a rare mandibular intraosseous schwannoma derived from the main trunk of the inferior alveolar nerve in a 33-year-old man. Fusiform expansion in the mandibular canal was observed and a mass showing the target sign in the mandibular canal was confirmed on T2-weighted and Gd contrastenhanced T1-weighted MRI. Based on these findings, an inferior alveolar nerve-derived schwannoma or other benign nervous system neoplasm was diagnosed. A buccal side cortical bone flap in the mandibular molar region was removed to expose the mass, which was then peeled away from the nerve fibers and completely removed. Some inferior alveolar nerve fibers that were connected to the mass were removed at the same time, but the remaining nerve fiber bundle was preserved. Histopathology confirmed the diagnosis of a schwannoma with Antoni type A and Antoni type B regions. Although the patient experienced extremely mild paresthesia in the skin over the mental region and mental foramen at immediately after surgery, this had almost entirely disappeared at 7 years and 4 months later, and there has been no tumor recurrence.

  16. Anesthetic technique for inferior alveolar nerve block: a new approach

    PubMed Central

    PALTI, Dafna Geller; de ALMEIDA, Cristiane Machado; RODRIGUES, Antonio de Castro; ANDREO, Jesus Carlos; LIMA, José Eduardo Oliveira

    2011-01-01

    Background Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 1329% of cases. Objective Objective: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. Materials and Methods A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition) from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side), and the second following the oclusal plane (left side), a line can be achieved whose projection coincides with the left mandibular foramen. Results The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. Conclusion This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry. PMID:21437463

  17. Inferior epigastric artery: Surface anatomy, prevention and management of injury.

    PubMed

    Wong, Clare; Merkur, Harry

    2016-04-01

    The anatomical position of the inferior epigastric artery (IEA) subjects it to risk of injury during abdominal procedures that are close to the artery, such as laparoscopic trocar insertion, insertion of intra-abdominal drains, Tenckhoff(®) catheter (peritoneal dialysis catheter) and paracentesis. This article aims to raise the awareness of the anatomical variations of the course of the IEA in relation to abdominal landmarks in order to define a safer zone for laparoscopic ancillary trocar placement. Methods of managing the IEA injury as well as techniques to minimise the risk of injury to the IEA are reviewed and discussed.

  18. CT fluoroscopic guided insertion of inferior vena cava filters.

    PubMed

    Ignotus, P; Wetton, C; Berry, J

    2006-03-01

    The value and use of inferior vena cava (IVC) filters is well documented and has been growing since the first reported filter placement in 1973 and the first percutaneous insertion in 1982. Access routes now include both jugular veins, both ante-cubital veins and both femoral veins. However, all insertions require some form of imaging, usually fluoroscopy, to identify the location of the filter with respect to the IVC and the renal veins. We describe two cases where the patients' weight was significantly greater than the weight limit of the angiography table, necessitating insertion under CT fluoroscopic guidance.

  19. A Novel Technique for Inferior Vena Cava Filter Extraction

    SciTech Connect

    Johnston, Edward William Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian

    2013-05-02

    Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed.

  20. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    PubMed Central

    Koeth, Oliver; Zeymer, Uwe; Schiele, Rudolf; Zahn, Ralf

    2010-01-01

    Takotsubo cardiomyopathy (TCM) is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI) is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM. PMID:20811565

  1. Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment.

    PubMed

    Yatsuhashi, Takaaki; Nakagawa, Kan-Ichi; Matsumoto, Miho; Kasahara, Masataka; Igarashi, Tomoko; Ichinohe, Tatsuya; Kaneko, Yuzuru

    2003-11-01

    We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.

  2. Duplicate inferior vena cava filters: more is not always better.

    PubMed

    Katyal, Anup; Javed, Muhammad Ali

    2016-01-01

    Duplication of the inferior vena cava (IVC) has been reported in literature. This achieves clinical significance in the setting of lower extremity venous thromboembolism with a contraindication for anticoagulation. We describe a case of lower extremity deep vein thrombosis with duplicate IVC. Anticoagulation was contraindicated in this case leading to successful treatment with double IVC filters. We conducted a PubMed search for all current English language published literature, where filters were placed in the presence of duplicate IVC. We suggest that patients with deep vein thrombosis should have an accurate assessment of venous anatomy before IVC filter placement. Duplication of IVC, although rare, should be considered as this has management implications.

  3. Using inferior vena cava filters to prevent pulmonary embolism

    PubMed Central

    Chung, John; Owen, Richard J.T.

    2008-01-01

    OBJECTIVE To review the evidence for using inferior vena cava (IVC) filters to prevent pulmonary embolism (PE) in high-risk patients. QUALITY OF EVIDENCE Ovid MEDLINE was searched from 1966 to 2006 for all English-language papers on IVC filters. Evidence was graded according to the 3-level classification system. Most evidence found was level II. MAIN MESSAGE Inferior vena cava filters are used to prevent PE in patients with contraindications to, complications of, or failure of anticoagulation therapy and patients with extensive free-floating thrombi or residual thrombi following massive PE. Current evidence indicates that IVC filters are largely effective; breakthrough PE occurs in only 0% to 6.2% of cases. Contraindications to implantation of IVC filters include lack of venous access, caval occlusion, uncorrectable coagulopathy, and sepsis. Complications include misplacement or embolization of the filter, vascular injury or thrombosis, pneumothorax, and air emboli. Recurrent PE, IVC thrombosis, filter migration, filter fracture, or penetration of the caval wall sometimes occur with long-term use. CONCLUSION When used appropriately, IVC filters are a safe and effective method of preventing PE. Using retrievable filters might reduce long-term complications. PMID:18208955

  4. [LGM inferior vena cava filters--observation of 79 patients].

    PubMed

    Hajduk, B; Tomkowski, W; Fijałkowska, A; Oniszh, K; Małek, G; Wawrzyńska, L; Radomyski, A; Filipecki, S; Torbicki, A

    2000-11-01

    The aim of the study was to assess effectiveness and safety of the LGM inferior vena cava (IVC) filters in patients with venous thromboembolic disease. In the Department of Internal Medicine of Institute of Tuberculosis and Lung Diseases in Warsaw 79 LGM IVC filters have been inserted since 1993. Indications for filters placement were as follows: recurrent pulmonary embolism (pe) despite anticoagulation--17 patients (pts), severe bleeding complications of thrombolytic or anticoagulant therapy--11 pts, contraindications for thrombolytic and/or anticoagulant treatment--5 pts, massive pe--14 pts, chronic thromboembolic-major vessel pulmonary hypertension (CTEPH)--30 pts, extensive deep vein thrombosis of lower limbs or vena cava inferior in patients with urgent indications for surgery--24 pts. Each filter placement was preceded by cavography. The diagnostic procedures (mainly ultrasonography) were performed after 3-6 and 12 months in the first year then once yearly during follow-up period. Oral anticoagulants (OA) or low-molecular-weight heparins (LMWH) were instituted in the majority of patients. 58 patients are still alive, 21 patients died. Only two non-fatal episodes of recurrent pe were documented. Other complications were rare and insignificant. We have not observed excess rate of recurrent deep venous thrombosis nor thrombosis at the filter site. The LGM IVC filters are effective and safe in such selectively chosen group of patients.

  5. Monopolar intracochlear pulse trains selectively activate the inferior colliculus.

    PubMed

    Schoenecker, Matthew C; Bonham, Ben H; Stakhovskaya, Olga A; Snyder, Russell L; Leake, Patricia A

    2012-10-01

    Previous cochlear implant studies using isolated electrical stimulus pulses in animal models have reported that intracochlear monopolar stimulus configurations elicit broad extents of neuronal activation within the central auditory system-much broader than the activation patterns produced by bipolar electrode pairs or acoustic tones. However, psychophysical and speech reception studies that use sustained pulse trains do not show clear performance differences for monopolar versus bipolar configurations. To test whether monopolar intracochlear stimulation can produce selective activation of the inferior colliculus, we measured activation widths along the tonotopic axis of the inferior colliculus for acoustic tones and 1,000-pulse/s electrical pulse trains in guinea pigs and cats. Electrical pulse trains were presented using an array of 6-12 stimulating electrodes distributed longitudinally on a space-filling silicone carrier positioned in the scala tympani of the cochlea. We found that for monopolar, bipolar, and acoustic stimuli, activation widths were significantly narrower for sustained responses than for the transient response to the stimulus onset. Furthermore, monopolar and bipolar stimuli elicited similar activation widths when compared at stimulus levels that produced similar peak spike rates. Surprisingly, we found that in guinea pigs, monopolar and bipolar stimuli produced narrower sustained activation than 60 dB sound pressure level acoustic tones when compared at stimulus levels that produced similar peak spike rates. Therefore, we conclude that intracochlear electrical stimulation using monopolar pulse trains can produce activation patterns that are at least as selective as bipolar or acoustic stimulation.

  6. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2011-01-01

    ABSTRACT Objectives The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies. Results In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement. Conclusions The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management. PMID:24421983

  7. Aneurysm in the anterior inferior cerebellar artery-posterior inferior cerebellar artery variant: Case report and review of literature

    PubMed Central

    Akhtar, Saad; Azeem, Abdul; Jiwani, Amyna; Javed, Gohar

    2016-01-01

    Introduction There are variations in the anatomy of the vertebrobasilar system amongst which the Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) variant is thought to have a prevalence of 20–24% (based on retrospective studies). Despite this, aneurysms of the AICA-PICA variant are rare. We present a case of an AICA-PICA aneurysm and discuss its presentation and management, along with a review of literature. Presentation of case We describe the case of a 35 year old female who presented with signs of meningismus. On the basis of radiological imaging it was initially misdiagnosed as a thrombosed arteriovenous malformation (AVM). The patient was eventually discharged with a plan of interval imaging and interventional radiology (if required). The patient presented again with similar signs and symptoms. Re-evaluation of imaging revealed an aneurysm of the AICA-PICA variant which was managed surgically. Discussion Aneurysms of the AICA-PICA variant are rare. The radiological features and surgical management represent a unique clinical entity and are discussed below. Conclusion The prevalence of the AICA-PICA variant might be high but aneurysms in this vessel are rare. The scant knowledge available on this subject makes it a diagnostic difficulty. PMID:27017276

  8. Preservation of the recipient inferior vena cava in liver transplantation.

    PubMed

    Pereira, F; Herrera, J; Mora, N P; Nuño, J; Turrión, V S; Vicente, E; Ardaiz, J

    1994-01-01

    Twenty piggy-back (PB) liver transplantations (LT) were compared with 20 LT performed by the standard technique in order to evaluate whether or not the theoretical haemodynamic advantages of the preservation of the inferior vena cava (IVC) have any impact on the final results of the LT. Statistically significant differences were observed in the duration of the hepatectomy, which was longer for PB LT (192 min vs. 146 min), and in the duration of the anhepatic phase, which was shorter in that group (52 min vs. 76 min). There were no differences in the duration of the complete surgical procedure, consumption of blood products, incidence of postoperative acute renal failure, number of reoperations or survival.

  9. Posttransplant Complex Inferior Venacava Balloon Dilatation After Hepatic Vein Stenting

    SciTech Connect

    Kohli, Vikas; Wadhawan, Manav; Gupta, Subhash; Roy, Vipul

    2010-02-15

    Orthotopic and living related liver transplantation is an established mode of treatment of end-stage liver disease. One of the major causes of postoperative complications is vascular anastomotic stenosis. One such set of such complications relates to hepatic vein, inferior vena cava (IVC), or portal vein stenosis, with a reported incidence of 1-3%. The incidence of vascular complications is reported to be higher in living donor versus cadaveric liver transplants. We encountered a patient with hepatic venous outflow tract obstruction, where the hepatic vein had been previously stented, but the patient continued to have symptoms due to additional IVC obstruction. The patient required double-balloon dilatation of the IVC simultaneously from the internal jugular vein and IVC.

  10. Retrieval of Inferior Vena Cava Filters: Technical Considerations.

    PubMed

    Laws, James L; Lewandowski, Robert J; Ryu, Robert K; Desai, Kush R

    2016-06-01

    Placement of retrievable inferior vena cava filters has seen rapid growth since their introduction into clinical practice. When retrieved, these devices offer the notional benefit of temporary protection from pulmonary embolism related to lower extremity deep venous thrombosis, and mitigation of filter-related deep venous thrombosis. When promptly removed after the indication for mechanical prophylaxis is no longer present, standard endovascular retrieval techniques are frequently successful. However, the majority of these devices are left in place for extended periods of time, which has been associated with greater device-related complications when left in situ, and failure of standard techniques when retrieval is attempted. The development of advanced retrieval techniques has had a positive impact on retrieval of these embedded devices. In this article, technical considerations in the retrieval of such devices, with an emphasis on advanced techniques to facilitate retrieval of embedded devices, are discussed.

  11. Inferior vena caval filter strut perforation causing intramural duodenal haematoma

    PubMed Central

    Williams, Zoheb Berry; Organ, Nicole M.; Deane, Stephen

    2016-01-01

    We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means. Causes of duodenal haematoma include blunt trauma, haematologic malignancy, coagulopathy, percutaneous or endoscopic procedures, pancreatic pathology, peptic ulcer disease and aortoenteric fistula. Duodenal haematoma is rare and is usually managed conservatively or by percutaneous drainage. While this patient had a typical presentation, IVC filter strut perforation has not been described in the literature as a cause for duodenal haematoma. PMID:27887016

  12. Indications, Management, and Complications of Temporary Inferior Vena Cava Filters

    SciTech Connect

    Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen

    1998-11-15

    Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters. Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis. Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis. Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

  13. Commissural functional topography of the inferior colliculus assessed in vitro

    PubMed Central

    Lee, Charles C.; Yanagawa, Yuchio; Imaizumi, Kazuo

    2015-01-01

    The inferior colliculus (IC) receives ascending and descending information from several convergent neural sources. As such, exploring the neural pathways that converge in the IC is crucial to uncovering their multi-varied roles in the integration of auditory and other sensory information. Among these convergent pathways, the IC commissural connections represent an important route for the integration of bilateral information in the auditory system. Here, we describe the preparation and validation of a novel in vitro slice preparation for examining the functional topography and synaptic properties of the commissural and intrinsic projections in the IC of the mouse. This preparation, in combination with modern genetic approaches in the mouse, enables the specific examination of these pathways, which potentially can reveal cell-type specific processing channels in the auditory midbrain. PMID:26319767

  14. Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

    PubMed Central

    Volpato, Maria Cristina; Ranali, José; Ramacciato, Juliana Cama; de Oliveira, Patrícia Cristine; Ambrosano, Glaúcia Maria Bovi; Groppo, Francisco Carlos

    2005-01-01

    The purpose of this study was to compare the anesthetic efficacy of 2 bupivacaine solutions. Twenty-two volunteers randomly received in a crossover, double-blinded manner 2 inferior alveolar nerve blocks with 1.8 mL of racemic bupivacaine and a mixture of 75% levobupivacaine and 25% dextrobupivacaine, both 0.5% and with 1 : 200,000 epinephrine. Before and after the injection, the first mandibular pre-molar was evaluated every 2 minutes until no response to the maximal output (80 reading) of the pulp tester and then again every 20 minutes. Data were analyzed using the Wilcoxon paired test and the paired t test. No differences were found between the solutions for onset and duration of pulpal anesthesia and duration of soft tissue anesthesia (P > .05). It was concluded that the solutions have similar anesthetic efficacy. PMID:16596912

  15. Catheter directed interventions for inferior vena cava thrombosis

    PubMed Central

    Warhit, Michael; Matsunaga, Felipe; Cynamon, Jacob

    2016-01-01

    Inferior vena cava (IVC) thrombosis, although similar in many aspects to deep venous thrombosis (DVT), has distinct clinical implications, treatments and roles for endovascular management. Etiologies of IVC thrombosis vary from congenital malformations of the IVC to acquired, where indwelling IVC filters have been implicated as a leading cause. With an increasing incidence of IVC thrombosis throughout the United States, clinicians need to be educated on the clinical signs and diagnostic tools available to aid in the diagnosis as well as available treatment options. Untreated IVC thrombus can result in serious morbidity and mortality, both in the acute phase with symptoms related to venous outflow occlusion and embolism, and in the long-term, sequelae of post-thrombotic syndrome (PTS) related to chronic venous occlusion. This manuscript will discuss the clinical presentation of IVC thrombosis, diagnostic and treatment options, as well as the role of endovascular management. PMID:28123981

  16. Is left inferior frontal gyrus a general mechanism for selection?

    PubMed

    Zhang, John X; Feng, Ching-Mei; Fox, Peter T; Gao, Jia-Hong; Tan, Li Hai

    2004-10-01

    Converging lines of research in neuroimaging recognize selection as one of the critical functions of prefrontal cortex (e.g., see Annu. Rev. Neurosci. 24, 2001 167). We examined a central thesis of a selection hypothesis (Neuropsychologia 41, 2003 280) that the left inferior frontal gyrus (LIFG) serves as a general mechanism for selecting among competing representations (Annu. Rev. Neurosci. 18, 1995 193). Participants were presented with two sets of letters to remember and then cued to select one set from the two as the target set for subsequent recognition. LIFG showed significantly more activation when the cue elicited a strong need for selection, relative to when it did not, suggesting that the involvement of this area in selection is generalizable beyond semantic retrieval tasks as originally found. This result provides supporting evidence for the selection hypothesis.

  17. Inferior Vena Cava Filter Erosion Causing Symptomatic Obstructive Hydronephrosis

    PubMed Central

    Locke, Nathan; Duchene, David

    2016-01-01

    Abstract Background: Transcaval inferior vena cava (IVC) filter penetration involving the urinary tract is rare, but has been previously reported. We herein present unique management of symptomatic hydronephrosis secondary to erosion of an IVC filter limb into the lumen of the proximal right ureter. Case Presentation: A 59-year-old woman presented with abdominal and right flank pain in October 2015 and was found to have right hydronephrosis, apparently secondary to obstruction from erosion of an IVC filter limb into the proximal right ureter. This was effectively managed with percutaneous, endovascular, and endourologic procedures, without the need for a major invasive surgical procedure. Conclusion: Endovascular removal of the IVC filter was performed safely in this case and can be considered when the urinary tract is involved in filter erosion. PMID:27579443

  18. Sensitivity of rat inferior colliculus neurons to frequency distributions

    PubMed Central

    Parthasarathy, Aravindakshan; Han, Emily X.; Bartlett, Edward L.

    2015-01-01

    Stimulus-specific adaptation refers to a neural response reduction to a repeated stimulus that does not generalize to other stimuli. However, stimulus-specific adaptation appears to be influenced by additional factors. For example, the statistical distribution of tone frequencies has recently been shown to dynamically alter stimulus-specific adaptation in human auditory cortex. The present study investigated whether statistical stimulus distributions also affect stimulus-specific adaptation at an earlier stage of the auditory hierarchy. Neural spiking activity and local field potentials were recorded from inferior colliculus neurons of rats while tones were presented in oddball sequences that formed two different statistical contexts. Each sequence consisted of a repeatedly presented tone (standard) and three rare deviants of different magnitudes (small, moderate, large spectral change). The critical manipulation was the relative probability with which large spectral changes occurred. In one context the probability was high (relative to all deviants), while it was low in the other context. We observed larger responses for deviants compared with standards, confirming previous reports of increased response adaptation for frequently presented tones. Importantly, the statistical context in which tones were presented strongly modulated stimulus-specific adaptation. Physically and probabilistically identical stimuli (moderate deviants) in the two statistical contexts elicited different response magnitudes consistent with neural gain changes and thus neural sensitivity adjustments induced by the spectral range of a stimulus distribution. The data show that already at the level of the inferior colliculus stimulus-specific adaptation is dynamically altered by the statistical context in which stimuli occur. PMID:26354316

  19. Electrophysiological properties of inferior olive neurons: A compartmental model.

    PubMed

    Schweighofer, N; Doya, K; Kawato, M

    1999-08-01

    As a step in exploring the functions of the inferior olive, we constructed a biophysical model of the olivary neurons to examine their unique electrophysiological properties. The model consists of two compartments to represent the known distribution of ionic currents across the cell membrane, as well as the dendritic location of the gap junctions and synaptic inputs. The somatic compartment includes a low-threshold calcium current (I(Ca_l)), an anomalous inward rectifier current (I(h)), a sodium current (I(Na)), and a delayed rectifier potassium current (I(K_dr)). The dendritic compartment contains a high-threshold calcium current (I(Ca_h)), a calcium-dependent potassium current (I(K_Ca)), and a current flowing into other cells through electrical coupling (I(c)). First, kinetic parameters for these currents were set according to previously reported experimental data. Next, the remaining free parameters were determined to account for both static and spiking properties of single olivary neurons in vitro. We then performed a series of simulated pharmacological experiments using bifurcation analysis and extensive two-parameter searches. Consistent with previous studies, we quantitatively demonstrated the major role of I(Ca_l) in spiking excitability. In addition, I(h) had an important modulatory role in the spike generation and period of oscillations, as previously suggested by Bal and McCormick. Finally, we investigated the role of electrical coupling in two coupled spiking cells. Depending on the coupling strength, the hyperpolarization level, and the I(Ca_l) and I(h) modulation, the coupled cells had four different synchronization modes: the cells could be in-phase, phase-shifted, or anti-phase or could exhibit a complex desynchronized spiking mode. Hence these simulation results support the counterintuitive hypothesis that electrical coupling can desynchronize coupled inferior olive cells.

  20. Interruption of the inferior vena cava with azygos termination associated with congenital absence of portal vein.

    PubMed

    Le Borgne, J; Paineau, J; Hamy, A; Dupas, B; Lerat, F; Raoul, S; Hamel, A; Robert, R; Armstrong, O; Rogez, J M

    2000-01-01

    The authors report an exceptional and well-documented case of interruption of the retrohepatic segment of the inferior vena cava with an "azygos continuation", combined with absence of the portal vein. The only known combination of congenital anomalies of the inferior vena cava and the portal vein was that of an "azygos continuation" and a preduodenal portal vein. The double interruption, portal and inferior caval, may be associated with a disturbance of preferential flows induced by the left umbilical thrust. According to hemodynamic theory, the left umbilical flow is the determining factor in organogenesis of the portal vein and the retrohepatic segment of the inferior vena cava.

  1. Breast-feeding after inferior pedicle reduction mammaplasty.

    PubMed

    Brzozowski, D; Niessen, M; Evans, H B; Hurst, L N

    2000-02-01

    The breast-feeding practices of a series of postpartum women, who had undergone prior reduction mammaplasty by means of an inferior pedicle approach, are reported in this retrospective study. Also identified are the factors that influenced the decision to breast-feed postoperatively. From a patient pool of 544 individuals who elected to have reduction mammaplasty between 1984 and 1994 (age range, 15 to 35 years), 334 could be contacted and interviewed by means of telephone by using a standardized questionnaire. Successful breast-feeding was defined as the ability to feed for a duration equal to or greater than 2 weeks. Seventy-eight patients had children after their breast reduction surgery. Fifteen of the 78 patients (19.2 percent) breast-fed exclusively, 8 (10.3 percent) breast-fed with formula supplementation, 14 (17.9 percent) had an unsuccessful breast-feeding attempt, and 41 (52.6 percent) did not attempt breast-feeding. Of the 41 patients not attempting to breast-feed, 9 patients did so as a direct consequence of discouragement by a health care professional. Further reasons for feeding with supplementation, having an unsuccessful attempt, and not attempting to breast-feed are presented. Of the 78 women who had children postoperatively, a total of 27 were discouraged from breast-feeding by medical professionals with only 8 of the 27 (29.6 percent) subsequently attempting, despite this recommendation. In comparison, 26 patients were encouraged to breast-feed; nineteen (73.1 percent) of them did subsequently attempt breast-feeding. This rate is statistically significant by using a chi2 test with 1 df(p = 0.0016). Postpartum breast engorgement and lactation was experienced by 31 of the 41 patients not attempting to breast-feed. Of these 31 patients, 19 believed that they would have been able to breast-feed due to the extent of breast engorgement and lactation experienced. Given the use of an inferior flap mammaplasty technique and patient encouragement, the

  2. 75 FR 9228 - Draft Guidance for Industry on Non-Inferiority Clinical Trials; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... ``Non- Inferiority Clinical Trials.'' This draft guidance provides sponsors and review staff in the... announcing the availability of a draft guidance for industry entitled ``Non-Inferiority Clinical Trials... clinical trials. It does not create or confer any rights for or on any person and does not operate to...

  3. Does the Left Inferior Longitudinal Fasciculus Play a Role in Language? A Brain Stimulation Study

    ERIC Educational Resources Information Center

    Mandonnet, Emmanuel; Nouet, Aurelien; Gatignol, Peggy; Capelle, Laurent; Duffau, Hugues

    2007-01-01

    Although advances in diffusion tensor imaging have enabled us to better study the anatomy of the inferior longitudinal fasciculus (ILF), its function remains poorly understood. Recently, it was suggested that the subcortical network subserving the language semantics could be constituted, in parallel with the inferior occipitofrontal fasciculus, by…

  4. Dynamic Analysis of Gene Expression in Rice Superior and Inferior Grains by RNA-Seq.

    PubMed

    Sun, Hongzheng; Peng, Ting; Zhao, Yafan; Du, Yanxiu; Zhang, Jing; Li, Junzhou; Xin, Zeyu; Zhao, Quanzhi

    2015-01-01

    Poor grain filling of inferior grains located on lower secondary panicle branch causes great drop in rice yield and quality. Dynamic gene expression patterns between superior and inferior grains were examined from the view of the whole transcriptome by using RNA-Seq method. In total, 19,442 genes were detected during rice grain development. Genes involved in starch synthesis, grain storage and grain development were interrogated in particular in superior and inferior grains. Of the genes involved in sucrose to starch transformation process, most were expressed at lower level in inferior grains at early filling stage compared to that of superior grains. But at late filling stage, the expression of those genes was higher in inferior grains and lower in superior grains. The same trends were observed in the expression of grain storage protein genes. While, evidence that genes involved in cell cycle showed higher expression in inferior grains during whole period of grain filling indicated that cell proliferation was active till the late filling stage. In conclusion, delayed expression of most starch synthesis genes in inferior grains and low capacity of sink organ might be two important factors causing low filling rate of inferior grain at early filling stage, and shortage of carbohydrate supply was a limiting factor at late filling stage.

  5. Generalizing Screen Inferiority--Does the Medium, Screen versus Paper, Affect Performance Even with Brief Tasks?

    ERIC Educational Resources Information Center

    Sidi, Yael; Ophir, Yael; Ackerman, Rakefet

    2016-01-01

    Screen inferiority in performance and metacognitive processes has been repeatedly found with text learning. Common explanations for screen inferiority relate to technological and physiological disadvantages associated with extensive reading on screen. However, recent studies point to lesser recruitment of mental effort on screen than on paper.…

  6. Simultaneous paresthesia of the lingual nerve and inferior alveolar nerve caused by a radicular cyst.

    PubMed

    Hamada, Yoshiki; Yamada, Hiroyuki; Hamada, Akiko; Kondoh, Toshirou; Suzuki, Mami; Noguchi, Kazuhide; Ito, Ko; Seto, Kanichi

    2005-10-01

    The inferior alveolar nerve is sometimes affected by periapical pathoses and mandibular cysts. However, mandibular intraosseous lesions have not been reported to disturb the lingual nerve. A case of simultaneous paresthesia of the right lingual nerve and the right inferior alveolar nerve is presented. The possible mechanisms of this extremely uncommon condition are discussed.

  7. Supra Hepatic Inferior Vena Cava Thrombosis–Surgical Challenges

    PubMed Central

    Ramamurthy, Anand; Gopashetty, Mahesh; Vijayshankar, Cuddalore Sadasivam; Khakhar, Anand

    2016-01-01

    Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts. There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of the retrohepatic Inferior Vena Cava (IVC) by an enlarged polycystic liver may impede clear visualization on pre-operative imaging and miss an underlying thrombosis or obliteration. This may result in an intra-operative surprise. Management can be challenging requiring modification of conventional surgical approach. We present our experience of a 67-year-old patient who underwent combined liver-kidney deceased donor transplantation for decompensated chronic liver disease with chronic kidney disease due to ADPKD. She was diagnosed with ADPKD for 16 year, with progressive deterioration in kidney function over the last 6 year and liver decompensation following knee replacement surgery requiring regular renal replacement therapy. We report this case to highlight the peri-operative challenges and their management along with a review of published literature on this uncommon occurrence. PMID:28208936

  8. Direction Selectivity Mediated by Adaptation in the Owl's Inferior Colliculus

    PubMed Central

    Peña, José Luis

    2013-01-01

    Motion direction is a crucial cue for predicting future states in natural scenes. In the auditory system, the mechanisms that confer direction selectivity to neurons are not well understood. Neither is it known whether sound motion is encoded independently of stationary sound location. Here we investigated these questions in neurons of the owl's external nucleus of the inferior colliculus, where auditory space is represented in a map. Using a high-density speaker array, we show that the preferred direction and the degree of direction selectivity can be predicted by response adaptation to sounds moving over asymmetric spatial receptive fields. At the population level, we found that preference for sounds moving toward frontal space increased with eccentricity in spatial tuning. This distribution was consistent with larger receptive-field asymmetry in neurons tuned to more peripheral auditory space. A model of suppression based on spatiotemporal summation predicted the observations. Thus, response adaptation and receptive-field shape can explain direction selectivity to acoustic motion and an orderly distribution of preferred direction. PMID:24305813

  9. Obstruction increases activation in the right inferior frontal gyrus.

    PubMed

    Liu, Tao; Saito, Hirofumi; Oi, Misato

    2016-01-01

    The right inferior frontal gyrus (IFG) is involved in intention understanding during interpersonal interactions. To examine how prior experience of cooperation and competition affects one's right IFG activation in the subsequent interaction, using near-infrared spectroscopy (NIRS) we simultaneously measured paired participants' bilateral IFG activations during a turn-taking game. Participant pairs were assigned to either one of two roles: a Builder taking the initial move to copy a target disk-pattern on monitor and the Partner taking the second move to aid in (cooperation) or to obstruct (competition) the Builder. The experiment consisted of two sessions. One participant (B-P) played as a Builder (B-) in session 1 and changed the role to the Partner (-P) in session 2, and vice versa for the paired participant (P-B). NIRS data in competition demonstrated that the Builder (B-) being obstructed in session 1 showed higher right IFG activation when (s)he took a role of obstructor (-P) in session 2 (the obstructed effect), whereas "the cooperated effect" was not revealed in cooperation. These results suggest that prior experience of being obstructed may facilitate understanding of the Builder and/or the obstructor's tactical move, thereby increasing his/her right IFG activation when one is meant to obstruct in subsequent competitions.

  10. The inferior cochlear vein: surgical aspects in cochlear implantation.

    PubMed

    Guo, Rui; Zhang, HongLei; Chen, Wei; Zhu, XiaoQuan; Liu, Wei; Rask-Andersen, Helge

    2016-02-01

    The patency of the inferior cochlear vein (ICV) may be challenged in cochlear implantation (CI) due to its location near the round window (RW). This may be essential to consider during selection of different trajectories for electrode insertion aiming at preserving residual hearing. Venous blood from the human cochlea is drained through the ICV. The vein also drains blood from the modiolus containing the spiral ganglion neurons. Surgical interference with this vein could cause neural damage influencing CI outcome. We analyzed the topographical relationship between the RW and ICV bony channel and cochlear aqueduct (CA) from a surgical standpoint. Archival human temporal bones were further microdissected to visualize the CA and its accessory canals (AC1 and AC2). This was combined with examinations of plastic and silicone molds of the human labyrinth. Metric analyses were made using photo stereomicroscopy documenting the proximal portion of the AC1, the internal aperture of the CA and the RW. The mean distance between the AC1 and the anterior rim of the RW was 0.81 mm in bone specimens and 0.67 mm assessed in corrosion casts. The AC1 runs from the floor of the scala tympani through the otic capsule passing parallel to the CA to the posterior cranial fossa. The mean distance between the CA and AC1 canal was 0.31 and 0.25 mm, respectively.

  11. Dopaminergic Input to the Inferior Colliculus in Mice

    PubMed Central

    Nevue, Alexander A.; Elde, Cameron J.; Perkel, David J.; Portfors, Christine V.

    2016-01-01

    The response of sensory neurons to stimuli can be modulated by a variety of factors including attention, emotion, behavioral context, and disorders involving neuromodulatory systems. For example, patients with Parkinson’s disease (PD) have disordered speech processing, suggesting that dopamine alters normal representation of these salient sounds. Understanding the mechanisms by which dopamine modulates auditory processing is thus an important goal. The principal auditory midbrain nucleus, the inferior colliculus (IC), is a likely location for dopaminergic modulation of auditory processing because it contains dopamine receptors and nerve terminals immunoreactive for tyrosine hydroxylase (TH), the rate-limiting enzyme in dopamine synthesis. However, the sources of dopaminergic input to the IC are unknown. In this study, we iontophoretically injected a retrograde tracer into the IC of mice and then stained the tissue for TH. We also immunostained for dopamine beta-hydroxylase (DBH), an enzyme critical for the conversion of dopamine to norepinephrine, to differentiate between dopaminergic and noradrenergic inputs. Retrogradely labeled neurons that were positive for TH were seen bilaterally, with strong ipsilateral dominance, in the subparafascicular thalamic nucleus (SPF). All retrogradely labeled neurons that we observed in other brain regions were TH-negative. Projections from the SPF were confirmed using an anterograde tracer, revealing TH-positive and DBH-negative anterogradely labeled fibers and terminals in the IC. While the functional role of this dopaminergic input to the IC is not yet known, it provides a potential mechanism for context dependent modulation of auditory processing. PMID:26834578

  12. Tinnitus-Related Changes in the Inferior Colliculus

    PubMed Central

    Berger, Joel I.; Coomber, Ben

    2015-01-01

    Tinnitus is highly complex, diverse, and difficult to treat, in part due to the fact that the underlying causes and mechanisms remain elusive. Tinnitus is generated within the auditory brain; however, consolidating our understanding of tinnitus pathophysiology is difficult due to the diversity of reported effects and the variety of implicated brain nuclei. Here, we focus on the inferior colliculus (IC), a midbrain structure that integrates the vast majority of ascending auditory information and projects via the thalamus to the auditory cortex. The IC is also a point of convergence for corticofugal input and input originating outside the auditory pathway. We review the evidence, from both studies with human subjects and from animal models, for the contribution the IC makes to tinnitus. Changes in the IC, caused by either noise exposure or drug administration, involve fundamental, heterogeneous alterations in the balance of excitation and inhibition. However, differences between hearing loss-induced pathology and tinnitus-related pathology are not well understood. Moreover, variability in tinnitus induction methodology has a significant impact on subsequent neural and behavioral changes, which could explain some of the seemingly contradictory data. Nonetheless, the IC is likely involved in the generation and persistence of tinnitus perception. PMID:25870582

  13. Skeletal stability after inferior maxillary repositioning without interpositional graft.

    PubMed

    Santos, S E; Moreira, R W F; de Moraes, M; Asprino, L; Araujo, M M

    2012-04-01

    True vertical maxillary deficiency is a characteristic of short face syndrome. In these patients, inferior repositioning of the maxilla (IRM) is indicated to improve facial aesthetics and function, but this procedure has been described as the most unstable. The aim of this study was to evaluate the long term, post surgical stability of IRM, fixed with four 2.0mm L-shaped miniplates, without any type of graft. A cephalometric study was performed, analysing linear measurements (anterior nasal spine, the A point, top of the incisor, top of the buccal-mesial cusp of the first molar, and posterior nasal spine on an X-Y coordinate system) traced immediately preoperatively, immediately postoperatively and at least 6 months post operatively. Eight young adult patients who underwent IRM were studied. The average results of this study were: surgical movement of 4.65 mm at I point, 5.32 mm at anterior nasal spine (ANS) point, and 4.70 mm at A point and relapses of 1.60 mm (35%), 2.23 mm (43%) and 2.10 mm (46%), respectively. It was concluded, that IRM using this type of internal rigid fixation without graft is unstable.

  14. [RADICAL LAPAROSCOPIC NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY].

    PubMed

    Perlin, D V; Aleksandrov, I V; Zipunnikov, V P; Ljaljuev, A M

    2015-01-01

    Laparoscopic radical nephrectomy has proven itself as the "gold standard" treatment of renal cell carcinoma. Inferior vena cava (IVC) tumor thrombus is a complicating factor that occurs in 5% to 10% of patients with renal cell carcinoma. In world literature, there are only anecdotal reports on using laparoscopic approach for IVC thrombectomy in patients with renal cell carcinoma. Herein we report our experience of laparoscopic radical nephrectomy and thrombectomy of the level II tumor thrombus in the IVC. Two patients (79-year-old female and 48-year-old male) underwent radical nephrectomy with thrombectomy from IVC for renal cell carcinoma T3bNxM0 complicated by the formation of a tumor thrombus in the IVC. To do this, IVC was isolated, the right gonadal and lumbar veins were ligated and transected. The IVC and the left renal vein blood flow were controlled with a plastic clip and Satinski clamp. After thrombectomy and resection of the IVC, the wall the defect was sutured with continuous Prolene suture. Laparoscopic radical nephrectomy with thrombectomy without conversion to open surgery was successfully carried out in both patients. During 6-18 months follow-up no local recurrence or distant metastasis were observed. Laparoscopic radical nephrectomy with thrombectomy for renal cell carcinoma complicated with tumor thrombus level II is a safe and reproducible method, which can be applied to a specific population of patients.

  15. Responses of inferior colliculus neurons to double harmonic tones.

    PubMed

    Sinex, Donal G; Li, Hongzhe

    2007-12-01

    The auditory system can segregate sounds that overlap in time and frequency, if the sounds differ in acoustic properties such as fundamental frequency (f0). However, the neural mechanisms that underlie this ability are poorly understood. Responses of neurons in the inferior colliculus (IC) of the anesthetized chinchilla were measured. The stimuli were harmonic tones, presented alone (single harmonic tones) and in the presence of a second harmonic tone with a different f0 (double harmonic tones). Responses to single harmonic tones exhibited no stimulus-related temporal pattern, or in some cases, a simple envelope modulated at f0. Responses to double harmonic tones exhibited complex slowly modulated discharge patterns. The discharge pattern varied with the difference in f0 and with characteristic frequency. The discharge pattern also varied with the relative levels of the two tones; complex temporal patterns were observed when levels were equal, but as the level difference increased, the discharge pattern reverted to that associated with single harmonic tones. The results indicated that IC neurons convey information about simultaneous sounds in their temporal discharge patterns and that the patterns are produced by interactions between adjacent components in the spectrum. The representation is "low-resolution," in that it does not convey information about single resolved components from either individual sound.

  16. Surgical treatment of painful lesions of the inferior alveolar nerve.

    PubMed

    Biglioli, Federico; Allevi, Fabiana; Lozza, Alessandro

    2015-10-01

    Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94% of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset.

  17. Complications of orthognathic surgery: the inferior alveolar nerve.

    PubMed

    D'Agostino, Antonio; Trevisiol, Lorenzo; Gugole, Fabio; Bondí, Vincenzo; Nocini, Pier Francesco

    2010-07-01

    This study analyzes permanent paresthetic disorders regarding the inferior alveolar nerve (IAN) after mandibular ramus sagittal osteotomy procedures. Fifty patients (ie, 100 nerves) who underwent mandibular bilateral sagittal split osteotomy between 2003 and 2007 were evaluated to detect sensorial disorders of the IAN. The evaluation was performed for each patient at least 1 year after surgical intervention. The sagittal osteotomy of the mandible ramus was performed according to Epker-Hunsuk technique. The method of fixing through titanium plates and monocortical screws and the displacement width of the osteotomized stumps were also considered. The evaluation of the IAN functionality was performed both subjectively, by means of a questionnaire, and clinically, by using 4 types of tests: light-touch sensation, pinprick sensation, Weber test, and Dellon test.The clinical test analysis revealed that no nervous lesion was detected in 52% of the tested sites, whereas 24% reported significant nervous lesions. In the subjective evaluations, 74% of the patients described the discomfort related to the neurologic alteration as "absent to mild" or "mild to moderate," 10% as "moderate to serious," and 4% as "serious."We observe that the percentage of significant nervous lesions is relatively low and that it matches the mean described in literature. The central nervous system capacity to hide or compensate for functional deficits due to peripheral nervous lesions was confirmed by the comparison between the results of the clinical tests and the patients' subjective evaluations.

  18. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    SciTech Connect

    Iliescu, Bogdan; Haskal, Ziv J.

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  19. Histological examination of the human obliquus capitis inferior myodural bridge.

    PubMed

    Pontell, Matthew E; Scali, Frank; Enix, Dennis E; Battaglia, Patrick J; Marshall, Ewarld

    2013-12-01

    This study was designed to examine the anatomical relationship between the obliquus capitis inferior (OCI) muscle and the cervical dura mater at the histological level. Eight human cadavers, with an average age of 65 ± 7.9 years were selected from a convenience sample for suboccipital dissection. Twelve OCI muscle specimens were excised, 100% of which emitted grossly visible soft tissue tracts that inserted into the posterolateral aspect of the cervical dura. These 12 myodural specimens were excised as single, continuous structures and sent for H&E staining. One sample also underwent immuno-peroxidase staining. Microscopic evaluation confirmed a connective tissue bridge emanating from the OCI muscular body and attaching to the posterolateral aspect of the cervical dura mater in 75% of the specimens. Microtome slices of the remaining 25% were not able to capture muscle, connective tissue and dura within the same plane and were therefore unable to be properly analyzed. The sample sent for neuro-analysis stained positively for several neuronal fascicles traveling within, and passing through the OCI myodural bridge. This study histologically confirms the presence of a connective tissue bridge that links the OCI muscle to the dura mater and the presence of neuronal tissue within this connection warrants further examination. This structure may represent a component of normal human anatomy. In addition to its hypothetical role in human homeostasis, it may contribute to certain neuropathological conditions, as well.

  20. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    PubMed Central

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  1. Neurohistological examination of the inferior glenohumeral ligament of the shoulder.

    PubMed

    Steinbeck, Jörn; Brüntrup, Jens; Greshake, Oliver; Pötzl, Wolfgang; Filler, Timm; Liljenqvist, Ulf

    2003-03-01

    The neural histology of the anterior band of the inferior glenohumeral ligament (IGHL) was studied in 11 fresh shoulder specimen using a special silver impregnation technique. Between the collagen fibers small myelinated and unmyelinated dendrites could be detected. The appearance of neurovascular structures in the adjacent synovial layer clearly exceeded the typical supply to soft tissues. Analysing about 11,000 sections Ruffini mechanoreceptors that are known to be slow adapting were found on the humeral insertion of the band. The sections containing these neural end organs were identified by means of transillumination and reflection-contrast microscopy and reconstructed using three-dimensional image processing. The presence of neural structures including Ruffini corpuscles in these most important passive stabilizers of the shoulder joint shows that these ligaments function also as an active safety device. There slow adaption is a prerequisite for muscular reflexes counteracting the tensile stresses to which the passive stabilizing structures of the shoulder are exposed. A disruption of the continuity of these structures by mechanical forces or surgery can reduce the biofeedback and proprioceptive quality and thus lead to a decrease of shoulder function and/or stability. These observations should be taken into account when planning surgical interventions involving the IGHL. Procedures like capsule shifts or plications may affect mechanoreceptor orientation and concentrations, thereby affecting the interaction between these structures and the synergistic muscles. When possible, these intervention should avoid receptor-dense regions while attempting to restore normal anatomical orientation and tissue tension.

  2. Predictions Shape Confidence in Right Inferior Frontal Gyrus.

    PubMed

    Sherman, Maxine T; Seth, Anil K; Kanai, Ryota

    2016-10-05

    It is clear that prior expectations shape perceptual decision-making, yet their contribution to the construction of subjective decision confidence remains largely unexplored. We recorded fMRI data while participants made perceptual decisions and confidence judgments, manipulating perceptual prior expectations while controlling for potential confounds of attention. Results show that subjective confidence increases as expectations increasingly support the decision, and that this relationship is associated with BOLD activity in right inferior frontal gyrus (rIFG). Specifically, rIFG is sensitive to the discrepancy between expectation and decision (mismatch), and higher mismatch responses are associated with lower decision confidence. Connectivity analyses revealed expectancy information to be represented in bilateral orbitofrontal cortex and sensory signals to be represented in intracalcarine sulcus. Together, our results indicate that predictive information is integrated into subjective confidence in rIFG, and reveal an occipital-frontal network that constructs confidence from top-down and bottom-up signals. This interpretation was further supported by exploratory findings that the white matter density of right orbitofrontal cortex negatively predicted its respective contribution to the construction of confidence. Our findings advance our understanding of the neural basis of subjective perceptual processes by revealing an occipitofrontal functional network that integrates prior beliefs into the construction of confidence.

  3. Panmedullary edema with inferior olivary hypertrophy in bilateral medial medullary infarction.

    PubMed

    Inoue, Yasuteru; Miyashita, Fumio; Koga, Masatoshi; Yamada, Naoaki; Toyoda, Kazunori; Minematsu, Kazuo

    2014-03-01

    Bilateral medial medullary infarction (MMI) is a rare type of stroke with poor outcomes. Inferior olivary nucleus hypertrophy results from a pathologic lesion in the Guillain-Mollaret triangle. The relationship between inferior olivary nucleus hypertrophy and the medullary lesion is obscure. To the best of our knowledge, only 1 autopsy case with unilateral medial medullary infarction that was associated with ipsilateral inferior olivary nucleus hypertrophy has been reported. We describe a rare case with acute infarction in the bilateral medial medulla oblongata accompanied by subacute bilateral inferior olivary nucleus hypertrophy and panmedullary edema. The hypertrophy appeared to have been caused by local ischemic damage to the termination of the central tegmental tract at the bilateral inferior olivary nucleus.

  4. Inferior vena cava filter retrievals, standard and novel techniques

    PubMed Central

    Walker, T. Gregory

    2016-01-01

    The placement of an inferior vena cava (IVC) filter is a well-established management strategy for patients with venous thromboembolism (VTE) disease in whom anticoagulant therapy is either contraindicated or has failed. IVC filters may also be placed for VTE prophylaxis in certain circumstances. There has been a tremendous growth in placement of retrievable IVC filters in the past decade yet the majority of the devices are not removed. Unretrieved IVC filters have several well-known complications that increase in frequency as the filter dwell time increases. These complications include caval wall penetration, filter fracture or migration, caval thrombosis and an increased risk for lower extremity deep vein thrombosis (DVT). Difficulty is sometimes encountered when attempting to retrieve indwelling filters, mainly because of either abnormal filter positioning or endothelization of filter components that are in contact with the IVC wall, thereby causing the filter to become embedded. The length of time that a filter remains indwelling also impacts the retrieval rate, as increased dwell times are associated with more difficult retrievals. Several techniques for difficult retrievals have been described in the medical literature. These techniques range from modifications of standard retrieval techniques to much more complex interventions. Complications related to complex retrievals are more common than those associated with standard retrieval techniques. The risks of complex filter retrievals should be compared with those of life-long anticoagulation associated with an unretrieved filter, and should be individualized. This article summarizes current techniques for IVC filter retrieval from a clinical point of view, with an emphasis on advanced retrieval techniques. PMID:28123984

  5. Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism

    SciTech Connect

    Jha, V. M.; Lee-Llacer, J.; Williams, J.; Ubaissi, H.; Gutierrez, G.

    2010-08-15

    Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a retrospective study of patients with acute PE treated with full anticoagulation admitted to a single academic medical center. Information abstracted from patient charts included presence or absence of right heart strain and of deep-vein thrombosis, and whether or not an IVC filter was placed. The endpoint was in-hospital mortality. Over 2.75 years, we found that 248 patients were diagnosed with acute PE, with an in-hospital mortality rate of 4.4%. The prevalence of adjunctive IVC filter placement was 13.3% (33 of 248), and the prevalence of documented right heart strain was 27.0% (67 of 248). In-hospital mortality was 10.2% in the non-filter-treated group (5 of 49), whereas there were no deaths in the filter-treated group (0 of 18); however, the difference was not statistically significant (P = 0.37). Both the presence of deep-vein thrombosis and of right heart strain increased the likelihood that an adjunctive IVC filter was placed (P < 0.0001 and P < 0.001, respectively). At our institution, patients were treated with IVC filters in addition to anticoagulation in 13.3% of cases of acute PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

  6. Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

    SciTech Connect

    Geisbuesch, Philipp Benenati, James F.; Pena, Constantino S.; Couvillon, Joseph; Powell, Alex; Gandhi, Ripal; Samuels, Shaun; Uthoff, Heiko

    2012-10-15

    Purpose: To report and analyze the indications, procedural success, and complications of retrievable inferior vena cava filters (rIVCF) placement and to identify parameters that influence retrieval attempt and failure. Methods: Between January 2005 and December 2010, a total of 200 patients (80 men, median age 67 years, range 11-95 years) received a rIVCF with the clinical possibility that it could be removed. All patients with rIVCF were prospectively entered into a database and followed until retrieval or a decision not to retrieve the filter was made. A retrospective analysis of this database was performed. Results: Sixty-one percent of patients had an accepted indication for filter placement; 39% of patients had a relative indication. There was a tendency toward a higher retrieval rate in patients with relative indications (40% vs. 55%, P = 0.076). Filter placement was technically successful in all patients, with no procedure-related mortality. The retrieval rate was 53%. Patient age of >80 years (odds ratio [OR] 0.056, P > 0.0001) and presence of malignancy (OR 0.303, P = 0.003) was associated with a significantly reduced probability for attempted retrieval. Retrieval failure occurred in 7% (6 of 91) of all retrieval attempts. A time interval of > 90 days between implantation and attempted retrieval was associated with retrieval failure (OR 19.8, P = 0.009). Conclusions: Patient age >80 years and a history of malignancy are predictors of a reduced probability for retrieval attempt. The rate of retrieval failure is low and seems to be associated with a time interval of >90 days between filter placement and retrieval.

  7. Temporary Inferior Vena Cava Filters: How Do We Move Forward?

    PubMed

    Arous, Edward J; Messina, Louis M

    2016-05-01

    Despite their widespread use, the indications for the selective use of temporary inferior vena cava (IVC) filters remains uncertain with few trials supporting their use. Additionally, the risks of long-term temporary IVC filter insertion are being increasingly discussed amongst the mainstream media and through multiple class action lawsuits. Retrievable IVC filters were specifically designed to have a less secure implantation in order to facilitate retrieval. However, multiple reports have demonstrated significant filter-related complications, most commonly related to duration of implantation. Furthermore, the risk is not isolated to one manufacturer alone. The incidence of filter-related complications is linearly related to its duration of time on the market. Currently, the FDA recommends that IVC filters be removed within 25-54 days of their implantation. Unfortunately, little evidence exists to show that this recommendation is followed routinely. Recently, the PRESERVE Trial (NCT02381509) was initiated as a multicenter non-randomized open label study to determine the safety and effectiveness of commercially available IVC filters (both temporary and permanent) in individuals who require mechanical prophylaxis against pulmonary embolism. Until such evidence is developed, temporary IVC filters should be implanted based on best available evidence and routinely removed within the guidelines of the FDA of 25-54 days. A fair question at this point is whether the design features themselves that are required to manufacture a low profile removable IVC filter can achieve effective prophylaxis against pulmonary embolism at a low rate of short and long-term complications.

  8. Multiple components of ipsilaterally evoked inhibition in the inferior colliculus.

    PubMed

    Klug, A; Bauer, E E; Pollak, G D

    1999-08-01

    The central nucleus of the inferior colliculus (ICc) receives a large number of convergent inputs that are both excitatory and inhibitory. Although excitatory inputs typically are evoked by stimulation of the contralateral ear, inhibitory inputs can be recruited by either ear. Here we evaluate ipsilaterally evoked inhibition in single ICc cells in awake Mexican free-tailed bats. The principal question we addressed concerns the degree to which ipsilateral inhibition at the ICc suppresses contralaterally evoked discharges and thus creates the excitatory-inhibitory (EI) properties of ICc neurons. To study ipsilaterally evoked inhibition, we iontophoretically applied excitatory neurotransmitters and visualized the ipsilateral inhibition as a gap in the carpet of background activity evoked by the transmitters. Ipsilateral inhibition was seen in 86% of ICc cells. The inhibition in most cells had both glycinergic and GABAergic components that could be blocked by the iontophoretic application of bicuculline and strychnine. In 80% of the cells that were inhibited, the ipsilateral inhibition and contralateral excitation were temporally coincident. In many of these cells, the ipsilateral inhibition suppressed contralateral discharges and thus generated the cell's EI property in the ICc. In other cells, the ipsilateral inhibition was coincident with the initial portion of the excitation, but the inhibition was only 2-4 ms in duration and suppressed only the first few contralaterally evoked discharges. The suppression was so slight that it often could not be detected as a decrease in the spike count generated by increasing ipsilateral intensities. Twenty percent of the cells that expressed inhibition, however, had inhibitory latencies that were longer than the excitatory latencies. In these neurons, the inhibition arrived too late to suppress most or any of the discharges. Finally, in the majority of cells, the ipsilateral inhibition persisted for tens of milliseconds beyond

  9. Radiofrequency volumetric inferior turbinate reduction: long-term clinical results.

    PubMed

    De Corso, E; Bastanza, G; Di Donfrancesco, V; Guidi, M L; Morelli Sbarra, G; Passali, G C; Poscia, A; de Waure, C; Paludetti, G; Galli, J

    2016-06-01

    The aim of our study was to assess long-term results of radiofrequency volumetric tissue reduction of inferior turbinates (RVTR). We performed a prospective long-term longitudinal evaluation of 305 patients affected by rhinitis (114 allergic and 191 non-allergic) who were unresponsive to medical treatment and underwent RVTR (January 2004 - December 2010). Subjects were followed for a mean period of 39.70 ± 19.41 months (range 24-60). Patients completed the NOSE-scale questionnaire pre- and post-operatively after 1 month and yearly for 5-years. Recurrence was assumed if the post-operative total NOSE score increased by at least 75% during follow-up and the patient restarted medical treatments. Estimation of relapse over time was performed by Kaplan-Meyer analyses. We documented overall good satisfaction of patients regarding the procedure, with a good rate of pain control and a low rate of complications. Post-operatively there was a significant improvement in nasal stuffiness, nasal obstruction and mouth breathing (p < 0.05). We observed a worsening trend for symptoms after 36 months with progressive increasing rate of recurrences that were significantly higher in allergic than non-allergic patients (p < 0.05). We also observed a slight worsening trend of global satisfaction of patients. Our study confirms the minor discomfort and low risk of side effects of RVTR. Our data showed good efficacy of the procedure in the majority of patients for at least 36 months after surgery, and in fact in this time period the cumulative probability to remain relapse-free was up to 0.8. In the following 2 years, we observed a worse temporal trend in term of recurrence rate, and in particular in allergic patients with a significant difference vs non-allergic individuals (p < 0.05).

  10. Retinoic acid influences the development of the inferior olivary nucleus in the rodent.

    PubMed

    Yamamoto, Miyuki; Fujinuma, Masahiro; Hirano, Shinji; Hayakawa, Yoshika; Clagett-Dame, Margaret; Zhang, Jinghua; McCaffery, Peter

    2005-04-15

    All-trans retinoic acid (atRA) is an endogenous morphogen that regulates gene transcription. Maternal exposure to atRA results in severe developmental abnormalities by disrupting normal patterns of atRA distribution. Previously, we have shown that the pontine nucleus, which originates from the rhombic lip, is severely atrophied in the mouse on exposure to atRA at gestational days 9 and 10. In this study, we show that this same period of atRA exposure has the contrary effect on the inferior olive and this rhombic lip derivative is expanded in volume and probably contains an increased number of cells. The posterior region of the inferior olive maintains a relatively normal shape but is significantly expanded in size. In contrast, the organization of the anterior inferior olive is severely disrupted. Because endogenous atRA levels are known to be higher in the region of the posterior inferior olive at the time of birth of inferior olivary neurons, these results suggest that endogenous atRA may promote the generation, or select the fate, of posterior neurons of the inferior olive. In support of this concept, a reduction in atRA resulting from vitamin A deficiency results in loss of cells of the posterior inferior olive.

  11. Study of the inferior colliculus in patients with schizophrenia by magnetic resonance spectroscopy.

    PubMed

    Martinez-Granados, B; Martinez-Bisbal, M C; Sanjuan, J; Aguilar, E J; Marti-Bonmati, L; Molla, E; Celda, B

    2014-07-01

    INTRODUCTION. Previous studies have suggested morphometric and functional abnormalities in the inferior colliculus in patients with schizophrenia. Auditory hallucinations are one of the central symptoms in schizophrenia. In this complex and multidimensional event both attention and emotion are thought to play a key role. AIM. To study metabolic changes in the inferior colliculus, a nucleus integrated in the auditory pathway, in patients with schizophrenia and the possible relationship with auditory hallucinations. SUBJECTS AND METHODS. Magnetic resonance spectroscopic imaging studies were performed in 30 right-handed patients with chronic schizophrenia (19 of them with auditory hallucinations) and 28 controls. A magnetic resonance spectroscopic imaging 2D slice was acquired and the voxels representative of both inferior colliculi were selected. N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) peak areas were measured. RESULTS. The patients with schizophrenia showed a NAA/Cr significant reduction in the right inferior colliculus compared to the control subjects. The metabolic data in the right inferior colliculus were correlated with emotional auditory hallucinations items. CONCLUSIONS. The contribution of the inferior colliculus on neural underpinnings of auditory hallucinations is particularly relevant for the right inferior colliculus and is centered on attention-emotional component of this symptom.

  12. A case of atherosclerotic inferior mesenteric artery aneurysm secondary to high flow state.

    PubMed

    Troisi, Nicola; Esposito, Giovanni; Cefalì, Pietro; Setti, Marco

    2011-07-01

    Inferior mesenteric artery aneurysms are very rare and they are among the rarest of visceral artery aneurysms. Sometimes, the distribution of the blood flow due to chronic atherosclerotic occlusion of some arteries can establish an increased flow into a particular supplying district (high flow state). A high flow state in a stenotic inferior mesenteric artery in compensation for a mesenteric occlusive disease can produce a rare form of aneurysm. We report the case of an atherosclerotic inferior mesenteric aneurysm secondary to high flow state (association with occlusion of the celiac trunk and severe stenosis of the superior mesenteric artery), treated by open surgical approach.

  13. [Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].

    PubMed

    Peces, R; Gil, F; Costero, O; Pobes, A

    2002-01-01

    We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment.

  14. Inputs to combination-sensitive neurons of the inferior colliculus.

    PubMed

    Wenstrup, J J; Mittmann, D H; Grose, C D

    1999-07-12

    In the mustached bat, combination-sensitive neurons display integrative responses to combinations of acoustic elements in biosonar or social vocalizations. One type of combination-sensitive neuron responds to multiple harmonics of the frequency-modulated (FM) components in the sonar pulse and echo of the bat. These neurons, termed FM-FM neurons, are sensitive to the pulse-echo delay and may encode the distance of sonar targets. FM-FM neurons are common in high-frequency regions of the central nucleus of the inferior colliculus (ICC) and may be created there. If so, they must receive low-frequency inputs in addition to the expected high-frequency inputs. We placed single deposits of a tracer at FM-FM recording sites in the ICC and then analyzed retrograde labeling in the brainstem and midbrain. We were particularly interested in labeling patterns suggestive of low-frequency input to these FM-FM neurons. In most nuclei containing labeled cells, there was a single focus of labeling in regions thought to be responsive to high-frequency sounds. More complex labeling patterns were observed in three nuclei. In the anteroventral cochlear nucleus, labeling in the anterior and marginal cell divisions occurred in regions thought to respond to low-frequency sounds. This labeling comprised 6% of total brainstem labeled cells. Labeling in the intermediate nucleus of the lateral lemniscus and the magnocellular part of the ventral nucleus of the lateral lemniscus together comprised nearly 40% of all labeled cells. In both nuclei, multiple foci of labeling occurred. These different foci may represent groups of cells tuned to different frequency bands. Thus, one or more of these three nuclei may provide low-frequency input to high-frequency-sensitive cells in the ICC, creating FM-FM responses. We also examined whether ICC neurons responsive to lower frequencies project to high-frequency-sensitive ICC regions; only 0.15% of labeling originated from these lower frequency

  15. Language outcomes after resection of dominant inferior parietal lobule gliomas.

    PubMed

    Southwell, Derek G; Riva, Marco; Jordan, Kesshi; Caverzasi, Eduardo; Li, Jing; Perry, David W; Henry, Roland G; Berger, Mitchel S

    2017-01-06

    OBJECTIVE The dominant inferior parietal lobule (IPL) contains cortical and subcortical regions essential for language. Although resection of IPL tumors could result in language deficits, little is known about the likelihood of postoperative language morbidity or the risk factors predisposing to this outcome. METHODS The authors retrospectively examined a series of patients who underwent resections of gliomas from the dominant IPL. Postoperative language outcomes were characterized across the patient population. To identify factors associated with postoperative language morbidity, the authors then compared features between those patients who experienced postoperative deficits and those who experienced no postoperative language dysfunction. RESULTS Twenty-four patients were identified for analysis. Long-term language deficits occurred in 29.2% of patients (7 of 24): 3 of these patients had experienced preoperative language deficits, whereas new long-term language deficits occurred in 4 patients (16.7%; 4 of 24). Of those patients who exhibited preoperative language deficits, 62.5% (5 of 8) experienced long-term resolution of their language deficits with surgical treatment. All patients underwent intraoperative brain mapping by direct electrical stimulation. Awake, intraoperative cortical language mapping was performed on 17 patients (70.8%). Positive cortical language sites were identified in 23.5% of these patients (4 of 17). Awake, intraoperative subcortical language mapping was performed in 8 patients (33.3%). Positive subcortical language sites were identified in 62.5% of these patients (5 of 8). Patients with positive cortical language sites exhibited a higher rate of long-term language deficits (3 of 4, 75%), compared with those who did not (1 of 13, 7.7%; p = 0.02). Although patients with positive subcortical language sites exhibited a higher rate of long-term language deficits than those who exhibited only negative sites (40.0% vs 0.0%, respectively), this

  16. Pathological study of pseudohypertrophy of the inferior olivary nucleus.

    PubMed

    Ogawa, Katsuhiko; Mizutani, Tomohiko; Uehara, Kenji; Minami, Masayuki; Suzuki, Yoshio; Uchihara, Toshiki

    2010-02-01

    There have been only a few reports about the immunohistochemical study of pseudohypertrophy of the inferior olivary nucleus (PH-IO). We therefore performed the detailed immunohistochemical study of 10 PH-IOs in 8 patients to clarify the mechanism of neuronal degeneration and its related phenomenon of PH-IO. We used various antibodies to alphaB-crystallin (alphaBC), synaptophysin (SYP), microtubule-associated protein 2 (MAP2), Lys-Asp-Glu-Leu (KDEL) receptors, heat shock protein (HSP) 27 as well as SMI-31. We found alphaBC-positive neurons on the ipsilateral side of 10 PH-IOs. SMI-31-positive neurons were also observed in 6 PH-IOs. Confocal laser microscopy showed co-localization of alphaBC and SMI-31 in some neurons. However, there were no HSP27-positive neurons or astrocytes in any of the 10 PH-IOs. MAP2 immunostaining showed MAP2-positive hypertrophic thick neurites around hypertrophic neurons on the ipsilateral side of 7 PH-IOs and demonstrated "glomeruloid structures" in 3 PH-IOs. In addition, fine granular SYP-immunoreactivity was decreased in the neuropils on the ipsilateral side of all 10 PH-IOs. SYP-immunoreactive dots were scattered in the neuropils and on the neuronal cell bodies on the side of 7 PH-IOs, and the aggregation of SYP-immunoreactive dots scattered in the neuropils was shown in 3 PH-IOs. Double-immunostainings using anti-MAP2 and anti-SYP antibodies demonstrated frequent SYP-immunoreactive dots along the MAP2-positive hypertrophic thick neurites and their cell bodies. Periphery-stained KDEL-positive neurons were also found on the side of 7 PH-IOs. We showed that the change of the distribution of presynaptic terminals correlated well to the hypertrophic thick neurites in PH-IO. Our immuohistochemical stainings demonstrated various changes which occurred to the neurons in PH-IO, and their neurites and presynaptic terminals. We considered that alphaBC was expressed in the neurons in PH-IO, induced by cellular stress. Such a detailed

  17. Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury

    PubMed Central

    Abdel-Aal, Ahmed Kamel; Ezzeldin, Islam B.; Moustafa, Amr Soliman; Ertel, Nathan; Oser, Rachel

    2015-01-01

    We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple’s pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure. PMID:27200175

  18. Inferior Vena Cava Filter Migration to the Right Ventricle Causing Nonsustained Ventricular Tachycardia

    PubMed Central

    Peters, Matthew N.; Khazi Syed, Rashad H.; Katz, Morgan J.; Moscona, John C.; Nijjar, Vikram S.; Bisharat, Mohannad B.

    2013-01-01

    Inferior vena cava filters are commonly used to prevent pulmonary embolism in patients who manifest deep vein thrombosis and recurrent pulmonary embolism despite anticoagulation, or in patients with contraindications to anticoagulation. We report the case of a 69-year-old man with a structurally normal heart who experienced migration of an inferior vena cava filter to the right ventricle, which caused the abrupt onset of recurrent episodes of nonsustained ventricular tachycardia unresponsive to intravenous antiarrhythmic medication. Cardiac imaging revealed the location of the filter within the right ventricle, and the device was removed, with subsequent resolution of the arrhythmia. We anticipate that the incidence of inferior vena cava filter migration might increase in the future because of recent changes in device construction. The sudden appearance of nonsustained ventricular tachycardia in a patient with an inferior vena cava filter might indicate the occurrence of this potentially life-threatening sequela and should lead to emergent cardiac imaging. PMID:23914030

  19. A Bayesian non-inferiority test for two independent binomial proportions.

    PubMed

    Kawasaki, Yohei; Miyaoka, Etsuo

    2013-01-01

    In drug development, non-inferiority tests are often employed to determine the difference between two independent binomial proportions. Many test statistics for non-inferiority are based on the frequentist framework. However, research on non-inferiority in the Bayesian framework is limited. In this paper, we suggest a new Bayesian index τ = P(π₁  > π₂-Δ₀|X₁, X₂), where X₁ and X₂ denote binomial random variables for trials n1 and n₂, and parameters π₁ and π₂ , respectively, and the non-inferiority margin is Δ₀> 0. We show two calculation methods for τ, an approximate method that uses normal approximation and an exact method that uses an exact posterior PDF. We compare the approximate probability with the exact probability for τ. Finally, we present the results of actual clinical trials to show the utility of index τ.

  20. Inferior vena cava thrombosis as a cause of haemolysis in a patient on ECMO.

    PubMed

    Wills, Samantha; Forrest, Paul

    2017-03-01

    Haemolysis, thrombosis and haemorrhage are well-documented complications of extracorporeal membrane oxygenation. This case report outlines an unusual case of haemolysis, thought secondary to a large mobile thrombus in the inferior vena cava.

  1. Activation of c-fos expression in the rat inferior olivary nucleus by ghrelin.

    PubMed

    Zhang, Weizhen; Lin, Theodore R; Hu, Yuexian; Fan, Yongyi; Zhao, Lili; Mulholland, Michael W

    2003-12-26

    Ghrelin, a novel 28-amino-acid hormone secreted by gastric oxyntic glands, stimulates food intake and induces adiposity. We examined whether ghrelin activates the inferior olivary nucleus. Systemic administration of ghrelin (37 nmol/kg) induced the expression of c-fos immunoreactivity in inferior olive neurons (n=6 rats). The number of neurons containing c-fos staining was significantly increased in the ghrelin-treated rats (65+/-14 vs.11+/-6 positive neurons, n=5). No significant difference in c-fos-positive neurons was observed between left (32+/-5) and right (33+/-6) inferior olivary nuclei. The number of c-fos-positive neurons in rats with bilateral vagotomy was not significantly different from those with intact vagal nerves. The present study demonstrates that ghrelin induces c-fos expression in inferior olivary nucleus via a central mechanism.

  2. Correction of Excyclotropia by Surgery on the Inferior Rectus Muscle in Patients with Thyroid Eye Disease: A Retrospective, Observational Study

    PubMed Central

    Takahashi, Yasuhiro; Kitaguchi, Yoshiyuki; Nakakura, Shunsuke; Mito, Hidenori; Kimura, Akiko; Kakizaki, Hirohiko

    2016-01-01

    Purpose To examine the characteristics of excyclotropia correction through surgery on the inferior rectus muscle in patients with thyroid eye disease. Methods This was a retrospective, observational study at a single institution. We reviewed 36 patients who had undergone unilateral inferior rectus muscle recession, with or without nasal inferior rectus muscle transposition. The following factors were investigated as possibly influencing excyclotropia correction: inferior rectus muscle thickness, degree of adipose change in the inferior rectus muscle, smoking status, history of orbital radiotherapy, and the amount of inferior rectus muscle recession. Using T1-weighted coronal magnetic resonance imaging, we measured the cross-sectional area of the inferior rectus muscle at its largest point, as well as the bright-signal area of the inferior rectus muscle, which reflects intermuscular adipose change. We then calculated the percentage internal bright-signal area at the point of the largest inferior rectus muscle cross-sectional area. The history of orbital radiotherapy was graded using a binary system. We evaluated correlations among excyclotropia correction, the amount of nasal inferior rectus muscle transposition, and the possible influencing factors listed, using stepwise multiple regression analyses. Results The multiple regression model demonstrated a significant relationship among excyclotropia correction, amount of nasal inferior rectus muscle transposition, and the amount of inferior rectus muscle recession (YCORRECTION = 8.546XTENDON WIDTH + 0.405XRECESSION− 0.908; r = 0.844; adjusted r2 = 0.695; P < 0.001). Conclusions Excyclotropia correction was correlated with the amount of nasal inferior rectus muscle transposition and the amount of inferior rectus muscle recession, but not with the other factors. The regression model presented in this study will enable us to determine more precisely the amount of nasal inferior rectus muscle transposition in patients

  3. Inferior vena cava occlusion secondary to an inflammatory abdominal aortic aneurysm.

    PubMed

    Yoshizaki, Tomoya; Tabuchi, Noriyuki; Makita, Satoru

    2007-02-01

    Inflammatory abdominal aortic aneurysms (IAAAs) represent 3% to 10% of all AAAs. However, inferior vena cava occlusion secondary to an IAAA is rarely reported. We report a case of inferior vena cava occlusion secondary to an IAAA presenting deep venous thrombosis. As it is crucial to avoid pulmonary embolism and excessive blood loss during an operation, we pre-operatively implanted a venous filter and minimized intra-operative dissection that allowed successful operative repair.

  4. [Investigation of the age-dependent development of brachygnathia inferior in the East Friesian milk sheep].

    PubMed

    Pielmeier, Ricarda; Kerkmann, Andrea; Distl, Ottmar

    2012-01-01

    Shortness of the lower jaw (brachygnathia inferior, underbite) is a common anomaly in sheep. In order to study the age-dependent development of brachygnathia inferior, data of 73 East Friesian milk sheep from a breeding experiment over six generations were analysed. Data were recorded in regular intervals of four weeks from birth up to an age of at least 25 weeks. Brachygnathia inferior was determined by the distance between the edge of the central incisor of the lower jaw and the anterior surrounding of the upper jaw (DIFF-UK) using a measuring tape. Four main types of brachygnathia inferior were distinguished using means, standard deviations and maximum values of the individual animals.The thresholds were a maximum and mean DIFF-UK of 0.5 cm and a standard deviation of 0.266 cm. A total of 14 sheep (main types 3 and 4) showed an obvious brachygnathia inferior with mean DIFF-UK larger than 0.5 cm whereof ten animals showed a large variation of DIFF-UK values (standard deviation > 0.226 cm). Mean DIFF-UK values of 59 sheep were smaller than 0.5 cm (main types 1 and 2). One of these 59 animals had during the first four weeks of life DIFF-UK values of 1 cm and than decreasing values reaching zero within the next nine months (main type 2). Five of the 58 animals with main type 1 had a perfect occlusion of jaws, all with DIFF-UK values at zero during the whole recording period. Parents with severe or mild brachygnathia inferior had severely affected progeny. Selection of sheep for breeding with a perfect occlusion of jaws decreases the risk to pass on the hereditary disposition for brachygnathia inferior. An early inspection of potential breeding animals is advisable to detect all cases of brachygnathia inferior even if the underbite decreases in the first year of life.

  5. Preduodenal portal vein and anomalous continuation of inferior vena cava: CT findings.

    PubMed

    Tsuda, Y; Nishimura, K; Kawakami, S; Kimura, I; Nakano, Y; Konishi, J

    1991-01-01

    Four cases of a rare congenital anomaly, preduodenal portal vein (PPV), are presented. Preduodenal portal vein is known to be frequently associated with other anomalies including intestinal malrotation, situs inversus, biliary atresia, and pancreatic, splenic, and cardiac anomalies. Of our four cases, three had azygos or hemiazygos continuation of the inferior vena cava and other anomalies. We want to call attention to association of azygos or hemiazygos continuation of inferior vena cava with PPV.

  6. Relief of membranous obstruction of the inferior vena cava in a 5-year-old child.

    PubMed

    Amodeo, A; Di Donato, R; Dessanti, A; Caccia, G; Zaltron, D; Alberti, D; Callea, F; Marcelletti, C

    1986-12-01

    Membranous obstruction of the inferior vena cava is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of the hepatic drainage. We report membranous obstruction of the inferior vena cava in a 5-year-old boy. Surgical repair was prompted by signs and symptoms of hepatic venous obstruction. To our knowledge, this is the youngest patient successfully operated on for this anomaly.

  7. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    PubMed Central

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-01-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas. PMID:8655416

  8. Inferior Vena Cava Torsion and Stenosis Complicated by Compressive Pericaval Regional Ascites following Orthotopic Liver Transplantation

    PubMed Central

    Gilroy, Richard; Johnson, Philip

    2013-01-01

    Inferior vena cava (IVC) stenosis and torsion are well-described rare complications following orthotopic liver transplantation (OLT). We present a case of inferior vena cava intermittent torsion and stenosis complicated by compressive regional ascites. To the best of our knowledge, this is the second case of post-OLT regional ascites related compressive IVC stenosis reported and the first reported case of torsion complicated by regional ascites compression. PMID:24386585

  9. Traumatic Inferior Gluteal Artery Pseudoaneurysm and Arteriovenous Fistula Managed with Emergency Transcatheter Embolization

    SciTech Connect

    Keeling, A. N.; Naughton, P. A.; Leahy, A. L.; Lee, M. J.

    2008-07-15

    We present a case of blunt trauma to the buttock resulting in an inferior gluteal artery pseudoaneurysm and arteriovenous fistula. The characteristic diagnostic features on CT angiography and digital subtraction angiography (DSA), along with the emergency percutaneous management of this traumatic vascular injury, are described. A review of the literature demonstrates inferior gluteal artery pseudoaneurysm is a rare condition, while successful treatment with glue embolization is previously unreported.

  10. Renal Vein and Inferior Vena Cava Thrombosis: A Rare Extrasplanchnic Complication of Acute Pancreatitis

    PubMed Central

    Choksi, Dhaval; Chaubal, Alisha; Pipaliya, Nirav; Ingle, Meghraj; Sawant, Prabha

    2016-01-01

    Acute pancreatitis is an inflammatory disorder often associated with various complications. Approximately one fourth of patients with acute pancreatitis develop vascular complications, of which venous thrombosis forms a major group. Extrasplanchnic venous thrombosis is less common, and simultaneous renal vein and inferior vena cava thrombosis is reported only twice. We report a case of alcohol-related acute pancreatitis complicated by simultaneous renal vein and inferior vena cava thrombosis. PMID:28008405

  11. Exposed inferior alveolar neurovascular bundle during surgical removal of a residual cyst.

    PubMed

    Boffano, Paolo; Gallesio, Cesare

    2010-01-01

    Iatrogenic neurodeficiency is one of the most distressing complications to any surgical procedure. The prediction of close proximity of the oral lesions to the inferior alveolar neurovascular bundle is extremely important. Furthermore, iatrogenic neurosensory dysfunctions of the facial region involve important medicolegal issues. In this report, we describe the case of a patient who did not show either paresthesia or anesthesia after the surgical removal of a mandibular residual cyst that exhibited adherence to the inferior alveolar nerve bundle.

  12. Permanent nerve damage from inferior alveolar nerve blocks: a current update.

    PubMed

    Pogrel, M Anthony

    2012-10-01

    Permanent nerve involvement has been reported following inferior alveolar nerve blocks. This study provides an update on cases reported to one unit in the preceding six years. Lidocaine was associated with 25 percent of cases, articaine with 33 percent of cases, and prilocaine with 34 percent of cases. It does appear that inferior alveolar nerve blocks can cause permanent nerve damage with any local anesthetic, but the incidences may vary.

  13. Pseudoaneurysm of the Inferior Epigastric Artery Successfully Treated by Ultrasound-guided Compression

    SciTech Connect

    Takase, Kei Kazama, Takuro; Abe, Kayoko; Chiba, Yoshihiro; Saito, Haruo; Takahashi, Shoki

    2004-09-15

    An 82-year-old woman underwent right hemicolectomy by median laparotomy. Two weeks later, a pulsatile mass was found at the left side of the surgical wound, which was diagnosed as pseudoaneurysm of the inferior epigastric artery by color Doppler US and CT. The pseudoaneurysm was successfully treated by US-guided compression of the neck of the aneurysm for 30 minutes. US-guided compression should be considered the treatment of choice for postsurgical pseudoaneurysm of the inferior epigastric artery.

  14. Differential expression of the microRNAs in superior and inferior spikelets in rice (Oryza sativa).

    PubMed

    Peng, Ting; Lv, Qiang; Zhang, Jing; Li, Junzhou; Du, Yanxiu; Zhao, Quanzhi

    2011-10-01

    MicroRNAs (miRNAs) play a critical role in post-transcriptional gene regulation and have been shown to control many genes involved in various biological and metabolic processes. This work investigated miRNAs in rice (Oryza sativa), an important food crop. High-throughput sequencing technology was used to reveal expression differences in miRNAs between superior and inferior spikelets in rice (japonica cultivar Xinfeng 2) at 18 d after fertilization. Totals of 351 and 312 known miRNAs were obtained from the superior and inferior spikelets, respectively. Analysis of the expression profiles of these miRNAs showed that 189 miRNAs were differentially expressed between superior spikelets and inferior spikelets. In addition, 43 novel miRNAs were identified mostly by the accumulation of miRNA*s expressed differentially between the superior and inferior spikelets. Further analysis with bioinformatics software and comparison with existing databases showed that these differentially expressed miRNAs may individually participate in regulating hormone metabolism, carbohydrate metabolic pathways, and cell division during rice grain development. The results indicate that the slow grain-filling and low grain weight of rice inferior spikelets are attributed partly to differences in expression and function between superior and inferior spikelet miRNAs.

  15. Active integration of glutamatergic input to the inferior olive generates bidirectional postsynaptic potentials

    PubMed Central

    Garden, Derek L. F.; Rinaldi, Arianna

    2016-01-01

    Key points We establish experimental preparations for optogenetic investigation of glutamatergic input to the inferior olive.Neurones in the principal olivary nucleus receive monosynaptic extra‐somatic glutamatergic input from the neocortex.Glutamatergic inputs to neurones in the inferior olive generate bidirectional postsynaptic potentials (PSPs), with a fast excitatory component followed by a slower inhibitory component.Small conductance calcium‐activated potassium (SK) channels are required for the slow inhibitory component of glutamatergic PSPs and oppose temporal summation of inputs at intervals ≤ 20 ms.Active integration of synaptic input within the inferior olive may play a central role in control of olivo‐cerebellar climbing fibre signals. Abstract The inferior olive plays a critical role in motor coordination and learning by integrating diverse afferent signals to generate climbing fibre inputs to the cerebellar cortex. While it is well established that climbing fibre signals are important for motor coordination, the mechanisms by which neurones in the inferior olive integrate synaptic inputs and the roles of particular ion channels are unclear. Here, we test the hypothesis that neurones in the inferior olive actively integrate glutamatergic synaptic inputs. We demonstrate that optogenetically activated long‐range synaptic inputs to the inferior olive, including projections from the motor cortex, generate rapid excitatory potentials followed by slower inhibitory potentials. Synaptic projections from the motor cortex preferentially target the principal olivary nucleus. We show that inhibitory and excitatory components of the bidirectional synaptic potentials are dependent upon AMPA (GluA) receptors, are GABAA independent, and originate from the same presynaptic axons. Consistent with models that predict active integration of synaptic inputs by inferior olive neurones, we find that the inhibitory component is reduced by blocking large conductance

  16. Relationship Between Posterior-Inferior Tibial Slope and Bilateral Noncontact ACL Injury.

    PubMed

    Hendrix, Steven T; Barrett, Austin M; Chrea, Bopha; Replogle, William H; Hydrick, Josie M; Barrett, Gene R

    2016-10-18

    Is there a correlation between increased posterior-inferior tibial slope angle and noncontact anterior cruciate ligament (ACL) injury? Does increasing the posterior-inferior tibial slope angle increase the risk of bilateral ACL injury? A computerized relational database (Access 2007; Microsoft Inc, Redmond, Washington) was used to conduct a retrospective review of patients undergoing bilateral or unilateral ACL reconstruction surgery or treatment by a single surgeon between 1995 and 2013. Included in the study were patients with bilateral and unilateral ACL injuries and patellofemoral pain syndrome with no associated ACL deficiency. Exclusion criteria included concomitant ligament injury, previous ACL reconstruction, and previous knee surgery. Also excluded were patients who did not have plain lateral radiographs. Fifty patients were randomly selected from each group. After controlling for age and Tegner activity level, the authors found that the posterior-inferior tibial slope angle was a significant predictor (P=.002) of noncontact ACL injury. Mean posterior-inferior tibial slope angle for the bilateral, unilateral, and control groups was 11.8°±2.3°, 9.3°±2.4°, and 7.5°±2.3°, respectively. In the group with unilateral ACL injury vs the group without ACL deficiency, a 1° increase in posterior-inferior tibial slope angle (P=.03) was associated with a 20% increase in unilateral ACL injury. In those with bilateral ACL injury vs those without ACL deficiency, a 1° increase in posterior-inferior tibial slope angle (P=.001) increased bilateral knee injury by 34%. The difference between the mean angles of the control group without ACL deficiency and both the bilateral injury and unilateral injury cohorts was statistically significant (P=.003). Increased posterior-inferior tibial slope angle is associated with an increased risk of noncontact bilateral and unilateral ACL injury. [Orthopedics. 201x; xx(x):xx-xx.].

  17. Patient-specific factors in the proximity of the inferior alveolar nerve to the tooth apex

    PubMed Central

    Adigüzel, Özkan; Kaya, Sadullah; Akkuş, Zeki

    2012-01-01

    Objectives: To evaluate whether age and gender differences are predictive factors for inferior alveolar nerve position with respect to mandibular first molar roots. Study Design: Cone-beam computed tomography scans [0.2-mm3 voxel size; n = 200 (100 males, 100 females)] of patients aged 15–65 years showing mandibular first and second molars were included in this study. Patients with pathoses that might affect inferior alveolar nerve position, including second molar and/or first premolar extraction, were excluded. Fourteen measurements (mm) were taken from the inferior alveolar nerve to the mesial and distal root apices. Subjects were grouped by age and gender. Data were analysed using two-way analyses of variance with post hoc Bonferroni corrections. Results: The distance from the inferior alveolar nerve to the root apices was smaller in females than males, regardless of age (p < 0.01). Distal roots were closer to the nerve than mesial roots in both genders (p < 0.05). Total buccolingual mandibular length (at 3-mm apical level) was shorter in females than males (p < 0.01) but mean buccolingual mandibular width at the level of the inferior alveolar canal did not differ. Nerve–root apex distances were significantly shorter in males and females aged 16–25 and 56–65 years than in other age groups (p < 0.01). Conclusions: The distance between inferior alveolar nerve and mandibular first molar roots depends upon the age and gender: it is shorter in females than in males and in subjects aged 16–25 years and >55 years than in other age groups. Key words:Age, cone-beam computed tomography, inferior alveolar nerve, root apex, gender. PMID:22926478

  18. Prognostic significance of resting anterior thallium-201 defects in patients with inferior myocardial infarction

    SciTech Connect

    Gibson, R.S.; Taylor, G.J.; Watson, D.D.; Berger, B.C.; Crampton, R.S.; Martin, R.P.; Beller, G.A.

    1980-11-01

    To determine whether Tl-201 scintigraphy performed at rest during the late hospital phase of inferior myocardial infarction can predict subsequent coronary events, 25 patients with historical, enzymatic, and electrocardiographic criteria of transmural inferior infarction underwent serial imaging with computer quantification 7 to 35 days after admission. All 25 patients had inferior defects, and 13 (52%) also had anterior defects implying stenosis of the left anterior descending coronary artery. The patients were divided into those with inferior and anterior perfusion defects (Group 1) and those with inferior defects alone (Group 2). In Group 1, three patients had persistent defects in the anterior wall and ten had initial defects with redistribution. New or recurrent coronary events - which included new onset or progression of angina pectoris, sudden death, reinfarction, and congestive heart failure - were recorded over an average 7.2 months of followup (range 3 to 9 mo) for all patients. Ten of 13 (77%) patients in Group 1 had 17 coronary events and four of 12 (33%) patients in Group 2 had six coronary events (p < 0.02). Nine patients in Group 1 and three in Group 2 developed angina (p < 0.03). The apparently increased prevalence in Group 1 of sudden death (8% against 0%), reinfarction (8% against 0%), and congestive heart failure (46% against 25%) was not statistically significant. Thus resting T1-201 scintigraphy with computer quantification is a highly sensitive method to detect inferior myocardial infarction even in the late hospital phase. Moreover, it appears to identify those patients with inferior infarction at high risk for subsequent coronary events, presumably due to stenosis of the left anterior descending coronary artery.

  19. Anesthetic efficacy of a combination of hyaluronidase and lidocaine with epinephrine in inferior alveolar nerve blocks.

    PubMed Central

    Ridenour, S.; Reader, A.; Beck, M.; Weaver, J.

    2001-01-01

    The purpose of this prospective, randomized, double-blind study was to determine the anesthetic efficacy of a buffered lidocaine with epinephrine solution compared to a combination buffered lidocaine with epinephrine plus hyaluronidase solution in inferior alveolar nerve blocks. Thirty subjects randomly received an inferior alveolar nerve block using 1 of the 2 solutions at 2 separate appointments using a repeated-measures design. Mandibular anterior and posterior teeth were blindly pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive readings of 80 were obtained. A postoperative survey was used to measure pain and trismus. The results demonstrated 100% of the subjects had profound lip numbness with both solutions for inferior alveolar nerve blocks. The anesthetic success rates for individual teeth ranged from 20 to 80%. There were no significant differences (P > .05) between the 2 solutions. However, the combination lidocaine/hyaluronidase solution resulted in a significant increase in postoperative pain and trismus. It was concluded that adding hyaluronidase to a buffered lidocaine solution with epinephrine did not statistically increase the incidence of pulpal anesthesia in inferior alveolar nerve blocks and, because of its potential tissue damaging effect, it should not be added to local anesthetic solutions for inferior alveolar nerve blocks. PMID:11495405

  20. Inferior capsular shift operation for multidirectional instability of the shoulder in players of contact sports

    PubMed Central

    Choi, C; Ogilvie-Harris, D

    2002-01-01

    Objectives: To assess the results of inferior capsular shift for multidirectional instability of the shoulder in athletes. Methods: Multidirectional instability was surgically corrected in 53 shoulders in 47 athletes who engaged in contact sports. A history of major trauma was found in eight patients, the others having had minor episodes. Before surgery, all patients had complex combinations of instabilities. The surgical approach was selected according to the predominant direction of instability. Results: Anterior inferior capsular shift was carried out in 37 shoulders, and anterior dislocation recurred in three. In one of these, it was anterior alone, one was anterior and inferior, and one was unstable in all three directions. After posterior inferior capsular shift in 16 shoulders, one dislocation occurred anteriorly and one posteriorly. With the anterior approach, four athletes could not return to sport. Two patients treated with the posterior approach could not return to sport. Of these six failures, five patients had had bilateral repairs. Successful repair based on the criteria of the American Shoulder and Elbow Association was achieved in 92% of anterior repairs and 81% of posterior repairs. Successful return to sport was noted in 82% of patients with anterior repairs, 75% with posterior repairs, and 17% with bilateral repairs. Overall, there were five subsequent dislocations, three in the anterior repair group (8%), and two in the posterior repair group (12%). Conclusions: Inferior capsular shift can successfully correct multidirectional instability in most players of contact sports, but the results in bilateral cases are poor. PMID:12145120

  1. Peritoneal fluid causing inferior attenuation on SPECT thallium-201 myocardial imaging in women

    SciTech Connect

    Rab, S.T.; Alazraki, N.P.; Guertler-Krawczynska, E.

    1988-11-01

    On SPECT thallium images, myocardial left ventricular (LV) anterior wall attenuation due to breast tissue is common in women. In contrast, in men, inferior wall counts are normally decreased compared to anterior counts. The purpose of this report is to describe cases of inferior wall attenuation of counts in women caused by peritoneal fluid, not myocardial disease. Twelve consecutive SPECT thallium myocardial studies performed in women on peritoneal dialysis, being evaluated for kidney transplant, were included in this study. For all studies, 3.5 mCi 201Tl were injected intravenously. Thirty-two images were acquired over 180 degrees (45 degrees RAO progressing to 45 degrees LPO) at 40 sec per stop. SPECT images were reviewed in short axis, horizontal long and vertical long axes. Data were also displayed in bullseye format with quantitative comparison to gender-matched normal files. Ten of 12 female patients studied had inferior wall defects on images, confirmed by bullseye display. All patients had approximately 2 liters of peritoneal fluid. Review of planar rotational views showed diaphragm elevation and fluid margin attenuations affecting left ventricular inferior wall. Thus, peritoneal fluid is a cause of inferior attenuation on 201Tl cardiac imaging.

  2. Sensorimotor integration for speech motor learning involves the inferior parietal cortex.

    PubMed

    Shum, Mamie; Shiller, Douglas M; Baum, Shari R; Gracco, Vincent L

    2011-12-01

    Sensorimotor integration is important for motor learning. The inferior parietal lobe, through its connections with the frontal lobe and cerebellum, has been associated with multisensory integration and sensorimotor adaptation for motor behaviors other than speech. In the present study, the contribution of the inferior parietal cortex to speech motor learning was evaluated using repetitive transcranial magnetic stimulation (rTMS) prior to a speech motor adaptation task. Subjects' auditory feedback was altered in a manner consistent with the auditory consequences of an unintended change in tongue position during speech production, and adaptation performance was used to evaluate sensorimotor plasticity and short-term learning. Prior to the feedback alteration, rTMS or sham stimulation was applied over the left supramarginal gyrus (SMG). Subjects who underwent the sham stimulation exhibited a robust adaptive response to the feedback alteration whereas subjects who underwent rTMS exhibited a diminished adaptive response. The results suggest that the inferior parietal region, in and around SMG, plays a role in sensorimotor adaptation for speech. The interconnections of the inferior parietal cortex with inferior frontal cortex, cerebellum and primary sensory areas suggest that this region may be an important component in learning and adapting sensorimotor patterns for speech.

  3. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    PubMed Central

    Juodzbalys, Gintaras

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed literature investigation through MEDLINE (PubMed) electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes. PMID:25635209

  4. Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

    PubMed

    Brunetti, Natale D; Ieva, Riccardo; Correale, Michele; Cuculo, Andrea; Santoro, Francesco; Guaricci, Andrea I; De Gennaro, Luisa; Gaglione, Antonio; Di Biase, Matteo

    2016-01-01

    The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.

  5. Importance of human right inferior frontoparietal network connected by inferior branch of superior longitudinal fasciculus tract in corporeal awareness of kinesthetic illusory movement.

    PubMed

    Amemiya, Kaoru; Naito, Eiichi

    2016-05-01

    It is generally believed that the human right cerebral hemisphere plays a dominant role in corporeal awareness, which is highly associated with conscious experience of the physical self. Prompted by our previous findings, we examined whether the right frontoparietal activations often observed when people experience kinesthetic illusory limb movement are supported by a large-scale brain network connected by a specific branch of the superior longitudinal fasciculus fiber tracts (SLF I, II, and III). We scanned brain activity with functional magnetic resonance imaging (MRI) while nineteen blindfolded healthy volunteers experienced illusory movement of the right stationary hand elicited by tendon vibration, which was replicated after the scanning. We also scanned brain activity when they executed and imagined right hand movement, and identified the active brain regions during illusion, execution, and imagery in relation to the SLF fiber tracts. We found that illusion predominantly activated the right inferior frontoparietal regions connected by SLF III, which were not substantially recruited during execution and imagery. Among these regions, activities in the right inferior parietal cortices and inferior frontal cortices showed right-side dominance and correlated well with the amount of illusion (kinesthetic illusory awareness) experienced by the participants. The results illustrated the predominant involvement of the right inferior frontoparietal network connected by SLF III when people recognize postural changes of their limb. We assume that the network bears a series of functions, specifically, monitoring the current status of the musculoskeletal system, and building-up and updating our postural model (body schema), which could be a basis for the conscious experience of the physical self.

  6. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures.

    PubMed

    Renton, T

    2010-09-01

    This article aims to review current hypotheses on the aetiology and prevention of inferior alveolar nerve (IAN) injuries in relation to dental procedures. The inferior alveolar nerve can be damaged during many dental procedures, including administration of local anaesthetic, implant bed preparation and placement, endodontics, third molar surgery and other surgical interventions. Damage to sensory nerves can result in anaesthesia, paraesthesia, pain, or a combination of the three. Pain is common in inferior alveolar nerve injuries, resulting in significant functional problems. The significant disability associated with these nerve injuries may also result in increasing numbers of medico-legal claims. Many of these iatrogenic nerve injuries can be avoided with careful patient assessment and planning. Furthermore, if the injury occurs there are emerging strategies that may facilitate recovery. The emphasis of this review is on how we may prevent these injuries and facilitate resolution in the early post surgical phase.

  7. Naming difficulties in alexia with agraphia for kanji after a left posterior inferior temporal lesion.

    PubMed Central

    Sakurai, Y; Sakai, K; Sakuta, M; Iwata, M

    1994-01-01

    The case is described of a patient with alexia and agraphia for kanji, and severe anomia after a subcortical haemorrhage in the left posterior inferior temporal area. Magnetic resonance imaging at four months after onset showed a lesion in the inferior temporal and fusiform gyri, extending from the temporo-occipital junction toward the anterior third of the temporal lobe. Comparison with other reported cases of alexia with agraphia and anomia made it clear that when accompanied by severe anomia, the lesions extended either forward to the anterior part of the middle temporal gyrus or medially to the parahippocampal gyrus. It is suggested that the disconnection of association fibres between the parahippocampal, fusiform, middle, and inferior temporal gyri, especially between the parahippocampal gyrus and the other temporal gyri, or the cortical damage to the posterior part of these gyri is essential for the production of anomia. Images PMID:8201334

  8. Avoiding injury to the inferior alveolar nerve by routine use of intraoperative radiographs during implant placement.

    PubMed

    Burstein, Jeffrey; Mastin, Chris; Le, Bach

    2008-01-01

    Injury to the inferior alveolar nerve during implant placement in the posterior atrophic mandible is a rare but serious complication. Although a preoperative computerized tomography scan can help determine the distance from the alveolar ridge to the nerve canal, variables such as magnification errors, ridge anatomy, and operator technique can increase the chance for complications. The routine use of intraoperative periapical radiographs during the drilling sequence is an inexpensive and reliable tool, allowing the operator to confidently adjust the direction and depth of the implant during placement. Most important, it helps avoid the risk of injury to the inferior alveolar nerve in cases in which there is limited vertical alveolar bone. Using this technique for 21 implants placed in the posterior atrophic mandible, with less than 10 mm of vertical bone to the inferior alveolar nerve canal, the authors observed no incidents of postoperative paresthesia.

  9. Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails

    PubMed Central

    Serrano, Fátima; Torres, Rita; Borges, Augusta

    2013-01-01

    The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy. PMID:23781361

  10. Connexin 43 contributes to ectopic orofacial pain following inferior alveolar nerve injury

    PubMed Central

    Shinoda, Masamichi; Honda, Kuniya; Unno, Syumpei; Shimizu, Noriyoshi; Iwata, Koichi

    2016-01-01

    Background Clinically, it is well known that injury of mandibular nerve fiber induces persistent ectopic pain which can spread to a wide area of the orofacial region innervated by the uninjured trigeminal nerve branches. However, the exact mechanism of such persistent ectopic orofacial pain is not still known. The present study was undertaken to determine the role of connexin 43 in the trigeminal ganglion on mechanical hypersensitivity in rat whisker pad skin induced by inferior alveolar nerve injury. Here, we examined changes in orofacial mechanical sensitivity following inferior alveolar nerve injury. Furthermore, changes in connexin 43 expression in the trigeminal ganglion and its localization in the trigeminal ganglion were also examined. In addition, we investigated the functional significance of connexin 43 in relation to mechanical allodynia by using a selective gap junction blocker (Gap27). Results Long-lasting mechanical allodynia in the whisker pad skin and the upper eyelid skin, and activation of satellite glial cells in the trigeminal ganglion, were induced after inferior alveolar nerve injury. Connexin 43 was expressed in the activated satellite glial cells encircling trigeminal ganglion neurons innervating the whisker pad skin, and the connexin 43 protein expression was significantly increased after inferior alveolar nerve injury. Administration of Gap27 in the trigeminal ganglion significantly reduced satellite glial cell activation and mechanical hypersensitivity in the whisker pad skin. Moreover, the marked activation of satellite glial cells encircling trigeminal ganglion neurons innervating the whisker pad skin following inferior alveolar nerve injury implies that the satellite glial cell activation exerts a major influence on the excitability of nociceptive trigeminal ganglion neurons. Conclusions These findings indicate that the propagation of satellite glial cell activation throughout the trigeminal ganglion via gap junctions, which are

  11. Inferior retinal light exposure is more effective than superior retinal exposure in suppressing melatonin in humans

    NASA Technical Reports Server (NTRS)

    Glickman, Gena; Hanifin, John P.; Rollag, Mark D.; Wang, Jenny; Cooper, Howard; Brainard, George C.

    2003-01-01

    Illumination of different areas of the human retina elicits differences in acute light-induced suppression of melatonin. The aim of this study was to compare changes in plasma melatonin levels when light exposures of equal illuminance and equal photon dose were administered to superior, inferior, and full retinal fields. Nine healthy subjects participated in the study. Plexiglass eye shields were modified to permit selective exposure of the superior and inferior halves of the retinas of each subject. The Humphrey Visual Field Analyzer was used both to confirm intact full visual fields and to quantify exposure of upper and lower visual fields. On study nights, eyes were dilated, and subjects were exposed to patternless white light for 90 min between 0200 and 0330 under five conditions: (1) full retinal exposure at 200 lux, (2) full retinal exposure at 100 lux, (3) inferior retinal exposure at 200 lux, (4) superior retinal exposure at 200 lux, and (5) a dark-exposed control. Plasma melatonin levels were determined by radioimmunoassay. ANOVA demonstrated a significant effect of exposure condition (F = 5.91, p < 0.005). Post hoc Fisher PLSD tests showed significant (p < 0.05) melatonin suppression of both full retinal exposures as well as the inferior retinal exposure; however, superior retinal exposure was significantly less effective in suppressing melatonin. Furthermore, suppression with superior retinal exposure was not significantly different from that of the dark control condition. The results indicate that the inferior retina contributes more to the light-induced suppression of melatonin than the superior retina at the photon dosages tested in this study. Findings suggest a greater sensitivity or denser distribution of photoreceptors in the inferior retina are involved in light detection for the retinohypothalamic tract of humans.

  12. The curious case of the disappearing IVC: A case report and review of the aetiology of Inferior Vena Cava Agenesis

    PubMed Central

    Paddock, Michael; Robson, Nicola

    2014-01-01

    We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth. PMID:24967034

  13. Leiomyosarcoma of the inferior vena cava: a case report and review of the literature.

    PubMed

    Sartori, Alberto; Vigna, Silvia; Dal Pozzo, Aldo; Balduino, Maurizio; Sartori, Carlo Augusto

    2009-01-01

    Leiomyosarcoma of the inferior vena cava is a particularly rare tumour, originating from the smooth muscle of the vessel wall. The authors describe the case of a female patient admitted with a picture of anorexia and weight loss, accompanied by epi- and mesogastric pain. Preoperative examinations revealed the presence of a mass of considerable size originating from the inferior vena cava. The patient was submitted to surgery consisting in removal of the mass and of part of the wall of the vena cava. A review of the literature confirms the rarity of this tumour and demonstrates that optimal anatomical knowledge is absolutely indispensable for the management of this pathology.

  14. Bilateral Pedicled Superficial Inferior Epigastric Artery Flap in the Treatment of Hidradenitis Suppurativa

    PubMed Central

    Hoang, Don; Saber, Sepideh; Patel, Ketan; Carey, Joseph

    2016-01-01

    Summary: The authors present a new technique in surgically treating hidradenitis suppurativa (HS), a debilitating skin condition. In HS, surgical treatment is often the best option because of the high recurrence rates despite extensive medical treatment. A commonly successful surgical method is using skin flaps after excision of the affected area. A superficial inferior epigastric artery flap is demonstrated here as a new alternative approach to treating a case of extensive HS of the groin. By using the pedicled superficial inferior epigastric artery flap for groin reconstruction, inguinal HS can be widely excised and reconstructed with minimal donor-site morbidity and a good aesthetic outcome. PMID:27622101

  15. Spontaneous Recanalization of Superior Mesenteric Artery Occlusion Following Angioplasty and Stenting of Inferior Mesenteric Artery

    SciTech Connect

    Akpinar, Erhan Cil, Barbaros E.; Arat, Anil; Baykal, Atac; Karaman, Kerem; Balkanci, Ferhun

    2006-02-15

    An 84-year-old woman with a history of hypertension and coronary artery disease was admitted with a progressively worsening diffuse abdominal pain. Computed tomography scan of the abdomen and angiography revealed occlusion of the origin and proximal portion of superior mesenteric artery. Aortography also showed severe origin stenosis of inferior mesenteric artery and that the distal part of the superior mesenteric artery was supplied by a prominent marginal artery of Drummond. Patient was effectively treated with percutaneous transluminal angioplasty and stenting of the inferior mesenteric artery. Follow-up imaging studies demonstrated patency of the stent and spontaneous recanalization of superior mesenteric artery occlusion.

  16. Traumatic Inferior Gluteal Artery Aneurysm Managed with Emergency Transcatheter Thrombin Injection

    SciTech Connect

    Juszkat, Robert; Zielinski, Maciej; Wykretowicz, Mateusz; Piekarek, Alina; Majewski, Waclaw

    2010-06-15

    Pseudoaneurysms of the inferior gluteal artery (IGA) are rare and are often caused by trauma. Treatment options vary and include surgery, ultrasound-guided percutaneous thrombin injection, and endovascular procedures such as stent-graft placement, coil embolization, and glue injection. We report a 70-year-old male who presented to the hospital after a road accident with a posttraumatic pseudoaneurysm that was treated by endovascular thrombin embolization. To the best of our knowledge, this is the first reported case of inferior gluteal artery false aneurysm treated by this method.

  17. Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

    SciTech Connect

    Carnevale, Francisco Cesar Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

    2010-06-15

    We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

  18. Medial pterygoid trismus (myospasm) following inferior alveolar nerve block: case report and literature review.

    PubMed

    Wright, Edward F

    2011-01-01

    A patient developed a medial pterygoid trismus (myospasm) the day after receiving three inferior alveolar nerve blocks and a routine restoration. She had a significantly restricted mouth opening and significant medial pterygoid muscle pain when she opened beyond the restriction; however, she had no swelling, lymphadenopathy, or fever. A medial pterygoid myospasm can occur secondary to an inferior alveolar nerve block. This disorder generally is treated by the application of heat, muscle stretches, analgesic and/or muscle relaxant ingestion, and a physical therapy referral. The severity of the disorder typically dictates the extent of therapy that is needed.

  19. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    PubMed Central

    Juodzbalys, Gintaras

    2014-01-01

    ABSTRACT Objectives The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted) on the inferior alveolar nerve was clearly seen. Conclusions The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare. PMID:25635208

  20. Prominence vs. Aboutness in Sequencing: A Functional Distinction within the Left Inferior Frontal Gyrus

    ERIC Educational Resources Information Center

    Bornkessel-Schlesewsky, Ina; Grewe, Tanja; Schlesewsky, Matthias

    2012-01-01

    Prior research on the neural bases of syntactic comprehension suggests that activation in the left inferior frontal gyrus (lIFG) correlates with the processing of word order variations. However, there are inconsistencies with respect to the specific subregion within the IFG that is implicated by these findings: the pars opercularis or the pars…

  1. Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty

    SciTech Connect

    Athreya, S.; Mathias, N.; Rogers, P.; Edwards, R.

    2009-07-15

    Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

  2. Attention, Emotion, and Deactivation of Default Activity in Inferior Medial Prefrontal Cortex

    ERIC Educational Resources Information Center

    Geday, Jacob; Gjedde, Albert

    2009-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC with positron emission tomography (PET) of labeled water…

  3. Inferior fronto-temporo-occipital connectivity: a missing link between maltreated girls and neglectful mothers

    PubMed Central

    León, Inmaculada; Góngora, Daylin; Hernández-Cabrera, Juan A.; Byrne, Sonia; Bobes, María A.

    2016-01-01

    The neurobiological alterations resulting from adverse childhood experiences that subsequently may lead to neglectful mothering are poorly understood. Maternal neglect of an infant’s basic needs is the most prevalent type of child maltreatment. We tested white matter alterations in neglectful mothers, the majority of whom had also suffered maltreatment in their childhood, and compared them to a matched control group. The two groups were discriminated by a structural brain connectivity pattern comprising inferior fronto-temporo-occipital connectivity, which constitutes a major portion of the face-processing network and was indexed by fewer streamlines in neglectful mothers. Mediation and regression analyses showed that fewer streamlines in the right inferior longitudinal fasciculus tract (ILF-R) predicted a poorer quality of mother–child emotional availability observed during cooperative play and that effect depended on the respective interactions with left and right inferior fronto-occipital fasciculi (IFO-R/L), with no significant impact of psychopathological and cognitive conditions. Volume alteration in ILF-R but not in IFO-L modulated the impact of having been maltreated on emotional availability. The findings suggest the altered inferior fronto-temporal-occipital connectivity, affecting emotional visual processing, as a possible common neurological substrate linking a history of childhood maltreatment with maternal neglect. PMID:27342834

  4. Recession Vs Myotomy–Comparative Analysis of Two Surgical Procedures of Weakening Inferior Oblique Muscle Overaction

    PubMed Central

    Alajbegovic-Halimic, Jasmina; Zvizdic, Denisa; Sahbegovic-Holcner, Amra; Kulanic-Kuduzovic, Amira

    2015-01-01

    Introduction: Inferior oblique overaction (IOOA) can be primary or secondary, isolated or combined to other types of horizontal deviation, mostly with esotropias. Surgical weakening of IOOA means several techniques like; recession, myotomy, myectomy, anteroposition etc. Goals: we analyzed the effect of inferior oblique muscle surgical weakening comparing two groups of patients with primary hypertropia. Material and methods: In 5-years retrospective study, we observed 33 patients on which we did the surgical procedure of weakening inferior muscle overaction by two methods; recession and myotomy. Results: In total number of 33 patients, there were 57,6% male and 42,4% female patients with average age of 10,6±7,5 (in range of 4–36). There was 33,3% of isolated primary hypertropias, and 66,7% combined with esotropias. At 23 (69,9%) patients the recession surgical procedure was done, and with 10 (30,1%) myotomy. Better effect and binocularity was in 65,2% of patients in recession group which was statistically significant with significance level of p<0,0, χ2=5,705; p=0,021. Conclusion: Comparing of two surgical procedures of weakening inferior oblique muscles overaction, recession is better procedure than myotomy. PMID:26261384

  5. Effects of sexual reproduction of the inferior competitor Brachionus calyciflorus on its fitness against Brachionus angularis

    NASA Astrophysics Data System (ADS)

    Li, Chen; Niu, Cuijuan

    2015-03-01

    Sexual reproduction adversely affects the population growth of cyclic parthenogenetic animals. The density-dependent sexual reproduction of a superior competitor could mediate the coexistence. However, the cost of sex may make the inferior competitor more vulnerable. To investigate the effect of sexual reproduction on the inferior competitor, we experimentally paired the competition of one Brachionus angularis clone against three Brachionus calyciflorus clones. One of the B. calyciflorus clones showed a low propensity for sexual reproduction, while the other two showed high propensities. The results show that all B. calyciflorus clones were excluded in the competition for resources at low food level. The increased food level promoted the competition persistence, but the clones did not show a clear pattern. Both the cumulative population density and resting egg production increased with the food level. The cumulative population density decreased with the mixis investment, while the resting egg production increased with the mixis investment. A trade-off between the population growth and sexual reproduction was observed in this research. The results indicate that although higher mixis investment resulted in a lower population density, it would not determinately accelerate the exclusion process of the inferior competitor. On the contrary, higher mixis investment promoted resting egg production before being excluded and thus promised a long-term benefit. In conclusion, our results suggest that mixis investment, to some extent, favored the excluded inferior competitor under fierce competition or some other adverse conditions.

  6. The Loss and Search for the Puer, A Consideration of Inferiority Feelings in Certain Male Adolescents.

    ERIC Educational Resources Information Center

    Daher, Douglas

    1981-01-01

    A sense of inferiority in adolescent males can result from a split senex-puer archetype, a Jungian construct focused on the individual's identification with and/or repression of psychic age and youth. Adolescents experience healing of the split senex-puer archetype to the degrees to which they involve themselves in the eros and power of their life…

  7. Unusual case of left ventricular ballooning involving the inferior wall: a case report

    PubMed Central

    2009-01-01

    Background Tako – tsubo like syndrome (also named left ventricular apical ballooning) is an unusual cardiomyopathy with an high incidence in Japanese population of female sex, following an emotional stress. The clinical features (typical chest pain), and the electrocardiographic changes (negative T wave and persistent ST elevation in anterior leads), are suggestive of an acute myocardial infarction; nevertheless the coronary angiography show coronary arteries without lesions and the ventriculography show specific segmental dysfunction. In the literature there are many reports of typical left ventricular ballooning (apical); due to the rarity of the atypical localizations (such as mid, basal, anterior or inferior left ventricular wall) many authors think they are different physiopatologic entity. Case report We report a case of 50 – years old woman, with a family history of ischeamic cardiomyopathy but with no additional cardiovascular risk factors, who arrived to emergency department with a recent episode of chest pain (about 30 minutes) with electrocardiographic and echocardiographic features suggested of a inferior ST elevation myocardial infarction. Coronary angiography showed coronary arteries without atherosclerotic lesions; ventriculography showed an inferior dysfunction. Conclusion This data can suggest for an atypical form (in term of clinical presentation and localization) of left ventricular ballooning involving the inferior wall (never described in the literature), not preceded by any emotional or physical stress. The follow – up performed by transthoracic echocardiography (2 months later) revealed a complete regression of wall motions abnormalities. PMID:19232097

  8. Mechanical Thrombectomy in Inferior Vena Cava Thrombosis After Caval Filter Placement: A Report of Three Cases

    SciTech Connect

    Poon, W.L.; Luk, S.H.; Yam, K.Y.; Lee, Anselm C.W.

    2002-10-15

    Inferior vena caval (IVC) filter thrombosis inpatients with contraindications to anticoagulant therapy is a difficult and challenging clinical problem. We report our experience in treating three such patients using a mechanical thrombectomy device, which resulted in rapid symptomatic relief until anticoagulant therapy could be safely introduced.

  9. [The syndrome of blepharophimosis-ptosis-dystopia of the inferior puncta lacrimalia and epicanthus].

    PubMed

    Dumitrache, L

    1991-01-01

    The paper presents a family with 28 members belonging to four generations. 12 of them show an association of blepharophimosis--ptosis--dystopia of the inferior lacrimal points and epicanthus. 9 members of the family in the 3rd and 4th generations were examined and a dominant mode of transmission was evidenced.

  10. Effects of Category Learning on the Stimulus Selectivity of Macaque Inferior Temporal Neurons

    ERIC Educational Resources Information Center

    De Baene, Wouter; Ons, Bart; Wagemans, Johan; Vogels, Rufin

    2008-01-01

    Primates can learn to categorize complex shapes, but as yet it is unclear how this categorization learning affects the representation of shape in visual cortex. Previous studies that have examined the effect of categorization learning on shape representation in the macaque inferior temporal (IT) cortex have produced diverse and conflicting results…

  11. Inferior angle of the scapula as a vascularized bone graft: an anatomic study.

    PubMed

    Sundine, M J; Sharobaro, V I; Ljubic, I; Acland, R D; Tobin, G R

    2000-04-01

    In reconstructing patients with massive midface losses, the authors required a vascularized bone graft that could be used to reconstruct the palate and orbital floor, provide vertical maxillary support, and provide soft tissue. The inferior angle of the scapula appears to be a promising source of vascularized bone stock, and until now, there has been no clear description of its vascular anatomy. The purpose of this study was to define the vascular anatomy of the inferior angle of the scapula. Thirteen fresh cadavers were studied. The subscapular artery was injected with Microfil (Flow Tec, Carver, MA) at its origin. Two branches of the subscapular artery were found to converge on the angle of the scapula: the descending osseous branch of the circumflex scapular, and the transverse branch of the thoracodorsal. The descending osseous branch of the circumflex scapular artery supplied the inferior angle of the scapula in 100 percent of cases. The transverse branch of the thoracodorsal artery supplied it in 76 percent of cases. The descending osseous branch of the circumflex scapular artery is the principal artery supplying the inferior angle of the scapula.

  12. A double J stent misplaced in the inferior vena cava during Boari flap repair

    PubMed Central

    Maheshwari, Pankaj N.; Oswal, Ajay T.; Wagaskar, Vinayak G.

    2016-01-01

    A 30-year-old lady underwent a Boari flap repair for post-hysterectomy mid-ureteric stricture. The upper end of the double J stent inserted during the procedure was misplaced in the supra-renal inferior venal cava. Cystoscopic stent removal could be performed uneventfully, while the stricture was managed by endoureterotomy. PMID:26941499

  13. "A Hidden Part of Me": Latino/a Students, Silencing, and the Epidermalization of Inferiority

    ERIC Educational Resources Information Center

    Irizarry, Jason G.; Raible, John

    2014-01-01

    Using Critical Race Theory (CRT) and Latino/a Critical Race Theory (LatCrit) as analytical tools, this article examines the experiences of a seven Latino/a high school students at various points of engagement with the school-to-prison pipeline. Building on and extending Franz Fanon's (1952) concept of the epidermalization of inferiority, the…

  14. Surgical treatment of pyoderma gangrenosum following deep inferior epigastric perforator flap breast reconstruction.

    PubMed

    Tamer, Funda; Adışen, Esra; Tuncer, Serhan; Gurer, Mehmet A

    2016-09-01

    Pyoderma gangrenosum is a chronic inflammatory disease characterized by painful cutaneous ulcers. The etiology remains unknown; however, pyoderma gangrenousm can be triggered by surgery. Here we report the case of a 34-year-old Caucasian female that developed pyoderma gangrenosum following deep inferior epigastric perforator flap breast reconstruction. The patient was successfully treated with systemic immunosuppressive therapy and primary closure.

  15. Inferior fronto-temporo-occipital connectivity: a missing link between maltreated girls and neglectful mothers.

    PubMed

    Rodrigo, María José; León, Inmaculada; Góngora, Daylin; Hernández-Cabrera, Juan A; Byrne, Sonia; Bobes, María A

    2016-10-01

    The neurobiological alterations resulting from adverse childhood experiences that subsequently may lead to neglectful mothering are poorly understood. Maternal neglect of an infant's basic needs is the most prevalent type of child maltreatment. We tested white matter alterations in neglectful mothers, the majority of whom had also suffered maltreatment in their childhood, and compared them to a matched control group. The two groups were discriminated by a structural brain connectivity pattern comprising inferior fronto-temporo-occipital connectivity, which constitutes a major portion of the face-processing network and was indexed by fewer streamlines in neglectful mothers. Mediation and regression analyses showed that fewer streamlines in the right inferior longitudinal fasciculus tract (ILF-R) predicted a poorer quality of mother-child emotional availability observed during cooperative play and that effect depended on the respective interactions with left and right inferior fronto-occipital fasciculi (IFO-R/L), with no significant impact of psychopathological and cognitive conditions. Volume alteration in ILF-R but not in IFO-L modulated the impact of having been maltreated on emotional availability. The findings suggest the altered inferior fronto-temporal-occipital connectivity, affecting emotional visual processing, as a possible common neurological substrate linking a history of childhood maltreatment with maternal neglect.

  16. Calcified thrombus of the inferior vena cava in transposition of the great vessels.

    PubMed

    Velasquez, G; D'Souza, V J; Glass, T A; Sumner, T E; Formanek, A G

    1986-01-01

    Calcified thrombus of the inferior vena cava (IVC) in children is an entity usually not associated with significant complications. The possibility of pulmonary embolism from the soft thrombus, however, has been suggested but never reported. We give an account of a child with transposition of the great vessels who suffered embolization from a calcified thrombus in the IVC that entered the systemic circulation.

  17. Left Inferior Frontal Cortex and Syntax: Function, Structure and Behaviour in Patients with Left Hemisphere Damage

    ERIC Educational Resources Information Center

    Tyler, Lorraine K.; Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left…

  18. Unilateral inferior turbinate hypoplasia caused by a longstanding (approximately 35 yr) nasal foreign body.

    PubMed

    Derosas, Fiorenza; Marioni, Gino; Brescia, Giuseppe; Florio, Alessandra; Staffieri, Claudia; Staffieri, Alberto

    2008-01-01

    We report the unusual case of a 44-year-old man who presented with a plastic foreign body that had been lodged in his right nasal cavity for approximately 35 years. Initial attempts to remove the object were unsuccessful; only after it was broken into several parts was removal achieved. Rigid nasal endoscopy and computed tomography revealed hypoplasia of the ipsilateral inferior turbinate.

  19. The Contribution of the Inferior Parietal Cortex to Spoken Language Production

    ERIC Educational Resources Information Center

    Geranmayeh, Fatemeh; Brownsett, Sonia L. E.; Leech, Robert; Beckmann, Christian F.; Woodhead, Zoe; Wise, Richard J. S.

    2012-01-01

    This functional MRI study investigated the involvement of the left inferior parietal cortex (IPC) in spoken language production (Speech). Its role has been apparent in some studies but not others, and is not convincingly supported by clinical studies as they rarely include cases with lesions confined to the parietal lobe. We compared Speech with…

  20. Randomized Controlled Non-Inferiority Trial of a Telehealth Treatment for Chronic Stuttering: The Camperdown Program

    ERIC Educational Resources Information Center

    Carey, Brenda; O'Brian, Sue; Onslow, Mark; Block, Susan; Jones, Mark; Packman, Ann

    2010-01-01

    Background: Although there are treatments that can alleviate stuttering in adults for clinically significant periods, in Australia there are barriers to the accessibility and availability of best-practice treatment. Aims: This parallel group, non-inferiority randomized controlled trial with multiple blinded outcome assessments investigated whether…

  1. Complete heart block in late presentation of inferior STEMI successfully treated with percutaneous coronary intervention.

    PubMed

    Liang, Michael; Chin, John; Pasupati, Sanjeevan

    2011-09-01

    A 55-year-old female presented with 4-day history of fatigue and exertional shortness of breath. A late presentation inferior ST elevation myocardial infarction (STEMI) was diagnosed based on ST elevation in the inferior leads of electrocardiography and elevated cardiac troponin T (TnT). She developed complete heart block 1 day after admission to the hospital and remained hemodynamically stable. She was taken to the catheterization laboratory for a temporary pacing wire insertion. Coronary angiogram at the same time showed an occluded right coronary artery at the mid-section. The lesion was successfully opened. Within 24 hours, the patient's heart rhythm returned to sinus with first-degree atrioventricular block (AVB), thus avoiding the need for a permanent pacemaker. Current guidelines recommend medical management for late presentation hemodynamically stable STEMI of more than 72 H onset. Current ACC/AHA/HRS Pacemaker Guidelines recommend reperfusion strategy for acute presentation inferior STEMI associated with AVB. However, no clear strategy exists in the case of late presentation inferior STEMI with advanced AVB. Our case report suggests that late coronary intervention could be a management strategy in such a scenario in order to avoid a permanent pacemaker.

  2. Inferior alveolar nerve paresthesia caused by a dentigerous cyst associated with three teeth.

    PubMed

    Sumer, Mahmut; Baş, Burcu; Yildiz, Levent

    2007-09-01

    The dentigerous cyst is a common pathologic entity associated with an impacted tooth, usually third molars. They generally are asymptomatic, being found on routine dental radiographic examination. This report describes the case of a 43 year old male with a large dentigerous cyst associated with mandibular canine, first and second premolar teeth that caused paresthesia of the inferior alveolar nerve.

  3. Acute Anterior Myocardial Infarction Accompanied by Acute Inferior Myocardial Infarction: A Very Rare Coronary Artery Anomaly.

    PubMed

    Alsancak, Y; Sezenöz, B; Duran, M; Unlu, S; Turkoglu, S; Yalcın, R

    2015-01-01

    Coronary artery anomalies are rare and mostly silent in clinical practice. First manifestation of this congenital abnormality can be devastating as syncope, acute coronary syndrome, and sudden cardiac death. Herein we report a case with coronary artery anomaly complicated with ST segment myocardial infarction in both inferior and anterior walls simultaneously diagnosed during primary percutaneous coronary intervention.

  4. Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction

    SciTech Connect

    Croft, C.H.; Woodward, W.; Nicod, P.; Corbett, J.R.; Lewis, S.E.; Willerson, J.T.; Rude, R.E.

    1982-09-01

    To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such reciprocal changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms.

  5. Inferiorly based thigh flap for reconstruction of defects around the knee joint

    PubMed Central

    Akhtar, Md. Sohaib; Khan, Arshad Hafeez; Khurram, Mohammed Fahud; Ahmad, Imran

    2014-01-01

    Background: Soft-tissue defects around the knees are common in injured limbs and in the same injury the leg is often involved and the thigh is spared. Furthermore due to pliable and relatively lax skin, we have used inferiorly based thigh flap to reconstruct defects around knee joint. Aims and Objectives: The aim of this study is to evaluate the use of inferiorly based thigh flap to cover soft-tissue defects over the proximal one-third of the leg, patellar region, knee, and lower thigh. Materials and Methods: This study was conducted during the period between October 2011 and February 2013. Inferiorly based anteromedial thigh fasciocutaneous flap was performed on 12 patients and inferiorly based anterolateral thigh fasciocutaneous flap on four patients. The sites of the soft-tissue defects included patellar regions, infrapatellar region, upper one-third of leg, lower thigh, and over the knee joint. Results: Patients were evaluated post-operatively in terms of viability of flap, the matching of the flap with the recipient site, and donor site morbidity. All the flaps survived well except one which developed distal marginal flap loss, one in which wound dehiscence was noticed, and two in which mild venous congestion was observed. Venous congestion in two patients subsided on its own within 3 days. One patient with wound dehiscence achieved complete healing by secondary intention. Patient who developed distal flap loss required debridement and skin grafting. No appreciable donor site morbidity was encountered. Skin colour and texture of the flap matched well with the recipient site. Conclusions: The inferiorly based thigh flap is a reliable flap to cover the defect over proximal one-third of the leg, patellar region, knee, and lower thigh. PMID:25190918

  6. Heart block and cardiac embolization of fractured inferior vena cava filter

    PubMed Central

    Abudayyeh, Islam; Takruri, Yessar; Weiner, Justin B

    2016-01-01

    Objective: A 66-year-old man underwent a placement of an inferior vena cava filter before a gastric surgery 9 years prior, presented to the emergency room with a complete atrioventricular block. Chest x-ray and transthoracic echocardiogram showed struts migrating to right ventricle with tricuspid regurgitation. Cardiothoracic surgery was consulted and declined an open surgical intervention due to the location of the embolized fragments and the patient’s overall condition. It was also felt that the fragments had migrated chronically and were adhered to the cardiac structures. Methods: The patient underwent a dual-chamber permanent pacemaker implantation. Post-implant fluoroscopy showed no displacement of the inferior vena cava filter struts due to the pacemaker leads indicating that the filter fracture had likely been a chronic process. Results: This case highlights a rare combination of complications related to inferior vena cava filter fractures and the importance of assessing for such fractures in chronic placements. Inferior vena cava filter placement for a duration greater than 1 month can be associated with filter fractures and strut migration which may lead to, although rare, serious or fatal complications such as complete atrioventricular conduction system disruption and valvular damage including significant tricuspid regurgitation. Conclusions: Assessing for inferior vena cava filter fractures in chronic filter placement is important to avoid such complications. When possible, retrieval of the filter should be considered in all patients outside the acute setting in order to avoid filter-related complications. Filter retrieval rates remain low even when a retrievable filter is in place and the patient no longer has a contraindication to anticoagulation. PMID:28228959

  7. Factors involved in the antinatriuretic effects of acute constriction of the thoracic and abdominal inferior vena cava.

    NASA Technical Reports Server (NTRS)

    Schrier, R. W.; Humphreys, M. H.

    1971-01-01

    Study of the antinatriuretic effect of acute thoracic inferior vena cava (TIVC) constriction in the absence of alterations in renal perfusion pressure. A comparison is made of the effects of equivalent degrees of TIVC and abdominal inferior vena cava constriction on arterial pressure, renal hemodynamics, and electrolyte excretion.

  8. A Case of the Inferior Mesenteric Artery Arising from the Superior Mesenteric Artery in a Korean Woman

    PubMed Central

    Yoo, Seung Jin; Ku, Min Jung; Cho, Sa Sun

    2011-01-01

    Anatomical variations of the inferior mesenteric artery are extremely uncommon, since the inferior mesenteric artery is regularly diverged at the level of the third lumbar vertebra. We found a rare case in which the inferior mesenteric artery arose from the superior mesenteric artery. The findings were made during a routine dissection of the cadaver of an 82-yr-old Korean woman. This is the tenth report on this anomaly, the second female and the first Korean. The superior mesenteric artery normally arising from abdominal aorta sent the inferior mesenteric artery as the second branch. The longitudinal anastomosis vessels between the superior mesenteric artery and inferior mesenteric artery survived to form the common mesenteric artery. This anatomical variation concerning the common mesenteric artery is of clinical importance, performing procedures containing the superior mesenteric artery. PMID:22022194

  9. The Anterior Branch of the Left Inferior Phrenic Artery Arising from the Right Inferior Phrenic Artery: An Angiographic and CT Study

    SciTech Connect

    Hieda, Masashi Toyota, Naoyuki; Kakizawa, Hideaki; Ishikawa, Masaki; Horiguchi, Jun; Ito, Katsuhide

    2009-03-15

    The purpose of this study was to retrospectively analyze the frequency and anatomical pattern of the anterior branch of the left inferior phrenic artery (LIPA) arising from the right inferior phrenic artery (RIPA). Angiography of the RIPA for patients (n = 140) with hepatic malignancy was retrospectively reviewed. The frequency at which the anterior branch of the LIPA arose from the RIPA was 14.3% (20 of 140 patients [pts]). Among the three branches that may arise from the RIPA in these cases (the anterior branch of the LIPA and the anterior and posterior branches of the RIPA), the anterior branch of the LIPA was the first branch of the RIPA in 9 of 20 pts (45%), and the posterior branch of the RIPA in 11 of 20 pts (55%). The anterior branch of the LIPA ran along the ventral side of the esophagus or stomach and supplied the esophagogastric region and dome of the left diaphragm in all cases. In conclusion, the anterior branch of the LIPA arises from the RIPA at a comparatively high frequency. In embolization of the RIPA, to effectively treat and avoid possible complications, interventionalists should be aware of this potential variant anatomy.

  10. A network centred on the inferior frontal cortex is critically involved in levodopa-induced dyskinesias.

    PubMed

    Cerasa, Antonio; Koch, Giacomo; Donzuso, Giulia; Mangone, Graziella; Morelli, Maurizio; Brusa, Livia; Stampanoni Bassi, Mario; Ponzo, Viviana; Picazio, Silvia; Passamonti, Luca; Salsone, Maria; Augimeri, Antonio; Caltagirone, Carlo; Quattrone, Aldo

    2015-02-01

    Levodopa-induced dyskinesias are disabling motor complications of long-term dopamine replacement in patients with Parkinson's disease. In recent years, several alternative models have been proposed to explain the pathophysiological mechanisms underlying this hyperkinetic motor disorder. In particular, our group has shed new light on the role of the prefrontal cortex as a key site of interest, demonstrating that, among other areas, the inferior frontal cortex is particularly characterized by altered patterns of anatomical and functional changes. However, how neural activity varies depending on levodopa treatment in patients with dyskinesias and whether the reported prefrontal abnormalities may have a critical role in dyskinesias is debated. To answer these questions we performed independent functional magnetic resonance imaging and repetitive transcranial magnetic stimulation studies. In the first experiment we applied resting state functional magnetic resonance imaging on 12 patients with Parkinson's disease with levodopa-induced dyskinesias and 12 clinically matched patients without dyskinesias, before and after administration of levodopa. Functional connectivity of brain networks in the resting state was assessed in both groups. We chose the right inferior frontal cortex as the seed region given the evidence highlighting the role of this region in motor control. In a second experiment, we applied different forms of repetitive transcranial magnetic stimulation over the right inferior frontal cortex in a new group of dyskinetic patients who were taking a supramaximal dose of levodopa, to verify the clinical relevance of this area in controlling the development of hyperkinetic movements. The resting state functional imaging analysis revealed that in patients with levodopa-induced dyskinesias connectivity of the right inferior frontal cortex was decreased with the left motor cortex and increased with the right putamen when compared to patients without levodopa

  11. [Functional interactions between caudate nuclei and inferior frontal gyrus in deliberate deception processing].

    PubMed

    Kireev, M V; Medvedeva, N S; Korotkov, A D; Medvedev, S V

    2015-01-01

    The present paper dedicated to the research of the functional interactions between brain structures while executing deliberate deceptive actions. Based on our own and literature data, we formulated the hypothesis that the functional interaction between brain areas responsible for the executive control, localized in the prefrontal cortex (inferior frontal gyrus), and the elements of error detection brain system, underlies deception. To test this hypothesis, we applied an analysis of the psychophysiological interaction (PPI), which revealed that the false actions (in comparison with true honestones) associated with increased functional connectivity between the left caudate nucleus and the left inferior frontal gyrus. Obtained experimental data support our hypothesis that the interaction of neural brain systems, which are responsible for executive control and error detection, underpins the brain maintenance of the execution of deceptive actions.

  12. Extranasopharyngeal Angiofibroma Originating in the Inferior Turbinate: A Distinct Clinical Entity at an Unusual Site

    PubMed Central

    Baptista, Marco Antonio Ferraz de Barros; Pinna, Fábio de Rezende; Voegels, Richard Louis

    2014-01-01

    Introduction The extranasopharyngeal angiofibroma is histologically similar to juvenile nasopharyngeal angiofibroma, differing from the latter in clinical and epidemiologic characteristics. Objectives We present a case of extranasopharyngeal angiofibroma originating in the inferior turbinate. Resumed Report The patient was a girl, 8 years and 6 months of age, who had constant bilateral nasal obstruction and recurrent epistaxis for 6 months, worse on the right side, with hyposmia and snoring. Nasal endoscopy showed a reddish lesion, smooth, friable, and nonulcerated. Computed tomography showed a lesion with soft tissue density in the right nasal cavity. We used an endoscopic approach and found the lesion inserted in the right inferior turbinate. We did a subperiosteal dissection and excision with a partial turbinectomy with a resection margin of 0.5 cm. Histopathology reported it to be an extranasopharyngeal angiofibroma. Conclusion Although rare, extranasopharyngeal angiofibroma should be considered in the diagnosis of vascular tumors of the head and neck. PMID:25992131

  13. Ruptured partially thrombosed anterior inferior cerebellar artery aneurysms: two case reports and review of literature

    PubMed Central

    Kanamori, Fumiaki; Kawabata, Teppei; Muraoka, Shinsuke; Kojima, Takao; Watanabe, Tadashi; Hatano, Norikazu; Seki, Yukio

    2016-01-01

    ABSTRACT Aneurysms arising from the distal anterior inferior cerebellar artery (AICA) are very rare. When the parent artery is an AICA−posterior inferior cerebellar artery (PICA) variant, occlusion of the artery, even distal to the meatal loop, leads to a significant area of cerebellar infarction. We report two cases of ruptured partially thrombosed distal AICA aneurysms. In both cases, the parent artery was an AICA−PICA variant. The aneurysms were clipped in one case and trapped following occipital artery (OA)−AICA anastomosis in another case. It is important to keep the OA as a donor artery for revascularization in the treatment of the AICA−PICA variant aneurysms, especially when the absence of intra-aneurysmal thrombus is not comfirmed preoperatively. PMID:28008208

  14. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

    PubMed

    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  15. [Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

    PubMed

    Bucur, A; Dincă, O; Totan, C; Ghită, V

    2007-01-01

    The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

  16. Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues

    PubMed Central

    PHILLIPS, C.; ESSICK, G.

    2011-01-01

    SUMMARY The sensory branches of the trigeminal nerve encode information about facial expressions, speaking and chewing movements, and stimuli that come into contact with the orofacial tissues. Whatever the cause, damage to the inferior alveolar nerve negatively affects the quality of facial sensibility as well as the patient's ability to translate patterns of altered nerve activity into functionally meaningful motor behaviours. There is no generally accepted, standard method of estimating sensory disturbances in the distribution of the inferior alveolar nerve following injury. Assessment of sensory alterations can be conducted using three types of measures: (i) objective electrophysiological measures of nerve conduction, (ii) sensory testing (stimulus) measures and (iii) patient report. Each type of measure with advantages and disadvantages for use are reviewed. PMID:21058973

  17. Is Consent Based on Trust Morally Inferior to Consent Based on Information?

    PubMed

    Kongsholm, Nana Cecilie Halmsted; Kappel, Klemens

    2017-02-27

    Informed consent is considered by many to be a moral imperative in medical research. However, it is increasingly acknowledged that in many actual instances of consent to participation in medical research, participants do not employ the provided information in their decision to consent, but rather consent based on the trust they hold in the researcher or research enterprise. In this article we explore whether trust-based consent is morally inferior to information-based consent. We analyse the moral values essential to valid consent - autonomy, voluntariness, non-manipulation, and non-exploitation - and assess whether these values are less protected and promoted by consent based on trust than they are by consent based on information. We find that this is not the case, and thus conclude that trust-based consent if not morally inferior to information-based consent.

  18. Multiple Stability of a Sparsely Encoded Attractor Neural Network Model for the Inferior Temporal Cortex

    NASA Astrophysics Data System (ADS)

    Kimoto, Tomoyuki; Uezu, Tatsuya; Okada, Masato

    2008-12-01

    We study a neural network model for the inferior temporal cortex, in terms of finite memory loading and sparse coding. We show that an uncorrelated Hopfield-type attractor and some correlated attractors have multiple stability, and examine the retrieval dynamics for these attractors when the initial state is set to a noise-degraded memory pattern. Then, we show that there is a critical initial overlap: that is, the system converges to the correlated attractor when the noise level is large, and otherwise to the Hopfield-type attractor. Furthermore, we study the time course of the correlation between the correlated attractors in the retrieval dynamics. On the basis of these theoretical results, we resolve the controversy regarding previous physiologic experimental findings regarding neuron properties in the inferior temporal cortex and propose a new experimental paradigm.

  19. Memory of music: roles of right hippocampus and left inferior frontal gyrus.

    PubMed

    Watanabe, Takamitsu; Yagishita, Sho; Kikyo, Hideyuki

    2008-01-01

    We investigated neural correlates of retrieval success for music memory using event-related functional magnetic resonance imaging. To minimize the interference from MRI scan noise, we used sparse temporal sampling technique. Newly composed music materials were employed as stimuli, which enabled us to detect regions in absence of effects of experience with the music stimuli in this study. Whole brain analyses demonstrated significant retrieval success activities in the right hippocampus, bilateral lateral temporal regions, left inferior frontal gyrus and left precuneus. Anatomically defined region-of-interests analyses showed that the activity of the right hippocampus was stronger than that of the left, while the activities of the inferior frontal gyri showed the reverse pattern. Furthermore, performance-based analyses demonstrated that the retrieval success activity of the right hippocampus was positively correlated with the corrected recognition rate, suggesting that the right hippocampus contributes to the accuracy of music retrieval outcome.

  20. Giant biatrial myxoma nearly obstructing the orifice of the inferior vena cava

    PubMed Central

    2013-01-01

    Cardiac myxomas are the most common type of benign cardiac tumors and most of them occur in the left atrium but the biatrial myxoma is uncommon. We present a rare case of giant biatrial myxoma nearly obstructing the orifice of the inferior vena cava. A 58-year old woman presented with exertional dyspnea and intermittent chest discomfort. The non-pedunculated tumor involved most of the interatrial septum and extended from the orifice of the inferior vena cava to the displaced mitral annulus and the lower left pulmonary vein. The resected specimen weighed 76 gram and measured 80 × 40 × 30 mm. She did not complain of dyspnea or show any sign of recurrence by echocardiography during the 2-year follow-up period. PMID:23758983

  1. Duplication of Inferior Vena Cava with Associated Anomalies: A Rare Case Report

    PubMed Central

    Shaha, Pramod; Sahoo, Kulamani; Kothari, Nupoor; Garg, Pooja

    2016-01-01

    Duplication of inferior vena cava is an uncommon abnormality and is important in daily today practice for vascular surgeons, radiologist and urologist especially during retroperitoneal surgeries and treatment of thromboembolic disease. Radiologically, Duplicated IVC can be mistaken for lymphadenopathy or left pyeloureteric dilatation. Crossed fused kidney with a single ureter defy the embryological theory of ureteric bud crossing the opposite side and induce nephron formation associated anomaly of Duplication of inferior vena cava and malrotation of gut are not reported in a same patient. On meticulous search of literature no such combination of abnormalities has been reported. In this case report we bring forward this rare type of combination of three congenital malformations that is Duplication of IVC, crossed fused kidney and malrotation of gut. PMID:27134964

  2. Methodology of superiority vs. equivalence trials and non-inferiority trials.

    PubMed

    Christensen, Erik

    2007-05-01

    The randomized clinical trial (RCT) is generally accepted as the best method of comparing effects of therapies. Most often the aim of an RCT is to show that a new therapy is superior to an established therapy or placebo, i.e. they are planned and performed as superiority trials. Sometimes the aim of an RCT is just to show that a new therapy is not superior but equivalent to or not inferior to an established therapy, i.e. they are planned and performed as equivalence trials or non-inferiority trials. Since the types of trials have different aims, they differ significantly in various methodological aspects. The awareness of the methodological differences is generally quite limited. This paper reviews the methodology of these types of trials with special reference to differences in respect to planning, performance, analysis and reporting of the trial. In this context the relevant basal statistical concepts are reviewed. Some of the important points are illustrated by examples.

  3. [Radical surgical resection of leiomyosarcoma of the inferior vena cava with intracardial tumour growth].

    PubMed

    Pedersen, Christian Ross; Larsen, Peter Nørgaard; Arendrup, Henrik C; Rasmussen, Allan

    2005-11-07

    Sarcoma of the inferior vena cava (IVC) is a rare clinical entity. Surgical treatment of IVC is associated with improved survival. This case report describes a 42-year-old woman with biopsy-proven leiomyosarcoma of the inferior vena cava with intracardial tumour growth. The primary tumour was only 1 x 1 cm in the wall of the vena cava while the intracaval tumour was 12 cm long with a diameter of 5 cm and 1.5 cm in the right atrium. Using venovenous bypass with circulatory support, the tumour was excised in toto and the caval vein closed with a pericardial patch. The patient was discharged in good condition after 19 days.

  4. Infection-related mental and inferior alveolar nerve paresthesia: literature review and presentation of two cases.

    PubMed

    Morse, D R

    1997-07-01

    A review of the literature on infection-related mental and inferior alveolar nerve paresthesia is given. This is followed by 2 case reports. The first case is of a mandibular left second molar in which a chloropercha overfill puff occurred in the vicinity of the inferior alveolar canal. The tooth remained asymptomatic until 2 and 1/2 yr later, when the periapical lesion enlarged and swelling, pain, and paresthesia developed. The paresthesia resolved 2 weeks following periapical surgery. The second case is of a mandibular right first premolar in which paresthesia began 1 day after the initial endodontic treatment. The intracanal medication was formocresol on a cotton pellet that was squeezed dry. The paresthesia was treated by irrigation, antibiotics, and dexamethasone. The paresthesia lasted 7 weeks, and when it resolved the root canal was filled with gutta-percha/eucapercha. Almost 9 months later, the tooth remained asymptomatic.

  5. Inferior alveolar nerve paresthesia caused by endodontic pathosis: a case report and review of the literature.

    PubMed

    Giuliani, M; Lajolo, C; Deli, G; Silveri, C

    2001-12-01

    Sensory disturbances such as anesthesia, hypoesthesia, hyperesthesia, and paresthesia may be present in the oral cavity, stemming from many local and systemic factors. Paresthesia of the inferior alveolar nerve is quite rare because of the unique anatomy of this nerve. Among other effects, periapical lesions can damage the nerve, resulting in paresthesia of its innervated area. Only a few cases of paresthesia caused by these lesions are reported in the literature. In this report we present a case of paresthesia of the right inferior alveolar nerve; discuss the anatomy, pathobiology, and etiology; and suggest that a periapical lesion affecting the lower right second molar (No. 31) may have been the cause. The routine x-rays (intraoral and panorex) and the axial and cross-sectional tomographs of the mandible by means of computed tomography contribute to making this case a good example of nerve injury.

  6. Repair of injured right inferior pulmonary vein during mitral valve replacement

    PubMed Central

    2009-01-01

    During mitral valve surgery right pulmonary veins injury, subsequent to excessive traction (for better exposure of the mitral apparatus), is often unavoidable. This is more likely in patients with small left atrium. This common complication may cause severe intraoperative bleeding, while its surgical repair may lead to complications such as late stenosis or obstruction of the pulmonary veins. This injury should be early detected, before left atriotomy closing, and it is suggested to be repaired using a patch so as to avoid any possible late constriction. We describe a case -to our knowledge, the first reported in the literature- of intraoperatively injured right inferior pulmonary vein in a patient who underwent mitral valve replacement. As outlined we propose that the ostium of the right inferior pulmonary vein can be repaired by using autologous pericardial patch, incorporated in the completion of left atriotomy closure. PMID:19895700

  7. Importance of cholescintigraphy and inferior vena cava flow studies in the differential diagnosis of hepatocellular carcinoma

    SciTech Connect

    Botha, U.; Pilloy, W.; Strydom, W.J.

    1989-01-01

    In order to assess the usefulness of inferior vena cava flow studies and cholescintigraphy complementary to the routine static liver scintigraphy in the differential diagnosis of hepatocellular carcinoma (HCC), we studied 37 patients with a proven diagnosis of HCC and 11 patients with a liver abcess or cyst. The procedure followed was (1) a {sup 99m}Tc-colloid flow study of the inferior vena cava (IVC) and iliac veins followed by static liver imaging and (2) cholescintigraphy using a dynamic acquisition mode to determine the perfusion as well as the concentration/excretion of the liver and pathological area. The hepatic perfusion index (HPI) was calculated by the slope method of Sarper et al.: Radiology 141:179-184 (1981) and the area method of Biersack et al. The results were compared with data previously collected in patients without liver disease (control) and other liver pathologies.

  8. CaV3.1 is a tremor rhythm pacemaker in the inferior olive

    PubMed Central

    Park, Young-Gyun; Park, Hye-Yeon; Lee, C. Justin; Choi, Soonwook; Jo, Seonmi; Choi, Hansol; Kim, Yang-Hann; Shin, Hee-Sup; Llinas, Rodolfo R.; Kim, Daesoo

    2010-01-01

    The rhythmic motor pathway activation by pacemaker neurons or circuits in the brain has been proposed as the mechanism for the timing of motor coordination, and the abnormal potentiation of this mechanism may lead to a pathological tremor. Here, we show that the potentiation of CaV3.1 T-type Ca2+ channels in the inferior olive contributes to the onset of the tremor in a pharmacological model of essential tremor. After administration of harmaline, 4- to 10-Hz synchronous neuronal activities arose from the IO and then propagated to cerebellar motor circuits in wild-type mice, but those rhythmic activities were absent in mice lacking CaV3.1 gene. Intracellular recordings in brain-stem slices revealed that the CaV3.1-deficient inferior olive neurons lacked the subthreshold oscillation of membrane potentials and failed to trigger 4- to 10-Hz rhythmic burst discharges in the presence of harmaline. In addition, the selective knockdown of CaV3.1 gene in the inferior olive by shRNA efficiently suppressed the harmaline-induced tremor in wild-type mice. A mathematical model constructed based on data obtained from patch-clamping experiments indicated that harmaline could efficiently potentiate CaV3.1 channels by changing voltage-dependent responsiveness in the hyperpolarizing direction. Thus, CaV3.1 is a molecular pacemaker substrate for intrinsic neuronal oscillations of inferior olive neurons, and the potentiation of this mechanism can be considered as a pathological cause of essential tremor. PMID:20498062

  9. Outcomes of ischaemic mitral regurgitation in anterior versus inferior ST elevation myocardial infarction

    PubMed Central

    Mentias, Amgad; Raza, Mohammad Q; Barakat, Amr F; Hill, Elizabeth; Youssef, Dalia; Krishnaswamy, Amar; Desai, Milind Y; Griffin, Brian; Ellis, Stephen; Menon, Venu; Tuzcu, E Murat; Kapadia, Samir R

    2016-01-01

    Background Ischaemic mitral regurgitation (IMR) is a detrimental complication of ST elevation myocardial infarction (STEMI). Objective We sought to determine patient characteristics and outcomes of patients with IMR with focus on anterior or inferior location of STEMI. Methods All patients presenting with STEMI complicated by IMR to our centre who underwent primary percutaneous coronary intervention within the first 12 hours of presentation from 1995 to 2014 were included. IMR was graded from 1+ to 4+ within 3 days of index myocardial infarction by echocardiography, divided into 2 groups based on infarct location and outcomes were compared. Results Overall, 805 patients were included. There were 302 (17.8%) patients with mitral regurgitation (MR) out of the 1700 patients with anterior STEMI while 503 (21.8%) had MR out of the 2305 patients with inferior STEMI. There was no significant difference between both groups in comorbidities, clinical presentation or door-to-balloon time (DBT; median 104 vs 106 min, p=0.5). 30-day and 1-year mortality were higher in anterior STEMI compared with inferior STEMI (14.9% vs 6.8% and 26.4% vs 14.3%, respectively, p<0.001 both), as well as 5-year mortality (39.7% vs 24.8%, p<0.01). When analysis was performed for each grade of IMR, anterior was associated with worse outcomes in every grade. On multivariate cox survival analysis, after adjustment for age, gender, comorbidities, grade of IMR, ejection fraction and DBT, anterior STEMI was still associated with worse outcomes (HR 1.62 (95% CI 1.23 to 2.12), p<0.001). Conclusions Although IMR occurs more frequently with inferior infarction, outcomes are worse following anterior infarction. PMID:27933193

  10. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    PubMed Central

    Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

    2016-01-01

    The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block. PMID:28182074

  11. Inferior wall diverticulum of left ventricle coexisting with mental retardation and atrial septal defect.

    PubMed

    Liu, Henry; Zhou, Ting; Liu, Jiao; Tong, Yiru; Shanewise, Jack S

    2012-10-01

    We report a case of congenital inferior wall left ventricular diverticulum (LVD), atrial septal defect and mental retardation detected by intraoperative transesophageal echocardiography. The combination of three features strongly suggests that genetic factors play important role in the pathogenesis of the disorder. Most LVDs are asymptomatic. Echocardiographers and cardiac anesthesiologists should be aware of this anomaly, and include it in the differential diagnosis of abnormally shaped ventricular wall and seek other congenital abnormalities if LVD is detected.

  12. Percutaneous Stent Placement as Treatment of Renal Vein Obstruction Due to Inferior Vena Caval Thrombosis

    SciTech Connect

    Stecker, Michael S. Casciani, Thomas; Kwo, Paul Y.

    2006-02-15

    A patient who had undergone his third orthotopic liver transplantation nearly 9 years prior to presentation developed worsening hepatic and renal function, as well as severe bilateral lower extremity edema. Magnetic resonance imaging demonstrated vena caval thrombosis from the suprahepatic venous anastomosis to the infrarenal inferior vena cava, obstructing the renal veins. This was treated by percutaneous placement of metallic stents from the renal veins to the right atrium. At 16 months clinical follow-up, the patient continues to do well.

  13. Left inferior frontal cortex and syntax: function, structure and behaviour in patients with left hemisphere damage.

    PubMed

    Tyler, Lorraine K; Marslen-Wilson, William D; Randall, Billi; Wright, Paul; Devereux, Barry J; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A

    2011-02-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left hemisphere damage and healthy participants to ask whether the left inferior frontal gyrus is essential for syntactic processing. In a functional neuroimaging study, participants listened to spoken sentences that either contained a syntactically ambiguous or matched unambiguous phrase. Behavioural data on three tests of syntactic processing were subsequently collected. In controls, syntactic processing co-activated left hemisphere Brodmann areas 45/47 and posterior middle temporal gyrus. Activity in a left parietal cluster was sensitive to working memory demands in both patients and controls. Exploiting the variability in lesion location and performance in the patients, voxel-based correlational analyses showed that tissue integrity and neural activity-primarily in left Brodmann area 45 and posterior middle temporal gyrus-were correlated with preserved syntactic performance, but unlike the controls, patients were insensitive to syntactic preferences, reflecting their syntactic deficit. These results argue for the essential contribution of the left inferior frontal gyrus in syntactic analysis and highlight the functional relationship between left Brodmann area 45 and the left posterior middle temporal gyrus, suggesting that when this relationship breaks down, through damage to either region or to the connections between them, syntactic processing is impaired. On this view, the left inferior frontal gyrus may not itself be specialized for syntactic processing, but plays an essential role in the neural network that carries out syntactic computations.

  14. A case of renal cell carcinoma with an extensive inferior vena cava thrombosis

    PubMed Central

    Alfreijat, Majd

    2016-01-01

    Renal cell carcinoma (RCC) is the most prevalent primary renal malignant neoplasm in adults. Most of the cases are usually found incidentally. It is commonly associated with venous thrombosis. We demonstrate a case of a RCC which was associated with an extensive thrombus that reached the upper part of the inferior vena cava (IVC). We also perform a brief literature review about the association between RCC and IVC thrombosis. PMID:27802848

  15. Inferior Vena Cava and Renal Vein Thrombosis Associated with Thymic Carcinoma

    PubMed Central

    Paraschiv, Marina; Sorohan, Bogdan

    2017-01-01

    Thymic tumors are rare mediastinal tumors that can present with a wide variety of symptoms. They can cause distant manifestations and are frequently associated with paraneoplastic syndromes. In our case, we describe the evolution of a 68-year-old male whose first manifestation was thrombosis of the inferior vena cava and renal veins. Thrombosis of large abdominal veins is rare, especially without being associated with any other comorbidity or risk factors. PMID:28163719

  16. Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

    SciTech Connect

    Brountzos, Elias N.; Kaufman, John A. Lakin, Paul L.

    2004-01-15

    Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach.

  17. Left inferior frontal cortex and syntax: function, structure and behaviour in patients with left hemisphere damage

    PubMed Central

    Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left hemisphere damage and healthy participants to ask whether the left inferior frontal gyrus is essential for syntactic processing. In a functional neuroimaging study, participants listened to spoken sentences that either contained a syntactically ambiguous or matched unambiguous phrase. Behavioural data on three tests of syntactic processing were subsequently collected. In controls, syntactic processing co-activated left hemisphere Brodmann areas 45/47 and posterior middle temporal gyrus. Activity in a left parietal cluster was sensitive to working memory demands in both patients and controls. Exploiting the variability in lesion location and performance in the patients, voxel-based correlational analyses showed that tissue integrity and neural activity—primarily in left Brodmann area 45 and posterior middle temporal gyrus—were correlated with preserved syntactic performance, but unlike the controls, patients were insensitive to syntactic preferences, reflecting their syntactic deficit. These results argue for the essential contribution of the left inferior frontal gyrus in syntactic analysis and highlight the functional relationship between left Brodmann area 45 and the left posterior middle temporal gyrus, suggesting that when this relationship breaks down, through damage to either region or to the connections between them, syntactic processing is impaired. On this view, the left inferior frontal gyrus may not itself be specialized for syntactic processing, but plays an essential role in the neural network that carries out syntactic computations. PMID:21278407

  18. Retrograde Stent Placement for Coil Embolization of a Wide-Necked Posterior Inferior Cerebellar Artery Aneurysm

    PubMed Central

    Roh, Hong Gee; Choi, Jin Woo; Cho, Joon; Moon, Won-Jin; Solander, Sten

    2012-01-01

    Wide-necked aneurysms of the posterior inferior cerebellar artery (PICA) are infrequently encountered in cerebrovascular practice, and endovascular treatment is difficult or impossible even with the use of several neck remodeling techniques. We present the case of a patient with a wide-necked aneurysm of the PICA, which was treated by the retrograde stenting through the contralateral vertebral artery and vertebrobasilar junction with antegrade coil embolization. PMID:22778576

  19. Aberrant origin of the inferior thyroid artery from the common carotid artery: a rare anatomical variation

    PubMed Central

    Ngo Nyeki, Adèle-Rose; Peloni, Giuseppe; Karenovics, Wolfram; Triponez, Frédéric

    2016-01-01

    We describe the case of a rare anatomical variant of the inferior thyroid artery (ITA) taking its origin directly from the common carotid artery (CCA) instead of the thyrocervical trunk (TCT). This anatomical feature exposes to risks of perioperative bleeding and nerve injuries when it is unrecognized by the surgeons. Knowledge of its existence may be helpful to reduce risks for the patient. PMID:28149813

  20. Inferior mesenteric vein thrombosis in Crohn`s disease: CT diagnosis

    SciTech Connect

    Coralnick, J.R.; Budin, J.A.; Sedarat, A.

    1996-01-01

    Mesenteric vein thrombosis has been described in association with such risk factors as coagulation disorders, postoperative dehydration, sepsis, and trauma. CT and ultrasound have greatly facilitated early diagnosis, and the features of superior mesenteric and portal vein thrombosis are well recognized. We present a case of inferior mesenteric vein thrombosis in a patient with Crohn`s disease. To our knowledge, this entity has not been reported in the radiologic literature. 7 refs., 2 figs.

  1. The inferior olivary nucleus: a postmortem study of essential tremor cases versus controls.

    PubMed

    Louis, Elan D; Babij, Rachel; Cortés, Etty; Vonsattel, Jean-Paul G; Faust, Phyllis L

    2013-06-01

    The pathogenesis of essential tremor is poorly understood. Historically, it has been hypothesized that the inferior olivary nucleus plays an important role in the generation of tremor in essential tremor, yet a detailed, controlled, anatomic-pathological study of that brain region has yet to be conducted. A detailed postmortem study was undertaken of the microscopic changes in the inferior olivary nucleus of 14 essential tremor cases versus 15 age-matched controls at the Essential Tremor Centralized Brain Repository. A series of metrics was used to quantify microscopic neuronal and glial changes in the inferior olivary nucleus and its input and output tracts. Olivary linear neuronal density also was assessed. Cases and controls did not differ from one another with respect to any of the assessed metrics (P values ranged from 0.23 to 1.0). Olivary linear neuronal density also was similar in cases and controls (P = 0.62). Paddle-shaped neurons, a morphologic shape change in olivary neurons, which, to our knowledge, have not been previously recognized, occurred to an equal degree in essential tremor cases and controls (P = 0.89) and were correlated with several markers of neuronal loss and gliosis. A systematic postmortem study of the microscopic changes in the inferior olivary nucleus did not detect any differences between cases and controls. These data, along with positron emission tomography data, which have failed to identify any metabolic abnormality of the olive, indicate that, if the olive is involved in essential tremor, then there is no clearly identifiable structural or metabolic correlate.

  2. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    PubMed

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  3. Inferior Lateral Genicular Artery Injury during Anterior Cruciate Ligament Reconstruction Surgery

    PubMed Central

    Lamo-Espinosa, J. M.; Llombart Blanco, R.; Valentí, J. R.

    2012-01-01

    We report a case of inferior lateral genicular artery (ILG) injury during anterior cruciate ligament (ACL) reconstruction surgery with lateral partial meniscectomy. This is a rare arthroscopy complication. A review of the literature has been made with the aim to define the anatomy of ILG across the lateral articular line and the risk of lesion during knee arthroscopy. We propose embolization as a good treatment option for this type of injuries. PMID:22957293

  4. Reappraisal of the inferior epigastric flap: a new neurovascular flap model in the rat.

    PubMed

    Hirigoyen, M B; Rhee, J S; Weisz, D J; Zhang, W X; Urken, M L; Weinberg, H

    1996-09-01

    An anatomic, histologic, and electrophysiologic study was carried out in order to determine the distribution and cutaneous sensory territory of the epigastric nerve in the rat. Results for nerve staining (Sihler's method) and electrophysiologic nerve mapping indicate that the neurosome of the epigastric nerve has a different autonomy than the vascular territory of the inferior epigastric artery. Based on these findings, an experimental model for neurovascular free-tissue transfer is proposed.

  5. The Effect of 2 Injection Speeds on Local Anesthetic Discomfort During Inferior Alveolar Nerve Blocks

    PubMed Central

    de Souza Melo, Marcelo Rodrigo; Sabey, Mark Jon Santana; Lima, Carla Juliane; de Almeida Souza, Liane Maciel; Groppo, Francisco Carlos

    2015-01-01

    This randomized double-blind crossover trial investigated the discomfort associated with 2 injection speeds, low (60 seconds) and slow (100 seconds), during inferior alveolar nerve block by using 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine. Three phases were considered: (a) mucosa perforation, (b) needle insertion, and (c) solution injection. Thirty-two healthy adult volunteers needing bilateral inferior alveolar nerve blocks at least 1 week apart were enrolled in the present study. The anesthetic procedure discomfort was recorded by volunteers on a 10-cm visual analog scale in each phase for both injection speeds. Comparison between the 2 anesthesia speeds in each phase was performed by paired t test. Results showed no statistically significant difference between injection speeds regarding perforation (P = .1016), needle placement (P = .0584), or speed injection (P = .1806). The discomfort in all phases was considered low. We concluded that the 2 injection speeds tested did not affect the volunteers' pain perception during inferior alveolar nerve blocks. PMID:26398126

  6. Complications in right-sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava

    PubMed Central

    Turyna, Radovan; Kachlik, David; Kucera, Eduard; Kujal, Petr; Feyereisl, Jaroslav; Baca, Vaclav

    2013-01-01

    The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure. PMID:23692119

  7. [A case of inflammatory abdominal aortic aneurysm with associated inferior vena caval and bilateral ureteral obstruction].

    PubMed

    Hirose, Y; Hayashida, K; Ishida, Y; Hamada, S; Takahashi, N; Takamiya, M; Ando, M; Nishimura, T

    1994-09-01

    One year ago, a 48-year-old man complained of dyspnea, and was diagnosed as mitral valve regurgitation and aortic dissection. He underwent mitral valve replacement and aortic arch grafting. He was also pointed out to have an inflammatory aortic aneurysm (IAAA) in the infrarenal abdominal aorta, but did not undergo surgery. At this admission, he had lumbago and low grade fever probably due to deterioration of the IAAA. On the preoperative radionuclide studies, inferior vena caval obstruction and bilateral ureteral obstruction or severe stenosis were demonstrated by 99mTc-MAA venography and 123I-OIH renogram, respectively. 67Ga scan showed faint abnormal accumulation at the IAAA. He underwent surgery. IAAA had a thick wall in white and hard fibrotic tissue adhered closely to duodenum, jejunum, inferior vena cava and bilateral ureters. After surgery, his renal function was improved. In this case, radionuclide studies were useful for detecting the inferior vena caval obstruction, assessing renal function and inflammatory activity.

  8. Demand on verbal working memory delays haemodynamic response in the inferior prefrontal cortex.

    PubMed

    Thierry, Guillaume; Ibarrola, Danielle; Démonet, Jean-François; Cardebat, Dominique

    2003-05-01

    Event-related functional magnetic resonance imaging was used to test the involvement of the inferior prefrontal cortex in verbal working memory. Pairs of French nouns were presented to ten native French speakers who had to make semantic or grammatical gender decisions. Verbal working memory involvement was manipulated by making the categorization of the second noun optional. Decisions could be made after processing the first noun only (RELEASE condition) or after processing the two nouns (HOLD condition). Reaction times suggested faster processing for gender than for semantic category in RELEASE. Despite the absence of anatomical difference across tasks and conditions in the wide activated network, the haemodynamic response peak latencies of the inferior prefrontal cortex were significantly delayed in HOLD versus RELEASE while no such peak delay was observed in the superior temporal gyrus. Interestingly, this pattern did not interact with language tasks. This study shows that cognitive manipulation can influence haemodynamic time-course and suggests that the main cognitive process determining inferior prefrontal activation is verbal working memory rather than specific linguistic processes such as grammatical or semantic analysis.

  9. Inferior Prefrontal Cortex Mediates the Relationship between Phosphatidylcholine and Executive Functions in Healthy, Older Adults

    PubMed Central

    Zamroziewicz, Marta K.; Zwilling, Chris E.; Barbey, Aron K.

    2016-01-01

    Objectives: This study examines the neural mechanisms that mediate the relationship between phosphatidylcholine and executive functions in cognitively intact older adults. We hypothesized that higher plasma levels of phosphatidylcholine are associated with better performance on a particular component of the executive functions, namely cognitive flexibility, and that this relationship is mediated by gray matter structure of regions within the prefrontal cortex (PFC) that have been implicated in cognitive flexibility. Methods: We examined 72 cognitively intact adults between the ages of 65 and 75 in an observational, cross-sectional study to investigate the relationship between blood biomarkers of phosphatidylcholine, tests of cognitive flexibility (measured by the Delis–Kaplan Executive Function System Trail Making Test), and gray matter structure of regions within the PFC. A three-step mediation analysis was implemented using multivariate linear regressions and we controlled for age, sex, education, income, depression status, and body mass index. Results: The mediation analysis revealed that gray matter thickness of one region within the PFC, the left inferior PFC (Brodmann’s Area 45), mediates the relationship between phosphatidylcholine blood biomarkers and cognitive flexibility. Conclusion: These results suggest that particular nutrients may slow or prevent age-related cognitive decline by influencing specific structures within the brain. This report demonstrates a novel structural mediation between plasma phosphatidylcholine levels and cognitive flexibility. Future work should examine the potential mechanisms underlying this mediation, including phosphatidylcholine-dependent cell membrane integrity of the inferior PFC and phosphatidylcholine-dependent cholinergic projections to the inferior PFC. PMID:27733825

  10. Neuromodulation of the inferior thalamic peduncle for major depression and obsessive compulsive disorder.

    PubMed

    Jiménez, F; Velasco, F; Salín-Pascual, R; Velasco, M; Nicolini, H; Velasco, A L; Castro, G

    2007-01-01

    Neuromodulation of the inferior thalamic peduncle is a new surgical treatment for major depression and obsessive-compulsive disorder. The inferior thalamic peduncle is a bundle of fibers connecting the orbito-frontal cortex with the non-specific thalamic system in a small area behind the fornix and anterior to the polar reticular thalamic nucleus. Electrical stimulation elicits characteristic frontal cortical responses (recruiting responses and direct current (DC)-shift) that confirm correct localization of this anatomical structure. A female with depression for 23 years and a male with obsessive-compulsive disorder for 9 years had stereotactic implantation of electrodes in the inferior thalamic peduncle and were evaluated over a long-term period. Initial OFF stimulation period (1 month) showed no consistent changes in the Hamilton Depression Scale (HAM-D), Yale Brown Obsessive Compulsive Scale (YBOCS), or Global Assessment of Functioning scale (GAF). The ON stimulation period (3-5 V, 130-Hz frequency, 450-msec pulse width in a continuous program) showed significant decrease in depression, obsession, and compulsion symptoms. GAF improved significantly in both cases. The neuropsychological tests battery showed no significant changes except from a reduction in the perseverative response of the obsessive-compulsive patient and better performance in manual praxias of the female depressive patient. Moderate increase in weight (5 kg on average) was observed in both cases.

  11. Anesthetic efficacy of lidocaine/meperidine for inferior alveolar nerve blocks in patients with irreversible pulpitis.

    PubMed

    Bigby, Jason; Reader, Al; Nusstein, John; Beck, Mike

    2007-01-01

    The purpose of this prospective, randomized, single-blind study was to compare the anesthetic efficacy of lidocaine with epinephrine to lidocaine plus meperidine with epinephrine for inferior alveolar nerve blocks (IAN) in patients with mandibular posterior teeth experiencing irreversible pulpitis. Forty-eight emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a single-blind manner, 36 mg of lidocaine with 18 mug epinephrine or 36 mg of lidocaine with 18 mug of epinephrine plus 36 mg meperidine with 18 mug epinephrine, using a conventional inferior alveolar nerve block. Endodontic access was begun 15 minutes after solution deposition, and all patients were required to have profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) upon endodontic access or initial instrumentation. The success rate for the inferior alveolar nerve block using the lidocaine solution was 26%, and for the lidocaine/meperidine solution, the success rate was 12%. There was no significant difference (p = 0.28) between the two solutions. In conclusion, for mandibular posterior teeth with irreversible pulpitis, the addition of 36 mg of meperidine to a lidocaine solution administered in a conventional IAN block did not improve the success rate over a standard lidocaine solution.

  12. TMJ inferior compartment arthroplasty procedure through a 25-year follow-up (functional arthroplasty)

    PubMed Central

    Cascone, Piero; Ramieri, Valerio; Arangio, Paolo; Vellone, Valentino; Tarsitano, Achille; Marchetti, Claudio

    2016-01-01

    Summary Objective The purpose of this study was to assess the outcomes of temporomandibular joint (TMJ) “functional arthroplasty” on the inferior compartment and disc reposition as a surgical treatment for internal derangement (ID). Patients and methods By retrospective chart review, all patients who had TMJ surgery on the inferior compartment for TMJ ID from 1985 to 2010 were identified. Their charts were reviewed and subjective data as well as objective data was collected. Results The chart review yielded 352 patients treated through this approach for a total of 696 joints involved. Analysis of the data showed that there was a good health improvement. The mid VAS about pre surgical TMJ pain was 58.3, after surgery 7.7. About headache and cervical pain the pre surgery mid VAS was 47.7, after surgery 16.7. Conclusions Outcome data presented show that TMJ surgery on the inferior compartment and disc reposition could be an effective and successful surgical treatment of TMJ ID. This success has been seen and maintained also in long term follow up in this specific patient population. For this reason, we propose to call this procedure “functional arthroplasty”. PMID:28149452

  13. Inferior petrosal sinus route microcatheterization study and embolization for primary orbital varix

    PubMed Central

    Singh, Vivek; Udiya, Alok; Shetty, Gurucharan S; Sharma, Kumudini; Kanaujia, Vikas

    2016-01-01

    Purpose Primary orbital varix is a rare lesion but difficult to treat. Our main aim was to demonstrate the varices and their central venous communication and to explore the feasibility of embolization of these lesions. Method In four patients with clinical suspicion of varix, in whom MRI showed retro-global vascular channels, microcatheter digital subtraction angiography (DSA) of the varices was performed using femoral venous access. Embolization was carried out in two patients. Results In all four patients orbital varices could be accessed with a microcatheter through inferior petrosal sinus and ophthalmic vein (superior or inferior) route. Microcatheter angiography showed opacification of varices and demonstrated their central venous communication. Two patients were treated with coil embolization. Complete resolution of symptoms was seen in one patient and partial relief in the other. Conclusion The study presents microcatheterization of orbital varices via the inferior petrosal sinus–cavernous sinus–ophthalmic vein route with injections into distal ophthalmic veins for demonstration of these variceal sacs and their central venous connection. Coiling to disconnect the venous communication should be the primary goal of embolization. PMID:26628456

  14. Impaired Motor Learning in a Disorder of the Inferior Olive: Is the Cerebellum Confused?

    PubMed

    Shaikh, Aasef G; Wong, Aaron L; Optican, Lance M; Zee, David S

    2017-02-01

    An attractive hypothesis about how the brain learns to keep its motor commands accurate is centered on the idea that the cerebellar cortex associates error signals carried by climbing fibers with simultaneous activity in parallel fibers. Motor learning can be impaired if the error signals are not transmitted, are incorrect, or are misinterpreted by the cerebellar cortex. Learning might also be impaired if the brain is overwhelmed with a sustained barrage of meaningless information unrelated to simultaneously appearing error signals about incorrect performance. We test this concept in subjects with syndrome of oculopalatal tremor (OPT), a rare disease with spontaneous, irregular, roughly pendular oscillations of the eyes thought to reflect an abnormal, synchronous, spontaneous discharge to the cerebellum from the degenerating neurons in the inferior olive. We examined motor learning during a short-term, saccade adaptation paradigm in patients with OPT and found a unique pattern of disturbed adaptation, quite different from the abnormal adaption when the cerebellum is involved directly. Both fast (seconds) and slow (minutes) timescales of learning were impaired. We suggest that the spontaneous, continuous, synchronous output from the inferior olive prevents the cerebellum from receiving the error signals it needs for appropriate motor learning. The important message from this study is that impaired motor adaptation and resultant dysmetria is not the exclusive feature of cerebellar disorders, but it also highlights disorders of the inferior olive and its connections to the cerebellum.

  15. Complications in the use of bilateral inferiorly based nasolabial flaps for advanced oral submucous fibrosis

    PubMed Central

    Kshirsagar, Rajesh; Mohite, Ajay; Gupta, Suman; Patankar, Amod; Sane, Vikrant; Raut, Pratik

    2016-01-01

    Surgical management of advanced oral submucous fibrosis (OSMF) using bilateral inferiorly based nasolabial flaps is becoming increasingly popular. However no comprehensive analysis of delayed complications using this technique is available in the literature. The authors have conducted a retrospective study to examine the delayed complications of bilateral inferiorly based nasolabial flaps used in advanced oral submucous fibrosis at their institute along with a detailed review of literature on the subject. Thirty-two patients from January 2004 to December 2015 with OSMF and an interincisal distance less than 15 mm were included. All patients were treated with bilateral inferiorly based nasolabial flaps for correction of the restricted mouth opening. All patients had postoperative physiotherapy and were followed up for a minimum period of 6 months. All complaints of patients during the follow up phase were included in this study. In this series, complications such as partial necrosis, intra-oral hair growth, unacceptable extra-oral scar, wound dehiscence, orocutaneous fistula, and pincushioning effect were observed. Numerous complications can occur with the use of nasolabial flaps for the management of advanced oral submucous fibrosis. Although most complications are of inconsequential nature the surgeon must observe due diligence when using this flap. PMID:28356681

  16. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    PubMed Central

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric repetitions on the Cybex Normö dynamometer; the average torque was determined for both pre- and post-intervention measurements. These data were analyzed using the independent samples t-test with the significance level set at P<0.05. The results showed a statistically significant difference between the two groups for an increase in hip abductor torque in the experimental group (P=0.03). The experimental group demonstrated a 17.35% increase in average torque whereas the control group demonstrated a 3.68% decrease in average torque. These findings are consistent with other studies demonstrating that the use of grade IV non-thrust mobilization improves strength immediately post-intervention in healthy individuals. The results of this pilot study provide physical therapists with further support for the utilization of manual therapy in conjunction with therapeutic exercise to enhance muscle strength. PMID:19066650

  17. Pleural and Pulmonary Staining at Inferior Phrenic Arteriography Mimicking a Tumor Staining of Hepatocellular Carcinoma

    SciTech Connect

    Lee, Deok Hee; Hwang, Jae Cheol; Lim, Soo Mee; Yoon, Hyun-Ki; Sung, Kyu-Bo; Song, Ho-Young

    2000-03-15

    Purpose: To describe the findings of pleural and pulmonary staining of the inferior phrenic artery, which can be confused with tumor staining during transarterial chemoembolization (TACE) of hepatoma.Methods: Fifteen patients who showed pleural and pulmonary staining without relationship to hepatic masses at inferior phrenic arteriography were enrolled. The staining was noted at initial TACE (n = 8), at successive TACE (n = 5), and after hepatic surgery (n = 2). The angiographic pattern, the presence of pleural change on computed tomography (CT), and clinical history were evaluated.Results: Draining pulmonary veins were seen in all cases. The lower margin of the staining corresponded to the lower margin of the pleura in 10 patients. CT showed pleural and/or pulmonary abnormalities in all cases. After embolization of the inferior phrenic artery, the accumulation of iodized oil in the lung was noted.Conclusion: Understanding the CT and angiographic findings of pleural and pulmonary staining during TACE may help differentiate benign staining from tumor staining.

  18. Hypoactivation in right inferior frontal cortex is specifically associated with motor response inhibition in adult ADHD

    PubMed Central

    Morein-Zamir, Sharon; Dodds, Chris; van Hartevelt, Tim J; Schwarzkopf, Wolfgang; Sahakian, Barbara; Müller, Ulrich; Robbins, Trevor

    2014-01-01

    Adult ADHD has been linked to impaired motor response inhibition and reduced associated activation in the right inferior frontal cortex (IFC). However, it is unclear whether abnormal inferior frontal activation in adult ADHD is specifically related to a response inhibition deficit or reflects a more general deficit in attentional processing. Using functional magnetic resonance imaging, we tested a group of 19 ADHD patients with no comorbidities and a group of 19 healthy control volunteers on a modified go/no-go task that has been shown previously to distinguish between cortical responses related to response inhibition and attentional shifting. Relative to the healthy controls, ADHD patients showed increased commission errors and reduced activation in inferior frontal cortex during response inhibition. Crucially, this reduced activation was observed when controlling for attentional processing, suggesting that hypoactivation in right IFC in ADHD is specifically related to impaired response inhibition. The results are consistent with the notion of a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation. Hum Brain Mapp 35:5141–5152, 2014. PMID:24819224

  19. Learning Curve of Septoplasty with Radiofrequency Volume Reduction of the Inferior Turbinate

    PubMed Central

    Heo, Sung Jae; Park, Chang Mook

    2013-01-01

    Objectives Since few studies on surgical training and learning curves have been performed, majority of inexperienced surgeons are anxious about performing operations. We aimed to access the results and learning curve of septoplasty with radiofrequency volume reduction (RFVR) of the inferior turbinate. Methods We included 270 patients who underwent septoplasty with RFVR of the inferior turbinate by 6 inexperienced surgeons between January 2009 and July 2011. We analyzed success score, cases of revision, cases of complication, operation time, and acoustic rhinometry. Results Success score was relatively high and every surgeon had few cases of revision and complication. No significant difference was found in success score, revision, complication case, or acoustic rhinometry values between early cases and later cases. Operation time decreased according to increase in experience. However, there was no significant difference in the operation time after more than 30 cases. Conclusion We can conclude that 30 cases are needed to develop mature surgical skills for septoplasty with RFVR of the inferior turbinate and that training surgeons do not need to be anxious about performing this operation in the unskilled state. PMID:24353863

  20. [The influence of radiofrequency thermal ablation on the clinical course of hypertrophic rhinitis and histomorphology of the inferior turbinated bones].

    PubMed

    Talyshinskiĭ, A A; Siutaĭ, Semikh; Ozogul, Dzhandal; Talyshinskiĭ, A M

    2013-01-01

    The objective of the present work was to study the influence of radiofrequency thermal ablation (RFTA) of the inferior turbinated bones on the main functions of the nasal cavity in the patients suffering hypertrophic rhinitis. The secondary objective was to elucidate the histomorphological features of the inferior turbinated bones. A total of 40 patients presenting with nasal breathing disorders associated with the inferior turbinated bone hypertrophy were available for the examination. This work was supplemented by an experimental study with the use of rabbit the inferior turbinated bones. The influence of radiofrequency thermal energy on the hypertrophic the inferior turbinated bones was estimated based on dynamics of clinical symptoms and functional state of the nasal cavity before and after its application. The patients' complaints and the results of the objective evaluation were analysed and compared with the help of the visual-analog scale (VAS) before and 1-8 weeks after RFTA. The study has demonstrated that the size of the inferior turbinated bones and the severity of nasal obstruction significantly decreased within 28 days after RFTA whereas the patients' complaints of nasal stiffness and difficulty of nasal breathing totally disappeared. The inferior turbinated bones of the rabbits underwent a marked reduction of density and cilia growth in conjunction with the thickening of the basal membrane and the onset of subepithelial fibrosis within 7 days after RFTA. The structure of basal membrane was virtually normalized within 28 days after RFTA simultaneously with a rise in the number of cilia and the enhancement of their growth. It is concluded that the results of clinical and experimental studies give reason to consider RFTA as an effective method for the treatment of nasal stiffness caused by hypertrophy of the inferior turbinated bones. RFTA induces subepithelial fibrosis and thereby promotes the decrease of the inferior turbinated bone volume in the

  1. Endoscopic endonasal retrieval of a nasolacrimal duct stone via the valve of Hasner in the inferior meatus.

    PubMed

    Cnaan, Ran Ben; Moosajee, Mariya; Heatley, Catherine J; Olver, Jane M

    2012-01-01

    A 37 year old man presented with a 6 month history of a right epiphora with associated mucus discharge. Lacrimal irrigation demonstrated right unilateral partial nasolacrimal duct obstruction, confirmed with lacrimal scintigraphy. Nasal endoscopy showed a pale elevation in the right inferior meatus. Endoscopic endonasal examination revealed a yellow-white nasolacrimal duct stone emerging from the valve of Hasner in the inferior meatus. The distal nasolacrimal duct in the lateral wall of the inferior meatus was marsupialised and the stone removed. At 12 months follow-up the patient maintained complete resolution of symptoms.

  2. The effect of 3-acetylpyridine on inferior olivary neuron degeneration in Lurcher mutant and wild-type mice.

    PubMed

    Caddy, K W; Vozeh, F

    1997-07-09

    Lurcher mutant and wild-type mice were given intraperitoneal injections of 3-acetylpyridine to look at the toxic effects of this drug on the inferior olivary neurons. Intraperitoneal administration of 3-acetylpyridine is characterized by the different sensitivity of inferior olivary neurons in Lurcher mutant and wild-type mice. Lurcher mutants suffered a destruction of these neurons while wild-type mice were unaffected. The results show that there is a different effect of 3-acetylpyridine between genetic mutations and wild-type mice on the same inbred strain of mice. The different affinity of 3-acetylpyridine for the inferior olivary neurons of this mutant is briefly discussed.

  3. The left occipitotemporal system in reading: disruption of focal fMRI connectivity to left inferior frontal and inferior parietal language areas in children with dyslexia.

    PubMed

    van der Mark, Sanne; Klaver, Peter; Bucher, Kerstin; Maurer, Urs; Schulz, Enrico; Brem, Silvia; Martin, Ernst; Brandeis, Daniel

    2011-02-01

    Developmental dyslexia is a severe reading disorder, which is characterized by dysfluent reading and impaired automaticity of visual word processing. Adults with dyslexia show functional deficits in several brain regions including the so-called "Visual Word Form Area" (VWFA), which is implicated in visual word processing and located within the larger left occipitotemporal VWF-System. The present study examines functional connections of the left occipitotemporal VWF-System with other major language areas in children with dyslexia. Functional connectivity MRI was used to assess connectivity of the VWF-System in 18 children with dyslexia and 24 age-matched controls (age 9.7-12.5 years) using five neighboring left occipitotemporal regions of interest (ROIs) during a continuous reading task requiring phonological and orthographic processing. First, the results revealed a focal origin of connectivity from the VWF-System, in that mainly the VWFA was functionally connected with typical left frontal and parietal language areas in control children. Adjacent posterior and anterior VWF-System ROIs did not show such connectivity, confirming the special role that the VWFA plays in word processing. Second, we detected a significant disruption of functional connectivity between the VWFA and left inferior frontal and left inferior parietal language areas in the children with dyslexia. The current findings add to our understanding of dyslexia by showing that functional disconnection of the left occipitotemporal system is limited to the small VWFA region crucial for automatic visual word processing, and emerges early during reading acquisition in children with dyslexia, along with deficits in orthographic and phonological processing of visual word forms.

  4. Arthroscopic Repair of Inferior Labrum From Anterior to Posterior Lesions Associated With Multidirectional Instability of the Shoulder

    PubMed Central

    Burt, David M.

    2014-01-01

    Multidirectional instability (MDI) of the shoulder may arise spontaneously; however, recent evidence suggests that traumatic events may play a role in this syndrome. Variable degrees of injury around the circumference of the glenoid have been reported, ranging from Bankart and Kim lesions to 270° of injury and even 360° of injury. Hyperabduction injury may cause inferior subluxation of the shoulder and result in traumatic isolated injury to the inferior labrum from anterior to posterior. This particular lesion spans approximately 180° of the inferior hemisphere and may lead to symptomatic MDI. In contrast to open or arthroscopic plication procedures for atraumatic MDI without labral injury, the goal in these cases is anatomic arthroscopic repair of the inferior labrum tear without the need for capsular plication, volume reduction, or rotator interval closure. PMID:25685683

  5. Dysgenesis of the inferior vena cava associated with deep venous thrombosis and a partial Protein C deficiency

    PubMed Central

    Tribe, Howard; Borgstein, Rudi

    2013-01-01

    Dysgenesis of the inferior vena cava is rare but it is being increasingly diagnosed by cross-sectional imaging techniques. Patients are usually asymptomatic with abnormalities detected incidentally. An 11 year old boy presented with a 10 day history of fever, vomiting and abdominal pain, which progressed to his back and lower limbs. Magnetic resonance imaging, computerised tomography and Doppler ultrasonography showed the absence of a suprarenal inferior vena cava with bilateral superficial femoral vein thrombi extending cranially to the end of the aberrant inferior vena cava. Haematological testing revealed a partial Protein C deficiency. The presenting clinical picture in this case is unique within the English literature and highlights that deep venous thrombosis associated with inferior vena cava dysgenesis may not present with typical symptoms in children. Early use of advanced imaging modalities would expedite diagnosis and subsequent treatment. PMID:24421930

  6. Clinical utility of a multigated modified anterior projection in the detection of left ventricular inferior and apical wall motion abnormalities

    SciTech Connect

    Polak, J.F.; Bianco, J.A.; Kemper, A.J.; Tow, D.E.

    1982-04-01

    Recent evidence indicates that the left anterior oblique projection (LAO) multigated radionuclide ventriculogram (RVG) underestimates presence and extent of apical and inferior left ventricular (LV) wall motion abnormalities. We investigated, prospectively, the sensitivity and specificity of a modified anterior projection (MAP), which incorporates cephalad tilting. Thirty-three consecutive patients undergoing cardiac catheterization suspected to have coronary artery disease were studied with RVG, using both the MAP and LAO views. LAO views were analyzed using the ejection fraction image (REFI), and the regional ejection fraction (REF) of the inferoapical region. The MAP studies were analyzed using stroke volume image (SVI) to evaluate apical and inferior LV regions. Results were as follows: (Formula: see text), Both intraobserver and interobserver variabilities were comparable to those of conventional angiographic studies used in detection of apical and inferior asynergy. It is concluded that the multigated MAP offers additional information about abnormalities of the LV inferior and apical regions.

  7. Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient

    SciTech Connect

    Veerapong, Jula; Wahlgren, Carl Magnus; Jolly, Neeraj; Bassiouny, Hisham

    2008-07-15

    The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

  8. Responses from two firing patterns in inferior colliculus neurons to stimulation of the lateral lemniscus dorsal nucleus

    PubMed Central

    Li, Xiao-ting; Wang, Ning-yu; Wang, Yan-jun; Xu, Zhi-qing; Liu, Jin-feng; Bai, Yun-fei; Dai, Jin-sheng; Zhao, Jing-yi

    2016-01-01

    The γ-aminobutyric acid neurons (GABAergic neurons) in the inferior colliculus are classified into various patterns based on their intrinsic electrical properties to a constant current injection. Although this classification is associated with physiological function, the exact role for neurons with various firing patterns in acoustic processing remains poorly understood. In the present study, we analyzed characteristics of inferior colliculus neurons in vitro, and recorded responses to stimulation of the dorsal nucleus of the lateral lemniscus using the whole-cell patch clamp technique. Seven inferior colliculus neurons were tested and were classified into two firing patterns: sustained-regular (n = 4) and sustained-adapting firing patterns (n = 3). The majority of inferior colliculus neurons exhibited slight changes in response to stimulation and bicuculline. The responses of one neuron with a sustained-adapting firing pattern were suppressed after stimulation, but recovered to normal levels following application of the γ-aminobutyric acid receptor antagonist. One neuron with a sustained-regular pattern showed suppressed stimulation responses, which were not affected by bicuculline. Results suggest that GABAergic neurons in the inferior colliculus exhibit sustained-regular or sustained-adapting firing patterns. Additionally, GABAergic projections from the dorsal nucleus of the lateral lemniscus to the inferior colliculus are associated with sound localization. The different neuronal responses of various firing patterns suggest a role in sound localization. A better understanding of these mechanisms and functions will provide better clinical treatment paradigms for hearing deficiencies. PMID:27335563

  9. Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves' orbitopathy.

    PubMed

    Monteiro, Mário Luiz Ribeiro; Gonçalves, Allan Christian Pieroni; Bezerra, Alanna Mara Pinheiro Sobreira

    2016-01-01

    The diagnosis of Graves' orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves' orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves' orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves' orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves' orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. RESUMO O diagnóstico de orbitopatia de Graves usualmente é fácil de ser estabelecido. No entanto, doenças da órbita que simulam alguns sinais clínicos da orbitopatia de Graves podem levar à confusão diagnóstica, particularmente quando associada à alguma forma de disfunção tireoidiana. Relatamos a ocorrência rara de amiloidose localizada no músculo reto inferior em paciente com hipotireoidismo autoimune, que recebeu inicialmente o diagnóstico errôneo de orbitopatia de Graves. Paciente masculino, 48 anos, com queixa de proptose progressiva e indolor do lado esquerdo e diplopia vertical intermitente há 6 meses. O diagnóstico de orbitopatia de Graves foi

  10. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    SciTech Connect

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating

  11. Mild Perceptual Categorization Deficits Follow Bilateral Removal of Anterior Inferior Temporal Cortex in Rhesus Monkeys

    PubMed Central

    Matsumoto, Narihisa; Eldridge, Mark A.G.; Saunders, Richard C.; Reoli, Rachel

    2016-01-01

    In primates, visual recognition of complex objects depends on the inferior temporal lobe. By extension, categorizing visual stimuli based on similarity ought to depend on the integrity of the same area. We tested three monkeys before and after bilateral anterior inferior temporal cortex (area TE) removal. Although mildly impaired after the removals, they retained the ability to assign stimuli to previously learned categories, e.g., cats versus dogs, and human versus monkey faces, even with trial-unique exemplars. After the TE removals, they learned in one session to classify members from a new pair of categories, cars versus trucks, as quickly as they had learned the cats versus dogs before the removals. As with the dogs and cats, they generalized across trial-unique exemplars of cars and trucks. However, as seen in earlier studies, these monkeys with TE removals had difficulty learning to discriminate between two simple black and white stimuli. These results raise the possibility that TE is needed for memory of simple conjunctions of basic features, but that it plays only a small role in generalizing overall configural similarity across a large set of stimuli, such as would be needed for perceptual categorical assignment. SIGNIFICANCE STATEMENT The process of seeing and recognizing objects is attributed to a set of sequentially connected brain regions stretching forward from the primary visual cortex through the temporal lobe to the anterior inferior temporal cortex, a region designated area TE. Area TE is considered the final stage for recognizing complex visual objects, e.g., faces. It has been assumed, but not tested directly, that this area would be critical for visual generalization, i.e., the ability to place objects such as cats and dogs into their correct categories. Here, we demonstrate that monkeys rapidly and seemingly effortlessly categorize large sets of complex images (cats vs dogs, cars vs trucks), surprisingly, even after removal of area TE

  12. Interhemispheric insular and inferior frontal connectivity are associated with substance abuse in a psychiatric population.

    PubMed

    Viswanath, Humsini; Velasquez, Kenia M; Savjani, Ricky; Molfese, David L; Curtis, Kaylah; Molfese, Peter J; Eagleman, David M; Baldwin, Philip R; Frueh, B Christopher; Fowler, J Christopher; Salas, Ramiro

    2015-05-01

    Substance abuse is highly comorbid with major psychiatric disorders. While the neural underpinnings of drug abuse have been studied extensively, most existing studies compare drug users without comorbidities and healthy, non-user controls. Such studies do not generalize well to typical patients with substance abuse disorders. Therefore, we studied a population of psychiatric inpatients (n = 151) with a range of mental illnesses. Psychiatric disorders were diagnosed via structured interviews. Sixty-five percent of patients met criteria for at least one substance use disorder. Patients were recruited for resting state functional connectivity (RSFC) and diffusion tensor imaging (DTI) experiments to examine the interhemispheric connectivity between brain regions hypothesized to be involved in drug addiction, namely: the inferior, medial, and superior frontal gyri; insula; striatum; and anterior cingulate cortex. The World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHOA) questionnaire was used to further assess drug use. An association between use of tobacco, alcohol, cocaine, sedatives, and hallucinogens with increased insular interhemispheric connectivity was observed. In addition, increased inferior frontal gyrus interhemispheric connectivity was associated with amphetamine and inhalant use. Our results suggest that increased inter-hemispheric insula connectivity is associated with the use of several drugs of abuse. Importantly, psychiatric inpatients without a history of drug dependence were used as an ecologically valid control group rather than the more typical comparison between "mentally ill vs. healthy control" populations. We suggest that dysfunction of interhemispheric connectivity of the insula and to a lesser extent of the inferior frontal gyrus, are related to drug abuse in psychiatric populations.

  13. Choosing between small, likely rewards and large, unlikely rewards activates inferior and orbital prefrontal cortex.

    PubMed

    Rogers, R D; Owen, A M; Middleton, H C; Williams, E J; Pickard, J D; Sahakian, B J; Robbins, T W

    1999-10-15

    Patients sustaining lesions of the orbital prefrontal cortex (PFC) exhibit marked impairments in the performance of laboratory-based gambling, or risk-taking, tasks, suggesting that this part of the human PFC contributes to decision-making cognition. However, to date, little is known about the particular regions of the orbital cortex that participate in this function. In the present study, eight healthy volunteers were scanned, using H(2)(15)0 PET technology, while performing a novel computerized risk-taking task. The task involved predicting which of two mutually exclusive outcomes would occur, but critically, the larger reward (and penalty) was associated with choice of the least likely outcome, whereas the smallest reward (and penalty) was associated with choice of the most likely outcome. Resolving these "conflicting" decisions was associated with three distinct foci of regional cerebral blood flow increase within the right inferior and orbital PFC: laterally, in the anterior part of the middle frontal gyrus [Brodmann area 10 (BA 10)], medially, in the orbital gyrus (BA 11), and posteriorly, in the anterior portion of the inferior frontal gyrus (BA 47). By contrast, increases in the degree of conflict inherent in these decisions was associated with only limited changes in activity within orbital PFC and the anterior cingulate cortex. These results suggest that decision making recruits neural activity from multiple regions of the inferior PFC that receive information from a diverse set of cortical and limbic inputs, and that the contribution of the orbitofrontal regions may involve processing changes in reward-related information.

  14. Development of the human infrahepatic inferior caval and azygos venous systems

    PubMed Central

    Hikspoors, Jill P J M; Soffers, Jelly H M; Mekonen, Hayelom K; Cornillie, Pieter; Köhler, S Eleonore; Lamers, Wouter H

    2015-01-01

    Differences in opinion regarding the development of the infrahepatic inferior caval and azygos venous systems in mammals centre on the contributions of ‘caudal cardinal’, ‘subcardinal’, ‘supracardinal’, ‘medial and lateral sympathetic line’ and ‘sacrocardinal’ veins. The disagreements appear to arise from the use of topographical position rather than developmental origin as criterion to define separate venous systems. We reinvestigated the issue in a closely spaced series of human embryos between 4 and 10 weeks of development. Structures were visualized with the Amira® reconstruction and Cinema4D® remodelling software. The vertebral level and neighbouring structures were used as topographic landmarks. The main results were that the caudal cardinal veins extended caudally from the common cardinal vein between CS11 and CS15, followed by the development of the subcardinal veins as a plexus sprouting ventrally from the caudal cardinal veins. The caudal cardinal veins adapted their course from lateral to medial relative to the laterally expanding lungs, adrenal glands, definitive kidneys, sympathetic trunk and umbilical arteries between CS15 and CS18, and then became interrupted in the part overlaying the regressing mesonephroi (Th12-L3). The caudal part of the left caudal cardinal vein then also regressed. The infrarenal part of the inferior caval vein originated from the right caudal cardinal vein, while the renal part originated from subcardinal veins. The azygos veins developed from the remaining cranial part of the caudal cardinal veins. Our data show that all parts of the inferior caval and azygos venous systems developed directly from the caudal cardinal veins or from a plexus sprouting from these veins. PMID:25496171

  15. A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning.

    PubMed

    McMahon, Patrick J; Chow, Stephen; Sciaroni, Laura; Yang, Bruce Y; Lee, Thay Q

    2003-01-01

    A novel cadaveric model for anterior-inferior shoulder dislocation using forcible apprehension positioning is presented. This model simulates an in vivo mechanism and yields capsulolabral lesions. The scapulae of 14 cadaveric entire upper limbs (82 +/- 9 years, mean +/- standard deviation) were each rigidly fixed to a custom shoulder-testing device. A pneumatic system was used with pulleys and cables to simulate the rotator cuff and the deltoid muscles (anterior and middle portions). The glenohumeral joint was then positioned in the apprehension position of abduction, external rotation, and horizontal abduction. A 6-degree-of-freedom load cell (Assurance Technologies, Garner, North Carolina) measured the joint reaction force that was then resolved into three orthogonal components of compression force, anteriorly directed force, and superiorly directed force. With the use of a thrust bearing, the humerus was moved along a rail with a servomotor-controlled system at 50 mm/s that resulted in horizontal abduction. Force that developed passively in the pectoralis major muscle was recorded with an independent uniaxial load cell. Each of the glenohumeral joints dislocated anterior-inferior, six with avulsion of the capsulolabrum from the anterior-inferior glenoid bone and eight with capsulolabral stretching. Pectoralis major muscle force as well as the joint reaction force increased with horizontal abduction until dislocation. At dislocation, the magnitude of the pectoralis major muscle force, 609.6 N +/- 65.2 N was similar to the compression force, 569.6 N +/- 37.8 N. A cadaveric model yielded an anterior dislocation with a mechanism of forcible apprehension positioning when the appropriate shoulder muscles were simulated and a passive pectoralis major muscle was included. Capsulolabral lesions resulted, similar to those observed in vivo.

  16. Transvenous Lead Extraction via the Inferior Approach Using a Gooseneck Snare versus Simple Manual Traction

    PubMed Central

    Jo, Uk; Hwang, You-Mi; Lee, Ji-Hyun; Kim, Min-Su; Choi, Hyung-Oh; Lee, Woo-Seok; Kwon, Chang-Hee; Ko, Gi-Young; Yoon, Hyun-Ki; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

    2016-01-01

    Background and Objectives The number of patients with cardiac implantable electronic devices needing lead extraction is increasing for various reasons, including infections, vascular obstruction, and lead failure. We report our experience with transvenous extraction of pacemaker and defibrillator leads via the inferior approach of using a gooseneck snare as a first-line therapy and compare extraction using a gooseneck snare with extraction using simple manual traction. Subjects and Methods The study included 23 consecutive patients (43 leads) who underwent transvenous lead extraction using a gooseneck snare (group A) and 10 consecutive patients (17 leads) who underwent lead extraction using simple manual traction (group B). Patient characteristics, indications, and outcomes were analyzed and compared between the groups. Results The dwelling time of the leads was longer in group A (median, 121) than in group B (median, 56; p=0.000). No differences were noted in the overall procedural success rate (69.6% vs. 70%), clinical procedural success rate (82.6% vs. 90%), and lead clinical success rate (86% vs. 94.1%) between the groups. The procedural success rates according to lead type were 89.2% and 100% for pacing leads and 66.7% and 83.3% for defibrillator leads in groups A and B, respectively. Major complications were noted in 3 (mortality in 1) patients in group A and 2 patients in group B. Conclusion Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective. However, stand-alone transvenous extraction of defibrillator leads using the inferior approach was suboptimal. PMID:27014349

  17. Embolization in a Patient with Ruptured Anterior Inferior Pancreaticoduodenal Arterial Aneurysm with Median Arcuate Ligament Syndrome

    SciTech Connect

    Ogino, Hiroyuki; Sato, Yozo; Banno, Tatsuo; Arakawa, Toshinao; Hara, Masaki

    2002-08-15

    In median arcuate ligament syndrome, the root of the celiac artery is compressed and narrowed by the median arcuate ligament of the diaphragm during expiration, causing abdominal angina.Aneurysm may be formed in arteries of the pancreas and duodenum due toa chronic increase in blood flow from the superior mesenteric artery into the celiac arterial region. We report a patient saved by embolization with coils of ruptured aneurysm that developed with markedly dilated anterior inferior pancreaticoduodenal artery due to median arcuate ligament syndrome.

  18. Disappearance of myocardial bridging of the left anterior descending coronary artery after inferior myocardial infarction.

    PubMed

    Yıldız, Bekir Serhat; Esin, Fatma; Alihanoğlu, Yusuf Izzettin; Kılıç, Ismail Doğu; Evrengül, Harun

    2014-06-01

    Myocardial bridging (MB) is defined as the intramural course of a major epicardial coronary artery, and is mostly confined to the left ventricle and the left anterior descending coronary artery (LAD). MB is a common congenital abnormality of a coronary artery, and is usually thought to be a benign anatomical variant. Although rare, previous studies have reported that patients with MB may suffer from myocardial ischemia, myocardial infarction (MI), arrhythmias, and even sudden death. Therefore, the diagnosis and treatment of MB are both important. Since MB is congenital, its disappearance is unlikely. We here report a very rare case of disappearance of MB after inferior MI.

  19. Ozonated water is inferior to propanol-based hand rubs for disinfecting hands.

    PubMed

    Appelgrein, C; Hosgood, G; Dunn, A L; Schaaf, O

    2016-04-01

    Ozone is a strong oxidizing biocide that has broad-spectrum antimicrobial properties. The aim of the study was to compare the efficacy of ozone to a propanol-based hand rub for hand disinfection. Twenty subjects were enrolled in an in-vivo cross-over trial (prEN 12791). Subjects treated their hands with the reference procedure (propan-1-ol 60%) or with ozone (4 ppm). Post-wash bacterial counts were determined from one hand (immediate effect), and from the other hand that had been gloved for 3h (delayed effect). The investigation indicated that ozone is inferior to propan-1-ol 60% hand rub for hand asepsis.

  20. Left Ventricular Pseudoaneurysm Following Inferior Myocardial Infarction: A Case for Conservative Management

    PubMed Central

    Ludmir, Jonathan; Kapoor, Karan; George, Praveen; Khural, Jasjeet; Barr, Brian

    2016-01-01

    Left ventricular pseudoaneurysm is a rare complication of myocardial infarction that carries a high mortality rate. Although conventional wisdom suggests prompt surgical repair in order to mitigate risk of expansion and rupture, there are some data to support non-operative management in asymptomatic individuals with likely chronic pseudoaneurysms, particularly when surgical candidacy is poor. We present a case of a medically managed left ventricular pseudoaneurysm subsequent to inferior ST-segment elevation myocardial infarction with 6-month follow-up data. PMID:28197266

  1. Leiomyosarcoma of Inferior Vena Cava and Right Atrium with Ascites and Jaundice: A Case Report

    PubMed Central

    Hasheminasab Zavareh, Roshanak; Riahi Beni, Hassan; Iranpour, Aida; Alam Samimi, Mojgan; Sadeghipour, Alireza; Alavi Niakou, Seyedeh Nina

    2016-01-01

    Leiomyosarcoma is one of the soft tissue sarcomas that could originate from different parts of body and are mostly presented as retropritoneal mass. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in inferior vena cava (IVC). Here, we report the case of a 35-year-old male patient who presented with ascites and jaundice. Further evaluation revealed large hepatic and cardiac masses with extension to IVC. Since it was not possible to determine the point of origin of leiomyosarcoma, the patient received chemotherapy under diagnosis of metastatic leiomyosarcoma but unfortunately passed away. PMID:27928478

  2. Liver transplantation in a patient with developmental interruption of the inferior vena cava with azygos substitution.

    PubMed

    Zinser, M J; Hanto, D W

    2012-06-01

    Infrahepatic interruption of the inferior vena cava (IVC) with azygos or hemiazygos substitution has been reported frequently in children with biliary atresia where this venous abnormality is associated with other venous abnormalities such as preduodenal portal vein or congenital heart disease. It is important to recognize this anomaly pretransplant because the hepatic vein may drain directly into the right atrium rather than into the suprahepatic vena cava. We describe herein the first report of an orthotopic deceased donor liver transplant in an adult patient with an interrupted IVC and azygos continuation. We also review the embryological development of the IVC and the vascular anomalies that can occur.

  3. The management of thermomechanically compacted gutta percha extrusion in the inferior dental canal.

    PubMed

    Fanibunda, K; Whitworth, J; Steele, J

    1998-04-11

    Endodontic material inadvertently forced into the inferior dental canal during root-canal therapy can cause damage to the underlying nerve. The effect of toxic filling materials on nervous tissues has been well publicised, however, the thermal and pressure changes produced by chemically bland materials has not been adequately highlighted. In the case reported, thermoplasticised gutta percha was inadvertently introduced into the canal during endodontic treatment of a lower molar. Factors affecting the outcome are discussed and guidelines are presented for the management of such a case with reference to surgery against observation.

  4. Acute inferior myocardial infarction after electrical weapon exposure: case report and review of the literature.

    PubMed

    Belen, Erdal; Tipi, Fatih Fahri; Bayyiğit, Akif; Helvacı, Ayşen Şerife

    2015-03-01

    The use of conducted electrical weapons (CEWs) by legal security forces and in civil society is rapidly increasing. While they are generally considered safe devices, and fatal complications are rare, it is possible to see a small number of complications. In the present case, we describe the detection of acute inferior myocardial infarction in a patient who experienced chest pain after being exposed to a CEW. In such cases, multiple factors should be considered, and the choice of treatment and follow-up should be decided accordingly.

  5. Multiple aneurysms of the inferior pancreaticoduodenal artery: a rare complication of acute pancreatitis.

    PubMed

    Klonaris, Chris; Psathas, Emmanouil; Katsargyris, Athanasios; Lioudaki, Stella; Chatziioannou, Achilleas; Karatzas, Theodore

    2013-01-01

    Inferior pancreaticoduodenal artery (IPDA) aneurysms are uncommon, representing nearly 2% of all visceral aneurysms, and sporadically associated with celiac artery stenosis. Multiple IPDA aneurysms have been rarely reported. We report a case of a 53-year-old female patient with a history of prior pancreatitis, who presented with two IPDA aneurysms combined with median arcuate ligament-syndrome-like stenosis of the celiac trunk. The patient was treated successfully with coil embolization under local anesthesia. The procedure is described and illustrated in detail and the advantages and technical considerations of such an approach are also being discussed.

  6. Multiple Aneurysms of the Inferior Pancreaticoduodenal Artery: A Rare Complication of Acute Pancreatitis

    PubMed Central

    Klonaris, Chris; Katsargyris, Athanasios; Lioudaki, Stella; Chatziioannou, Achilleas; Karatzas, Theodore

    2013-01-01

    Inferior pancreaticoduodenal artery (IPDA) aneurysms are uncommon, representing nearly 2% of all visceral aneurysms, and sporadically associated with celiac artery stenosis. Multiple IPDA aneurysms have been rarely reported. We report a case of a 53-year-old female patient with a history of prior pancreatitis, who presented with two IPDA aneurysms combined with median arcuate ligament-syndrome-like stenosis of the celiac trunk. The patient was treated successfully with coil embolization under local anesthesia. The procedure is described and illustrated in detail and the advantages and technical considerations of such an approach are also being discussed. PMID:23509663

  7. Lateralization of the inferior alveolar nerve with simultaneous implant placement: surgical techniques.

    PubMed

    Garg, A K; Morales, M J

    1998-01-01

    In the event of moderate to severe mandibular bone resorption posterior to the mental foramen, repositioning of the inferior alveolar nerve provides a greater amount of available bone for implant placement and reduces the risk of nerve injury. While neural paresthesia may initially occur, this altered sensation generally resolves spontaneously. Alveolar nerve repositioning may be possible in cases in which other procedures cannot be performed due to the extent of atrophy of the posterior mandibular alveolar crest. This article presents the surgical technique to achieve this objective.

  8. Infection-related inferior alveolar and mental nerve paresthesia: case reports.

    PubMed

    Yeler, Hasan; Ozeç, Ilker; Kiliç, Erdem

    2004-04-01

    Nerve injury can be related to mechanical, chemical, and thermal factors. Infection-related paresthesia is usually related to mechanical pressure and ischemia associated with the inflammatory process. Another cause of paresthesia could be the toxic metabolic products of bacteria or inflammatory products released following tissue damage. This article presents cases of inferior alveolar and mental nerve paresthesia caused by an infected impacted tooth, an infected cyst, and periapical infection. The possible pathophysiologic mechanism of nerve injury, therapy, and prognosis for recovery are also discussed.

  9. Spectral integration in the inferior colliculus: role of glycinergic inhibition in response facilitation.

    PubMed

    Wenstrup, J; Leroy, S A

    2001-02-01

    This study examined the contribution of glycinergic inhibition to the time-sensitive spectral integration performed by neurons in the inferior colliculus of the mustached bat (Pteronotus parnellii). These neurons are sometimes called combination-sensitive because they display facilitatory (or inhibitory) responses to the combination of distinct spectral elements in sonar or social vocalizations. Present in a wide range of vertebrates, their temporally and spectrally selective integration is thought to endow them with the ability to discriminate among social vocalizations or to analyze particular cues concerning sonar targets. The mechanisms that underlie these responses or the sites in the auditory system where they are created are not known. We examined combination-sensitive neurons that are facilitated by the presentation of two different harmonic elements of the bat's sonar call and echo. Responses of 24 single units were recorded before and during local application of strychnine, an antagonist of glycinergic inhibition. For each of the 24 units, strychnine application eliminated or greatly reduced temporally sensitive facilitation. There was no difference in this effect for neurons tuned to frequencies associated with the frequency-modulated or the constant-frequency sonar components. These results are unusual because glycine is considered to be an inhibitory neurotransmitter, but here it appears to be essential for the expression of combination-sensitive facilitation. The findings provide strong evidence that facilitatory combination-sensitive response properties present throughout the mustached bat's auditory midbrain, thalamus, and cortex originate through neural interactions in the inferior colliculus.

  10. Branching Patterns of Medial and Inferior Calcaneal Nerves Around the Tarsal Tunnel

    PubMed Central

    Kim, Beom Suk; Choung, Phil Woo; Kwon, Soon Wook; Rhyu, Im Joo

    2015-01-01

    Objective To demonstrate the bifurcation pattern of the tibial nerve and its branches. Methods Eleven legs of seven fresh cadavers were dissected. The reference line for the bifurcation point of tibial nerve branches was an imaginary horizontal line passing the tip of the medial malleolus. The distances between the reference line and the bifurcation points were measured. The bifurcation branching patterns were categorized as type I, the pattern in which the medial calcaneal nerve (MCN) branched most proximally; type II, the pattern in which the three branches occurred at the same point; and type III, in which MCN branched most distally. Results There were seven cases (64%) of type I, three cases (27%) of type III, and one case (9%) of type II. The median MCN branching point was 0.2 cm (range, -1 to 3 cm). The median bifurcation points of the lateral plantar nerves and inferior calcaneal nerves was -0.6 cm (range, -1.5 to 1 cm) and -2.5 cm (range, -3.5 to -1 cm), respectively. Conclusion MCN originated from the tibial nerve in most cases, and plantar nerves were bifurcated below the medial malleolus. In all cases, inferior calcaneal nerves originated from the lateral plantar nerve. These anatomical findings could be useful for performing procedures, such as nerve block or electrophysiologic studies. PMID:25750872

  11. The effects of inferior turbinoplasty on nasal airflow during cosmetic rhinoplasty.

    PubMed

    Zojaji, R; Keshavarzmanesh, M; Bakhshaee, M; Behdani, R; Esmaeelzadeh, S; MazloumFarsiBaf, M

    2016-04-01

    Rhinoplasty is one of the most common and challenging cosmetic procedures. One of the complications of rhinoplasty associated with dissatisfaction is nasal obstruction, which is often due to narrowing of the nasal valve area. Application of certain procedures such as turbinoplasty can prevent and correct this problem. This study aim was to investigate the effect of inferior turbinoplasty in reduction of airflow resistance and nasal obstruction. Using active anterior rhinomanometry, nasal airflow was measured in 50 patients who underwent cosmetic rhinoplasty and bilateral turbinoplasty before and 6 months after surgery. None of the patients subjectively complained of nasal obstruction before or after surgery. According to rhinomanometry results, improvement in nasal airflow was seen both in inspiration and expiration, although only expiration was significant (p = 0.034). Airflow changes in males and females and in different age groups was not significant (p > 0.05). It appears that rhinoplasty does not adversely affect nasal airflow when it is accompanied by simple adjuvant procedure inferior turbinoplasty.

  12. Taurine acts as a glycine receptor agonist in slices of rat inferior colliculus.

    PubMed

    Xu, Han; Wang, Wei; Tang, Zheng-Quan; Xu, Tian-Le; Chen, Lin

    2006-10-01

    Taurine is an important endogenous amino acid for neural development and for many physiological functions, but little is known about its functional role in the central auditory system. We investigated in young rats (P10-P14) the effects of taurine on the neuronal responses and synaptic transmissions in the central nucleus of the inferior colliculus (ICC) with a brain slice preparation and with whole-cell patch-clamp recordings. Perfusion of taurine at 1mM reliably evoked a current across the membrane and decreased the input resistance in neurons of the ICC. Taurine also depressed the spontaneous and current-evoked firing of ICC neurons. All these effects were reversible after washout and could be blocked by 3 microM strychnine, an antagonist of glycine receptors, but not by 10 microM bicuculline, an antagonist of GABA(A) receptors. When the inhibitory receptors were not pharmacologically blocked, taurine reversibly reduced the postsynaptic currents/potentials evoked by electrically stimulating the commissure of the inferior colliculus or the ipsilateral lateral lemniscus. The results demonstrate that taurine reduces the neuronal excitability and depresses the synaptic transmission in the ICC by activating glycine-gated chloride channels. Our findings suggest that taurine acts as a ligand of glycine receptors in the ICC and can be involved in the information processing of the central auditory system similarly like the neurotransmitter glycine.

  13. Long-term follow-up and patient satisfaction after reduction mammoplasty: Superomedial versus inferior pedicle

    PubMed Central

    Makboul, Mohamed; Abdelhamid, Mahmoud S.; Al-Attar, Ghada S.

    2016-01-01

    Background: Surgery for hypertrophied breasts represents a challenge for plastic surgeons. The search for a good post-surgical cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, a round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. Patients and Methods: This study was carried out on sixty cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and were asked for late post-operative results and overall patients' satisfaction. Results: Long-term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistically significant difference. No statistically significant difference was observed between patients underwent either superomedial or inferior pedicle reduction mammoplasty with regard to breast shape symmetry, nipple symmetry and sensation. The mean score for satisfaction was higher among patients who underwent superomedial pedicle rather than the inferior pedicle method. Conclusion: The superomedial pedicle shows better long-term cosmetic results. PMID:27833284

  14. Dopamine D2-Like Receptors Modulate Unconditioned Fear: Role of the Inferior Colliculus

    PubMed Central

    de Oliveira, Amanda Ribeiro; Colombo, Ana Caroline; Muthuraju, Sangu; Almada, Rafael Carvalho; Brandão, Marcus Lira

    2014-01-01

    Background A reduction of dopamine release or D2 receptor blockade in the terminal fields of the mesolimbic system clearly reduces conditioned fear. Injections of haloperidol, a preferential D2 receptor antagonist, into the inferior colliculus (IC) enhance the processing of unconditioned aversive information. However, a clear characterization of the interplay of D2 receptors in the mediation of unconditioned and conditioned fear is still lacking. Methods The present study investigated the effects of intra-IC injections of the D2 receptor-selective antagonist sulpiride on behavior in the elevated plus maze (EPM), auditory-evoked potentials (AEPs) to loud sounds recorded from the IC, fear-potentiated startle (FPS), and conditioned freezing. Results Intra-IC injections of sulpiride caused clear proaversive effects in the EPM and enhanced AEPs induced by loud auditory stimuli. Intra-IC sulpiride administration did not affect FPS or conditioned freezing. Conclusions Dopamine D2-like receptors of the inferior colliculus play a role in the modulation of unconditioned aversive information but not in the fear-potentiated startle response. PMID:25133693

  15. Submucous tramadol increases the anesthetic efficacy of mepivacaine with epinephrine in inferior alveolar nerve block.

    PubMed

    Isiordia-Espinoza, Mario Alberto; Orozco-Solis, Mariana; Tobías-Azúa, Francisco Javier; Méndez-Gutiérrez, Elsa Patricia

    2012-03-01

    The purpose of this study was to evaluate the effect of submucous tramadol as adjuvant of mepivacaine with epinephrine in inferior alveolar nerve block. A double-blind, randomized, placebo-controlled, crossover clinical trial was conducted. Twenty healthy young volunteers were randomized into two treatment sequences using a series of random numbers. Sequence 1: Group A, 2% mepivacaine with 1:100,000 epinephrine plus submucous tramadol 50mg (1mL of saline) and one week later Group B, 2% mepivacaine with 1:100,000 epinephrine plus submucous placebo (1mL of saline). Sequence 2: Group B and one week later Group A. All treatments were administered 1min after that patient informed anesthesia of lower lip. We evaluated the duration of anesthesia of lower lip, anesthetic efficacy, and local and systemic adverse events. Anesthetic efficacy was better in group receiving submucous tramadol during the first 2h compared with group receiving submucous placebo (P<0.05). Submucous tramadol increased the anesthetic efficacy of mepivacaine with epinephrine of soft tissue in inferior alveolar nerve block.

  16. Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer

    PubMed Central

    Alonso-Ezpeleta, Oscar; Martín, Pablo J.; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J.

    2014-01-01

    A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion. Key words:Endodontics, inferior alveolar nerve, neuropathic pain, orofacial pain, paraesthesia, pregabalin. PMID:24790724

  17. A rare case of synovial chondromatosis of the inferior TMJ compartment. Diagnosis and treatment aspect

    PubMed Central

    Sozzi, Davide; Bocchialini, Gabriele; Novelli, Giorgio; Valente, Maria Gabriella; Moltrasio, Francesca; Bozzetti, Alberto

    2015-01-01

    Summary Aim Synovial Chondromatosis (SC) is a rare, benign non neoplastic arthopathy characterized by the metaplastic development of cartilaginous nodules within the synovial membrane. In only 3% of all cases does it affect the temporomandibular joint (TMJ) and cases that arise from the lower compartment are rarely found in literature. The aim of this paper is to report a new case of SC of the inferior TMJ compartment with the description of the clinical, therapeutic and histopathological findings. Case report This article presents a 68-year-old woman with preauricular swelling on the right side, pain, crepitus and limited joint motion. This patient was evaluated by preoperative clinical manifestation, CT scan and MR images. Both showed multiple, calcified loose bodies in the inferior compartment. Based on these images as well as the patient’s signs and symptoms, a surgical intervention was performed. A good functional recovery with no signs of recurrence at 36 months of follow up was obtained. Conclusion Among cases of synovial chondromatosis in literature, only twelve originating in the lower compartment have been reported, this one included. In all the cases treated for SC in the lower compartment, both in literature and in our case report, surgical treatment led to healing. PMID:26941895

  18. Motivationally significant self-control: enhanced action withholding involves the right inferior frontal junction.

    PubMed

    O'Connor, David A; Upton, Daniel J; Moore, Jennifer; Hester, Robert

    2015-01-01

    In everyday life, people use self-control to withhold actions. This ability is particularly important when the consequences of action withholding have an impact on the individual's well-being. Despite its importance, it is unclear as to how the neural nodes implicated in action withholding contribute to this real-world type of self-control. By modifying an action withholding paradigm, the go/no-go task, we examined how the brain exerts self-control during a scenario in which the implications of withholding an action are meaningful and motivationally significant. A successfully withheld response contributed to long-term monetary rewards, whereas failure to withhold a response incurred an immediate monetary punishment. Compared with neutral action withholding, participants significantly improved their performance when these contingencies were applied. Crucially, although the right IFG and pre-SMA were found to promote overall action withholding, the enhancement in behavioral performance relative to a neutral condition was only reflected by a physiological change in a region encompassing the right inferior frontal junction and precentral gyrus. We speculate that the ability to flexibly modulate attention to goal-relevant stimuli is crucial to enhanced, motivationally driven action withholding and that this ability is subserved by the right inferior frontal junction. These findings suggest that control-modulating factors, rather than action withholding processes per se, can be critical to improving motivationally significant action withholding outcomes.

  19. Sudden death due to ventricular double rupture as a complication of inferior acute myocardial infarction

    PubMed Central

    Chen, Shi-Jian; Zhang, Chen; Meng, Qing-Tao; Peng, Yong; Chen, Mao

    2016-01-01

    Abstract Rationale: Ventricular double rupture (VDR) is a rare but lethal mechanical complication of acute myocardial infarction (AMI). The early identification and timely treatment of VDR remain challenging problems. We present a case of AMI with VDR and briefly review the characteristics and prognosis of this life-threatening disease. Patient concerns and Diagnoses: A 77-year-old male presented to our hospital with a 4-day history of severe dizziness, mild chest tightness, and dyspnea. An inferior AMI was diagnosed. Interventions and Outcomes: On the second hospital day, hypotension and a new cardiac murmur was found. The emergency echocardiographic study disclosed a ventricular septal defect. Soon after that the patient suddenly died of ventricular free-wall rupture. Lessons: In patients with AMI complicated by a septal perforation in the apical region, close to the septum-free wall junction, special attention should be paid to the great risk of VDR. Other high risk factors included advanced age, delayed reperfusion, and inferior infarction. Sufficient evaluation of the risk factors, close monitoring of vital signs, early identification of the specific symptoms, and timely treatment are the key points for the effective prediction and prevention of VDR. PMID:28033290

  20. Perception of emotional expressions is independent of face selectivity in monkey inferior temporal cortex.

    PubMed

    Hadj-Bouziane, Fadila; Bell, Andrew H; Knusten, Tamara A; Ungerleider, Leslie G; Tootell, Roger B H

    2008-04-08

    The ability to perceive and differentiate facial expressions is vital for social communication. Numerous functional MRI (fMRI) studies in humans have shown enhanced responses to faces with different emotional valence, in both the amygdala and the visual cortex. However, relatively few studies have examined how valence influences neural responses in monkeys, thereby limiting the ability to draw comparisons across species and thus understand the underlying neural mechanisms. Here we tested the effects of macaque facial expressions on neural activation within these two regions using fMRI in three awake, behaving monkeys. Monkeys maintained central fixation while blocks of different monkey facial expressions were presented. Four different facial expressions were tested: (i) neutral, (ii) aggressive (open-mouthed threat), (iii) fearful (fear grin), and (iv) submissive (lip smack). Our results confirmed that both the amygdala and the inferior temporal cortex in monkeys are modulated by facial expressions. As in human fMRI, fearful expressions evoked the greatest response in monkeys-even though fearful expressions are physically dissimilar in humans and macaques. Furthermore, we found that valence effects were not uniformly distributed over the inferior temporal cortex. Surprisingly, these valence maps were independent of two related functional maps: (i) the map of "face-selective" regions (faces versus non-face objects) and (ii) the map of "face-responsive" regions (faces versus scrambled images). Thus, the neural mechanisms underlying face perception and valence perception appear to be distinct.

  1. [Methodology for superiority versus equivalence and non-inferior clinical studies. A practical review].

    PubMed

    Rosas-Peralta, Martin; Santos-Martínez, Luis Efrén; Magaña-Serrano, José Antonio; Valencia-Sánchez, Jesús Salvador; Garrido-Garduño, Martin; Pérez-Rodríguez, Gilberto

    2016-01-01

    Physicians should always remember that a negative result in a superiority trial never would prove that the therapies under research are equivalent; more often, there may be a risk of type 2 (false negative) error. Equivalence and not inferiority studies demand high standards to provide reliable results. Physicians should take into account above all that the equivalence margins tend to be too large to be clinically significant and that the claim of equivalence can be misleading if a study has not been conducted at a sufficiently high level. In addition, physicians must be a bit skeptical of judgments that do not include the basic requirements of information, including the definition and justification of the equivalence margin, the calculation of the size of the sample bearing in mind this margin, the presentation of both analysis (intention-to-treat and by protocol), and provide confidence intervals for the results. Equivalence and inferiority studies are not indicated in certain areas. If one follows the required strict adherence to the specific methodology, such studies can provide new and important knowledge.

  2. The inferior olivary complex of guinea pig: cytoarchitecture and cellular morphology.

    PubMed

    Foster, R E; Peterson, B E

    1986-12-01

    The inferior olivary complex (I.O.C.) of the guinea pig can be divided into three primary subdivisions: the principal olive (PO), the medial accessory olive (MAO), and the dorsal accessory olive (DAO). In Nissl-stained preparations, the PO possessed darker staining cells than did the MAO and DAO and was the most densely populated with cells. All neuronal somata in the I.O.C. were oblique-spheroid in profile (mean size: coronal = 18.3 microns, parasagittal = 15.8 microns). Based on Golgi impregnations, it was apparent that inferior olive cells were of two unique radiate-cell types (I and II). Type I neurons had relatively diffuse, sparsely branched dendritic arbors, whereas type II cells had dendrites which were highly branched and massed about the cell body, at times creating complex spirals. Type II cells were further categorized into types IIa and IIb based on geometric variations of the type II dendritic arbors. Indices of branching and tortuosity, together with estimates of dendritic arbor volume, were quite helpful in distinguishing cell types. The cell types were differentially distributed across the subdivisions with type I neurons being encountered in the MAO while type II cells were found in all three subdivisions. Within the neuropil of the I.O.C., three different afferent axonal arbors were identified, as was the presence of dendrites from surrounding reticular formation cells. Neuronal aggregates creating a possible electrical syncytium within the I.O.C. are consistent with the dendroarchitectonics of the cells.

  3. Differential contributions of the superior and inferior parietal cortex to feedback versus feedforward control of tools

    PubMed Central

    Macuga, Kristen L.; Frey, Scott H.

    2016-01-01

    Damage to the superior and/or inferior parietal lobules (SPL, IPL) (Sirigu et al., 1996) or cerebellum (Grealy and Lee, 2011) can selectively disrupt motor imagery, motivating the hypothesis that these regions participate in predictive (i.e., feedforward) control. If so, then the SPL, IPL, and cerebellum should show greater activity as the demands on feedforward control increase from visually-guided execution (closed-loop) to execution without visual feedback (open-loop) to motor imagery. Using fMRI and a Fitts’ reciprocal aiming task with tools directed at targets in far space, we found that the SPL and cerebellum exhibited greater activity during closed-loop control. Conversely, open-loop and imagery conditions were associated with increased activity within the IPL and prefrontal areas. These results are consistent with a superior-to-inferior gradient in the representation of feedback-to-feedforward control within the posterior parietal cortex. Additionally, the anterior SPL displayed greater activity when aiming movements were performed with a stick vs. laser pointer. This may suggest that it is involved in the remapping of far into near (reachable) space (Maravita and Iriki, 2004), or in distalization of the end-effector from hand to stick (Arbib et al., 2009). PMID:24473100

  4. Effectiveness of Inferior Vena Cava Filters without Anticoagulation Therapy for Prophylaxis of Recurrent Pulmonary Embolism

    PubMed Central

    Zektser, Miri; Bartal, Carmi; Zeller, Lior; Nevzorov, Roman; Jotkowitz, Alan; Stavi, Vered; Romanyuk, Vitaly; Chudakov, Gregory; Barski, Leonid

    2016-01-01

    Objective The optimal treatment of deep vein thrombosis (DVT) is anticoagulation therapy. Inferior vena cava filter (IVC) placement is another option for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis. This is used mostly in patients with a contraindication to anticoagulant therapy. The purpose of the present study was to compare the two options. Methods A retrospective cohort study of two groups of patients with DVT: patients who received an IVC filter and did not receive anticoagulation due to contraindications; and patients with DVT and similar burden of comorbidity treated with anticoagulation without IVC insertion. To adjust for a potential misbalance in baseline characteristics between the two groups, we performed matching for age, gender, and Charlson’s index, which is used to compute the burden of comorbid conditions. The primary outcome was an occurrence of a PE. Results We studied 1,742 patients hospitalized with the diagnosis of DVT in our hospital;93 patients from this population received IVC filters. Charlson’s score index was significantly higher in the IVC filter group compared with the anticoagulation group. After matching of the groups of patients according to Charlson’s score index there were no significant differences in primary outcomes. Conclusion Inferior vena cava filter without anticoagulation may be an alternative option for prevention of PE in patients with contraindications to anticoagulant therapy. PMID:27487310

  5. Configuration of the inferior alveolar canal as detected by cone beam computed tomography

    PubMed Central

    Nair, Umadevi P; Yazdi, Mehran H; Nayar, Gautam M; Parry, Heath; Katkar, Rujuta A; Nair, Madhu K

    2013-01-01

    Aims: The aim of this study is to evaluate the course of the inferior alveolar canal (IAC) including its frequently seen variations in relation to root apices and the cortices of the mandible at fixed pre-determined anatomic reference points using cone beam volumetric computed tomography (CBVCT). Material and Methods: This retrospective study utilized CBVCT images from 44 patients to obtain quantifiable data to localize the IAC. Measurements to the IAC were made from the buccal and lingual cortical plates (BCP/LCP), inferior border of the mandible and the root apices of the mandibular posterior teeth and canine. Descriptive analysis was used to map out the course of the IAC. Results: IACs were noted to course superiorly toward the root apices from the second molar to the first premolar and closer to the buccal cortical plate anteriorly. The canal was closest to the LCP at the level of the second molar. In 32.95% of the cases, the canal was seen at the level of the canine. Conclusions: This study indicates that caution needs to be exercised during endodontic surgical procedures in the mandible even at the level of the canine. CBVCT seems to provide an optimal, low-dose, 3D imaging modality to help address the complexities in canal configuration. PMID:24347885

  6. Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer.

    PubMed

    Alonso-Ezpeleta, Oscar; Martín, Pablo J; López-López, José; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Segura-Egea, Juan J

    2014-04-01

    A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion. Key words:Endodontics, inferior alveolar nerve, neuropathic pain, orofacial pain, paraesthesia, pregabalin.

  7. The effect of anterior transposition of the inferior oblique muscle on eyelid configuration and function

    PubMed Central

    Göncü, Tuğba; Çakmak, Sevim; Akal, Ali; Oğuz, Halit

    2016-01-01

    Purpose: To evaluate the alteration of lower lid configuration and function with anterior transposition surgery of the inferior oblique (IO) muscle. Patients and Methods: A prospective clinical trial was conducted on a consecutive series of patients underwent anterior transposition of the IO as a sole operation. All patients received a thorough ophthalmic examination 1 day before and 3 months after surgery. Output parameters were consisted of palpebral fissure, margin reflex distance 1–2, lower lid function, hertel value, and lower lid crease. The differences of the collected data were calculated for statistical significance by using the Wilcoxon test. Results: A total of 19 eyes of 16 consecutive patients were included. The median preoperative grade of IO overaction was 3.5 (ranging from 3 to 4), which decreased to 0 (ranging from 0 to 2) postoperatively (P < 0.05). No significant change was observed in all parameters 3 months postoperatively (P > 0.05). Conclusion: In this study, no significant effect on lower lid configuration and function was observed following IO anterior transposition in which the disinserted muscle was placed posterior to inferior rectus insertion. PMID:26953021

  8. Response bias reveals enhanced attention to inferior visual field in signers of American Sign Language.

    PubMed

    Dye, Matthew W G; Seymour, Jenessa L; Hauser, Peter C

    2016-04-01

    Deafness results in cross-modal plasticity, whereby visual functions are altered as a consequence of a lack of hearing. Here, we present a reanalysis of data originally reported by Dye et al. (PLoS One 4(5):e5640, 2009) with the aim of testing additional hypotheses concerning the spatial redistribution of visual attention due to deafness and the use of a visuogestural language (American Sign Language). By looking at the spatial distribution of errors made by deaf and hearing participants performing a visuospatial selective attention task, we sought to determine whether there was evidence for (1) a shift in the hemispheric lateralization of visual selective function as a result of deafness, and (2) a shift toward attending to the inferior visual field in users of a signed language. While no evidence was found for or against a shift in lateralization of visual selective attention as a result of deafness, a shift in the allocation of attention from the superior toward the inferior visual field was inferred in native signers of American Sign Language, possibly reflecting an adaptation to the perceptual demands imposed by a visuogestural language.

  9. Congenital rubella with agenesis of the inferior cerebellar vermis and total anomalous pulmonary venous drainage.

    PubMed

    Cluver, C; Meyer, R; Odendaal, H; Geerts, L

    2013-08-01

    Congenital rubella infection has been associated with a number of abnormalities including cardiac, central nervous system and placental complications. We present a case with multiple fetal abnormalities detected on prenatal ultrasound, and confirmed postnatally, that included a single umbilical artery, severe tricuspid regurgitation, micrognathia and agenesis of the inferior cerebellar vermis. Postnatal echocardiography additionally revealed unobstructed total anomalous pulmonary venous drainage (TAPVD) into the coronary sinus. Placental examination showed signs of placentitis, and polymerase chain reaction on neonatal serum was positive for rubella. Following a multidisciplinary team review, it was decided to provide only supportive care, and the infant died at 6 months of age owing to a respiratory tract infection. To our knowledge, TAPVD and agenesis of the inferior cerebellar vermis have not been reported previously in association with congenital rubella infection. This case illustrates how congenital infection may present in atypical ways and stresses the importance of considering congenital infection in the differential diagnosis of fetal anomalies when multiple features are present.

  10. Effect of Removing Superior Spikelets on Grain Filling of Inferior Spikelets in Rice

    PubMed Central

    You, Cuicui; Zhu, Honglei; Xu, Beibei; Huang, Wenxiao; Wang, Shaohua; Ding, Yanfeng; Liu, Zhenghui; Li, Ganghua; Chen, Lin; Ding, Chengqiang; Tang, She

    2016-01-01

    Large-panicle rice cultivars often fail to reach their yield potential due to the poor grain filling of inferior spikelets (IS). Thus, it is important to determine the causes of poor IS grain filling. In this study, we attempted to identify whether inferior grain filling of large panicles is restricted by superior spikelets (SS) and their physiological mechanism. SS were removed from two homozygous japonica rice strains (W1844 and WJ165) during flowering in an attempt to force photosynthate transport to the IS. We measured the effects of SS removal on seed setting rate, grain weight, grain filling rate, sucrose content, as well as hormone levels, activities of key enzymes, and expression of genes involved in sucrose to starch metabolism in rice IS during grain filling. The results showed that SS removal improved IS grain filling by increasing the seed setting rate, grain weight, sucrose content, and hormone levels. SS removal also enhanced the activities of key enzymes and the expression levels of genes involved in sucrose to starch metabolism. These results suggest that sucrose and several hormones act as signal substances and play a vital role in grain filling by regulating enzyme activities and gene expression. Therefore, IS grain filling is restricted by SS, which limit assimilate supply and plant hormones, leading to poor grain filling of IS. PMID:27547210

  11. Effect of Removing Superior Spikelets on Grain Filling of Inferior Spikelets in Rice.

    PubMed

    You, Cuicui; Zhu, Honglei; Xu, Beibei; Huang, Wenxiao; Wang, Shaohua; Ding, Yanfeng; Liu, Zhenghui; Li, Ganghua; Chen, Lin; Ding, Chengqiang; Tang, She

    2016-01-01

    Large-panicle rice cultivars often fail to reach their yield potential due to the poor grain filling of inferior spikelets (IS). Thus, it is important to determine the causes of poor IS grain filling. In this study, we attempted to identify whether inferior grain filling of large panicles is restricted by superior spikelets (SS) and their physiological mechanism. SS were removed from two homozygous japonica rice strains (W1844 and WJ165) during flowering in an attempt to force photosynthate transport to the IS. We measured the effects of SS removal on seed setting rate, grain weight, grain filling rate, sucrose content, as well as hormone levels, activities of key enzymes, and expression of genes involved in sucrose to starch metabolism in rice IS during grain filling. The results showed that SS removal improved IS grain filling by increasing the seed setting rate, grain weight, sucrose content, and hormone levels. SS removal also enhanced the activities of key enzymes and the expression levels of genes involved in sucrose to starch metabolism. These results suggest that sucrose and several hormones act as signal substances and play a vital role in grain filling by regulating enzyme activities and gene expression. Therefore, IS grain filling is restricted by SS, which limit assimilate supply and plant hormones, leading to poor grain filling of IS.

  12. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking

    PubMed Central

    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous “standard” definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity

  13. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2010-01-01

    ABSTRACT Objectives It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present study was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery. Material and Methods Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed. Results In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle. Conclusions A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that osteotomies in implant dentistry should not be developed in the posterior mandible until the position of the mandibular canal is established. PMID:24421958

  14. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial

    PubMed Central

    Montserrat-Bosch, Marta; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-01-01

    Objectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study Design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries. Key words:Dental anesthesia, inferior alveolar nerve block, lidocaine, third molar, intravascular injection. PMID:24608204

  15. Regulation of self-renewing neural progenitors by FGF/ERK signaling controls formation of the inferior colliculus.

    PubMed

    Dee, Alexander; Li, Kairong; Heng, Xin; Guo, Qiuxia; Li, James Y H

    2016-10-15

    The embryonic tectum displays an anteroposterior gradient in development and produces the superior colliculus and inferior colliculus. Studies suggest that partition of the tectum is controlled by different strengths and durations of FGF signals originated from the so-called isthmic organizer at the mid/hindbrain junction; however, the underlying mechanism is unclear. We show that deleting Ptpn11, which links FGF with the ERK pathway, prevents inferior colliculus formation by depleting a previously uncharacterized stem cell zone. The stem-zone loss is attributed to shortening of S phase and acceleration of cell cycle exit and neurogenesis. Expression of a constitutively active Mek1 (Mek1(DD)), the known ERK activator, restores the tectal stem zone and the inferior colliculus without Ptpn11. By contrast, Mek1(DD) expression fails to rescue the tectal stem zone and the inferior colliculus in the absence of Fgf8 and the isthmic organizer, indicating that FGF and Mek1(DD) initiate qualitatively and/or quantitatively distinctive signaling. Together, our data show that the formation of the inferior colliculus relies on the provision of new cells from the tectal stem zone. Furthermore, distinctive ERK signaling mediates Fgf8 in the control of cell survival, tissue polarity and cytogenetic gradient during the development of the tectum.

  16. Power and sample size requirements for non-inferiority in studies comparing two matched proportions where the events are correlated.

    PubMed

    Nam, Jun-Mo

    2011-10-01

    Consider clustered matched-pair studies for non-inferiority where clusters are independent but units in a cluster are correlated. An inexpensive new procedure and the expensive standard one are applied to each unit and outcomes are binary responses. Appropriate statistics testing non-inferiority of a new procedure have been developed recently by several investigators. In this note, we investigate power and sample size requirement of the clustered matched pair study for non-inferiority. Power of a test is related primarily to the number of clusters. The effect of a cluster size on power is secondary. The efficiency of a clustered matched-pair design is inversely related to the intra-class correlation coefficient within a cluster. We present an explicit formula for obtaining the number of clusters for given a cluster size and the cluster size for a given number of clusters for a specific power. We also provide alternative sample size calculations when available information regarding parameters are limited. The formulae can be useful in designing a clustered matched-pair study for non-inferiority. An example for determining sample size to establish non-inferiority for a clustered matched-pair study is illustrated.

  17. Significance of inferior wall ischemia in non-dominant right coronary artery anatomy

    PubMed Central

    Malik, Ali Osama; Abela, Oliver; Devabhaktuni, Subodh; Malik, Arhama Aftab; Allenback, Gayle; Ahsan, Chowdhury H; Malhotra, Sanjay; Diep, Jimmy

    2017-01-01

    AIM To investigate the relationship of inferior wall ischemia on myocardial perfusion imaging in patients with non-dominant right coronary artery anatomy. METHODS This was a retrospective observational analysis of consecutive patients who presented to the emergency department with primary complaint of chest pain. Only patients who underwent single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) were included. Patients who showed a reversible defect on SPECT MPI and had coronary angiography during the same hospitalization was analyzed. Patients with prior history of coronary artery disease (CAD) including history of percutaneous coronary intervention and coronary artery bypass graft surgerys were excluded. True positive and false positive results were identified on the basis of hemodynamically significant CAD on coronary angiography, in the same territory as identified on SPECT MPI. Coronary artery dominance was determined on coronary angiography. Patients were divided into group 1 and group 2. Group 1 included patients with non-dominant right coronary artery (RCA) (left dominant and codominant). Group 2 included patients with dominant RCA anatomy. Demographics, baseline characteristics and positive predictive value (PPV) were analyzed for the two groups. RESULTS The mean age of the study cohort was 57.6 years. Sixty-one point seven percent of the patients were males. The prevalence of self-reported diabetes mellitus, hypertension and dyslipidemia was 36%, 71.9% and 53.9% respectively. A comparison of baseline characteristics between the two groups showed that patients with a non-dominant RCA were more likely to be men. For inferior wall ischemia on SPECT MPI, patients in study group 2 had a significantly higher PPV, 32/42 (76.1%), compared to patients in group 1, in which only 3 out of the 29 patients (10.3%) had true positive results (P value < 0.001 Z test). The difference remained statistically significant even when only patients

  18. Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice.

    PubMed

    Johnson, Thomas M; Badovinac, Rachel; Shaefer, Jeffry

    2007-09-01

    Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice. The confidence interval for the Gow-Gates method excludes this value, while the confidence interval for the Akinosi technique includes zero percent. We conclude that, in the study population, formal clinical training in the Gow-Gates and

  19. Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen.

    PubMed Central

    Takasugi, Y.; Furuya, H.; Moriya, K.; Okamoto, Y.

    2000-01-01

    The conventional inferior alveolar nerve block (conventional technique) has potential risks of neural and vascular injuries. We studied a method of inferior alveolar nerve block by injecting a local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen (anterior technique) with the purpose of avoiding such complications. The insertion angle of the anterior technique and the estimation of anesthesia in the anterior technique were examined. The predicted insertion angle measured on computed tomographic images was 60.1 +/- 7.1 degrees from the median, with the syringe end lying on the contralateral mandibular first molar, and the insertion depth was approximately 10 mm. We applied the anterior technique to 100 patients for mandibular molar extraction and assessed the anesthetic effects. A success rate of 74% was obtained. This is similar to that reported for the conventional technique but without the accompanying risks for inferior alveolar neural and vascular complications. Images Figure 2 PMID:11432177

  20. Activation in the Right Inferior Parietal Lobule Reflects the Representation of Musical Structure beyond Simple Pitch Discrimination

    PubMed Central

    Royal, Isabelle; Vuvan, Dominique T.; Zendel, Benjamin Rich; Robitaille, Nicolas; Schönwiesner, Marc; Peretz, Isabelle

    2016-01-01

    Pitch discrimination tasks typically engage the superior temporal gyrus and the right inferior frontal gyrus. It is currently unclear whether these regions are equally involved in the processing of incongruous notes in melodies, which requires the representation of musical structure (tonality) in addition to pitch discrimination. To this aim, 14 participants completed two tasks while undergoing functional magnetic resonance imaging, one in which they had to identify a pitch change in a series of non-melodic repeating tones and a second in which they had to identify an incongruous note in a tonal melody. In both tasks, the deviants activated the right superior temporal gyrus. A contrast between deviants in the melodic task and deviants in the non-melodic task (melodic > non-melodic) revealed additional activity in the right inferior parietal lobule. Activation in the inferior parietal lobule likely represents processes related to the maintenance of tonal pitch structure in working memory during pitch discrimination. PMID:27195523

  1. An Abnormal GABAergic System in the Inferior Colliculus Provides a Basis for Audiogenic Seizures in Genetically Epilepsy-Prone Rats

    PubMed Central

    Ribak, Charles E.

    2015-01-01

    In this review of neuroanatomical studies of the genetically epilepsy-prone rat (GEPR), three main topics will be covered. First, the number of GABAergic neurons and total neurons in the inferior colliculus of GEPRs will be compared to those of the non-epileptic Sprague-Dawley rat. Next, the number of small neurons in the inferior colliculus will be described in both developmental and genetic analyses of GEPRs and their backcrosses. Last, results from two types of studies on the propagation pathways for audiogenic seizures in GEPRs will be shown. Together, these studies demonstrate a unique GABAergic, small neuron defect in the inferior colliculus of GEPRs that may play a vital role in the initiation and spread of seizure activity during audiogenic seizures. PMID:25812940

  2. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms*

    PubMed Central

    de Abreu Junior, Luiz; Kuniyoshi, Cristina Hiromi; Wolosker, Angela Borri; Borri, Maria Lúcia; Antunes, Augusto; Ota, Vanessa Kiyomi Arashiro; Uchida, Daniela

    2016-01-01

    Objective To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion Vascular loops do not appear to be associated with otoneurological manifestations. PMID:27818543

  3. Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.

    PubMed

    Anderson, Fraser; Freeman, Daniel

    2013-08-01

    Paranoid ideation is more common in the general population than previously thought, and it is associated with low socioeconomic status. Daily life hassles, self-mastery, and striving to avoid inferiority may partly account for this association, but these factors have not been examined in relation to paranoid thoughts. Two hundred fifteen individuals from the general population completed self-report assessments of paranoid thoughts during the last month, daily life hassles, self-mastery, striving to avoid inferiority, and socioeconomic classification. A greater number of daily hassles, low self-mastery, and insecure striving were all associated with greater levels of paranoid thinking. Each variable was associated with markers of socioeconomic status. This study demonstrates for the first time the association of paranoid thoughts with life hassles, self-mastery, and striving to avoid inferiority. Each of the factors examined may be a plausible candidate to account for why lower socioeconomic status is associated with greater perceptions of threat from other people.

  4. Temporal properties of inferior colliculus neurons to photonic stimulation in the cochlea

    PubMed Central

    Tan, Xiaodong; Young, Hunter; Matic, Agnella Izzo; Zirkle, Whitney; Rajguru, Suhrud; Richter, Claus-Peter

    2015-01-01

    Infrared neural stimulation (INS) may be beneficial in auditory prostheses because of its spatially selective activation of spiral ganglion neurons. However, the response properties of single auditory neurons to INS and the possible contributions of its optoacoustic effects are yet to be examined. In this study, the temporal properties of auditory neurons in the central nucleus of the inferior colliculus (ICC) of guinea pigs in response to INS were characterized. Spatial selectivity of INS was observed along the tonotopically organized ICC. Trains of laser pulses and trains of acoustic clicks were used to evoke single unit responses in ICC of normal hearing animals. In response to INS, ICC neurons showed lower limiting rates, longer latencies, and lower firing efficiencies. In deaf animals, ICC neurons could still be stimulated by INS while unresponsive to acoustic stimulation. The site and spatial selectivity of INS both likely shaped the temporal properties of ICC neurons. PMID:26311831

  5. Conidiobolus coronatus granuloma of the right inferior turbinate: A rare presentation.

    PubMed

    Varshney, Saurabh; Gupta, Pratima; Bist, Sampan Singh; Bhagat, Sanjeev

    2015-01-01

    Fungal infections are common in tropical countries such as India. Very few clinical cases caused by the Entomophthorales Zygomycetes have been reported. Rhinofacial infection is a rare form of zygomycosis in humans, and only limited information regarding optimal treatment is available. We report here a rare case of rhinofacial Conidiobolus coronatus infection in a previously healthy 18-year-old man who presented with a fungal granuloma of the right inferior turbinate and face. Diagnosis was confirmed by microbiologic culture from a tissue biopsy. The infection was successfully treated with surgery and itraconazole therapy for 12 months. The clinical presentation and treatment of this rare, chronic, indolent form of fungal infection are highlighted in this article.

  6. Rapid gamma oscillations in the inferior occipital gyrus in response to eyes

    PubMed Central

    Sato, Wataru; Kochiyama, Takanori; Uono, Shota; Matsuda, Kazumi; Usui, Keiko; Usui, Naotaka; Inoue, Yushi; Toichi, Motomi

    2016-01-01

    Eyes are an indispensable communication medium for human social interactions. Although previous neuroscientific evidence suggests the activation of the inferior occipital gyrus (IOG) during eye processing, the temporal profile of this activation remains unclear. To investigate this issue, we analyzed intracranial electroencephalograms of the IOG during the presentation of eyes and mosaics, in either averted or straight directions. Time–frequency statistical parametric mapping analyses revealed greater gamma-band activation in the right IOG beginning at 114 ms in response to eyes relative to mosaics, irrespective of their averted or straight direction. These results suggest that gamma oscillations in the right IOG are involved in the early stages of eye processing, such as eye detection. PMID:27805017

  7. [Conservative management of a ruptured inferior pancreaticoduodenal artery aneurysm associated with celiac artery occlusion].

    PubMed

    Kidogawa, Hideo; Okamoto, Kohji; Yamayoshi, Takatomo; Noguchi, Junya

    2013-10-01

    A 45-year-old female presented at our hospital with a one-day history of upper abdominal pain. Abdominal computed tomography (CT) revealed that the root of the celiac artery was obstructed and that a large hematoma was present in the retroperitoneum. The patient was diagnosed with retroperitoneal hemorrhage associated with the rupture of an inferior pancreaticoduodenal artery aneurysm, which was caused by increased blood flow in the pancreaticoduodenal arterial arcade. Because the patient's general condition was stable, she was managed conservatively and discharged on achieving remission after a month. Follow-up CT revealed spontaneous resolution of the celiac artery obstruction and aneurysm. The celiac artery obstruction in this case was assumed to be caused by segmental arterial mediolysis.

  8. GABAA-Mediated Inhibition Modulates Stimulus-Specific Adaptation in the Inferior Colliculus

    PubMed Central

    Pérez-González, David; Hernández, Olga; Covey, Ellen; Malmierca, Manuel S.

    2012-01-01

    The ability to detect novel sounds in a complex acoustic context is crucial for survival. Neurons from midbrain through cortical levels adapt to repetitive stimuli, while maintaining responsiveness to rare stimuli, a phenomenon called stimulus-specific adaptation (SSA). The site of origin and mechanism of SSA are currently unknown. We used microiontophoretic application of gabazine to examine the role of GABAA-mediated inhibition in SSA in the inferior colliculus, the midbrain center for auditory processing. We found that gabazine slowed down the process of adaptation to high probability stimuli but did not abolish it, with response magnitude and latency still depending on the probability of the stimulus. Blocking GABAA receptors increased the firing rate to high and low probability stimuli, but did not completely equalize the responses. Together, these findings suggest that GABAA-mediated inhibition acts as a gain control mechanism that enhances SSA by modifying the responsiveness of the neuron. PMID:22479591

  9. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    SciTech Connect

    Abdel-Aal, Ahmed Kamel Saddekni, Souheil; Hamed, Maysoon Farouk; Fitzpatrick, Farley

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  10. Utilization of Inferiorly Based Dermofat Flap in Breast Reconstruction after Simple Mastectomy due to Gigantomastia.

    PubMed

    Bogdanov-Berezovsky, A; Krieger, Y; Shoham, Y; Silberstein, E

    2013-01-01

    Gigantomastia (GM) is a rare disabling condition characterized by excessive breast tissue growth. To date, there is no universal classification and definition of GM. At present, GM is determined as weight over 1.5 kg per breast (Dancey et al., 2008) or 3% or more of the patient's total body weight (Dafydd et al., 2011). The lack of generally acknowledged approach regarding GM is expressed by the different methods of its treatment ranging from hormonal prescription to mastectomy and subsequent complex breast reconstruction (Shoma et al., 2011). We describe a treatment approach, including simple mastectomy and immediate breast reconstruction by an inferiorly based dermofat flap with silicone implants and nipple grafting.

  11. [Congenital cardiac anomalies (pentalogy of Fallot) in a two year old ram with brachygnathia inferior].

    PubMed

    Pielmeier, Ricarda; Engelke, Elisabeth; Legler, Marko; Haist, Verena; Hopster-Iversen, Charlotte; Distl, Ottmar

    2013-01-01

    In a nearly two-year-old ram, descending from a breeding trial to investigate the effects of shortness of the lower jaw (brachygnathia inferior), a congenital cardiac anomaly was observed. At the age often months the affected animal, a cross breed of Cameroon Sheep and East Friesian Milk Sheep, showed exercise-induced respiratory distress for the first time. Auscultation revealed a loud systolic heart murmur (grade 5) on both sides of the thorax, most prominent over the left third intercostal space at shoulder height. Postmortem examination of the ram's heart showed a pentalogy of Fallot, consisting of a pulmonic stenosis, a ventricular septal defect, an overriding aorta, a right ventricular hypertrophy and a patent foramen ovale. A genetic defect has to be considered as a possible reason.

  12. A Dedicated Inferior Vena Cava Filter Service Line: How to Optimize Your Practice.

    PubMed

    Karp, Jennifer K; Desai, Kush R; Salem, Riad; Ryu, Robert K; Lewandowski, Robert J

    2016-06-01

    Despite the increased placement of retrievable inferior vena cava filters (rIVCFs), efforts to remove these devices are not commensurate. The majority of rIVCFs are left in place beyond their indicated usage, and often are retained permanently. With a growing understanding of the clinical issues associated with these devices, the United States Food and Drug Administration (FDA) has prompted clinicians to remove rIVCF when they are no longer indicated. However, major obstacles exist to filter retrieval, chief among them being poor clinical follow-up. The establishment of a dedicated IVC filter service line, or clinic, has been shown to improve filter retrieval rates. Usage of particular devices, specifically permanent versus retrievable filters, is enhanced by prospective physician consultation. In this article, the rationale behind a dedicated IVC filter service line is presented as well as described the structure and activities of the authors' IVC filter clinic; supporting data will also be provided when appropriate.

  13. Tolerating ambiguity: ambiguous words recruit the left inferior frontal gyrus in absence of a behavioral effect.

    PubMed

    Hargreaves, Ian S; Pexman, Penny M; Pittman, Daniel J; Goodyear, Bradley G

    2011-01-01

    Many models of word recognition predict a lexical ambiguity disadvantage in semantic categorization tasks (SCTs). However, recent evidence suggests that an ambiguity disadvantage in SCT results from a bias in the decision-making phase of the task and not in the meaning-activation phase: Behavioral effects of ambiguity disappear when these decision biases are controlled (Pexman, Hino, & Lupker, 2004). The current study used event-related functional magnetic resonance imaging to examine the neural correlates of ambiguity in a task that produced no behavioral ambiguity effect (i.e., SCT with a well-defined decision category). Twenty healthy adults participated. Results showed that despite producing no behavioral effect of ambiguity, ambiguous words were associated with the recruitment of cortical structures implicated in top-down modulation of noisy activity (e.g., left inferior frontal gyrus) when compared to unambiguous words. These results are interpreted as evidence that multiple meanings are activated for ambiguous words in SCT.

  14. Interaural time sensitivity of high-frequency neurons in the inferior colliculus.

    PubMed

    Yin, T C; Kuwada, S; Sujaku, Y

    1984-11-01

    Recent psychoacoustic experiments have shown that interaural time differences provide adequate cues for lateralizing high-frequency sounds, provided the stimuli are complex and not pure tones. We present here physiological evidence in support of these findings. Neurons of high best frequency in the cat inferior colliculus respond to interaural phase differences of amplitude modulated waveforms, and this response depends upon preservation of phase information of the modulating signal. Interaural phase differences were introduced in two ways: by interaural delays of the entire waveform and by binaural beats in which there was an interaural frequency difference in the modulating waveform. Results obtained with these two methods are similar. Our results show that high-frequency cells can respond to interaural time differences of amplitude modulated signals and that they do so by a sensitivity to interaural phase differences of the modulating waveform.

  15. Auditory cortex controls sound-driven innate defense behaviour through corticofugal projections to inferior colliculus

    PubMed Central

    Xiong, Xiaorui R.; Liang, Feixue; Zingg, Brian; Ji, Xu-ying; Ibrahim, Leena A.; Tao, Huizhong W.; Zhang, Li I.

    2015-01-01

    Defense against environmental threats is essential for animal survival. However, the neural circuits responsible for transforming unconditioned sensory stimuli and generating defensive behaviours remain largely unclear. Here, we show that corticofugal neurons in the auditory cortex (ACx) targeting the inferior colliculus (IC) mediate an innate, sound-induced flight behaviour. Optogenetic activation of these neurons, or their projection terminals in the IC, is sufficient for initiating flight responses, while the inhibition of these projections reduces sound-induced flight responses. Corticocollicular axons monosynaptically innervate neurons in the cortex of the IC (ICx), and optogenetic activation of the projections from the ICx to the dorsal periaqueductal gray is sufficient for provoking flight behaviours. Our results suggest that ACx can both amplify innate acoustic-motor responses and directly drive flight behaviours in the absence of sound input through corticocollicular projections to ICx. Such corticofugal control may be a general feature of innate defense circuits across sensory modalities. PMID:26068082

  16. Facial palsy after inferior alveolar nerve block: case report and review of the literature.

    PubMed

    Chevalier, V; Arbab-Chirani, R; Tea, S H; Roux, M

    2010-11-01

    Bell's palsy is an idiopathic and acute, peripheral nerve palsy resulting in inability to control facial muscles on the affected side because of the involvement of the facial nerve. This study describes a case of Bell's palsy that developed after dental anaesthesia. A 34-year-old pregnant woman at 35 weeks of amenorrhea, with no history of systemic disease, was referred by her dentist for treatment of a mandibular left molar in pulpitis. An inferior alveolar nerve block was made prior to the access cavity preparation. 2h later, the patient felt the onset of a complete paralysis of the left-sided facial muscles. The medical history, the physical examination and the complementary exams led neurologists to the diagnosis of Bell's palsy. The treatment and results of the 1-year follow-up are presented and discussed. Bell's palsy is a rare complication of maxillofacial surgery or dental procedures, the mechanisms of which remain uncertain.

  17. Effects of emotional music on visual processes in inferior temporal area.

    PubMed

    Jomori, Izumi; Hoshiyama, Minoru; Uemura, Jun-ichi; Nakagawa, Yoshiro; Hoshino, Aiko; Iwamoto, Yuko

    2013-01-01

    To investigate the effects of emotional music on visual processes, we analyzed visual evoked magnetic fields (VEF) on listening to emotional music in 14 healthy subjects. Positive and negative pieces of music were delivered during VEF recording following stimulation by emotionally neutral pictures of faces and landscapes. VEF components at 100 (M100) and 150 (M170)ms after stimulus onset were analyzed, and the estimated current strength for M170 following face stimulation was enhanced with negative compared to positive music in the right hemisphere. The equivalent current dipole for M100 and M170 was estimated in the primary visual cortex (V1) and inferior temporal area (IT), respectively. The present results indicate that background music showed a top-down control of the visual processes in IT, which is a core site responsible for the interpretation of facial expression. The emotional contents of music could alter visual processes, especially those involving the face.

  18. Stimulus expectancy modulates inferior frontal gyrus and premotor cortex activity in auditory perception.

    PubMed

    Osnes, Berge; Hugdahl, Kenneth; Hjelmervik, Helene; Specht, Karsten

    2012-04-01

    In studies on auditory speech perception, participants are often asked to perform active tasks, e.g. decide whether the perceived sound is a speech sound or not. However, information about the stimulus, inherent in such tasks, may induce expectations that cause altered activations not only in the auditory cortex, but also in frontal areas such as inferior frontal gyrus (IFG) and motor cortices, even in the absence of an explicit task. To investigate this, we applied spectral mixes of a flute sound and either vowels or specific music instrument sounds (e.g. trumpet) in an fMRI study, in combination with three different instructions. The instructions either revealed no information about stimulus features, or explicit information about either the music instrument or the vowel features. The results demonstrated that, besides an involvement of posterior temporal areas, stimulus expectancy modulated in particular a network comprising IFG and premotor cortices during this passive listening task.

  19. Pseudoadenomatous Hyperplasia of the Inferior Forniceal Conjunctiva Due To Prosthetic Irritation in an Anophthalmic Socket.

    PubMed

    Jakobiec, Frederick A; Rashid, Alia; Massoud, Vicky; Fay, Aaron

    2016-01-01

    Secondary complications in an anophthalmic socket can include late appearing shrinkage due to scarring and squamous cell carcinoma. This article reports a 51-year-old man who 27 years after an enucleation developed an inability to retain his ocular prosthesis due to an acquired multilobular fleshy mass in his inferior fornix. The patient had worn his prosthesis without removal for years at a time. Microscopic evaluation of the excised lesion disclosed a pseudoadenomatous (pseudoglandular) hyperplasia of the conjunctival epithelium with myriad goblet cells and accompanying chronic inflammation. In cross section, these structures microscopically resembled an adenoma but were found to display multifocal origins from the surface epithelium resembling exaggerated pseudoglands of Henle. Simple excision without recurrence 6 months later has permitted a new prosthesis to be comfortably worn with stability.

  20. Pseudoaneurysm of the inferior epigastric artery: a rare complication of laparoscopic ventral hernia repair.

    PubMed

    Nichols-Totten, Kysha; Pollema, Travis; Moncure, Michael

    2012-02-01

    Pseudoaneurysm of the inferior epigastric artery (IEA) is a recognized complication of surgery; however, it is a very rare clinical occurrence. The anatomic position of the IEA subjects patients to possible IEA injury during abdominal wall procedures that are close to the artery, such as insertions of drains, Tenckhoff catheters, laparoscopic trocars, or paracentesis. Treatment options include open surgery, percutaneous coil embolization, embolization with N-butyl cyanoacrylate, sonographic-guided thrombin injection, or sonographic-guided compression. We report the first case of a pseudoaneurysm arising from the IEA after a laparoscopic ventral hernia repair. To our knowledge, 17 IEA pseudoaneurysms have been reported, only 3 of which were spontaneous. The pseudoaneurysm in our patient was successfully treated by percutaneous injection of thrombin by interventional radiology.

  1. Accessory Inferior Sulci of the Liver in an Afro-Caribbean Population

    PubMed Central

    O. Cawich, Shamir; T. Gardner, Michael; Shetty, Ramnanand; W. Pearce, Neil; Naraynsingh, Vijay

    2016-01-01

    Introduction: There have been no previous reports on the anatomic variations that exist on inferior surface of the liver in Caribbean populations. This information is important to optimize radiology and hepatobiliary surgical services in the region. Methods: Two investigators independently observed 69 cadaveric dissections over five years and described the variations in surface anatomy. Results: In this population 88% of cadaveric livers had conventional hepatic surface anatomy. However, 12% had accessory sulci present on the visceral surface of the liver, with a 7:1 male preponderance. When present, there was 100% correlation between the presence of Rouvière’s sulcus and the right branch of portal pedicle. Conclusion: Abnormal surface anatomy is present in 12% of unselected specimens in this Caribbean population. Interventional radiologists and hepatobiliary surgeons practicing in the Caribbean must be cognizant of these differences in order to minimize morbidity during invasive procedures. PMID:27493591

  2. The ability of inferior colliculus neurons to signal differences in interaural delay

    PubMed Central

    Skottun, Bernt C.; Shackleton, Trevor M.; Arnott, Robert H.; Palmer, Alan R.

    2001-01-01

    Sound localization in humans depends largely on interaural time delay (ITD). The ability to discriminate differences in ITD is highly accurate. ITD discrimination (Δ ITD) thresholds, under some circumstances, are as low as 10–20 μs. It has been assumed that thresholds this low could only be obtained if the outputs from many neurons were combined. Here we use Receiver Operating Characteristic analysis to compute neuronal Δ ITD thresholds from 53 cells in the inferior colliculus in guinea pigs. The Δ ITD thresholds of single neurons range from several hundreds of μs down to 20–30 μs. The lowest single-cell thresholds are comparable to human thresholds determined with similar stimuli. This finding suggests that the highly accurate sound localization of human observers is consistent with the resolution of single cells and need not reflect the combined activity of many neurons. PMID:11707595

  3. Cardiac Perforation by Migrated Fractured Strut of Inferior Vena Cava Filter Mimicking Acute Coronary Syndrome.

    PubMed

    Piercecchi, Chris W; Vasquez, Julio C; Kaplan, Stephen J; Hoffman, Jordan; Puskas, John D; DeLaRosa, Jacob

    2017-02-01

    We present a rare late complication after inferior vena cava filter (IVC) placement. A 52-year-old woman with an IVC presented with sudden onset of chest pain. Cardiac catheterisation and echocardiography revealed an embolised IVC filter strut penetrating the right ventricle. Endovascular retrieval was considered but deemed unsafe due to proximity to the right coronary artery and concern for migration to pulmonary circulation. Urgent removal of the strut was performed via sternotomy. The postoperative course was uneventful. Two weeks later, she was asymptomatic. Minimally invasive approaches have been described for retrieval of intact IVC filters that have migrated to the right heart but not for embolised filter fragments. We recommend traditional sternotomy as the preferred method of retrieval as it limits the likelihood of further migration or trauma.

  4. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    PubMed Central

    Charlagorla, Pradeepkumar; Breinholt, John P.

    2016-01-01

    Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly. PMID:27212858

  5. Matching categorical object representations in inferior temporal cortex of man and monkey.

    PubMed

    Kriegeskorte, Nikolaus; Mur, Marieke; Ruff, Douglas A; Kiani, Roozbeh; Bodurka, Jerzy; Esteky, Hossein; Tanaka, Keiji; Bandettini, Peter A

    2008-12-26

    Inferior temporal (IT) object representations have been intensively studied in monkeys and humans, but representations of the same particular objects have never been compared between the species. Moreover, IT's role in categorization is not well understood. Here, we presented monkeys and humans with the same images of real-world objects and measured the IT response pattern elicited by each image. In order to relate the representations between the species and to computational models, we compare response-pattern dissimilarity matrices. IT response patterns form category clusters, which match between man and monkey. The clusters correspond to animate and inanimate objects; within the animate objects, faces and bodies form subclusters. Within each category, IT distinguishes individual exemplars, and the within-category exemplar similarities also match between the species. Our findings suggest that primate IT across species may host a common code, which combines a categorical and a continuous representation of objects.

  6. Transient Automatic Writing Behavior following a Left Inferior Capsular Genu Infarction

    PubMed Central

    Suzuki, Keisuke; Miyamoto, Tomoyuki; Miyamoto, Masayuki; Hirata, Koichi

    2009-01-01

    A 79-year-old, right-handed woman was admitted to the hospital with decreased spontaneity. Brain magnetic resonance imaging showed a left inferior capsular genu infarction. 99m TC-ECD single-photon emission computed tomography revealed a left-dominant diffuse hypoperfusionin the basal ganglia and frontal lobe. The patient showed abulia and increased writing activity without motor or sensory deficit. The writing was mainly perseverative, and words written along lines were legible and without spatial distortions. This augmented writing behavior disappeared on day 21. The writing characteristic was more similar to automatic writing behavior than hypergraphia. Dissociation between speech and writing behavior was present in our patient. We suggest that a disconnection within the frontal-subcortical circuit contributed to the development of motor perseveration in writing. PMID:20847925

  7. High baseline activity in inferior temporal cortex improves neural and behavioral discriminability during visual categorization

    PubMed Central

    Emadi, Nazli; Rajimehr, Reza; Esteky, Hossein

    2014-01-01

    Spontaneous firing is a ubiquitous property of neural activity in the brain. Recent literature suggests that this baseline activity plays a key role in perception. However, it is not known how the baseline activity contributes to neural coding and behavior. Here, by recording from the single neurons in the inferior temporal cortex of monkeys performing a visual categorization task, we thoroughly explored the relationship between baseline activity, the evoked response, and behavior. Specifically we found that a low-frequency (<8 Hz) oscillation in the spike train, prior and phase-locked to the stimulus onset, was correlated with increased gamma power and neuronal baseline activity. This enhancement of the baseline activity was then followed by an increase in the neural selectivity and the response reliability and eventually a higher behavioral performance. PMID:25404900

  8. Avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissue.

    PubMed

    Resnick, J M; Carrasco, C H; Edeiken, J; Yasko, A W; Ro, J Y; Ayala, A G

    1996-08-01

    Patients who have sustained an avulsion fracture and present clinically during the healing phase of the injury may manifest a mass that clinically and radiographically mimics a malignant neoplasm. A 15-year-old male soccer goalkeeper presented with a large ossified mass in the soft tissues overlying the right hip 6 months after experiencing a popping sensation in his hip joint during a game. Although an osteosarcoma was suspected clinically and radiographically, a Tru-Cut needle biopsy of the lesion revealed reactive bone formation. Correlation of the clinical, radiographic, and pathologic findings indicated an avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissues. The healing phase of an avulsion fracture may clinically and radiographically be mistaken for neoplasia. In such cases, a Tru-Cut needle biopsy may reveal the reactive nature of the process.

  9. Laceration of the posterior inferior cerebellar artery by suboccipital puncture of the cisterna magna: case report.

    PubMed

    Portela, Luiz Antonio Pezzi; Souza, Valéria; Pahl, Félix Hendrick; Cardoso, Alberto Cappel; Vellutini, Eduardo de Arnaldo Silva; Mutarelli, Eduardo Genaro; Machado, Luis dos Ramos; Livramento, José Antonio

    2004-09-01

    We report the case of a 27 year old man who presented to the emergency room of a hospital with headache, vomiting and an episode of loss of conciousness. A cranial CT scan was normal and the patient discharged. Ten hours later he came to the emergency room of our hospital with the same complaints. A technically difficult cisternal puncture in an anxious patient who moved during the needle introduction was done. The CSF sample showed 1600 intact red blood cells without other alterations. His headache worsened and after 6 hours he became drowsy, numb and exhibited decerebration signs. A new CT scan showed diffuse subarachnoid and intraventricular blood. An emergency angiogram demonstrated laceration of a left posterior-inferior cerebellar artery in its retrobulbar loop with a pseudoaneurysm. He was successfully treated by surgical clipping without injury. Sixteen days later he was discharged with a normal neurological exam.

  10. Mandibular Inferior Cortical Bone Thickness on Panoramic Radiographs in Patients using Bisphosphonates

    PubMed Central

    Torres, Sandra R.; Chen, Curtis S. K.; Leroux, Brian G.; Lee, Peggy P.; Hollender, Lars G.; Lloid, Michelle; Drew, Shane Patrick; Schubert, Mark M.

    2015-01-01

    Objective To detect dimensional changes in the mandibular cortical bone associated with bisphosphonate (BP) use and to correlate the measurements of the cortical bone with the cumulative dose of BP therapy. Methods Mandibular inferior cortical bone thickness (MICBT) was measured under the mental foramen from panoramic radiographs of subjects using BP with and without bisphosphonate related osteonecrosis of the jaws (BRONJ) and controls. Results The highest mean MICBT was observed in BRONJ subjects 6.81 (± 1.35 mm), when compared to subjects using BP 5.44 (± 1.09 mm) and controls 4.79 (± 0.85 mm; p<0.01). The mean MICBT of BRONJ subjects was significantly higher than that of subjects using BP without BRONJ. There was a correlation between MICBT and cumulative dose of zolendronate. Conclusion The MICBT on panoramic radiograph is a potentially useful tool for the detection of dimensional changes associated with BP therapy. PMID:25864820

  11. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    PubMed

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  12. Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.

    PubMed

    Gurer, G; Sahin, G; Cekirge, S; Tan, E; Saribas, O

    2001-10-01

    The most frequent type of cerebellar infarcts involved the posterior inferior cerebellar artery (PICA) and superior cerebellar artery territories but bilateral involvement of lateral or medial branches of PICA is extremely rare. In this report, we present a 55-year-old male who admitted to hospital with vomiting, nausea and dizziness. On examination left-sided hemiparesia and ataxic gait were detected. Infarct on bilateral medial branch of PICA artery territories was found out with cranial magnetic resonance imaging (MRI) technique and 99% stenosis of the left vertebral artery was found out with digital subtraction arteriography. The patient was put on heparin treatment. After 3 weeks, his complaints and symptoms had disappeared except for mild gait ataxia.

  13. Aorto-gastroduodenal bypass grafting for an inferior pancreaticoduodenal aneurysm and celiac trunk thrombosis.

    PubMed

    Ritter, Jens C; Johnston, Malcolm; Caruana, Mario F; Laws, Peter E

    2010-01-01

    We present a case of a male patient diagnosed with a large inferior pancreaticoduodenal artery (IPDA) aneurysm, associated with a fresh thrombotic occlusion of the celiac trunk. Given the risk of splanchnic ischaemia, radiologic embolisation of the aneurysm combined with celiac axis stenting was deemed unsafe. Management was therefore modified to elective revascularisation of the celiac axis prior to surgical resection of the aneurysm. A retropancreatic aorto-gastroduodenal artery bypass graft was performed prior to exposing and resecting the pancreaticoduodenal artery aneurysm. This ensured near uninterrupted retrograde supply to the celiac axis during the procedure. This is an effective, efficient and expeditious patient pathway for these rare and complex aneurysms complicated by celiac trunk involvement.

  14. Successful transcatheter arterial embolization of an inferior pancreaticoduodenal artery aneurysm associated with celiac axis stenosis.

    PubMed

    Kobayashi, Toshihiko; Uenoyama, Shoichi; Isogai, Satoshi

    2004-05-01

    A case of inferior pancreaticoduodenal artery (IPDA) aneurysm associated with celiac axis stenosis was successfully treated using only transcatheter arterial embolization (TAE). A 57-year-old woman was urgently referred to our hospital with sudden abdominal pain; computed tomography revealed retroperitoneal hematoma due to bleeding from an aneurysm around the superior mesenteric artery (SMA). Selective angiography into the SMA showed an aneurysm derived from the IPDA posterior branch; the IPDA anterior branch was intact and contrast medium flowed into the common hepatic artery territory through the pancreatic arcade because of celiac axis stenosis. We subsequently performed TAE on the lesion. Arteriography after TAE showed that the aneurysm had disappeared and that the IPDA anterior branch was intact. She had no aneurysm recurrence for about two years after the treatment. We believe that TAE is effective even for a PDA aneurysm with celiac axis stenosis or occlusion. However, it is important to perform embolization precisely and over a long period.

  15. Long Term Follow up and Patient Satisfaction after Reduction Mammoplasty: Superomedial versus Inferior Pedicle

    PubMed Central

    Makboul, Mohamed; Abdelhamid, Mahmoud; Al-Attar, Ghada

    2017-01-01

    BACKGROUND Surgery for hypertrophied breast represents a challenge for plastic surgeons. The search for a good cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, with round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. METHODS This study was carried out on 60 cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and asked for late post-operative results and overall patients’ satisfaction. RESULTS Long term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistical significant difference. No statistical significant difference was observed between patients undergone either types of operations concerning breast symmetry, nipple symmetry and sensation. The mean score of satisfaction was higher among patients undergone superomedial pedicle than inferior pedicle. CONCLUSION The superomedial pedicle shows better long term cosmetic result in reduction mammoplasty. PMID:28289618

  16. Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

    PubMed

    González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

    2010-08-01

    The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal.

  17. Displaced calcium hydroxide paste causing inferior alveolar nerve paraesthesia: report of a case.

    PubMed

    Ahlgren, Fredrik K E K; Johannessen, Anne Christine; Hellem, Sølve

    2003-12-01

    A patient presented with an intraoral red, painful, and hard swelling in the lower right jaw. Radiographs showed a 2 x 1 cm area of radiopaque material surrounding the apex of the second premolar. The material, according to the patient's dentist, was calcium hydroxide paste used as a temporary dressing material in the root canal. The patient developed paraesthesia in her lower lip probably due to a neurotoxic effect caused by calcium hydroxide. The foreign material was surgically excavated from the spongious bone, directly adjacent to the nerve, and the patient later regained her sensation in the lip. A histopathological analysis revealed necrosis, deposits of foreign bodies, and inflammatory cells and foreign-body giant cells. This report illustrates the toxicity and adjacent clinical symptoms of calcium hydroxide paste when displaced into bone tissue close to the alveolar inferior nerve. It also demonstrates the benefits of removing such displaced material before symptoms progress.

  18. Left-Sided Inferior Vena Cava Encountered During Organ Retrieval Surgery: Report of Two Cases

    PubMed Central

    Rajabnejad, Y.; Aliakbarian, M.; Rajabnejad, A.; Motie, M. R.

    2016-01-01

    Left-sided inferior vena cava (IVC) is the second most common anatomical anomaly of the IVC after duplication. Herein, we present two cases of left-sided IVC, diagnosed during organ retrieval procedure. In a young brain-dead man, a single left-sided IVC was observed; it originated from iliac confluence in the left side of the aorta and extended throughout the abdomen. There was no retrohepatic IVC in the patient; hepatic veins drained directly into the right atrium. The second case was a brain-dead young woman with a left-sided IVC originated from iliac confluence to the kidney level; then, the IVC crossed anterior to the abdominal aorta to join a normally positioned retrohepatic IVC. In cases of retroperitoneal surgeries, IVC anomalies should be considered during preoperative imaging studies, because they may be misdiagnosed as para-aortic lymphadenopathy, tumor or dilated gonadal vein that may result in iatrogenic damage during surgery. PMID:28078062

  19. Tonotopic and localized pathways from primary auditory cortex to the central nucleus of the inferior colliculus

    PubMed Central

    Markovitz, Craig D.; Tang, Tien T.; Lim, Hubert H.

    2013-01-01

    Descending projections from the cortex to subcortical structures are critical for auditory plasticity, including the ability for central neurons to adjust their frequency tuning to relevant and meaningful stimuli. We show that focal electrical stimulation of primary auditory cortex in guinea pigs produces excitatory responses in the central nucleus of the inferior colliculus (CNIC) with two tonotopic patterns: a narrow tuned pattern that is consistent with previous findings showing direct frequency-aligned projections; and a broad tuned pattern in which the auditory cortex can influence multiple frequency regions. Moreover, excitatory responses could be elicited in the caudomedial portion along the isofrequency laminae of the CNIC but not in the rostrolateral portion. This descending organization may underlie or contribute to the ability of the auditory cortex to induce changes in frequency tuning of subcortical neurons as shown extensively in previous studies. PMID:23641201

  20. Supradiaphragmatic Inferior Vena Caval Thrombectomy Without Cardiopulmonary Bypass: A Case Series at a Single Center

    PubMed Central

    Soleimani, Mohammad; Mohammadi, Reza; Masoumi, Navid; Safarinejad, Mohammad Reza

    2016-01-01

    Introduction Inferior vena cava tumor thrombectomy in renal cell carcinoma patients is a challenging procedure, frequently requiring the vascular bypass technique for high-level thrombi with additional complications. Adopting a technique such as intrapericardial control in selected cases will circumvent these problems. Here, we present the results of our intrapericardial control technique during supradiaphragmatic inferior vena caval tumor thrombectomy. Case Presentation The records of six patients with supradiaphragmatic tumor thrombi, who underwent radical nephrectomy and thrombectomy at our center with intrapericardial control between the years 2008 and 2015, were retrospectively reviewed. The patients’ characteristics, intra- and postoperative data, histology, and follow-up records were gathered and compared. There were no immediate or 30-day postoperative deaths. The mean age of the patients was 61.3 years (range 46 - 75). The total mean duration of surgery was 315 minutes and the mean amount of transfused red blood cells was 4.33 units during surgery and 0.8 units in the postoperative period. The average hospitalization duration was 8 days (range 5 - 17). Tumor stage was T3 in four patients and T4 in two, due to ipsilateral adrenal involvement. The mean duration of follow-up was 33.5 months. Only one of the patients developed recurrences, first in the tumor bed and then at the site of the skin incision; these were excised with no apparent complications. Conclusions Radical nephrectomy and tumor thrombectomy by intrapericardial control without cardiopulmonary bypass and hypothermic circulatory arrest is a safe and effective procedure that can avoid serious intra- and postoperative complications while providing acceptable cancer-control and mortality results. PMID:27878115

  1. Digital versus conventional panoramic radiography in predicting inferior alveolar nerve injury after mandibular third molar removal.

    PubMed

    Szalma, József; Lempel, Edina; Jeges, Sára; Olasz, Lajos

    2012-03-01

    The aim of the study was to compare the accuracy of conventional and digital panoramic radiography (OPG) in relation to 4 specific high-risk signs (interruption of the superior cortical line, diversion, narrowing of the canal, and dark band of the root), which would indicate a close anatomic relationship between third molar roots and the inferior alveolar canal.Four hundred mandibular third molar surgical removals after conventional and 272 after digital radiographs were evaluated in the study. The association between postoperative inferior alveolar nerve (IAN) paresthesia and the presence of any preoperative high-risk signs in the OPG was investigated. Bivariate and multivariate logistic regression analyses were completed to compare the accuracy of conventional and digital radiographic techniques detecting high-risk signs predicting possible IAN paresthesia.Digital OPG results showed significantly higher sensitivity in diversion (P = 0.014) and narrowing (P < 0.002) of the canal, whereas the specificity of these signs was significantly lower (P < 0.001 and P = 0.035). The likelihood ratio analysis and multivariate logistic regression analysis did not prove the significant difference between digital and conventional imaging according to the examined high-risk signs. Positive predictive values of the signs were found in conventional radiography between 3.6% and 10.9%, whereas in the digital images, it ranged from 2.9% to 7.9%.The results of this study failed to prove significant difference between the accuracy of digital and conventional OPG for predicting IAN paresthesia, whereas low positive predictive values indicate both imaging techniques as inadequate screening methods for predicting IAN paresthesia after mandibular third molar removal.

  2. Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

    PubMed Central

    Ozen, Tuncer; Orhan, Kaan; Gorur, Ilker; Ozturk, Adnan

    2006-01-01

    Background The most severe complication after the removal of mandibular third molars is injury to the inferior alveolar nerve or the lingual nerve. These complications are rather uncommon (0.4% to 8.4%) and most of them are transient. However, some of them persist for longer than 6 months, which can leave various degrees of long-term permanent disability. While several methods such as pharmacologic therapy, microneurosurgery, autogenous and alloplastic grafting can be used for the treatment of long-standing sensory aberrations in the inferior alveolar nerve, there are few reports regarding low level laser treatment. This paper reports the effects of low level laser therapy in 4 patients with longstanding sensory nerve impairment following mandibular third molar surgery. Methods Four female patients had complaints of paresthesia and dysesthesia of the lip, chin and gingiva, and buccal regions. Each patient had undergone mandibular third molar surgery at least 1 year before. All patients were treated with low level laser therapy. Clinical neurosensory tests (the brush stroke directional discrimination test, 2-point discrimination test, and a subjective assessment of neurosensory function using a visual analog scale) were used before and after treatment, and the responses were plotted over time. Results When the neurosensory assessment scores after treatment with LLL therapy were compared with the baseline values prior to treatment, there was a significant acceleration in the time course, as well as in the magnitude, of neurosensory return. The VAS analysis revealed progressive improvement over time. Conclusion Low level laser therapy seemed to be conducive to the reduction of long-standing sensory nerve impairment following third molar surgery. Further studies are worthwhile regarding the clinical application of this treatment modality. PMID:16480503

  3. Distinct roles of left inferior frontal regions that explain individual differences in second language acquisition.

    PubMed

    Sakai, Kuniyoshi L; Nauchi, Arihito; Tatsuno, Yoshinori; Hirano, Kazuyoshi; Muraishi, Yukimasa; Kimura, Masakazu; Bostwick, Mike; Yusa, Noriaki

    2009-08-01

    Second language (L2) acquisition is more susceptible to environmental and idiosyncratic factors than first language acquisition. Here, we used functional magnetic resonance imaging for L2 learners of different ages of first exposure (mean: 12.6 and 5.6 years) in a formal school environment, and compared the cortical activations involved in processing English sentences containing either syntactic or spelling errors, where the testing ages and task performances of both groups were matched. We found novel activation patterns in two regions of the left inferior frontal gyrus (IFG) that correlated differentially with the performances of the late and early learners. Specifically, activations of the dorsal and ventral triangular part (F3t) of the left IFG correlated positively with the accuracy of the syntactic task for the late learners, whereas activations of the left ventral F3t correlated negatively with the accuracy for the early learners. In contrast, other cortical regions exhibited differential correlation patterns with the reaction times (RTs) of the syntactic task. Namely, activations of the orbital part (F3O) of the left IFG, as well as those of the left angular gyrus, correlated positively with the RTs for the late learners, whereas those activations correlated negatively with the RTs for the early learners. Moreover, the task-selective activation of the left F3O was maintained for both the late and early learners. These results explain individual differences in L2 acquisition, such that the acquisition of linguistic knowledge in L2 is subserved by at least two distinct inferior frontal regions of the left F3t and F3O.

  4. Comparison of Astigmatism Induced by Combined Inferior Oblique Anterior Transposition Procedure and Lateral Rectus Recession Alone

    PubMed Central

    Eum, Sun Jung

    2016-01-01

    Purpose The purpose of this study is to compare the magnitude and axis of astigmatism induced by a combined inferior oblique (IO) anterior transposition procedure with lateral rectus (LR) recession versus LR recession alone. Methods Forty-six patients were retrospectively analyzed. The subjects were divided into two groups: those having concurrent inferior oblique muscle overaction (IOOA) and intermittent exotropia (group 1, 20 patients) and those having only intermittent exotropia as a control (group 2, 26 patients). Group 1 underwent combined anterior transposition of IO with LR recession and group 2 underwent LR recession alone. Induced astigmatism was defined as the difference between preoperative and postoperative astigmatism using double-angle vector analysis. Cylinder power, axis of induced astigmatism, and spherical equivalent were analyzed at 1 week, 1 month, and 3 months after surgery. Results Larger changes in the axis of induced astigmatism were observed in group 1, with 4.5° incyclotorsion, than in group 2 at 1 week after surgery (axis, 84.5° vs. 91°; p < 0.001). However, there was no statistically significant inter-group difference thereafter. Relaxation and rapid regression in the incyclotorsion of induced astigmatism were observed over-time. Spherical equivalent significantly decreased postoperatively at 1 month in both groups, indicating a myopic shift (p = 0.011 for group 1 and p = 0.019 for group 2) but did not show significant differences at 3 months after surgery (p = 0.107 for group 1 and p = 0.760 for group 2). Conclusions Combined IO anterior transposition procedures caused an increased change in the axis of induced astigmatism, including temporary incyclotorsion, during the first week after surgery. However, this significant difference was not maintained thereafter. Thus, combined IO surgery with LR recession does not seem to produce a sustained astigmatic change, which can be a potential risk factor of postoperative amblyopia or

  5. Infrahepatic inferior caval and azygos vein formation in mammals with different degrees of mesonephric development.

    PubMed

    Hikspoors, Jill P J M; Mekonen, Hayelom K; Mommen, Greet M C; Cornillie, Pieter; Köhler, S Eleonore; Lamers, Wouter H

    2016-03-01

    Controversies regarding the development of the mammalian infrahepatic inferior caval and azygos veins arise from using topography rather than developmental origin as criteria to define venous systems and centre on veins that surround the mesonephros. We compared caudal-vein development in man with that in rodents and pigs (rudimentary and extensive mesonephric development, respectively), and used Amira 3D reconstruction and Cinema 4D-remodelling software for visualisation. The caudal cardinal veins (CCVs) were the only contributors to the inferior caval (IVC) and azygos veins. Development was comparable if temporary vessels that drain the large porcine mesonephros were taken into account. The topography of the CCVs changed concomitant with expansion of adjacent organs (lungs, meso- and metanephroi). The iliac veins arose by gradual extension of the CCVs into the caudal body region. Irrespective of the degree of mesonephric development, the infrarenal part of the IVC developed from the right CCV and the renal part from vascular sprouts of the CCVs in the mesonephros that formed 'subcardinal' veins. The azygos venous system developed from the cranial remnants of the CCVs. Temporary venous collaterals in and around the thoracic sympathetic trunk were interpreted as 'footprints' of the dorsolateral-to-ventromedial change in the local course of the intersegmental and caudal cardinal veins relative to the sympathetic trunk. Interspecies differences in timing of the same events in IVC and azygos-vein development appear to allow for proper joining of conduits for caudal venous return, whereas local changes in topography appear to accommodate efficient venous perfusion. These findings demonstrate that new systems, such as the 'supracardinal' veins, are not necessary to account for changes in the course of the main venous conduits of the embryo.

  6. Significance of Radiological Variables Studied on Orthopantamogram to Pridict Post-Operative Inferior Alveoler Nerve Paresthesia After Third Molar Extraction

    PubMed Central

    Mishra, Nitin; Rastogi, Madhur Kant; Sharma, Shalini

    2014-01-01

    Context: Removal of impacted third molar is a procedure that is often associated with post-operative complications. The rate of complications is somewhat high because of its proximity to the vital structures. Inferior alveolar nerve paresthesia is one of the common complications of impacted their molar surgery. This is due to intimate relationship between roots of mandibular third molar and inferior alveolar canal. To access the proximity of inferior alveolar canal to third molar many diagnostic methods are suggested but in conventional radiography orthopantamogram is considered as the best. There are many findings onorthopantamogram that are suggestive of close proximity of nerve to the canal. In this study authors reviewed seven radiographic findings related to proximity of roots to the inferior alveolar nerve as seen on orthopantamogram and try to find a relationship between these radiographic variables and presence of post-operative paresthesia. Study Design: The study containd 100 impacted third molars need to be removed. Presence of radiographic findings on orthopantamogram were noted and analyzed, to find a relationship with occurrence of post-operative inferior alveolar nerve paresthesia. Materials and Methods: This study comprises of 100 impacted third molar teeth indicated for extraction. Cases were randomly selected from the patients, needs to undergo extraction of impacted mandibular third molar. After extraction cases were evaluated for occurrence of inferior alveolar nerve paresthesia. Stastical Analyisis: Data was transferred to SPss 21 software for frequency calculation, and two tailed p-values were obtained betweens these variables and post-operative paresthesia, by applying Fischer’s exact test (GRAPH PAD SOFTWARE). Results: Out of seven, four radiological findings that are grooving of roots, hooked roots, bifid roots and obliteration of white line are significantly related to post-operative paresthesia while bending of canal, narrow canal and

  7. Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

    PubMed Central

    Yeow, Vincent Kok-Leng

    2014-01-01

    We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects. PMID:24511499

  8. [Intraluminal dilation of inferior vena cava stenosis after repair of the scimitar syndrome in an adult patient].

    PubMed

    Benito Bartolomé, Fernando; González García, Ana; Oliver Ruiz, José M

    2002-02-01

    A 39 year-old woman diagnosed with anomalous drainage of middle and lower right pulmonary veins to the inferior vena cava was corrected surgically by means of baffle with patch up to the left atrium. Early after the operation the patient related intolerance to small efforts and an episode of syncope. The cardiac catheterization demonstrated the presence of a severe stenosis in the inferior vena cava, in its union with the right atrium, that was successfully treated by means of intraluminal percutaneous dilation with a catheter of Inoue. After the procedure the gradient decreased and she improved tolerance to effort, which persisted 10 months later.

  9. Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

    PubMed Central

    Fujita, Shuichi; Takahashi, Hideaki; Kanzaki, Yumiko; Fujisaka, Tomohiro; Takeda, Yoshihiro; Ozawa, Hideki; Kuwabara, Hiroko; Katsumata, Takahiro; Ishizaka, Nobukazu

    2016-01-01

    A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin) followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava. PMID:27920691

  10. New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio

    NASA Astrophysics Data System (ADS)

    Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

    2013-09-01

    In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

  11. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen.

    PubMed

    Heller, A A; Shankland, W E

    2001-01-01

    Local anesthesia block of the inferior alveolar nerve is routinely taught throughout dental education. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. Generally, the dentist or surgeon desires these structures to be anesthetized. However, in the placement of mandibular implants, it may be useful for the patient to be able to sense when the inferior alveolar nerve is in danger of being damaged, possibly producing permanent paresthesia. In this article, the technique of mandibular infiltration prior to mandibular implant placement in the mandible is discussed.

  12. Does the inferior frontal sulcus play a functional role in deception? A neuronavigated theta-burst transcranial magnetic stimulation study.

    PubMed

    Verschuere, Bruno; Schuhmann, Teresa; Sack, Alexander T

    2012-01-01

    By definition, lying involves withholding the truth. Response inhibition may therefore be the cognitive function at the heart of deception. Neuroimaging research has shown that the same brain region that is activated during response inhibition tasks, namely the inferior frontal region, is also activated during deception paradigms. This led to the hypothesis that the inferior frontal region is the neural substrate critically involved in withholding the truth. In the present study, we critically examine the functional necessity of the inferior frontal region in withholding the truth during deception. We experimentally manipulated the neural activity level in right inferior frontal sulcus (IFS) by means of neuronavigated continuous theta-burst stimulation (cTBS). Individual structural magnetic resonance brain images (MRI) were used to allow precise stimulation in each participant. Twenty-six participants answered autobiographical questions truthfully or deceptively before and after sham and real cTBS. Deception was reliably associated with more errors, longer and more variable response times than truth telling. Despite the potential role of IFS in deception as suggested by neuroimaging data, the cTBS-induced disruption of right IFS did not affect response times or error rates, when compared to sham stimulation. The present findings do not support the hypothesis that the right IFS is critically involved in deception.

  13. Caudally directed Inferior facetal and transfacetal screws for C1-C2 and C1-2-3 fixation.

    PubMed

    Goel, Atul

    2017-01-13

    An alternative caudally directed C2 inferior facetal screw is described. Such screw insertion can form the axial stabilization point in cases undergoing atlantoaxial lateral mass plate/rod and screw fixation and those undergoing C1-2and C1-2-3 spinal fixation. The C2 screw courses from the medial point of pedicle-laminar junction and travels caudally and laterally towards the C2-3 articulation. Deploying a longer screw that traverses in a transarticular fashion into the facetal mass of C3 vertebra one can perform C1-2-3 stabilization.Sixteen patients underwent C2 inferior facetal or C2-3 transarticular screw in combination with C1 screw for atlantoaxial fixation. Three of these patients with multilevel spinal instability underwent atlantoaxial and C2-3 fixation using the discussed technique. The technical issues, anatomical subtleties and indication for the use of the C2 inferior facetal screws are discussed. With an average follow-up of 9 months, all screws have successfully provided stability that resulted in arthrodesis of the treated spinal segments. Caudally directed C2 inferior facetal screw can enhance the armamentarium of the surgeon, provide an alternative to conventional techniques or a bailout option and add to safety of the procedure of atlantoaxial lateral mass fixation in anatomically challenged situations.

  14. Acute inferior myocardial infarction in a patient with a prosthetic aortic valve and high international normalized ratio

    PubMed Central

    Sari, Ibrahim; Delil, Kenan; Ileri, Cigdem; Samadov, Fuad

    2014-01-01

    ST elevation acute myocardial infarction in patients with a mechanical prosthetic valve is rare and usually due to inadequate anticoagulation. We present a case of acute inferior myocardial infarction in a patient with a prosthetic aortic valve and high international normalized ratio, which has not been reported previously. PMID:24799934

  15. Use of a retrievable inferior vena cava filter in term pregnancy: case report and review of literature.

    PubMed

    Milford, William; Chadha, Yogesh; Lust, Karin

    2009-06-01

    Venous thromboembolism is a significant cause of morbidity and mortality in obstetrics. Management with anticoagulation can be problematic, especially peripartum. We report the successful placement and retrieval of an inferior vena cava filter as prophylaxis for peripartum pulmonary embolism in a woman with a large, proximal, deep venous thrombosis at term.

  16. Computed Tomography-Guided Central Venous Catheter Placement in a Patient with Superior Vena Cava and Inferior Vena Cava Occlusion

    SciTech Connect

    Rivero, Maria A.; Shaw, Dennis W.W.; Schaller, Robert T. Jr.

    1999-01-15

    An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via a large tributary to the azygos vein.

  17. An unusual case: a giant paraesophageal hiatal hernia with intrathoracic spleen, preduodenal portal vein, malrotation, and left inferior vena cava.

    PubMed

    Başaklar, A Can; Sönmez, Kaan; Karabulut, Ramazan; Türkyilmaz, Zafer; Moralioğlu, Serdar

    2007-12-01

    A giant paraesophageal hiatal hernia with preduodenal portal vein, nonrotating gut, intrathoracic spleen, and left inferior vena cava has not been reported to date. This set of complex anomalies can have significant clinical implications. Awareness of these anomalies is essential to avoid further complications.

  18. Familiarity breeds plasticity: distinct effects of experience on putative excitatory and inhibitory neurons in inferior temporal cortex.

    PubMed

    Freedman, David J

    2012-04-12

    Primates have a remarkable capacity to recognize a vast array of visual objects, an ability that depends on experience. In this issue of Neuron, Woloszyn and Sheinberg (2012) report that putative excitatory and inhibitory neurons in inferior temporal cortex exhibit distinct influences long-term visual experience.

  19. Precordial ST segment depression during acute inferior myocardial infarction: early thallium-201 scintigraphic evidence of adjacent posterolateral or inferoseptal involvement

    SciTech Connect

    Lew, A.S.; Weiss, A.T.; Shah, P.K.; Maddahi, J.; Peter, T.; Ganz, W.; Swan, H.J.; Berman, D.S.

    1985-02-01

    To investigate the myocardial perfusion correlates of precordial ST segment depression during acute inferior myocardial infarction, a rest thallium-201 scintigram and a closely timed 12 lead electrocardiogram were obtained within 6 hours of the onset of infarction in 44 patients admitted with their first acute inferior myocardial infarction. Thirty-six patients demonstrated precordial ST segment depression (group 1) and eight did not (group 2). A perfusion defect involving the inferior wall was present in all 44 patients. Additional perfusion defects of the adjacent posterolateral wall (n . 20), the ventricular septum (n . 9) or both (n . 6) were present in 35 of 36 patients from group 1 compared with only 1 of 8 patients from group 2 (p less than 0.001). There was no significant difference in the frequency of multivessel coronary artery disease or disease of the left anterior descending artery between group 1 and group 2 or between patients with and those without a thallium-201 perfusion defect involving the ventricular septum. Thus, precordial ST segment depression during an acute inferior myocardial infarction is associated with thallium-201 scintigraphic evidence of more extensive involvement of the adjacent posterolateral or inferoseptal myocardial segments, which probably reflects the extent and pattern of distribution of the artery of infarction, rather than the presence of coexistent multivessel coronary artery disease or disease of the left anterior descending artery.

  20. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    SciTech Connect

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-07-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both.

  1. The role of GABAergic inhibition in shaping directional selectivity of bat inferior collicular neurons determined with temporally patterned pulse trains.

    PubMed

    Zhou, X M; Jen, P H-S

    2002-11-01

    This study examined the role of GABAergic inhibition in shaping directional selectivity of neurons in the inferior colliculus of the big brown bat, Eptesicus fuscus. When determined with temporally patterned pulse trains at different pulse repetition rates, 93 inferior colliculus neurons displayed three types of directional selectivity curves. A directionally selective curve always showed a maximum to a certain azimuthal angle (the best angle). A hemifield curve showed a maximum to a range of contralateral azimuthal angles. A non-directional curve did not show a maximum to any particular azimuthal angles. Directional selectivity curves of 42% neurons changed from hemifield or non-directional to directionally selective and the best angles of 16-21% neurons shifted toward the midline with increasing pulse repetition rate of pulse trains. Directional selectivity curves of most (74%) neurons that discharged impulses to each pulse of a pulse train also became sharper with increasing pulse repetition rate of pulse trains. Bicuculline application produced more pronounced broadening of directional selective curves of inferior colliculus neurons at higher than at lower pulse repetition rates. As a result, pulse repetition rate-dependent directional selectivity of inferior colliculus neurons was abolished. Possible mechanisms and biological significance of these findings are discussed.

  2. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial

    PubMed Central

    Huijbers, Marloes J.; Spinhoven, Philip; Spijker, Jan; Ruhé, Henricus G.; van Schaik, Digna J. F.; van Oppen, Patricia; Nolen, Willem A.; Ormel, Johan; Kuyken, Willem; van der Wilt, Gert Jan; Blom, Marc B. J.; Schene, Aart H.; Rogier, A.; Donders, T.; Speckens, Anne E. M.

    2016-01-01

    Background Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Aims To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. Method A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov: NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n = 249), were randomly allocated to either discontinue (n = 128) or continue (n = 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. Results The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Conclusions Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT. PMID:26892847

  3. Why I tense up when you watch me: Inferior parietal cortex mediates an audience’s influence on motor performance

    PubMed Central

    Yoshie, Michiko; Nagai, Yoko; Critchley, Hugo D.; Harrison, Neil A.

    2016-01-01

    The presence of an evaluative audience can alter skilled motor performance through changes in force output. To investigate how this is mediated within the brain, we emulated real-time social monitoring of participants’ performance of a fine grip task during functional magnetic resonance neuroimaging. We observed an increase in force output during social evaluation that was accompanied by focal reductions in activity within bilateral inferior parietal cortex. Moreover, deactivation of the left inferior parietal cortex predicted both inter- and intra-individual differences in socially-induced change in grip force. Social evaluation also enhanced activation within the posterior superior temporal sulcus, which conveys visual information about others’ actions to the inferior parietal cortex. Interestingly, functional connectivity between these two regions was attenuated by social evaluation. Our data suggest that social evaluation can vary force output through the altered engagement of inferior parietal cortex; a region implicated in sensorimotor integration necessary for object manipulation, and a component of the action-observation network which integrates and facilitates performance of observed actions. Social-evaluative situations may induce high-level representational incoherence between one’s own intentioned action and the perceived intention of others which, by uncoupling the dynamics of sensorimotor facilitation, could ultimately perturbe motor output. PMID:26787326

  4. Academic Achievement and Behavioral Health among Asian American and African American Adolescents: Testing the Model Minority and Inferior Minority Assumptions

    ERIC Educational Resources Information Center

    Whaley, Arthur L.; Noel, La Tonya

    2013-01-01

    The present study tested the model minority and inferior minority assumptions by examining the relationship between academic performance and measures of behavioral health in a subsample of 3,008 (22%) participants in a nationally representative, multicultural sample of 13,601 students in the 2001 Youth Risk Behavioral Survey, comparing Asian…

  5. Notes on testing non-inferiority under the partial verification design with a confirmatory procedure limited to screen positives.

    PubMed

    Lui, Kung-Jong

    2012-05-01

    When a new test with fewer invasions or less expenses to administer than the traditional test is developed, we may be interested in testing whether the former is non-inferior to the latter with respect to test accuracy. We define non-inferiority via both the odds ratio (OR) of correctly identifying a case and the OR of correctly identifying a non-case between two tests under comparison. We focus our discussion on testing the non-inferiority of a new screening test to a traditional screening test when a confirmatory procedure is performed only on patients with screen positives. On the basis of well-established methods for paired-sample data, we derive an asymptotic test procedure and an exact test procedure with respect to the two ORs defined here. Using Monte Carlo simulation, we evaluate the performance of these test procedures in a variety of situations. We note that the test procedures proposed here can also be applicable if we are interested in testing non-inferiority with respect to the ratio of sensitivities and the ratio of specificities. We discuss interval estimation of these ORs and sample size calculation based on the asymptotic test procedure considered here. We use the data taken from a study of the prostate-specific-antigen (PSA) test and the digital rectal examination (DRE) test to illustrate the practical use of these test procedures, interval estimators and sample size calculation formula.

  6. Anatomical Landmarks for Safe Elevation of the Deep Inferior Epigastric Perforator Flap: A Cadaveric Study

    PubMed Central

    Chowdhry, Saeed; Hazani, Ron; Collis, Philip; Wilhelmi, Bradon J.

    2010-01-01

    Background: Breast reconstruction techniques have focused increasingly on using autologous tissue, with emphasis being placed on employing muscle sparing adipocutaneous flaps to reduce abdominal wall complications such as hernias, bulges, weakness, and length of hospital stay. The result has been the emergence of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction. Isolating perforator vessels challenges most surgeons. We describe surface anatomical landmarks to predict the location of the deep inferior epigastric artery (DIEA) and its perforators to aid in the efficient elevation of this flap. Methods: Ten fresh hemi-abdomens were dissected with loupe magnification. The DIEA and its perforators were identified, and measurements in relation to the rectus muscle, xiphoid, umbilicus, and pubis were taken. Statistical analysis was undertaken to determine distance ratios to account for variance in patient size. Results: Average distance from the xiphoid to umbilicus was 18.2 ± 1.27 cm. The distance from the umbilicus to pubis was 14.9 ± 2.3 cm. The vertical distance from the umbilicus to the DRJ (DIEA rtctus junction) was 10.45 ± 1.58 cm, and the vertical distance from the level of the umbilicus to where the first DIEA perforator traverses the RAM was 7.4 ± 1.64 cm. The distance between the umbilicus and the DRJ is approximately 0.7 times the distance between the umbilicus and the pubic symphysis. The distance between the umbilicus and the first perforator is approximately 0.5 times the distance between the umbilicus and the pubic symphysis. Conclusions: Knowledge of anatomical landmarks can aid the surgeon in more efficiently harvesting the DIEP flap. Surface landmarks along the abdominal midline coupled with normalizing ratios can aid surgeons in predicting the location of the DIEA and its first perforator. The DIEA crosses the rectus at approximately two thirds of the distance between the umbilicus and pubis, and the first perforator

  7. Identification of a Circadian Clock in the Inferior Colliculus and Its Dysregulation by Noise Exposure

    PubMed Central

    Park, Jung-sub; Cederroth, Christopher R.; Basinou, Vasiliki; Meltser, Inna; Lundkvist, Gabriella

    2016-01-01

    Circadian rhythms regulate bodily functions within 24 h and long-term disruptions in these rhythms can cause various diseases. Recently, the peripheral auditory organ, the cochlea, has been shown to contain a self-sustained circadian clock that regulates differential sensitivity to noise exposure throughout the day. Animals exposed to noise during the night are more vulnerable than when exposed during the day. However, whether other structures throughout the auditory pathway also possess a circadian clock remains unknown. Here, we focus on the inferior colliculus (IC), which plays an important role in noise-induced pathologies such as tinnitus, hyperacusis, and audiogenic seizures. Using PER2::LUC transgenic mice and real-time bioluminescence recordings, we revealed circadian oscillations of Period 2 protein in IC explants for up to 1 week. Clock genes (Cry1, Bmal1, Per1, Per2, Rev-erbα, and Dbp) displayed circadian molecular oscillations in the IC. Averaged expression levels of early-induced genes and clock genes during 24 h revealed differential responses to day or night noise exposure. Rev-erbα and Dbp genes were affected only by day noise exposure, whereas Per1 and Per2 were affected only by night noise exposure. However, the expression of Bdnf was affected by both day and night noise exposure, suggesting that plastic changes are unlikely to be involved in the differences in day or night noise sensitivity in the IC. These novel findings highlight the importance of circadian responses in the IC and emphasize the importance of circadian mechanisms for understanding central auditory function and disorders. SIGNIFICANCE STATEMENT Recent findings identified the presence of a circadian clock in the inner ear. Here, we present novel findings that neurons in the inferior colliculus (IC), a central auditory relay structure involved in sound processing, express a circadian clock as evidenced at both the mRNA and protein levels. Using a reporter mouse that expresses a

  8. Non-inferiority of retrospective data collection for assessing perioperative morbidity.

    PubMed

    Patel, Amour B U; Reyes, Anna; Ackland, Gareth L

    2015-01-01

    Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS) would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time. Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients' morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence) set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam's RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test. Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [-0.13-0.013]; p < 0.001). Non-inferiority for sensitivity was observed for all other POMS domains and

  9. Non-inferiority of retrospective data collection for assessing perioperative morbidity

    PubMed Central

    Patel, Amour B.U.; Reyes, Anna

    2015-01-01

    Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS) would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time. Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients’ morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence) set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam’s RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test. Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [−0.13–0.013]; p < 0.001). Non-inferiority for sensitivity was observed for all other POMS

  10. Liver cirrhosis in hepatic vena cava syndrome (or membranous obstruction of inferior vena cava)

    PubMed Central

    Shrestha, Santosh Man

    2015-01-01

    Hepatic vena cava syndrome (HVCS) also known as membranous obstruction of inferior vena cava reported mainly from Asia and Africa is an important cause of hepatic venous outflow obstruction (HVOO) that is complicated by high incidence of liver cirrhosis (LC) and moderate to high incidence of hepatocellular carcinoma (HCC). In the past the disease was considered congenital and was included under Budd-Chiari syndrome (BCS). HVCS is a chronic disease common in developing countries, the onset of which is related to poor hygienic living condition. The initial lesion in the disease is a bacterial infection induced localized thrombophlebitis in hepatic portion of inferior vena cava at the site where hepatic veins open which on resolution transforms into stenosis, membrane or thick obstruction, and is followed by development of cavo-caval collateral anastomosis. The disease is characterized by long asymptomatic period and recurrent acute exacerbations (AE) precipitated by clinical or subclinical bacterial infection. AE is managed with prolonged oral antibiotic. Development of LC and HCC in HVCS is related to the severity and frequency of AEs and not to the duration of the disease or the type or severity of the caval obstruction. HVOO that develops during severe acute stage or AE is a pre-cirrhotic condition. Primary BCS on the other hand is a rare disease related to prothrombotic disorders reported mainly among Caucasians that clinically manifest as acute, subacute disease or as fulminant hepatic failure; and is managed with life-long anticoagulation, porto-systemic shunt/endovascular angioplasty and stent or liver transplantation. As epidemiology, etiology and natural history of HVCS are different from classical BCS, it is here, recognized as a separate disease entity, a third primary cause of HVOO after sinusoidal obstruction syndrome and BCS. Understanding of the natural history has made early diagnosis of HVCS possible. This paper describes epidemiology, natural

  11. Biomechanical evaluation of inferior scapula notching of reverse shoulder arthroplasty depending on implant configuration and scapula neck anatomy

    PubMed Central

    Smith, Tomas; Bäunker, Alexandra; Krämer, Manuel; Hurschler, Christof; Kaufmann, Melena; Pastor, Marc Frederic; Wellmann, Mathias

    2015-01-01

    Purpose: The presence of inferior scapula notching is significantly affected by the anatomy the scapula and can be influenced by the glenosphere design and position and the onlay type. Materials and Methods: A biomechanical study was undertaken with 13 human shoulder specimens in a robot-assisted shoulder simulator. Inferior scapula contact during adduction of the humerus was detected using a contact pressure film. Computed tomography scans with three-dimensional reconstructions of each specimen were performed. Results: The greatest improvement of the scapula notching angle (SNA) was achieved by simultaneous implantation of a shallow humeral onlay and an eccentric glenosphere design: 16.3-19.0° (P < 0.005). The SNA was significantly decreased by 5.8° when shifting from a 38 mm centric glenosphere to a 42 mm centric glenosphere (P < 0.005) and by 8.9° comparing the 38 mm centric glenosphere with 38 mm eccentric glenosphere (P < 0.005). The solitary implantation of a shallow onlay significantly decreased the SNA depending on the glenosphere size between 7.4° and 8.0° (P = 0.001). A more inferior position of the metaglene as well as a long scapula neck (P = 0.029) and a large lateral scapula pillar angle (P = 0.033) were correlated with a lower SNA. Conclusion: This study demonstrates the importance of inferior glenosphere placement and the benefit of eccentric glenosphere and shallow humeral cup design to reduce the adduction deficit of the reverse shoulder. The presence of a short neck of the scapula can have a negative prognostic effect on inferior impingement during adduction of the arm. Level of Evidence: Basic Science Study PMID:26622125

  12. The arcuate nucleus of the C57BL/6J mouse hindbrain is a displaced part of the inferior olive.

    PubMed

    Fu, Yu Hong; Watson, Charles

    2012-01-01

    The arcuate nucleus is a prominent cell group in the human hindbrain, characterized by its position on the pial surface of the pyramid. It is considered to be a precerebellar nucleus and has been implicated in the pathology of several disorders of respiration. An arcuate nucleus has not been convincingly demonstrated in other mammals, but we have found a similarly positioned nucleus in the C57BL/6J mouse. The mouse arcuate nucleus consists of a variable group of neurons lying on the pial surface of the pyramid. The nucleus is continuous with the ventrolateral part of the principal nucleus of the inferior olive and both groups are calbindin positive. At first we thought that this mouse nucleus was homologous with the human arcuate nucleus, but we have discovered that the neurons of the human nucleus are calbindin negative, and are therefore not olivary in nature. We have compared the mouse arcuate neurons with those of the inferior olive in terms of molecular markers and cerebellar projection. The neurons of the arcuate nucleus and of the inferior olive share three major characteristics: they both contain neurons utilizing glutamate, serotonin or acetylcholine as neurotransmitters; they both project to the contralateral cerebellum, and they both express a number of genes not present in the major mossy fiber issuing precerebellar nuclei. Most importantly, both cell groups express calbindin in an area of the ventral hindbrain almost completely devoid of calbindin-positive cells. We conclude that the neurons of the hindbrain mouse arcuate nucleus are a displaced part of the inferior olive, possibly separated by the caudal growth of the pyramidal tract during development. The arcuate nucleus reported in the C57BL/6J mouse can therefore be regarded as a subgroup of the rostral inferior olive, closely allied with the ventral tier of the principal nucleus.

  13. Telephone Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Non-inferiority Trial

    PubMed Central

    Turner, Cynthia M.; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

    2014-01-01

    Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children’s Yale–Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information–Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. PMID:25457928

  14. Microinfusion of nefazodone into the basolateral nucleus of the amygdala enhances defensive behavior induced by NMDA stimulation of the inferior colliculus.

    PubMed

    Maisonnette, S; Villela, C; Carotti, A P; Landeira-Fernandez, J

    2000-01-01

    The inferior colliculus is notably associated with defensive behavior. Electrical or pharmacological stimulation of the inferior colliculus induces aversive reactions such as running and jumping. Lesion of the basolateral nucleus of the amygdala decreases the threshold of aversive reactions induced by electrical stimulation of the inferior colliculus. The present work examined the influence of microinjections of nefazodone, a serotonin (5-HT(2)) antagonist, into the basolateral nucleus of amygdala on aversive reactions induced by N-methyl-D-aspartate (NMDA) microinjected into the inferior colliculus. Rats implanted with cannulae in the inferior colliculus and in the basolateral nucleus of the amygdala were submitted to the open-field test where defensive behaviors were observed. Results indicated that microinjection of nefazodone into the basolateral nucleus of the amygdala increases aversive responses induced by NMDA injections into the inferior colliculus. This result suggests that the inferior colliculus and the basolateral nucleus of the amygdala have a functional relationship on the neural circuitry of defensive behavior. Moreover, 5-HT(2) receptors located at the basolateral nucleus of the amygdala seem to play an inhibitory role on defensive behaviors induced by inferior colliculus stimulation.

  15. A function for binaural integration in auditory grouping and segregation in the inferior colliculus.

    PubMed

    Nakamoto, Kyle T; Shackleton, Trevor M; Magezi, David A; Palmer, Alan R

    2015-03-15

    Responses of neurons to binaural, harmonic complex stimuli in urethane-anesthetized guinea pig inferior colliculus (IC) are reported. To assess the binaural integration of harmonicity cues for sound segregation and grouping, responses were measured to harmonic complexes with different fundamental frequencies presented to each ear. Simultaneously gated harmonic stimuli with fundamental frequencies of 125 Hz and 145 Hz were presented to the left and right ears, respectively, and recordings made from 96 neurons with characteristic frequencies >2 kHz in the central nucleus of the IC. Of these units, 70 responded continuously throughout the stimulus and were excited by the stimulus at the contralateral ear. The stimulus at the ipsilateral ear excited (EE: 14%; 10/70), inhibited (EI: 33%; 23/70), or had no significant effect (EO: 53%; 37/70), defined by the effect on firing rate. The neurons phase locked to the temporal envelope at each ear to varying degrees depending on signal level. Many of the cells (predominantly EO) were dominated by the response to the contralateral stimulus. Another group (predominantly EI) synchronized to the contralateral stimulus and were suppressed by the ipsilateral stimulus in a phasic manner. A third group synchronized to the stimuli at both ears (predominantly EE). Finally, a group only responded when the waveform peaks from each ear coincided. We conclude that these groups of neurons represent different "streams" of information but exhibit modifications of the response rather than encoding a feature of the stimulus, like pitch.

  16. Echocardiographic Characterization of the Inferior Vena Cava in Trained and Untrained Females.

    PubMed

    Hedman, Kristofer; Nylander, Eva; Henriksson, Jan; Bjarnegård, Niclas; Brudin, Lars; Tamás, Éva

    2016-12-01

    The aim of the study was to explore the long- and short-axis dimensions, shape and collapsibility of the inferior vena cava in 46 trained and 48 untrained females (mean age: 21 ± 2 y). Echocardiography in the subcostal view revealed a larger expiratory long-axis diameter (mean: 24 ± 3 vs. 20 ± 3 mm, p < 0.001) and short-axis area (mean: 5.5 ± 1.5 vs. 4.7 ± 1.4 cm(2), p = 0.014) in trained females. IVC shape (the ratio of short-axis major to minor diameters) and the relative decrease in IVC dimension with inspiration were similar for the two groups. The IVC long-axis diameter reflected short-axis minor diameter and was correlated to maximal oxygen uptake (r = 0.52, p < 0.01). In summary, the results indicate that trained females have a larger IVC similar in shape and respiratory decrease in dimensions to that of untrained females. The long-axis diameter corresponded closely to short-axis minor diameter and, thus, underestimates maximal IVC diameter.

  17. Failure rate of inferior alveolar nerve block among dental students and interns

    PubMed Central

    AlHindi, Maryam; Rashed, Bayan; AlOtaibi, Noura

    2016-01-01

    Objectives: To report the failure rate of inferior alveolar nerve block (IANB) among dental students and interns, causes of failure, investigate awareness of different IANB techniques, and to report IANB-associated complications. Methods: A 3-page questionnaire containing 13 questions was distributed to a random sample of 350 third to fifth years students and interns at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia on January 2011. It included demographic questions (age, gender, and academic level) and questions on IANB failure frequency and reasons, actions taken to overcome the failure, and awareness of different anesthetic techniques, supplementary techniques, and complications. Results: Of the 250 distributed questionnaires, 238 were returned (68% response rate). Most (85.7%) of surveyed sample had experienced IANB failure once or twice. The participants attributed the failures most commonly (66.45%) to anatomical variations. The most common alternative technique used was intraligamentary injection (57.1%), although 42.8% of the sample never attempted any alternatives. Large portion of the samples stated that they either lacked both knowledge of and training for other techniques (44.9%), or that they had knowledge of them but not enough training to perform them (45.8%). Conclusion: To decrease IANB failure rates for dental students and interns, knowledge of landmarks, anatomical variation and their training in alternatives to IANB, such as the Gow-Gates and Akinosi techniques, both theoretically and clinically in the dental curriculum should be enhanced. PMID:26739980

  18. Modeling Flow Past a TrapEase Inferior Vena Cava Filter

    NASA Astrophysics Data System (ADS)

    Singer, Michael; Henshaw, William; Wang, Stephen

    2008-11-01

    This study uses three-dimensional computational fluid dynamics to evaluate the efficacy of the TrapEase inferior vena cava (IVC) filter. Hemodynamics of the unoccluded and partially occluded filter are examined, and the clinical implications are assessed. The IVC, which is the primary vein that drains the legs, is modeled as a straight pipe, and a geometrically accurate model of the filter is constructed using computer aided design. Blood is modeled as a homogeneous, incompressible, Newtonian fluid, and the method of overset grids is used to solve the Navier-Stokes equations. Results are corroborated with in-vitro studies. Flow around the unoccluded filter demonstrates minimal disruption, but spherical clots in the downstream trapping position lead to regions of stagnant and recirculating flow that may promote further clotting. The volume of stagnant flow and the peak wall shear stress increase with clot volume. For clots trapped in the upstream trapping position, flow is disrupted along the cava wall downstream of the clot and within the filter. The shape and location of trapped clots also effect the peak wall shear stress and may impact the efficacy of the filter.

  19. Inferior Oblique Weakening and Abnormal Head Position: Controlled Myotomy versus Recession

    PubMed Central

    Migliorini, R.; Malagola, R.; Comberiati, A. M.

    2016-01-01

    Purpose. Randomized controlled trial aimed at comparing surgical outcomes in a group of patients suffering from hyperfunction of the inferior oblique (IO) muscle with abnormal head position (AHP). The surgical techniques being compared are Recession and (thread) Controlled Myotomy. Materials and Methods. The group of 20 patients suffering from medium-high hyperfunction of the IO was assessed through an ophthalmological and orthoptic examination. 10 patients underwent traditional Recession (Group  A) and 10 were treated with Controlled Myotomy (Group  B). Results. The average age was 19 years ± 10.7 SD. After 1 year, 20% of Group  A showed a small Vertical Deviation associated with a small AHP, while 80% had orthophoria and 40% of them had a small AHP. 80% of Group  B showed a small Vertical Deviation associated with an equally small AHP, while 20% had orthophoria with a full resolution of AHP. Conclusion. Based on the results obtained and the fewer intrasurgical risks involved, thread Controlled Myotomy proved to be a valid alternative to Recession. Furthermore, in case of Recession, over the long period a small residual AHP remained in the patients who had orthophoria, unlike Myotomy which led to a total resolution. PMID:28018670

  20. Types of neurons in nucleus olivaris inferior of the European bison.

    PubMed

    Szteyn, S

    1988-01-01

    The studies were carried out on the medullae oblongatae of four European bisons. Preparations made by means of the Golgi technique, as well as preparations stained by the Klüver-Barrera methods, were used. Two types of neurons were distinguished in nucleus olivaris inferior of the European bison. Type I (about 90% of neurons) are multipolar cells whose perikaryons measure from 25 to 40 microns. The multipolar cells generate 5-6 thick dendrites which next give off a number of branches. The dendritic tree is ball-shaped. A single long, thin axon arises from the surface of the perikaryon or branches from the initial segment of one of the dendrites. The axon adopts a course along the plane corresponding to the transverse section of brain stem. Type II (about 10% of neurons) are pear-shaped and rounded cells measuring from 25 to 30 microns. These cells generate 2-3 thick dendritic trunks which are concentrated at one pole of the perikaryon. The dendritic tree has a stream-like form. A single short and rather thin axon emerges from the surface of the perikaryon. Its course corresponds to the long axis of brain stem.

  1. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus

    PubMed Central

    Mabe, Hiroyo; Yamada, Eiji; Masuda, Masato; Tomoda, Akemi

    2015-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV) were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG) and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG) (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05) of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01) and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset. PMID:26067825

  2. Distinct neural firing mechanisms to tonal stimuli offset in the inferior colliculus of mice in vivo.

    PubMed

    Kasai, Masatoshi; Ono, Munenori; Ohmori, Harunori

    2012-07-01

    Offset neurons, which fire at the termination of sound, likely encode sound duration and serve to process temporal information. Offset neurons are found in most ascending auditory nuclei; however, the neural mechanisms that evoke offset responses are not well understood. In this study, we examined offset neural responses to tonal stimuli in the inferior colliculus (IC) in vivo with extracellular and intracellular recording techniques in mice. Based on peristimulus time histogram (PSTH) patterns, we classified extracellular offset responses into four types: Offset, Onset-Offset, Onset-Sustained-Offset and Inhibition-Offset types. Moreover, using in vivo whole-cell recording techniques, we found that offset responses were generated in most cells through the excitatory and inhibitory synaptic inputs. However, in a small number of cells, the offset responses were generated as a rebound to hyperpolarization during tonal stimulation. Many offset neurons fired robustly at a preferred duration of tonal stimulus, which corresponded with the timing of rich excitatory synaptic inputs. We concluded that most IC offset neurons encode the termination of the tone stimulus by responding to inherited ascending synaptic information, which is tuned to sound duration. The remainder generates offset spikes de novo through a post-inhibitory rebound mechanism.

  3. Neural correlates of context-dependent perceptual enhancement in the inferior colliculus

    PubMed Central

    Nelson, Paul C.; Young, Eric D.

    2010-01-01

    In certain situations, preceding auditory stimulation can actually result in heightened sensitivity to subsequent sounds. Many of these phenomena appear to be generated in the brain as reflections of central computations. One example is the robust perceptual enhancement (or “pop out”) of a probe signal within a broad-band sound whose onset time is delayed relative to the remainder of a mixture of tones. Here we show that the neural representation of such stimuli undergoes a dramatic transformation as the pathway is ascended, from an implicit and distributed peripheral code to explicitly facilitated single-neuron responses at the level of the inferior colliculus (IC) of two awake and passively listening female marmoset monkeys (callithrix jacchus). Many key features of the IC responses directly parallel psychophysical measures of enhancement, including the dependence on the width of a spectral notch surrounding the probe, the overall level of the complex, and the duration of the preceding sound (referred to as the conditioner). Neural detection thresholds for the probe with and without the conditioner were also in qualitative agreement with analogous psychoacoustic measures. Response characteristics during the conditioners were predictive of the enhancement or suppression of the ensuing probe response: build-up responses were associated with enhancement while adapting conditioner responses were more likely to result in suppression. These data can be largely explained by a phenomenological computational model using dynamic (adapting) inhibition as a necessary ingredient in the generation of neural enhancement. PMID:20463220

  4. Differential Patterns of Inputs Create Functional Zones in Central Nucleus of Inferior Colliculus

    PubMed Central

    Loftus, William C.; Bishop, Deborah C.; Oliver, Douglas L.

    2010-01-01

    Distinct pathways carry monaural and binaural information from the lower auditory brainstem to the central nucleus of the inferior colliculus (ICC). Previous anatomical and physiological studies suggest that differential ascending inputs to regions of the ICC create functionally distinct zones. Here, we provide direct evidence of this relationship by combining recordings of single unit responses to sound in the ICC with focal, iontophoretic injections of the retrograde tracer Fluoro-gold (FG) at the physiologically characterized sites. Three main patterns of anatomical inputs were observed. One pattern was identified by inputs from the cochlear nucleus and ventral nucleus of the lateral lemniscus (VNLL) in isolation, and these injection sites were correlated with monaural responses. The second pattern had inputs only from the ipsilateral medial and lateral superior olive (MSO, LSO), and these sites were correlated with ITD-sensitive responses to low frequency (< 500 Hz). A third pattern had inputs from a variety of olivary and lemniscal sources, notably the contralateral lateral superior olive and dorsal nucleus of the lateral lemniscus. These were correlated with high-frequency ITD sensitivity to complex acoustic stimuli. These data support the notion of anatomical regions formed by specific patterns of anatomical inputs to the ICC. Such synaptic domains may represent functional zones in ICC. PMID:20926666

  5. Congenital Vitelline Band Causing Intestinal Obstruction in an Adult with a Double Inferior Vena Cava

    PubMed Central

    Pussepitiya, Kumari; Samarasinghe, Bandula; Wickramasinghe, Nuwan

    2016-01-01

    Introduction. Vitelline artery remnants are rare causes of intra-abdominal bands leading to bowel obstruction. These bands may be associated with Meckel's diverticulum. Double inferior vena cava (IVC) is a rare presentation and is usually identified incidentally. Case Presentation. A sixty-year-old male presented with progressive vomiting for five days and he was clinically diagnosed with intestinal obstruction. Plain X-ray abdomen showed evidence of small bowel obstruction. CT scan of the abdomen revealed dilated small bowel loops with a small outpouching in the distal ileum with a band like structure attached to it. In the CT, left sided patent IVC draining into the left renal vein was identified. Left external iliac vein was in continuity with the left IVC. Left internal iliac vein was draining into the right IVC. Exploratory laparotomy revealed a Meckel's diverticulum with a band identified as the vitelline remnant attached to its apex and inserting at the anterior abdominal wall near the umbilicus. Discussion. Meckel's diverticulum with vitelline bands, although rare, should be borne in mind in adult patients with intestinal obstruction. Identification of this anomaly can be difficult in imaging studies. Presence of double IVC should be mentioned in the imaging findings to prevent possible catastrophic complications during surgery. PMID:27843667

  6. Inferior Vena Cava Repair Using Serosal Patch of Small Bowel: An Experimental Study

    PubMed Central

    Hodjati, Hossein; Hoseinzadeh, Ahmad; Mousavi, Seyed Masoud; Dehghani Nazhavi, Seifollah; Kumar, Viginda; Sehhatpour, Maryam

    2017-01-01

    Objective: To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava (IVC) after resection of a part of infra-renal IVC in an animal model, as it may be encountered in extensive tumors of retroperitoneal and trauma patients. Methods: Five healthy sheep of both sexes were prepared. After general anesthesia and laparotomy, a defect with 1 cm width and 4cm length was made on anterior aspect of infra-renal IVC, and then an adjacent loop of small bowel was brought and sutured continuously to cover the defect of IVC as a patch graft. The observation period was two months. Results: Three of five IVCs were macroscopically patent without stenosis and thrombosis. Pathologic assay revealed complete endothelialization of serosal surface of the patch of small bowel loop. One of IVCs was completely occluded in gross evaluation and fibrous formation in pathologist review. The sheep had no sign of venous hypertension and edema of limbs. One sheep died at the night of first operation due to internal bleeding.   Conclusion: Serosal patch of small bowel is an accessible and feasible alternative in repair and reconstruction of IVC especially when there is restriction for use of prosthetic material in a contaminated space of abdomen. PMID:28246620

  7. Changes in the Response Properties of Inferior Colliculus Neurons Relating to Tinnitus

    PubMed Central

    Berger, Joel I.; Coomber, Ben; Wells, Tobias T.; Wallace, Mark N.; Palmer, Alan R.

    2014-01-01

    Tinnitus is often identified in animal models by using the gap prepulse inhibition of acoustic startle. Impaired gap detection following acoustic over-exposure (AOE) is thought to be caused by tinnitus “filling in” the gap, thus, reducing its salience. This presumably involves altered perception, and could conceivably be caused by changes at the level of the neocortex, i.e., cortical reorganization. Alternatively, reduced gap detection ability might reflect poorer temporal processing in the brainstem, caused by AOE; in which case, impaired gap detection would not be a reliable indicator of tinnitus. We tested the latter hypothesis by examining gap detection in inferior colliculus (IC) neurons following AOE. Seven of nine unilaterally noise-exposed guinea pigs exhibited behavioral evidence of tinnitus. In these tinnitus animals, neural gap detection thresholds (GDTs) in the IC significantly increased in response to broadband noise stimuli, but not to pure tones or narrow-band noise. In addition, when IC neurons were sub-divided according to temporal response profile (onset vs. sustained firing patterns), we found a significant increase in the proportion of onset-type responses after AOE. Importantly, however, GDTs were still considerably shorter than gap durations commonly used in objective behavioral tests for tinnitus. These data indicate that the neural changes observed in the IC are insufficient to explain deficits in behavioral gap detection that are commonly attributed to tinnitus. The subtle changes in IC neuron response profiles following AOE warrant further investigation. PMID:25346722

  8. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention.

    PubMed

    Lee, Jeyeon; Ku, Jeonghun; Han, Kiwan; Park, Jinsick; Lee, Hyeongrae; Kim, Kyung Ran; Lee, Eun; Husain, Masud; Yoon, Kang Jun; Kim, In Young; Jang, Dong Pyo; Kim, Sun I

    2013-01-01

    Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL) has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS), over the left and right superior parietal lobe (SPL) and IPL. We used two different types of visual sustained attention tasks: spatial (location based) and non-spatial (feature based). When the participants performed the spatial task, repetitive TMS (rTMS) over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants' performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative) gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive) were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL.

  9. Pancreatic and multiorgan resection with inferior vena cava reconstruction for retroperitoneal leiomyosarcoma

    PubMed Central

    Stauffer, John A; Fakhre, G Peter; Dougherty, Marjorie K; Nakhleh, Raouf E; Maples, William J; Nguyen, Justin H

    2009-01-01

    Background Inferior vena cava (IVC) leiomyosarcoma is a rare tumor of smooth muscle origin. It is often large by the time of diagnosis and may involve adjacent organs. A margin-free resection may be curative, but the resection must involve the tumor en bloc with the affected segment of vena cava and locally involved organs. IVC resection often requires vascular reconstruction, which can be done with prosthetic graft. Case presentation We describe a 39-year-old man with an IVC leiomyosarcoma that involved the adrenal gland, distal pancreas, and blood supply to the spleen and left kidney. Tumor excision involved en bloc resection of all involved organs with reimplantation of the right renal vein and reconstruction of the IVC with a polytetrafluoroethylene graft. The patient recovered without renal insufficiency, graft infection, or other complications. Follow-up abdominal imaging at 1 year showed a patent IVC graft and no locally recurrent tumor. Prosthetic graft provides a sufficient diameter and length for replacement conduit in extensive resection of IVC leiomyosarcoma. Conclusion To our knowledge, this is the first case of resection of an IVC sarcoma with prosthetic graft reconstruction in combination with pancreatic resection. Aggressive surgical resection including vascular reconstruction is warranted for select IVC tumors to achieve a potentially curative outcome. PMID:19126222

  10. Greater Left Inferior Frontal Activation for SVO than VOS during Sentence Comprehension in Kaqchikel

    PubMed Central

    Koizumi, Masatoshi; Kim, Jungho

    2016-01-01

    Cortical activations during the processing of Kaqchikel transitive sentences with canonical and non-canonical word orders were investigated using functional magnetic resonance imaging. Kaqchikel is an endangered Mayan language spoken in Guatemala. The word order in this language is relatively flexible. We observed higher cortical activations in the left inferior frontal gyrus for sentences with the subject-verb-object (SVO) word order, as compared to sentences with the verb-object-subject (VOS) word order, suggesting that Kaqchikel sentences are easier to process when they have the VOS order than when they have the SVO order. This supports the traditional analysis of Mayan word order: the syntactically simplest word order of transitive sentences in Mayan languages, including Kaqchikel, is VOS. More importantly, the results revealed that the subject-before-object word order preference in sentence comprehension, previously observed in other languages, might not reflect a universal aspect of human languages. Rather, processing preference may be language-specific to some extent, reflecting syntactic differences in individual languages. PMID:27790165

  11. Sudden sensorineural hearing loss as prodromal symptom of anterior inferior cerebellar artery infarction.

    PubMed

    Martines, Francesco; Dispenza, Francesco; Gagliardo, Cesare; Martines, Enrico; Bentivegna, Daniela

    2011-01-01

    Sudden sensorineural hearing loss is a clinical condition characterized by a sudden onset of unilateral or bilateral hearing loss. In recent years sudden deafness has been frequently described in association with anterior inferior cerebellar artery (AICA) infarction generally presenting along with other brainstem and cerebellar signs such as ataxia, dysmetria and peripheral facial palsy. The authors report a rare clinical case of a 53-year-old man who suddenly developed hearing loss and tinnitus without any brainstem or cerebellar signs. Computed tomography of his brain was normal, and the audiological results localized the lesion causing deafness to the inner ear. Surprisingly, magnetic resonance imaging showed an ischemic infarct in the right AICA territory. This case represents the fifth in the literature to date but it confirms that AICA occlusion can cause sudden deafness even without brainstem or cerebellar signs. Therefore, we recommend submitting the patient for neuroimaging, as an emergency, in order to exclude infarction of the AICA territory. By doing this, it may be possible to limit the extent of the lesion by commencing early therapy.

  12. The functional role of the inferior parietal lobe in the dorsal and ventral stream dichotomy

    PubMed Central

    Singh-Curry, Victoria; Husain, Masud

    2009-01-01

    Current models of the visual pathways have difficulty incorporating the human inferior parietal lobe (IPL) into dorsal or ventral streams. Some recent proposals have attempted to integrate aspects of IPL function that were not hitherto dealt with well, such as differences between the left and right hemisphere and the role of the right IPL in responding to salient environmental events. However, we argue that these models also fail to capture adequately some important findings regarding the functions of the IPL. Here we critically appraise existing proposals regarding the functional architecture of the visual system, with special emphasis on the role of this region, particularly in the right hemisphere. We review evidence that shows the right IPL plays an important role in two different, but broadly complementary, aspects of attention: maintaining attentive control on current task goals as well as responding to salient new information or alerting stimuli in the environment. In our view, findings from functional imaging, electrophysiological and lesion studies are all consistent with the view that this region is part of a system that allows flexible reconfiguration of behaviour between these two alternative modes of operation. Damage to the right IPL leads to deficits in both maintaining attention and also responding to salient events, impairments that contribute to hemineglect, the classical syndrome that follows lesions of this region. PMID:19138694

  13. Left posterior inferior frontal gyrus is causally involved in reordering during sentence processing.

    PubMed

    Kuhnke, Philipp; Meyer, Lars; Friederici, Angela D; Hartwigsen, Gesa

    2017-03-01

    Storage and reordering of incoming information are two core processes required for successful sentence comprehension. Storage is necessary whenever the verb and its arguments (i.e., subject and object) are separated over a long distance, while reordering is necessary whenever the argument order is atypical (e.g., object-first order in German, where subject-first order is typical). Previous neuroimaging work has associated storage with the left planum temporale (PT), and reordering with the left posterior inferior frontal gyrus (pIFG). Here, we tested the causal role of the PT and pIFG in storage and reordering using repetitive transcranial magnetic stimulation (rTMS). We applied either effective rTMS over PT or pIFG, or sham rTMS, while subjects listened to sentences that independently varied storage demands (short vs. long argument-verb distance) and reordering demands (subject- vs. object-first argument order). We found that rTMS over pIFG, but not PT, selectively affected reordering during the processing of sentences with a long argument-verb distance. Specifically, relative to sham rTMS, rTMS over pIFG significantly increased the performance difference between object- and subject-first long-distance sentences. These results demonstrate a causal involvement of left pIFG in reordering during sentence comprehension and thus contribute to a better understanding of the role of the pIFG in language processing.

  14. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention

    PubMed Central

    Lee, Jeyeon; Ku, Jeonghun; Han, Kiwan; Park, Jinsick; Lee, Hyeongrae; Kim, Kyung Ran; Lee, Eun; Husain, Masud; Yoon, Kang Jun; Kim, In Young; Jang, Dong Pyo; Kim, Sun I.

    2013-01-01

    Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL) has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS), over the left and right superior parietal lobe (SPL) and IPL. We used two different types of visual sustained attention tasks: spatial (location based) and non-spatial (feature based). When the participants performed the spatial task, repetitive TMS (rTMS) over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants' performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative) gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive) were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL. PMID:23403477

  15. Predicting goals in action episodes attenuates BOLD response in inferior frontal and occipitotemporal cortex.

    PubMed

    Wurm, Moritz F; Hrkać, Mari; Morikawa, Yuka; Schubotz, Ricarda I

    2014-11-01

    Actions are usually made of several action steps gearing towards an overarching goal. During observation of such action episodes the overarching action goal becomes more and more clear and upcoming action steps can be predicted with increasing precision. To tap this process, the present fMRI study investigated the dynamic changes of neural activity during the observation of distinct action steps that cohere by an overarching goal. Our hypotheses specifically addressed the role of the inferior frontal gyrus (IFG), a region assumed to be a key hub for integration functions during action processing, as well as the role of regions involved in action perception (often referred to as action observation network or AON) that should benefit from the predictability of forthcoming action steps. Participants watched separate action steps that formed a coherent action goal or not (factor goal coherence) and were performed by a single actor or not (factor actor coherence). Independent of actor coherence, neural activity in IFG and occipitotemporal cortex decreased as a function of goal predictability during the unfolding of goal-coherent episodes. In addition, we identified a network (precuneus, dorsolateral prefrontal and orbitofrontal cortex, angular gyrus, and middle temporal gyrus) that showed increased activity for goal coherence. We conclude that IFG fosters the integration of action steps to build overarching goals. Identifying the unifying goal of an action episode allows anticipation, and thus efficient processing, of forthcoming action steps. To this end, past action steps of the action episode are buffered and recollected with recourse to episodic memory.

  16. Morphometric characteristics of neuropeptide Y immunoreactive neurons in cortex of human inferior parietal lobule.

    PubMed

    Krivokuća, Dragan; Puskas, Laslo; Puskas, Nela; Erić, Mirela

    2010-03-01

    The aim of this study was to demonstrate and precisely define the morphology of neurons immunoreactive to neuropeptide Y (NPY) in cortex of human inferior parietal lobule (IPL). Five human brains were used for immunohistochemical investigation of the shape and laminar distribution of NPY neurons in serial section in the supramarginal and angular gyrus. Immunoreactivity to NPY was detected in all six layers of the cortex of human IPL. However a great number of NPY immunoreactive neurons were found in the white matter under the IPL cortex. The following types of NPY immunoreactive neurons were found: Cajal-Retzius, pyramidal, inverted pyramidal, "double bouquet" (bitufted), rare type 6, multipolar nonspinous, bipolar, voluminous "basket", and chandelier cells. These informations about morphometric characteristics of NPY immunoreactive neurons in cortical layers, together with morphometric data taken from brains having schizophrenia or Alzheimer's-type dementia may contribute to better understanding patogenesis of these neurological diseases. The finding of Cajal-Retzius neurons immunoreactive to NPY points to the need for further investigations because of great importance of these cells in neurogenesis and involvement in mentioned diseases instead of their rarity.

  17. A computational method for predicting inferior vena cava filter performance on a patient-specific basis.

    PubMed

    Aycock, Kenneth I; Campbell, Robert L; Manning, Keefe B; Sastry, Shankar P; Shontz, Suzanne M; Lynch, Frank C; Craven, Brent A

    2014-08-01

    A computational methodology for simulating virtual inferior vena cava (IVC) filter placement and IVC hemodynamics was developed and demonstrated in two patient-specific IVC geometries: a left-sided IVC and an IVC with a retroaortic left renal vein. An inverse analysis was performed to obtain the approximate in vivo stress state for each patient vein using nonlinear finite element analysis (FEA). Contact modeling was then used to simulate IVC filter placement. Contact area, contact normal force, and maximum vein displacements were higher in the retroaortic IVC than in the left-sided IVC (144 mm(2), 0.47 N, and 1.49 mm versus 68 mm(2), 0.22 N, and 1.01 mm, respectively). Hemodynamics were simulated using computational fluid dynamics (CFD), with four cases for each patient-specific vein: (1) IVC only, (2) IVC with a placed filter, (3) IVC with a placed filter and model embolus, all at resting flow conditions, and (4) IVC with a placed filter and model embolus at exercise flow conditions. Significant hemodynamic differences were observed between the two patient IVCs, with the development of a right-sided jet, larger flow recirculation regions, and lower maximum flow velocities in the left-sided IVC. These results support further investigation of IVC filter placement and hemodynamics on a patient-specific basis.

  18. Surface anatomy of the inferior epigastric artery in relation to laparoscopic injury.

    PubMed

    Epstein, J; Arora, A; Ellis, H

    2004-07-01

    The inferior epigastric artery (IEA) is at risk of injury in laparoscopic surgery. Current descriptions of the course of the IEA do not provide surface landmarks useful to the surgeon. This study aimed to define surface relations and propose guidelines for safer trocar placement. The posterior surfaces of the anterior abdominal walls of 30 preserved cadavers were dissected. The surface anatomy of 60 IEAs and their branches were defined. At the level of the anterior superior iliac spine (ASIS), the IEA is 38% +/- 18% (95% confidence interval [CI]) from the midline to the ASIS. At the mid-inguinal point the relation is 40% +/- 17% and at the umbilicus 40% +/- 22%. The pattern of branches is highly variable. Although giving guidelines for trocar insertion can be treacherous, we found the following to be of value: 1) the midline is avascular; 2) the main stem of the IEA will be avoided if trocars are inserted more than two-thirds of the distance along a horizontal line between the midline and the ASIS; and 3) IEA branches are least frequently found in the lowest part of the abdomen lateral to the artery.

  19. Spread of cochlear excitation during stimulation with pulsed infrared radiation: Inferior colliculus measurements

    PubMed Central

    Richter, C.-P.; Rajguru, S.M.; Matic, A.I.; Moreno, E.L.; Fishman, A.J.; Robinson, A.M.; Suh, E.; Walsh, J.T.

    2012-01-01

    Infrared neural stimulation (INS) has received considerable attention over the last few years. It provides an alternative method to artificially stimulate neurons without electrical current or the introduction of exogenous chromophores. One of the primary benefits of INS could be the improved spatial selectivity when compared with electrical stimulation. In the present study, we have evaluated the spatial selectivity of INS in the acutely damaged cochlea of guinea pigs and compared it to stimulation with acoustic tone pips in normal hearing animals. The radiation was delivered via a 200 μm-diameter optical fiber, which was inserted through a cochleostomy into the scala tympani of the basal cochlear turn. The stimulated section along the cochlear spiral ganglion was estimated from the neural responses recorded from the central nucleus of the inferior colliculus (ICC). ICC responses were recorded in response to cochlear INS using a multichannel penetrating electrode array. Spatial tuning curves were constructed from the responses. For INS, approximately 55% of the activation profiles showed a single maximum, ~22% had two maxima, and ~13% had multiple maxima. The remaining 10% of the profiles occurred at the limits of the electrode array and could not be classified. The majority of ICC spatial tuning curves indicated that the spread of activation evoked by optical stimuli is comparable to that produced by acoustic pips. PMID:21828906

  20. Disintegration of the 'waterfall phenomenon' in the inferior vena cava due to right heart failure.

    PubMed

    Kira, S; Dambara, T; Mieno, T; Tamaki, S; Natori, H

    1996-03-01

    The concept of the waterfall phenomenon in Zone 2 in the pulmonary vasculature is well known from West's lung model. It is believed that the flow through this zone is determined by the pressure difference between the pulmonary artery and alveoli, and the left atrial pressure is not transmissible to the alveolar capillaries. However, it is impossible to see whether alveolar capillaries are really displaying the waterfall phenomenon or not. In this review, the interrelation between the flow and geometry of the alveolar capillaries in the waterfall phenomenon is analyzed based on physiological studies using a model system and isolated lung lobe experiments. Further, extending the concept to the analysis of ventilatory changes of the inferior vena cava (IVC) configuration, it is ascertained that the waterfall phenomenon normally occurs in the IVC during inspiration just before it enters the thorax and the waterfall phenomenon in the IVC disintegrates with elevation of the central venous pressure. Because these configurations of the IVC in normal and abnormal conditions are visible with ultrasonography, the technique is very useful as a noninvasive approach to diagnose right heart failure.

  1. [Two Cases of Colorectal Cancer with Tumor Thrombus in the Inferior Mesenteric Vein].

    PubMed

    Matsumura, Atsushi; Hatakeyama, Tomoya; Ogino, Shiro; Takemura, Manabu; Mugitani, Tatsuro; Akami, Toshikazu; Okano, Shinji; Ueda, Yuji

    2015-11-01

    In colorectal cancer, progression with an intravenous tumor thrombus is very rare. Here, we report 2 cases of colorectal cancer which showed a tumor thrombus in the inferior mesenteric vein (IMV). Case 1: A 69-year-old woman was admitted for the treatment of advanced rectal cancer, and underwent a low anterior resection. Six months of post-operative therapy was carried out with mFOLFOX6, but a metachronous lung metastasis was detected and a lung partial resection was performed. Case 2: A 67-year-old man was admitted for the treatment of advanced sigmoid colon cancer with simultaneous liver metastasis, and underwent a laparoscopic high anterior resection. Four courses of mFOLFOX6+bevacizumab chemotherapy were carried out after surgery, and subsequently he underwent a partial hepatectomy. In both cases IMV tumor thrombus was suspected from abdominal contrast-enhanced computed tomography (CT). Tumor thrombus filling the lumen of the IMV was confirmed on histopathological examination. Colorectal cancer with IMV tumor thrombus is a form of advanced cancer with advanced vascular invasion, and there is a high risk of simultaneous or metachronous hematogenous metastasis. Combined modality therapy should therefore be given to improve the prognosis.

  2. Human inferior colliculus activity relates to individual differences in spoken language learning.

    PubMed

    Chandrasekaran, Bharath; Kraus, Nina; Wong, Patrick C M

    2012-03-01

    A challenge to learning words of a foreign language is encoding nonnative phonemes, a process typically attributed to cortical circuitry. Using multimodal imaging methods [functional magnetic resonance imaging-adaptation (fMRI-A) and auditory brain stem responses (ABR)], we examined the extent to which pretraining pitch encoding in the inferior colliculus (IC), a primary midbrain structure, related to individual variability in learning to successfully use nonnative pitch patterns to distinguish words in American English-speaking adults. fMRI-A indexed the efficiency of pitch representation localized to the IC, whereas ABR quantified midbrain pitch-related activity with millisecond precision. In line with neural "sharpening" models, we found that efficient IC pitch pattern representation (indexed by fMRI) related to superior neural representation of pitch patterns (indexed by ABR), and consequently more successful word learning following sound-to-meaning training. Our results establish a critical role for the IC in speech-sound representation, consistent with the established role for the IC in the representation of communication signals in other animal models.

  3. Assessment of Snared-Loop Technique When Standard Retrieval of Inferior Vena Cava Filters Fails

    SciTech Connect

    Doody, Orla Noe, Geertje; Given, Mark F.; Foley, Peter T.; Lyon, Stuart M.

    2009-01-15

    Purpose To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. Methods A retrospective review of all Cook Guenther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. Results The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range, 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. Conclusion The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.

  4. The Guenther temporary inferior vena cava filter for short-term protection against pulmonary embolism

    SciTech Connect

    Vos, Louwerens D.; Tielbeek, Alexander V.; Bom, Ernst P.; Gooszen, Harm C.; Vroegindeweij, Dammis

    1997-03-15

    Purpose. To evaluate clinically the Guenther temporary inferior vena cava (IVC) filter. Methods. Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted from the right femoral approach, three filters from the left. Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, during 4-60 months after filter removal was by clinical assessment, and imaging of the lungs was performed when pulmonary embolism (PE) was suspected. Patients received anticoagulation therapy for at least 6 months. Results. Ten filters were removed without complications 7-14 days (mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One patient developed sepsis, and one an infection at the insertion site. Clinically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal. Conclusion. The Guenther temporary IVC filter can be safely placed for short-term protection against PE. The use of this filter is not appropriate in agitated or immunocompromised patients.

  5. [Dissecting aneurysm of the posterior inferior cerebellar artery--studied by serial angiography].

    PubMed

    Yamashita, Y; Hayashi, S; Saitho, H; Teramoto, A

    2001-11-01

    We report the case of a 34-year-old male with cerebellar hemorrhagic infarction caused by a dissecting aneurysm of the left posterior inferior cerebellar artery (PICA). The patient suffered from a headache and vomiting for two days and was transferred to our hospital with sudden deterioration of consciousness. On admission, he was semicomatose. A CT scan revealed hemorrhagic infarction in the left cerebellum and upward herniation. The emergency operation for posterior fossa decompression was performed. Postoperatively, his consciousness level improved promptly and he had no neurological deficits except for slight gait disturbance. The first vertebral angiography was performed on Day 27. It showed a sausage-like dissecting aneurysm of the left distal PICA. We planned conservative therapy with careful observation because of there being no indication for an operation. Serial angiography was performed and demonstrated the regression of the dissecting aneurysm on Day 258. Dissecting aneurysms of the distal PICA are rare and their natural history is not well understood. Conservative therapy for vertebrobasilar dissecting aneurysms has often been reported. We suggest that conservative therapy with serial angiography is the treatment of choice especially for ischemic-type dissecting aneurysms. We review 17 cases of dissecting aneurysm of the distal PICA in this study.

  6. Inferior frontal cortex activity is modulated by reward sensitivity and performance variability.

    PubMed

    Fuentes-Claramonte, Paola; Ávila, César; Rodríguez-Pujadas, Aina; Costumero, Víctor; Ventura-Campos, Noelia; Bustamante, Juan Carlos; Rosell-Negre, Patricia; Barrós-Loscertales, Alfonso

    2016-02-01

    High reward sensitivity has been linked with motivational and cognitive disorders related with prefrontal and striatal brain function during inhibitory control. However, few studies have analyzed the interaction among reward sensitivity, task performance and neural activity. Participants (N=57) underwent fMRI while performing a Go/No-go task with Frequent-go (77.5%), Infrequent-go (11.25%) and No-go (11.25%) stimuli. Task-associated activity was found in inhibition-related brain regions, with different activity patterns for right and left inferior frontal gyri (IFG): right IFG responded more strongly to No-go stimuli, while left IFG responded similarly to all infrequent stimuli. Reward sensitivity correlated with omission errors in Go trials and reaction time (RT) variability, and with increased activity in right and left IFG for No-go and Infrequent-go stimuli compared with Frequent-go. Bilateral IFG activity was associated with RT variability, with reward sensitivity mediating this association. These results suggest that reward sensitivity modulates behavior and brain function during executive control.

  7. The impact of orientation filtering on face-selective neurons in monkey inferior temporal cortex.

    PubMed

    Taubert, Jessica; Goffaux, Valerie; Van Belle, Goedele; Vanduffel, Wim; Vogels, Rufin

    2016-02-16

    Faces convey complex social signals to primates. These signals are tolerant of some image transformations (e.g. changes in size) but not others (e.g. picture-plane rotation). By filtering face stimuli for orientation content, studies of human behavior and brain responses have shown that face processing is tuned to selective orientation ranges. In the present study, for the first time, we recorded the responses of face-selective neurons in monkey inferior temporal (IT) cortex to intact and scrambled faces that were filtered to selectively preserve horizontal or vertical information. Guided by functional maps, we recorded neurons in the lateral middle patch (ML), the lateral anterior patch (AL), and an additional region located outside of the functionally defined face-patches (CONTROL). We found that neurons in ML preferred horizontal-passed faces over their vertical-passed counterparts. Neurons in AL, however, had a preference for vertical-passed faces, while neurons in CONTROL had no systematic preference. Importantly, orientation filtering did not modulate the firing rate of neurons to phase-scrambled face stimuli in any recording region. Together these results suggest that face-selective neurons found in the face-selective patches are differentially tuned to orientation content, with horizontal tuning in area ML and vertical tuning in area AL.

  8. Neural selectivity and representation of gloss in the monkey inferior temporal cortex.

    PubMed

    Nishio, Akiko; Goda, Naokazu; Komatsu, Hidehiko

    2012-08-01

    When we view an object, its appearance depends in large part on specific surface reflectance properties; among these is surface gloss, which provides important information about the material composition of the object and the fine structure of its surface. To study how gloss is represented in the visual cortical areas related to object recognition, we examined the responses of neurons in the inferior temporal (IT) cortex of the macaque monkey to a set of object images exhibiting various combinations of specular reflection, diffuse reflection, and roughness, which are important physical parameters of surface gloss. We found that there are neurons in the lower bank of the superior temporal sulcus that selectively respond to specific gloss. This neuronal selectivity was largely maintained when the shape or illumination of the object was modified and perceived glossiness was unchanged. By contrast, neural responses were significantly altered when the pixels of the images were randomly rearranged, and perceived glossiness was dramatically changed. The stimulus preference of these neurons differed from cell to cell, and, as a population, they systematically represented a variety of surface glosses. We conclude that, within the visual cortex, there are mechanisms operating to integrate local image features and extract information about surface gloss and that this information is systematically represented in the IT cortex, an area playing an important role in object recognition.

  9. Intracranial Aneurysms Associated with a Double Origin of the Posterior Inferior Cerebellar Artery

    PubMed Central

    Padovani Trivelato, F.; Salles Rezende, M.T.; Brito Santos, R.; Hilton Vieira Madeira, T.; Cardoso Campos, R.; Cordeiro Ulhûa, A.

    2011-01-01

    Summary The posterior inferior cerebellar artery (PICA) frequently has a variable course and target territory. However, double origin PICA is a rare finding. Its significance is uncertain, but it has been associated with intracranial aneurysms localized at the PICA proper or at a distant site. The presence of this variation imposes specific challenges. We describe two cases of double origin PICA, one of them associated with an ipsilateral PICA aneurysm. The role of this finding was critically reviewed. A literature search identified 23 cases of double origin PICA, including both cases reported in this paper. Intracranial aneurysms were strongly associated with double origin PICA (71% in 21 detailed cases of double origin PICA). The current patient harboring a PICA aneurysm was successfully treated by endovascular trapping. In the setting of double origin PICA aneurysms, this variation beneficially affects the treatment choice once the two limbs enable the safe sacrifice of the channel involved, with preservation of blood flow through the other channel. PMID:22005699

  10. Effects of category learning on the stimulus selectivity of macaque inferior temporal neurons.

    PubMed

    De Baene, Wouter; Ons, Bart; Wagemans, Johan; Vogels, Rufin

    2008-09-01

    Primates can learn to categorize complex shapes, but as yet it is unclear how this categorization learning affects the representation of shape in visual cortex. Previous studies that have examined the effect of categorization learning on shape representation in the macaque inferior temporal (IT) cortex have produced diverse and conflicting results that are difficult to interpret owing to inadequacies in design. The present study overcomes these issues by recording IT responses before and after categorization learning. We used parameterized shapes that varied along two shape dimensions. Monkeys were extensively trained to categorize the shapes along one of the two dimensions. Unlike previous studies, our paradigm counterbalanced the relevant categorization dimension across animals. We found that categorization learning increased selectivity specifically for the category-relevant stimulus dimension (i.e., an expanded representation of the trained dimension), and that the ratio of within-category response similarities to between-category response similarities increased for the relevant dimension (i.e., category tuning). These small effects were only evident when the learned category-related effects were disentangled from the prelearned stimulus selectivity. These results suggest that shape-categorization learning can induce minor category-related changes in the shape tuning of IT neurons in adults, suggesting that learned, category-related changes in neuronal response mainly occur downstream from IT.

  11. The use of an inferior pennant flap during unilateral cleft lip repair improves lip height symmetry

    PubMed Central

    Russell, Aaron J.; Patel, Kamlesh B.; Skolnick, Gary B.; Woo, Albert S.

    2015-01-01

    Background In order to improve the rotation of Cupid’s bow and achieve sufficient vertical lip height, several variations of the Millard rotation-advancement have incorporated a small laterally-based triangular flap above the cutaneous roll. This study uses three-dimensional photogrammetry to evaluate the outcomes of unilateral cleft lip repairs performed with and without pennant flaps. Methods Three-dimensional photographs were analyzed to assess postoperative lip height asymmetry in 90 unilateral cleft lip patients (58 complete, 32 incomplete) treated between 2001 and 2012. Cleft lip repairs were performed by 3 pediatric cleft surgeons using different techniques. Thirty-nine of 90 (43%) procedures utilized an inferiorly placed triangular flap. All patients were photographed at least 9 months postoperatively (mean = 4.2 years). Lip height asymmetry was based on the vertical distances from the subnasale to the peaks of Cupid’s bow. Results Regression analysis revealed that the use of a pennant flap was a significant predictor of postoperative lip height asymmetry (B = 4.2%, p = 0.015). The surgeon performing the repair was also a significant factor in patients with complete cleft lips (B = 3.6%, p = 0.005). All three surgeons achieved greater lip height symmetry when a pennant flap was performed. Conclusions The results of unilateral cleft lip repairs are affected by both the surgeon and the surgical technique. Procedures that utilized a pennant flap showed better philtral height symmetry than non-pennant repairs. PMID:26505705

  12. Inferior Phrenic Arteries and Their Branches, Their Anatomy and Possible Clinical Importance: An Experimental Cadaver Study

    PubMed Central

    Gürses, İlke Ali; Gayretli, Özcan; Kale, Ayşin; Öztürk, Adnan; Usta, Ahmet; Şahinoğlu, Kayıhan

    2015-01-01

    Background: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. Aims: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. Study Design: Descriptive study. Methods: We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. Results: The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. Conclusion: As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well. PMID:26167344

  13. Spread of cochlear excitation during stimulation with pulsed infrared radiation: inferior colliculus measurements

    NASA Astrophysics Data System (ADS)

    Richter, C.-P.; Rajguru, S. M.; Matic, A. I.; Moreno, E. L.; Fishman, A. J.; Robinson, A. M.; Suh, E.; Walsh, J. T., Jr.

    2011-10-01

    Infrared neural stimulation (INS) has received considerable attention over the last few years. It provides an alternative method to artificially stimulate neurons without electrical current or the introduction of exogenous chromophores. One of the primary benefits of INS could be the improved spatial selectivity when compared with electrical stimulation. In the present study, we have evaluated the spatial selectivity of INS in the acutely damaged cochlea of guinea pigs and compared it to stimulation with acoustic tone pips in normal-hearing animals. The radiation was delivered via a 200 µm diameter optical fiber, which was inserted through a cochleostomy into the scala tympani of the basal cochlear turn. The stimulated section along the cochlear spiral ganglion was estimated from the neural responses recorded from the central nucleus of the inferior colliculus (ICC). ICC responses were recorded in response to cochlear INS using a multichannel penetrating electrode array. Spatial tuning curves (STCs) were constructed from the responses. For INS, approximately 55% of the activation profiles showed a single maximum, ~22% had two maxima and ~13% had multiple maxima. The remaining 10% of the profiles occurred at the limits of the electrode array and could not be classified. The majority of ICC STCs indicated that the spread of activation evoked by optical stimuli is comparable to that produced by acoustic tone pips.

  14. Activation of serotonin 3 receptors changes in vivo auditory responses in the mouse inferior colliculus

    PubMed Central

    Bohorquez, Alexander; Hurley, Laura M.

    2009-01-01

    Metabotropic serotonin receptors such as 5-HT1A and 5-HT1B receptors shape the level, selectivity, and timing of auditory responses in the inferior colliculus (IC). Less is known about the effects of ionotropic 5-HT3 receptors, which are cation channels that depolarize neurons. In the current study, the influence of the 5-HT3 receptor on auditory responses in vivo was explored by locally iontophoresing a 5-HT3 receptor agonist and antagonists onto single neurons recorded extracellularly in mice. Three main findings emerge from these experiments. First, activation of the 5-HT3 receptor can either facilitate or suppress auditory responses, but response suppressions are not consistent with 5-HT3 effects on presynaptic GABAergic neurons. Both response facilitations and suppressions are less pronounced in neurons with high precision in response latency, suggesting functional differences in the role of receptor activation for different classes of neuron. Finally, the effects of 5-HT3 activation vary across repetition rate within a subset of single neurons, suggesting that the influence of receptor activation sometimes varies with the level of activity. These findings contribute to the view of the 5-HT3 receptor as an important component of the serotonergic infrastructure in the IC, with effects that are complex and neuron- selective. PMID:19236912

  15. Periodotopy in the gerbil inferior colliculus: local clustering rather than a gradient map

    PubMed Central

    Schnupp, Jan W. H.; Garcia-Lazaro, Jose A.; Lesica, Nicholas A.

    2015-01-01

    Periodicities in sound waveforms are widespread, and shape important perceptual attributes of sound including rhythm and pitch. Previous studies have indicated that, in the inferior colliculus (IC), a key processing stage in the auditory midbrain, neurons tuned to different periodicities might be arranged along a periodotopic axis which runs approximately orthogonal to the tonotopic axis. Here we map out the topography of frequency and periodicity tuning in the IC of gerbils in unprecedented detail, using pure tones and different periodic sounds, including click trains, sinusoidally amplitude modulated (SAM) noise and iterated rippled noise. We found that while the tonotopic map exhibited a clear and highly reproducible gradient across all animals, periodotopic maps varied greatly across different types of periodic sound and from animal to animal. Furthermore, periodotopic gradients typically explained only about 10% of the variance in modulation tuning between recording sites. However, there was a strong local clustering of periodicity tuning at a spatial scale of ca. 0.5 mm, which also differed from animal to animal. PMID:26379508

  16. The serotonin releaser fenfluramine alters the auditory responses of inferior colliculus neurons

    PubMed Central

    Hall, Ian C.; Hurley, Laura M.

    2007-01-01

    Local direct application of the neuromodulator serotonin strongly influences auditory response properties of neurons in the inferior colliculus (IC), but endogenous stores of serotonin may be released in a distinct spatial or temporal pattern. To explore this issue, the serotonin releaser fenfluramine was iontophoretically applied to extracellularly recorded neurons in the IC of the Mexican free-tailed bat (Tadarida brasiliensis). Fenfluramine mimicked the effects of serotonin on spike count and first spike latency in most neurons, and its effects could be blocked by co-application of serotonin receptor antagonists, consistent with fenfluramine-evoked serotonin release. Responses to fenfluramine did not vary during single applications or across multiple applications, suggesting that fenfluramine did not deplete serotonin stores. A predicted gradient in the effects of fenfluramine with serotonin fiber density was not observed, but neurons with fenfluramine-evoked increases in latency occurred at relatively greater recording depths compared to other neurons with similar characteristic frequencies. These findings support the conclusion that there may be spatial differences in the effects of exogenous and endogenous sources of serotonin, but that other factors such as the identities and locations of serotonin receptors are also likely to play a role in determining the dynamics of serotonergic effects. PMID:17339086

  17. Pathological internal mammary lymph nodes in secondary and tertiary deep inferior epigastric perforator flap breast reconstructions.

    PubMed

    Hofer, Stefan O P; Rakhorst, Hinne A; Mureau, Marc A M; Moolenburgh, Sanne E; van Huizum, Martine A; van Geel, Albert N

    2005-12-01

    Use of internal mammary vessels during breast reconstruction provides information on part of the internal mammary chain lymph nodes (LNs). It was evaluated whether our current practice of screening should be changed to identify those delayed breast reconstruction patients with tumor-positive internal mammary nodes (IMNs) and whether breast reconstruction should be continued, in case suspicious IMNs were found intraoperatively. From February 2002 to December 2004, 81 patients had received 98 deep inferior epigastric perforator flaps for delayed breast reconstruction. Prospectively collected data for suspicious internal mammary LNs were evaluated. In 13 patients (16%) who had received a delayed breast reconstruction, macroscopically suspicious LNs were detected in the course of the internal mammary chain. Three patients (4%) had a pathologic diagnosis of malignancy, which was found to match their primary tumor. No relationship between positive internal mammary chain LNs and location of the primary tumor, TNM-stage, or previously administered adjuvant therapy was found. Suspicious internal mammary chain LNs found during recipient vessel dissection for breast reconstruction can have important consequences for treatment of malignant disease in individual patients. Presented data do not support changing the current perioperative approach of delayed breast reconstruction.

  18. USING ACTION UNDERSTANDING TO UNDERSTAND THE LEFT INFERIOR PARIETAL CORTEX IN THE HUMAN BRAIN

    PubMed Central

    Passingham, RE; Chung, A; Goparaju, B; Cowey, A; Vaina, LM

    2015-01-01

    In an fMRI study we tried to establish whether the areas in the human brain that are involved in the understanding of actions are homologous with the inferior parietal cortex (area PFG) in macaque monkeys. Cells have been described in area PFG that discharge differentially depending upon whether the observer sees food being brought to the mouth or a small object being put in a container. In our study the observers saw videos in which the use of different objects was demonstrated in pantomime; and after viewing the videos, the subject had to pick the object that was appropriate to the pantomime. We found a cluster of activated voxels in parietal areas PFop and PFt and this cluster was greater in the left hemisphere than in the right. We suggest a mechanism that could account for this asymmetry, relate our results to handedness and suggest that they shed light on the human syndrome of apraxia. Finally, we suggest that during the evolution of the hominids, this same pantomime mechanism could have been used to ‘name’ or request objects. PMID:25086203

  19. Histology of Tissue Adherent to OptEase Inferior Vena Cava Filters Regarding Indwelling Time

    SciTech Connect

    Rimon, Uri Volkov, Alexander; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Khaitovich, Boris; Abu-Salah, Kamel; Zissin, Rivka; Simon, Daniel; Konen, Eli

    2009-01-15

    The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism. Cavography was performed both before and after filter removal to evaluate the presence of thrombi or wall damage. Filters were retrieved with the snare and sheath method. All material adherents to the filters were examined histologically.The mean indwelling time of the filters was 24.9 days (range, 6-69 days). Red tissue fragments were seen on all the filters, consistent microscopically with clots and fibrin. On five filters (18%; mean indwelling time, 45.4 days) white tissue consistent with vascular intima was found. All postprocedure cavographies were normal. We conclude that most material adherent to the retrieved filters is thrombi, while vascular intima can be found in the minority of filters with a longer indwelling time.

  20. Structural hierarchies define toughness and defect-tolerance despite simple and mechanically inferior brittle building blocks

    PubMed Central

    Sen, Dipanjan; Buehler, Markus J.

    2011-01-01

    Mineralized biological materials such as bone, sea sponges or diatoms provide load-bearing and armor functions and universally feature structural hierarchies from nano to macro. Here we report a systematic investigation of the effect of hierarchical structures on toughness and defect-tolerance based on a single and mechanically inferior brittle base material, silica, using a bottom-up approach rooted in atomistic modeling. Our analysis reveals drastic changes in the material crack-propagation resistance (R-curve) solely due to the introduction of hierarchical structures that also result in a vastly increased toughness and defect-tolerance, enabling stable crack propagation over an extensive range of crack sizes. Over a range of up to four hierarchy levels, we find an exponential increase in the defect-tolerance approaching hundred micrometers without introducing additional mechanisms or materials. This presents a significant departure from the defect-tolerance of the base material, silica, which is brittle and highly sensitive even to extremely small nanometer-scale defects. PMID:22355554

  1. Structural hierarchies define toughness and defect-tolerance despite simple and mechanically inferior brittle building blocks.

    PubMed

    Sen, Dipanjan; Buehler, Markus J

    2011-01-01

    Mineralized biological materials such as bone, sea sponges or diatoms provide load-bearing and armor functions and universally feature structural hierarchies from nano to macro. Here we report a systematic investigation of the effect of hierarchical structures on toughness and defect-tolerance based on a single and mechanically inferior brittle base material, silica, using a bottom-up approach rooted in atomistic modeling. Our analysis reveals drastic changes in the material crack-propagation resistance (R-curve) solely due to the introduction of hierarchical structures that also result in a vastly increased toughness and defect-tolerance, enabling stable crack propagation over an extensive range of crack sizes. Over a range of up to four hierarchy levels, we find an exponential increase in the defect-tolerance approaching hundred micrometers without introducing additional mechanisms or materials. This presents a significant departure from the defect-tolerance of the base material, silica, which is brittle and highly sensitive even to extremely small nanometer-scale defects.

  2. Quantitative phosphoproteomic analyses of the inferior parietal lobule from three different pathological stages of Alzheimer's disease.

    PubMed

    Triplett, Judy C; Swomley, Aaron M; Cai, Jian; Klein, Jon B; Butterfield, D Allan

    2016-01-01

    Alzheimer's disease (AD), the most common age-related neurodegenerative disorder, is clinically characterized by progressive neuronal loss resulting in loss of memory and dementia. AD is histopathologically characterized by the extensive distribution of senile plaques and neurofibrillary tangles, and synapse loss. Amnestic mild cognitive impairment (MCI) is generally accepted to be an early stage of AD. MCI subjects have pathology and symptoms that fall on the scale intermediately between 'normal' cognition with little or no pathology and AD. A rare number of individuals, who exhibit normal cognition on psychometric tests but whose brains show widespread postmortem AD pathology, are classified as 'asymptomatic' or 'preclinical' AD (PCAD). In this study, we evaluated changes in protein phosphorylation states in the inferior parietal lobule of subjects with AD, MCI, PCAD, and control brain using a 2-D PAGE proteomics approach in conjunction with Pro-Q Diamond phosphoprotein staining. Statistically significant changes in phosphorylation levels were found in 19 proteins involved in energy metabolism, neuronal plasticity, signal transduction, and oxidative stress response. Changes in the disease state phosphoproteome may provide insights into underlying mechanisms for the preservation of memory with expansive AD pathology in PCAD and the progressive memory loss in amnestic MCI that escalates to the dementia and the characteristic pathology of AD brain.

  3. Neuroglia in the inferior olivary nucleus during normal aging and Alzheimer's disease.

    PubMed

    Lasn, H; Winblad, B; Bogdanovic, N

    2006-01-01

    It is likely that neuronal loss occurs in certain brain regions in Alzheimer's Disease (AD) without any neurofibrillary pathology. In the human principle inferior olivary nucleus (PO), we have shown that neuronal loss is about 34% (Lasn et al. Journal of Alzheimer Disease, 2001; 3: 159-168), but the fate of the neuroglial cells is unknown. Since the unique network of neurons and neuroglial cells and their cohabitation are essential for normal functioning of CNS, we designed a study to estimate the total number of oligodendrocytes and astrocytes in normally aged and AD brains. The study is based on 10 control and 11 AD post-mortem human brains. An unbiased stereological fractionator method was used. We found significant oligodendroglial cell loss (46%) in AD as compared to control brains, while the total number of astrocytes showed a tendency to decrease. It is likely that the ratio of oligodendroglial cells to neurons remains unchanged even in degenerative states, indicating that oligodendroglial cells parallel neuronal loss. Astroglial cells did not increase in total number, but the ratio to neurons was significantly increased due to the neuronal loss. Using a novel unbiased quantitative method, we were able to describe significant oligodendroglial loss in the PO but the pathogenic mechanism behind remains unknown.

  4. Oscillatory activity, phase differences, and phase resetting in the inferior olivary nucleus.

    PubMed

    Lefler, Yaara; Torben-Nielsen, Benjamin; Yarom, Yosef

    2013-01-01

    The generation of temporal patterns is one of the most fascinating functions of the brain. Unlike the response to external stimuli temporal patterns are generated within the system and recalled for a specific use. To generate temporal patterns one needs a timing machine, a "master clock" that determines the temporal framework within which temporal patterns can be generated and implemented. Here we present the concept that in this putative "master clock" phase and frequency interact to generate temporal patterns. We define the requirements for a neuronal "master clock" to be both reliable and versatile. We introduce this concept within the inferior olive nucleus which at least by some scientists is regarded as the source of timing for cerebellar function. We review the basic properties of the subthreshold oscillation recorded from olivary neurons, analyze the phase relationships between neurons and demonstrate that the phase and onset of oscillation is tightly controlled by synaptic input. These properties endowed the olivary nucleus with the ability to act as a "master clock."

  5. Chronometric electrical stimulation of right inferior frontal cortex increases motor braking.

    PubMed

    Wessel, Jan R; Conner, Christopher R; Aron, Adam R; Tandon, Nitin

    2013-12-11

    The right inferior frontal cortex (rIFC) is important for stopping responses. Recent research shows that it is also activated when response emission is slowed down when stopping is anticipated. This suggests that rIFC also functions as a goal-driven brake. Here, we investigated the causal role of rIFC in goal-driven braking by using computer-controlled, event-related (chronometric), direct electrical stimulation (DES). We compared the effects of rIFC stimulation on trials in which responses were made in the presence versus absence of a stopping-goal ("Maybe Stop" [MS] vs "No Stop" [NS]). We show that DES of rIFC slowed down responses (compared with control-site stimulation) and that rIFC stimulation induced more slowing when motor braking was required (MS) compared with when it was not (NS). Our results strongly support a causal role of a rIFC-based network in inhibitory motor control. Importantly, the results extend this causal role beyond externally driven stopping to goal-driven inhibitory control, which is a richer model of human self-control. These results also provide the first demonstration of double-blind chronometric DES of human prefrontal cortex, and suggest that--in the case of rIFC--this could lead to augmentation of motor braking.

  6. Repetition Suppression in the Left Inferior Frontal Gyrus Predicts Tone Learning Performance.

    PubMed

    Asaridou, Salomi S; Takashima, Atsuko; Dediu, Dan; Hagoort, Peter; McQueen, James M

    2016-06-01

    Do individuals differ in how efficiently they process non-native sounds? To what extent do these differences relate to individual variability in sound-learning aptitude? We addressed these questions by assessing the sound-learning abilities of Dutch native speakers as they were trained on non-native tone contrasts. We used fMRI repetition suppression to the non-native tones to measure participants' neuronal processing efficiency before and after training. Although all participants improved in tone identification with training, there was large individual variability in learning performance. A repetition suppression effect to tone was found in the bilateral inferior frontal gyri (IFGs) before training. No whole-brain effect was found after training; a region-of-interest analysis, however, showed that, after training, repetition suppression to tone in the left IFG correlated positively with learning. That is, individuals who were better in learning the non-native tones showed larger repetition suppression in this area. Crucially, this was true even before training. These findings add to existing evidence that the left IFG plays an important role in sound learning and indicate that individual differences in learning aptitude stem from differences in the neuronal efficiency with which non-native sounds are processed.

  7. Developmental changes in mental arithmetic: evidence for increased functional specialization in the left inferior parietal cortex.

    PubMed

    Rivera, S M; Reiss, A L; Eckert, M A; Menon, V

    2005-11-01

    Arithmetic reasoning is arguably one of the most important cognitive skills a child must master. Here we examine neurodevelopmental changes in mental arithmetic. Subjects (ages 8-19 years) viewed arithmetic equations and were asked to judge whether the results were correct or incorrect. During two-operand addition or subtraction trials, for which accuracy was comparable across age, older subjects showed greater activation in the left parietal cortex, along the supramarginal gyrus and adjoining anterior intra-parietal sulcus as well as the left lateral occipital temporal cortex. These age-related changes were not associated with alterations in gray matter density, and provide novel evidence for increased functional maturation with age. By contrast, younger subjects showed greater activation in the prefrontal cortex, including the dorsolateral and ventrolateral prefrontal cortex and the anterior cingulate cortex, suggesting that they require comparatively more working memory and attentional resources to achieve similar levels of mental arithmetic performance. Younger subjects also showed greater activation of the hippocampus and dorsal basal ganglia, reflecting the greater demands placed on both declarative and procedural memory systems. Our findings provide evidence for a process of increased functional specialization of the left inferior parietal cortex in mental arithmetic, a process that is accompanied by decreased dependence on memory and attentional resources with development.

  8. Decreased norepinephrine (NE) uptake in cerebral cortex and inferior colliculus of genetically epilepsy prone (GEP) rats

    SciTech Connect

    Browning, R.A.; Rigler-Daugherty, S.K.; Long, G.; Jobe, P.C.; Wade, D.R.

    1986-03-01

    GEP rats are characterized by an enhanced susceptibility to seizures caused by a variety of stimuli, most notably sound. Pharmacological treatments that reduce the synaptic concentration of NE increase seizure severity in GEP rats while elevations in NE have the opposite effect. GEP rats also display a widespread deficit in brain NE concentration suggesting that their increased seizure susceptibility is related to a deficit in noradrenergic transmission. The authors have compared the kinetics of /sup 3/H-NE uptake in the P/sub 2/ synaptosomal fraction isolated from the cerebral cortex of normal and GEP-rats. Although the apparent Kms were not significantly different (Normal +/- SEM:0.37 +/- 0.13..mu..M; GEP +/- SEM: 0.29 +/- 0.07..mu..M), the Vmax for GEP rats was 48% lower than that of normal rats (Normal +/- SEM: 474 +/- 45 fmole/mg/4min; GEP +/- SEM: 248 +/- 16 fmole/mg/4min). Because of the possible role of the inferior colliculus (IC) in the initiation of sound-induced seizures in GEP rats, the authors measured synaptosomal NE uptake in the IC using a NE concentration of 50 nM. The IC synaptosomal NE uptake was found to be 35% lower in GEP than in normal rats. These findings are consistent with the hypothesis that a deficit in noradrenergic transmission is related to the increased seizure susceptibility of GEP rats.

  9. Functional heterogeneity of inferior parietal cortex during mathematical cognition assessed with cytoarchitectonic probability maps.

    PubMed

    Wu, S S; Chang, T T; Majid, A; Caspers, S; Eickhoff, S B; Menon, V

    2009-12-01

    Although the inferior parietal cortex (IPC) has been consistently implicated in mathematical cognition, the functional roles of its subdivisions are poorly understood. We address this problem using probabilistic cytoarchitectonic maps of IPC subdivisions intraparietal sulcus (IPS), angular gyrus (AG), and supramarginal gyrus. We quantified IPC responses relative to task difficulty and individual differences in task proficiency during mental arithmetic (MA) tasks performed with Arabic (MA-A) and Roman (MA-R) numerals. The 2 tasks showed similar levels of activation in 3 distinct IPS areas, hIP1, hIP2, and hIP3, suggesting their obligatory role in MA. Both AG areas, PGa and PGp, were strongly deactivated in both tasks, with stronger deactivations in posterior area PGp. Compared with the more difficult MA-R task, the MA-A task showed greater responses in both AG areas, but this effect was driven by less deactivation in the MA-A task. AG deactivations showed prominent overlap with lateral parietal nodes of the default mode network, suggesting a nonspecific role in MA. In both tasks, greater bilateral AG deactivation was associated with poorer performance. Our findings suggest a close link between IPC structure and function and they provide new evidence for behaviorally salient functional heterogeneity within the IPC during mathematical cognition.

  10. Neurophysiological Organization of the Middle Face Patch in Macaque Inferior Temporal Cortex.

    PubMed

    Aparicio, Paul L; Issa, Elias B; DiCarlo, James J

    2016-12-14

    While early cortical visual areas contain fine scale spatial organization of neuronal properties, such as orientation preference, the spatial organization of higher-level visual areas is less well understood. The fMRI demonstration of face-preferring regions in human ventral cortex and monkey inferior temporal cortex ("face patches") raises the question of how neural selectivity for faces is organized. Here, we targeted hundreds of spatially registered neural recordings to the largest fMRI-identified face-preferring region in monkeys, the middle face patch (MFP), and show that the MFP contains a graded enrichment of face-preferring neurons. At its center, as much as 93% of the sites we sampled responded twice as strongly to faces than to nonface objects. We estimate the maximum neurophysiological size of the MFP to be ∼6 mm in diameter, consistent with its previously reported size under fMRI. Importantly, face selectivity in the MFP varied strongly even between neighboring sites. Additionally, extremely face-selective sites were ∼40 times more likely to be present inside the MFP than outside. These results provide the first direct quantification of the size and neural composition of the MFP by showing that the cortical tissue localized to the fMRI defined region consists of a very high fraction of face-preferring sites near its center, and a monotonic decrease in that fraction along any radial spatial axis.

  11. Properties of echo delay-tuning receptive fields in the inferior colliculus of the mustached bat.

    PubMed

    Macías, Silvio; Mora, Emanuel C; Hechavarría, Julio C; Kössl, Manfred

    2012-04-01

    One role of the inferior colliculus (IC) in bats is to create neuronal delay-tuning, which is used for the estimation of target distance in the echolocating bat's auditory system. In this study, we describe response properties of IC delay-tuned neurons of the mustached bat (Pteronotus parnellii) and compare it with those of delay-tuned neurons of the auditory cortex (AC). We also address the question if frequency content of the stimulus (pure-tone (PT) or frequency-modulated (FM) pairs stimulation) affects combination-sensitive interaction in the same neuron. Sharpness and sensitivity of delay-tuned neurons in the IC are similar to those described in the AC. However, in contrast to cortical responses, in collicular neurons the delay at which the neurons show the maximum response does not change with changes in echo level. This tolerance to changes in the echo level seems to be a property of collicular delay-tuned neurons, which is modified along the ascending auditory pathway. In the IC we found neurons that showed a facilitated delay-tuned response when stimulated with FM components and did not show any delay-tuning with PT stimulation. This result suggests that not only is echo delay-tuning generated in the IC but also its FM-specificity observed in the cortex could be created to some extent in the IC and then topographically organized at higher levels.

  12. Dissociable roles of the inferior longitudinal fasciculus and fornix in face and place perception

    PubMed Central

    Hodgetts, Carl J; Postans, Mark; Shine, Jonathan P; Jones, Derek K; Lawrence, Andrew D; Graham, Kim S

    2015-01-01

    We tested a novel hypothesis, generated from representational accounts of medial temporal lobe (MTL) function, that the major white matter tracts converging on perirhinal cortex (PrC) and hippocampus (HC) would be differentially involved in face and scene perception, respectively. Diffusion tensor imaging was applied in healthy participants alongside an odd-one-out paradigm sensitive to PrC and HC lesions in animals and humans. Microstructure of inferior longitudinal fasciculus (ILF, connecting occipital and ventro-anterior temporal lobe, including PrC) and fornix (the main HC input/output pathway) correlated with accuracy on odd-one-out judgements involving faces and scenes, respectively. Similarly, blood oxygen level-dependent (BOLD) response in PrC and HC, elicited during oddity judgements, was correlated with face and scene oddity performance, respectively. We also observed associations between ILF and fornix microstructure and category-selective BOLD response in PrC and HC, respectively. These striking three-way associations highlight functionally dissociable, structurally instantiated MTL neurocognitive networks for complex face and scene perception. DOI: http://dx.doi.org/10.7554/eLife.07902.001 PMID:26319355

  13. Inferior vena cava filters in cancer patients: to filter or not to filter

    PubMed Central

    Abdel-Razeq, Hikmat; Mansour, Asem; Ismael, Yousef; Abdulelah, Hazem

    2011-01-01

    Purpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE); active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC) filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE) or to avoid bleeding from systemic anticoagulation in high-risk situations. In this report, and utilizing a case study, we will address the appropriate utilization of such filters in cancer patients. Methods: The case of a 43-year-old female patient with rectal cancer, who developed deep vein thrombosis following a complicated medical course, will be presented. The patient was anticoagulated with a low molecular weight heparin, but a few months later and following an episode of bleeding, an IVC filter was planned. Using the PubMed database, articles published in English language addressing issues related to IVC filters in cancer patients were accessed and will be presented. Results: Many recent studies questioned the need to insert IVC filters in advanced-stage cancer patients, particularly those whose anticipated survival is short and prevention of PE may be of little clinical benefit and could be a poor utilization of resources. Conclusion: Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or pulmonary embolism is high, IVC filters can be utilized. However, placement of such filters should take into consideration the stage of disease and life expectancy of such patients. PMID:21479140

  14. Negative temporal summation of the responses to pairs of tone bursts in albino mice inferior colliculus

    NASA Astrophysics Data System (ADS)

    Bibikov, Nikolay G.; Cai, Chen Qi; Jie, Tang

    2003-10-01

    The extracellular activities of single units in an inferior colliculus of narcotized albino mice have been studied. As a stimuli pairs of best frequency (BF) tone bursts with different duration have been used and forward masking has been studied. The test tone usually has a 40 ms duration at intensity 5 dB above threshold. The intensity and duration of the masker could be changed. It was shown that the forward masking essentially depends upon the duration of the first burst. In many cases, the negative temporal summation can be seen. The increase in the duration of first burst (or masker) leads to the decrease in the whole response. Moreover, the BF tone burst which did not evoke any spike response could inhibit the response to the second (test) tone in some cases. Therefore in many units the inhibitory threshold was lower than the excitatory threshold even at the best frequency. The local application of bicuculline through a multibarrel-electrode increased the pulse activity considerably. However, the effect of forward masking usually left even after an inhibitory antagonist (bicuculline) application. [Work supported by grants 39970251 from NSFC, T010360056 from the Foreign Expert Bureau of the State Council of China, and 02-04-3900 from RFBR-NSFC.

  15. Chaotic Resonance in Coupled Inferior Olive Neurons with the Llinás Approach Neuron Model.

    PubMed

    Nobukawa, Sou; Nishimura, Haruhiko

    2016-09-14

    It is well known that cerebellar motor control is fine-tuned by the learning process adjusted according to rich error signals from inferior olive (IO) neurons. Schweighofer and colleagues proposed that these signals can be produced by chaotic irregular firing in the IO neuron assembly; such chaotic resonance (CR) was replicated in their computer demonstration of a Hodgkin-Huxley (HH)-type compartment model. In this study, we examined the response of CR to a periodic signal in the IO neuron assembly comprising the Llinás approach IO neuron model. This system involves empirically observed dynamics of the IO membrane potential and is simpler than the HH-type compartment model. We then clarified its dependence on electrical coupling strength, input signal strength, and frequency. Furthermore, we compared the physiological validity for IO neurons such as low firing rate and sustaining subthreshold oscillation between CR and conventional stochastic resonance (SR) and examined the consistency with asynchronous firings indicated by the previous model-based studies in the cerebellar learning process. In addition, the signal response of CR and SR was investigated in a large neuron assembly. As the result, we confirmed that CR was consistent with the above IO neuron's characteristics, but it was not as easy for SR.

  16. Chemoembolization for hepatocellular carcinoma via the inferior pancreaticoduodenal artery in patients with celiac artery stenosis.

    PubMed

    Okazaki, M; Higashihara, H; Ono, H; Koganemaru, F; Fujimitsu, R; Mizuma, Y; Nakamura, T; Sato, S; Kimura, S; Kodama, S

    1993-01-01

    Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.

  17. Central venous catheter placement in the inferior vena cava via the direct translumbar approach.

    PubMed

    Elduayen, B; Martínez-Cuesta, A; Vivas, I; Delgado, C; Pueyo, J C; Bilbao, J I

    2000-01-01

    The aim of this study was to evaluate the technical aspects and efficacy of placing tunneled central venous access catheters (CVA) in the inferior vena cava (IVC) via a direct translumbar approach. Between August 1994 and July 1998, 50 CVA (Hickman 13.5 F) were placed in the IVC via a direct translumbar approach in 46 patients (10 males, 36 females) with a mean age of 39.9 years (age range 10-87 years). The indications were chemotherapy administration plus leukoaphoresis (n = 39), bone marrow transplantation (n = 2) and hemodialysis (n = 5). The reasons for placing the CVA in the IVC were cosmetic (n = 34), supradiaphragmatic venous thrombosis (n = 8), previous catheter infection (n = 2), and non-functioning arteriovenous fistula (n = 2). There were no immediate complications. The mean period of time the CVA was in place was 3 months (15 days to 15 months), during which the function was excellent. The commonest late complication was infection (4 local, 6 bacteremia). Others included: pain (n = 2), ureteric fistula (n = 1), pericatheter fibrin sheath formation (n = 6) and catheter-tip impaction (n = 2). Two catheters were damaged due to postprocedural inappropriate manipulations and two others fell off due to incorrect fixation. Due to these complications, it was necessary to remove ten catheters, replace an additional four and reposition two. Direct translumbar catheterization of the IVC is a safe and effective way of placing a long-term CVA with a moderate complication rate.

  18. Anatomical characterization of subcortical descending projections to the inferior colliculus in mouse.

    PubMed

    Patel, Mili B; Sons, Stacy; Yudintsev, Georgiy; Lesicko, Alexandria M H; Yang, Luye; Taha, Gehad A; Pierce, Scott M; Llano, Daniel A

    2017-03-01

    Descending projections from the thalamus and related structures to the midbrain are evolutionarily highly conserved. However, the basic organization of this auditory thalamotectal pathway has not yet been characterized. The purpose of this study was to obtain a better understanding of the anatomical and neurochemical features of this pathway. Analysis of the distributions of retrogradely labeled cells after focal injections of retrograde tracer into the inferior colliculus (IC) of the mouse revealed that most of the subcortical descending projections originated in the brachium of the IC and the paralaminar portions of the auditory thalamus. In addition, the vast majority of thalamotectal cells were found to be negative for the calcium-binding proteins calbindin, parvalbumin, or calretinin. Using two different strains of GAD-GFP mice, as well as immunostaining for GABA, we found that a subset of neurons in the brachium of the IC is GABAergic, suggesting that part of this descending pathway is inhibitory. Finally, dual retrograde injections into the IC and amygdala plus corpus striatum as well into the IC and auditory cortex did not reveal any double labeling. These data suggest that the thalamocollicular pathway comprises a unique population of thalamic neurons that do not contain typical calcium-binding proteins and do not project to other paralaminar thalamic forebrain targets, and that a previously undescribed descending GABAergic pathway emanates from the brachium of the IC. J. Comp. Neurol. 525:885-900, 2017. © 2016 Wiley Periodicals, Inc.

  19. Changing from whole-cell to acellular pertussis vaccines would trade superior tolerability for inferior protection.

    PubMed

    Herzog, Christian

    2015-01-01

    Notifications of infant deaths, assumed to be related to the introduction of new pentavalent DTwP-Hib-HBV childhood vaccines, caused, during 2008-2010 in few Asian countries, temporary interruptions of the respective vaccination programs. The sudden appearance of fatal cases was due to increased awareness/publicity and improved safety monitoring/reporting in countries with relatively high background infant mortalities. WHO investigations could not establish any causal relationships and vaccinations were again resumed. Recently, questions were raised in one concerned country as to why not to change to less reactogenic acellular pertussis (aP)-containing vaccines that are available in private practice and are generally perceived as 'better'. For resource-poor countries, the financial impacts render such a switch impossible and would also not be supported by external funding. Furthermore, it would be a disservice to the children, as in recent years evidence of inferior long-term efficacy of aP vaccines has accumulated. This report summarizes current knowledge on comparative whole-cell pertussis (wP) and aP vaccine performance, outlines the new July 2014 WHO guidance on the choice of pertussis vaccines and presents recent data on outbreak protection, antibody waning, long-term protection, wP-priming, pathogen adaptation, transmission and herd immunity.

  20. Serotonin in the inferior colliculus fluctuates with behavioral state and environmental stimuli

    PubMed Central

    Hall, Ian C.; Rebec, George V.; Hurley, Laura M.

    2010-01-01

    SUMMARY Neuromodulation by serotonin (5-HT) could link behavioral state and environmental events with sensory processing. Within the auditory system, the presence of 5-HT alters the activity of neurons in the inferior colliculus (IC), but the conditions that influence 5-HT neurotransmission in this region of the brain are unknown. We used in vivo voltammetry to measure extracellular 5-HT in the IC of behaving mice to address this issue. Extracellular 5-HT increased with the recovery from anesthesia, suggesting that the neuromodulation of auditory processing is correlated with the level of behavioral arousal. Awake mice were further exposed to auditory (broadband noise), visual (light) or olfactory (2,5-dihydro-2,4,5-trimethylthiazoline, TMT) stimuli, presented with food or confined in a small arena. Only the auditory stimulus or restricted movement increased the concentration of extracellular 5-HT in the IC. Changes occurred within minutes of stimulus onset, with the auditory stimulus increasing extracellular 5-HT by an average of 5% and restricted movement increasing it by an average of 14%. These findings suggest that the neuromodulation of auditory processing by 5-HT is a dynamic process that is dependent on internal state and behavioral conditions. PMID:20228336

  1. The use of sensory action potential to evaluate inferior alveolar nerve damage after orthognathic surgery.

    PubMed

    Calabria, Francesca; Sellek, Lucy; Gugole, Fabio; Trevisiol, Lorenzo; Trevisol, Lorenzo; Bertolasi, Laura; D'Agostino, Antonio

    2013-03-01

    To assess and monitor the common event of neurosensory disturbance to the inferior alveolar nerve (IAN) after bilateral sagittal split osteotomy, we used clinical sensory tests and neurophysiologic test sensory action potentials. The diagnostic value of these tests was evaluated by comparing them with the degree of nerve damage reported by patients. Fourteen patients undergoing bilateral sagittal split osteotomy were analyzed preoperatively and 2 years postoperatively. Patients were evaluated bilaterally for positive and negative symptoms: light touch sensation, paraesthesia, hyperesthesia, and dysaesthesia; a "sensation score" was then calculated for each patient. Patients were also asked if they would be willing to repeat the procedure knowing the sensation loss they had now. Next, the right and left IAN were evaluated using sensory action potential and correlated with the other results. Before surgery, the medium latency difference between left and right was lower compared with postsurgery, with all patients having some deficit. The reduction in medium amplitude of 67% after the intervention was statistically significant. The frequency of abnormal findings in the electrophysiologic tests indicating IAN injury correlated with subjective sensory alteration. All patients said that they would repeat the surgery. Electrophysiologic testing is recommended for the evaluation of nerve dysfunction and seems a sensitive method for accurately assessing postsurgical nerve conduction.

  2. Vertical splitting of the mandibular body as an alternative to inferior alveolar nerve lateralization.

    PubMed

    Rodriguez, J G; Eldibany, R M

    2013-09-01

    The aim of this study was to present and evaluate a modified technique to inferior alveolar nerve lateralization (IANL) that allows the placement of longer implants in the posterior mandibular region. One hundred and forty-three consecutive patients were enrolled in this study; these patients had between 1.8 and 8mm residual crestal height above the mandibular canal. Vertical splitting of the mandibular body was performed using piezoelectric surgery followed by bone expansion and insertion of special conical implants of 10 and/or 12mm in length. Two hundred and sixty-nine osteotomies were performed and 636 implants were inserted, with a survival rate of 99% at the end of 12 months. Immediately postoperative there was an alteration of sensation in the lip/chin area in 8.5% of cases; 4.1% regained full sensation within 10-14 days, 2.6% after 8 weeks, and 0.7% had persistent paresthesia that did not affect their daily activities. Progressively increasing pain and numbness was present in 1.1%; the implants were removed 6 months postoperatively. This is a relatively simple procedure that has no limitations in clinical situations with minimal bone height. It allows for greater implant stability, and the risk of neurological disturbance is minimal.

  3. Use of the inferior epigastric artery to revascularize a lower pole renal artery in renal transplant.

    PubMed

    Young, J S; Rohr, M S

    1995-02-01

    The increasing use of living-related donors has increased the incidence wherein the transplant surgeon is required to use special vascular surgical techniques to transplant kidneys with anomalous arterial anatomy. One of the most commonly encountered arterial anomalies is the presence of a lower pole renal artery. In many cases, this artery can be anastomosed to the main renal artery, and the main renal artery can then be anastomosed into the recipient vessel. However, there are cases where the lower pole renal artery is too distant from the main renal artery to allow an anastomosis to be performed. The lower pole renal artery of the graft must be revascularized to avoid ischemic injury to the ureter. Thus, alternate methods for the revascularization of this vessel must be found. We describe the use of the recipient inferior epigastric artery as an arterial supply for the donor lower pole artery. In our case report, this method provided excellent flow to the lower kidney and was documented by later studies.

  4. Inferior frontal gyrus links visual and motor cortices during a visuomotor precision grip force task.

    PubMed

    Papadelis, Christos; Arfeller, Carola; Erla, Silvia; Nollo, Giandomenico; Cattaneo, Luigi; Braun, Christoph

    2016-11-01

    Coordination between vision and action relies on a fronto-parietal network that receives visual and proprioceptive sensory input in order to compute motor control signals. Here, we investigated with magnetoencephalography (MEG) which cortical areas are functionally coupled on the basis of synchronization during visuomotor integration. MEG signals were recorded from twelve healthy adults while performing a unimanual visuomotor (VM) task and control conditions. The VM task required the integration of pinch motor commands with visual sensory feedback. By using a beamformer, we localized the neural activity in the frequency range of 1-30Hz during the VM compared to rest. Virtual sensors were estimated at the active locations. A multivariate autoregressive model was used to estimate the power and coherence of estimated activity at the virtual sensors. Event-related desynchronisation (ERD) during VM was observed in early visual areas, the rostral part of the left inferior frontal gyrus (IFG), the right IFG, the superior parietal lobules, and the left hand motor cortex (M1). Functional coupling in the alpha frequency band bridged the regional activities observed in motor and visual cortices (the start and the end points in the visuomotor loop) through the left or right IFG. Coherence between the left IFG and left M1 correlated inversely with the task performance. Our results indicate that an occipital-prefrontal-motor functional network facilitates the modulation of instructed motor responses to visual cues. This network may supplement the mechanism for guiding actions that is fully incorporated into the dorsal visual stream.

  5. Diode laser turbinate reduction in the treatment of symptomatic inferior turbinate hypertrophy.

    PubMed

    Parida, Pradipta Kumar; Surianarayanan, Gopalakrishnan; Alexander, Arun; Saxena, Sunil Kumar; Santhosh, Krishnapriya

    2013-08-01

    To evaluate the efficacy of diode laser turbinate reduction procedure in treatment of symptomatic inferior turbinate hypertrophy (ITH) and to study the effect of it on mucociliary clearance of nose. This prospective study was carried out over 45 patients with symptomatic ITH refractory to medical management from July 2009 to March 2010 in Department of E.N.T, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. Each symptom (nasal obstruction, rhinorrhoea, sneezing, headache, hyposmia and snoring) was assessed by visual analogue scale (VAS). Mucociliary clearance was measured by saccharin transit time (STT). All patients underwent diode laser turbinate reduction (LTR) under local anesthesia. The patients were followed up at 1 week, 1, 3 and 6 months postoperatively. During each follow up visit, symptoms were reassessed by VAS score. Difference between preoperative and postoperative VAS score was statistically significant. All patients had significant symptomatic improvement which started from 1 week postoperatively and persisted throughout the follow up period. Prolongation of STT following diode laser turbinate reduction was significant. SST returned back to preoperative value by the end of 6 months. Crusting and pain were the main postoperative complaints. Diode laser turbinate reduction is safe, minimally invasive and effective in relieving the symptoms associated with ITH and can be performed on a day care basis under local anaesthesia. Longer follow up is required to assess the development of late complications and recurrence of symptoms after LTR.

  6. Macaque inferior temporal neurons are selective for three-dimensional boundaries and surfaces.

    PubMed

    Janssen, P; Vogels, R; Liu, Y; Orban, G A

    2001-12-01

    The lower bank of the superior temporal sulcus (TEs), part of the inferior temporal cortex, contains neurons selective for disparity-defined three-dimensional (3-D) shape. The large majority of these TEs neurons respond to the spatial variation of disparity, i.e., are higher-order disparity selective. To determine whether curved boundaries or curved surfaces by themselves are sufficient to elicit 3-D shape selectivity, we recorded the responses of single higher-order disparity-selective TEs neurons to concave and convex 3-D shapes in which the disparity varied either along the boundary of the shape, or only along its surface. For a majority of neurons, a 3-D boundary was sufficient for 3-D shape selectivity. At least as many neurons responded selectively to 3-D surfaces, and a number of neurons exhibited both surface and boundary selectivity. The second aim of this study was to determine whether TEs neurons can represent differences in second-order disparities along the horizontal axis. The results revealed that TEs neurons can also be selective for horizontal 3-D shapes and can code the direction of curvature (vertical or horizontal). Thus, TEs neurons represent both boundaries and surfaces curved in depth and can signal the direction of curvature along a surface. These results show that TEs neurons use not only boundary but also surface information to encode 3-D shape properties.

  7. Tones inferior to eye movements in the EMDR treatment of PTSD.

    PubMed

    van den Hout, Marcel A; Rijkeboer, Marleen M; Engelhard, Iris M; Klugkist, Irene; Hornsveld, Hellen; Toffolo, Marieke J B; Cath, Danielle C

    2012-05-01

    Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature.

  8. Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

    PubMed Central

    Goei, Anthony D.; Josephs, Shellie C.; Kinney, Thomas B.; Ray, Charles E.; Sacks, David

    2011-01-01

    Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process. PMID:22379282

  9. Left inferior-parietal lobe activity in perspective tasks: identity statements.

    PubMed

    Arora, Aditi; Weiss, Benjamin; Schurz, Matthias; Aichhorn, Markus; Wieshofer, Rebecca C; Perner, Josef

    2015-01-01

    We investigate the theory that the left inferior parietal lobe (IPL) is closely associated with tracking potential differences of perspective. Developmental studies find that perspective tasks are mastered at around 4 years of age. Our first study, meta-analyses of brain imaging studies shows that perspective tasks specifically activate a region in the left IPL and precuneus. These tasks include processing of false belief, visual perspective, and episodic memory. We test the location specificity theory in our second study with an unusual and novel kind of perspective task: identity statements. According to Frege's classical logical analysis, identity statements require appreciation of modes of presentation (perspectives). We show that identity statements, e.g., "the tour guide is also the driver" activate the left IPL in contrast to a control statements, "the tour guide has an apprentice." This activation overlaps with the activations found in the meta-analysis. This finding is confirmed in a third study with different types of statements and different comparisons. All studies support the theory that the left IPL has as one of its overarching functions the tracking of perspective differences. We discuss how this function relates to the bottom-up attention function proposed for the bilateral IPL.

  10. Nerve injury associated with orthognathic surgery. Part 2: inferior alveolar nerve.

    PubMed

    McLeod, N M H; Bowe, D C

    2016-05-01

    The inferior alveolar nerve (IAN) is the most commonly injured structure during mandibular osteotomies. The prevalence of temporary injury has been reported as 70/100 patients (95% CI 67 to 73/100) or 56/100 nerves (95% CI 46 to 65/100), and the prevalence of permanent alteration in sensation was 33/100 patients (95% CI 30 to 35/100) or 20/100 nerves (95% CI 18 to 21/100) when assessed subjectively. The prevalence varied significantly between different operations (p<0.0001). It was significantly higher for sagittal split osteotomy (SSO) combined with genioplasty than for SSO alone (p<0.0001) or vertical ramus osteotomy (VRO) (p<0.0001). Injury may result from traction during stripping or manipulation of the distal fragment, incorrect placement of the cuts, or misjudged placement of fixation in ramus ostotomy. During SSO, they can occur during retraction to make cuts in the medial ramus, when the bone is cut or split, and on fixation. The impact of injury is generally said to be low as it does not seem to affect patients' opinions about the operation.

  11. Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study

    PubMed Central

    Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K.; Forouzanfar, Tymour

    2014-01-01

    The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p = 0.03), isolated mandibular fractures (p = 0.01), and angle fractures (p = 0.004). A statistically significant association was also found between IAN injury and assaults (p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions. PMID:25383147

  12. Calcium Channel Dysfunction in Inferior Colliculus Neurons of the Genetically Epilepsy-Prone Rat

    PubMed Central

    N’Gouemo, Prosper; Faingold, Carl L.; Morad, Martin

    2008-01-01

    Summary Voltage-gated calcium (Ca2+) channels are thought to play an important role in epileptogenesis and seizure generation. Here, using the whole-cell configuration of patch-clamp techniques, we report on the modifications of biophysical and pharmacological properties of high threshold voltage-activated Ca2+ channel currents in inferior colliculus (IC) neurons of the genetically epilepsy-prone rats (GEPR-3s). Ca2+channel currents were measured by depolarizing pulses from a holding potential of −80 mV using barium (Ba2+) as the charge carrier. We found that the current density of high threshold voltage-activated Ca2+ channels was significantly larger in IC neurons of seizure-naive GEPR-3s compared to control Sprague-Dawley rats, and that seizure episodes further enhanced the current density in the GEPR-3s. The increased current density was reflected by both a −20 mV shifts in channel activation and a 25% increase in the non-inactivating fraction of channels in seizure-naive GEPR-3s. Such changes were reduced by seizure episodes in the GEPR-3s. Pharmacological analysis of the current density suggests that upregulation of L-, N- and R-type of Ca2+ channels may contribute to IC neuronal hyperexcitability that leads to seizure susceptibility in the GEPR-3s. PMID:19084544

  13. Successful third renal transplantation in a child with an occluded inferior vena cava: A novel technique to use the venous interposition between the transplant renal vein and the infrahepatic inferior vena cava.

    PubMed

    Muramatsu, Masaki; Shishido, Seiichiro; Takahashi, Yusuke; Hamasaki, Yuko; Yoshimura, Hiroshi; Nihei, Hiroshi; Itabashi, Yoshihiro; Kawamura, Takeshi; Aikawa, Atsushi

    2017-03-19

    A girl aged 11 years and 3 months with occlusion of the inferior vena cava had experienced two renal transplant graft failures since birth. The third renal transplant from a live donor was carried out. Preoperative evaluation showed that the arteries from the right common to the right external iliac artery were absent, and the ilio-caval vein was occluded below the level of the renal vein. The donor's renal artery was anastomosed to the aorta. The donor's ovarian and large saphenous veins were used to extend the transplant renal vein to the recipient's patent inferior vena cava. The present report concludes that the extension of a short donor renal vein using other donor veins is a viable therapeutic option for pediatric patients with vascular occlusions.

  14. The neurofibrovascular bundle of the inferior oblique muscle as its ancillary origin.

    PubMed Central

    Stager, D R

    1996-01-01

    PURPOSE: To establish that the neurofibrovascular bundle (NFVB) of the inferior oblique muscle (IO) has ligamentous qualities that enable it to function as an ancillary origin to the muscle. Also, to show that the NFVB does function as the ancillary origin for the IO muscle, particularly when recessing and anteriorly transposing its insertion. METHODS: Fresh (no formaldehyde preservative) cadaver and patient eyes were studied anatomically, histologically, and physiologically. Eighteen orbits were dissected to isolate the IO, the inferior rectus (IR), and the NFVB to demonstrate the linear course of the NFVB and its adjacent fibrous bands. The shape of the muscle was documented. Coronal sections of the two whole, intact orbits were analyzed histologically. Light and electron microscopic sections of an autopsy specimen and a surgical specimen were used to evaluate the capsule of the NFVB and the adjacent fibrous bands near the anterior portion of the NFVB and their attachment to the IR and IO muscle capsules. The elastic modulus was measured in six in situ and six in vitro cadaver NFVB specimens and in six in vivo surgical cases at the time of denervation of the NFVB. For additional comparison, four in vitro cadaver superior oblique tendons were similarly tested. Six eyes that developed recurrent IO overaction following an anterior transposition procedure were surgically explored to determine what structure was serving as its ancillary origin. RESULTS: Gross anatomic and microscopic studies showed a linear orientation of the NFVB with adjacent fibrous bands anteriorly joining the IO and IR muscle capsules. The surgical specimens of the anterior portion of the NFVB show about 50% nerve and 50% fibrocollagenous capsule with the collagen fibers aligned parallel to the NFVB. The elastic modulus was highest (stiffest) in surgical specimens of the NFVB and in situ cadaver NFVB, followed by in vitro cadaver NFVB and, finally, in vitro cadaver superior oblique tendon. In

  15. Relationship of the Gonial Angle and Inferior Alveolar Canal Course Using Cone Beam Computed Tomography

    PubMed Central

    Anbiaee, Najmeh; Bagherpour, Ali

    2015-01-01

    Objectives: Accurate localization of the inferior alveolar canal (IAC) is extremely important in some dental treatments. Anatomical variation of the canal means that it can be difficult to locate. The purpose of this study was to assess the relationship of the gonial angle (GA) size and IAC position using cone beam computed tomography (CBCT). Materials and Methods: In this in vitro study, 61 dry adult human hemi-mandibles were used. The CBCT scans were taken of all samples and GA was measured on all CBCT scans. The samples were divided into two groups of low angle (≤125°) and high angle (>125°). The canal dimensions, length and course were evaluated. On the sagittal view, the IAC path was classified as type A, B or C. On the axial view, canal course was defined as A1 or A2 according to the mental foramen angle. Results: The average GA size was 121.8±7.05° at the right side and 123.8±6.32° at the left side. On the sagittal view, there was a significant correlation between the GA size and the canal course (P=0.04). In the high-angle group, type A was dominant; whereas in the low-angle group, type B was more common. On the axial view of IAC course, type A1 was more common (73.43%). Conclusion: The results showed that GA size was associated with IAC course. In cases with a larger GA, the canal runs in a more straightforward path, and at the same level as the mental foramen. PMID:27252759

  16. Ultrastructural characterization of GABAergic and excitatory synapses in the inferior colliculus.

    PubMed

    Nakamoto, Kyle T; Mellott, Jeffrey G; Killius, Jeanette; Storey-Workley, Megan E; Sowick, Colleen S; Schofield, Brett R

    2014-01-01

    In the inferior colliculus (IC) cells integrate inhibitory input from the brainstem and excitatory input from both the brainstem and auditory cortex. In order to understand how these inputs are integrated by IC cells identification of their synaptic arrangements is required. We used electron microscopy to characterize GABAergic synapses in the dorsal cortex, central nucleus, and lateral cortex of the IC (ICd, ICc, and IClc) of guinea pigs. Throughout the IC, GABAergic synapses are characterized by pleomorphic vesicles and symmetric junctions. Comparisons of GABAergic synapses with excitatory synapses revealed differences (in some IC subdivisions) between the distributions of these synapse types onto IC cells. For excitatory cells in the IClc and ICd GABAergic synapses are biased toward the somas and large dendrites, whereas the excitatory boutons are biased toward spines and small dendrites. This arrangement could allow for strong inhibitory gating of excitatory inputs. Such differences in synaptic distributions were not observed in the ICc, where the two classes of bouton have similar distributions along the dendrites of excitatory cells. Interactions between excitatory and GABAergic inputs on the dendrites of excitatory ICc cells may be more restricted (i.e., reflecting local dendritic processing) than in the other IC subdivisions. Comparisons across IC subdivisions revealed evidence for two classes of GABAergic boutons, a small GABAergic (SG) class that is present throughout the IC and a large GABAergic (LG) class that is almost completely restricted to the ICc. In the ICc, LG, and SG boutons differ in their targets. SG boutons contact excitatory dendritic shafts most often, but also contact excitatory spines and somas (excitatory and GABAergic). LG synapses make comparatively fewer contacts on excitatory shafts, and make comparatively more contacts on excitatory spines and on somas (excitatory and GABAergic). LG boutons likely have a lemniscal origin.

  17. Cerebellar inhibitory output shapes the temporal dynamics of its somatosensory inferior olivary input.

    PubMed

    Hogri, Roni; Segalis, Eyal; Mintz, Matti

    2014-08-01

    The cerebellum is necessary and sufficient for the acquisition and execution of adaptively timed conditioned motor responses following repeated paired presentations of a conditioned stimulus and an unconditioned stimulus. The underlying plasticity depends on the convergence of conditioned and unconditioned stimuli signals relayed to the cerebellum by the pontine nucleus and the inferior olive (IO), respectively. Adaptive timing of conditioned responses relies on the correctly predicted onset of the unconditioned stimulus, usually a noxious somatosensory stimulus. We addressed two questions: First, does the IO relay information regarding the duration of somatosensory stimuli to the cerebellum? Multiple-unit recordings from the IO of anesthetized rats that received periorbital airpuffs of various durations revealed that sustained somatosensory stimuli are invariably transformed into phasic IO outputs. The phasic response was followed by a post-peak depression in IO activity as compared to baseline, providing the cerebellum with a highly synchronous signal, time-locked to the stimulus' onset. Second, we sought to examine the involvement of olivocerebellar interactions in this signal transformation. Cerebello-olivary inhibition was interrupted using temporary pharmacological inactivation of cerebellar output nuclei, resulting in more sustained (i.e., less synchronous) IO responses to sustained somatosensory stimuli, in which the post-peak depression was substituted with elevated activity as compared to baseline. We discuss the possible roles of olivocerebellar negative-feedback loops and baseline cerebello-olivary inhibition levels in shaping the temporal dynamics of the IO's response to somatosensory stimuli and the consequences of this shaping for cerebellar plasticity and its ability to adapt to varying contexts.

  18. Effect of background noise on neuronal coding of interaural level difference cues in rat inferior colliculus.

    PubMed

    Mokri, Yasamin; Worland, Kate; Ford, Mark; Rajan, Ramesh

    2015-07-01

    Humans can accurately localize sounds even in unfavourable signal-to-noise conditions. To investigate the neural mechanisms underlying this, we studied the effect of background wide-band noise on neural sensitivity to variations in interaural level difference (ILD), the predominant cue for sound localization in azimuth for high-frequency sounds, at the characteristic frequency of cells in rat inferior colliculus (IC). Binaural noise at high levels generally resulted in suppression of responses (55.8%), but at lower levels resulted in enhancement (34.8%) as well as suppression (30.3%). When recording conditions permitted, we then examined if any binaural noise effects were related to selective noise effects at each of the two ears, which we interpreted in light of well-known differences in input type (excitation and inhibition) from each ear shaping particular forms of ILD sensitivity in the IC. At high signal-to-noise ratios (SNR), in most ILD functions (41%), the effect of background noise appeared to be due to effects on inputs from both ears, while for a large percentage (35.8%) appeared to be accounted for by effects on excitatory input. However, as SNR decreased, change in excitation became the dominant contributor to the change due to binaural background noise (63.6%). These novel findings shed light on the IC neural mechanisms for sound localization in the presence of continuous background noise. They also suggest that some effects of background noise on encoding of sound location reported to be emergent in upstream auditory areas can also be observed at the level of the midbrain.

  19. Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma with Inferior Vena Cava and Right Atrial Tumors

    SciTech Connect

    Chern, M. C. Chuang, V. P. Cheng, T. Lin, Z. H. Lin, Y. M.

    2008-07-15

    Advanced hepatocelluar carcinoma (HCC) with invasion of venous systems usually indicates not only a poor prognosis but also a contraindication for transcatheter arterial chemoembolization (TACE). This study evaluated the feasibility of TACE for advanced HCC with inferior vena cava (IVC) and right atrium (RA) tumors and, also, to search for the ideal embolization particle size. Twenty-six patients who had HCC invasion into the IVC included five patients with coexistent RA tumors that were treated with TACE. The chemoembolization method was cisplatin, doxorubicin, and mitomycin C mixed with Lipiodol and Ivalon. The selection of Ivalon particles was divided into two groups based on their size: (A) >180 {mu}m, N = 9; and (B) 47-180 {mu}m, N = 17. The overall response rate was 53.8% (14/26). Based on the response to TACE, the median survival period of the entire group was 4.2 months (range, 1.5 to 76.7 months). The median survival period of the 14 responders was 13.5 months (1.5-76.7 months), and that of the 12 nonresponders, 3.3 months (2.1 to 24.3 months) (p < 0.002). Comparing the two Ivalon particle sizes, the response rate was 12.5% (1/9 patients) for group A and 76.5% for group B (13/17 patients) (p < 0.02). No serious complication was observed post-chemoembolization. In conclusion, TACE is a safe and effective treatment for advanced HCC with IVC and RA tumors, and small Ivalon particles (47-180 {mu}m) are superior to large ones (>180 {mu}m).

  20. Essential infantile esotropia with inferior oblique hyperfunction: long term follow-up of 6 muscles approach

    PubMed Central

    Magli, Adriano; Carelli, Roberta; Chiariello Vecchio, Elisabetta; Esposito, Francesca; Rombetto, Luca; Esposito Veneruso, Paolo

    2016-01-01

    AIM To evaluate long term follow-up (10y) of 6 muscle surgical approach in essential infantile esotropia (EIE). METHODS A 6 muscle approach to EIE was retrospectively evaluated in patients with inferior oblique (IO) hyperfunction and lateral rectus (LR) pseudoparalysis, who underwent surgery at different ages. Different clinical characters were analyzed pre- and postoperatively, in patients who underwent a 6 muscles approach ≤4 years of age. All patients underwent a multiple muscles approach: bilateral medial recti (MR) recession (4-5 mm), bilateral LR resection (lower than 7 mm) and bilateral IO recession and anteroposition. Of 108 children with preoperative angle ≥+30 prism diopters (PD) and IO hyperfunction were selected from larger cohort of patients (n=213, 103 females and 110 males) after excluding patients with: angle variability, who underwent reoperation and with incomplete follow up. Preoperative assessment and complete orthoptic examination were performed. Follow-up was performed 3mo, 2, 5 and 10y after surgery. Statistical analysis was performes using SAS statistical software package (version 9.1, SAS Institute Inc., Cary, NC, USA). RESULTS Ten years follow up data analysis showed the following percentage of orthotropic patients: (0 PD): 3mo, 22.2%; 2y, 16.7%; 5y, 25.0% and 10y, 27.8%. A slight, significant (P<0.01), increase of 2y follow up residual deviation was found when compared to 3mo one. Stationary surgical results is reported during time, with a trend of mean residual deviation reduction (P=0.04). CONCLUSION Our results confirm the reliability of multiple muscles surgical approach in the treatment of patients affected by EIE with OI hyperfunction. PMID:28003983

  1. Representation of Perceptual Color Space in Macaque Posterior Inferior Temporal Cortex (the V4 Complex)

    PubMed Central

    Bohon, Kaitlin S.; Hermann, Katherine L.; Hansen, Thorsten

    2016-01-01

    Abstract The lateral geniculate nucleus is thought to represent color using two populations of cone-opponent neurons [L vs M; S vs (L + M)], which establish the cardinal directions in color space (reddish vs cyan; lavender vs lime). How is this representation transformed to bring about color perception? Prior work implicates populations of glob cells in posterior inferior temporal cortex (PIT; the V4 complex), but the correspondence between the neural representation of color in PIT/V4 complex and the organization of perceptual color space is unclear. We compared color-tuning data for populations of glob cells and interglob cells to predictions obtained using models that varied in the color-tuning narrowness of the cells, and the color preference distribution across the populations. Glob cells were best accounted for by simulated neurons that have nonlinear (narrow) tuning and, as a population, represent a color space designed to be perceptually uniform (CIELUV). Multidimensional scaling and representational similarity analyses showed that the color space representations in both glob and interglob populations were correlated with the organization of CIELUV space, but glob cells showed a stronger correlation. Hue could be classified invariant to luminance with high accuracy given glob responses and above-chance accuracy given interglob responses. Luminance could be read out invariant to changes in hue in both populations, but interglob cells tended to prefer stimuli having luminance contrast, regardless of hue, whereas glob cells typically retained hue tuning as luminance contrast was modulated. The combined luminance/hue sensitivity of glob cells is predicted for neurons that can distinguish two colors of the same hue at different luminance levels (orange/brown). PMID:27595132

  2. Glutamatergic neurotransmission in the inferior colliculus influences intrastriatal haloperidol-induced catalepsy.

    PubMed

    Medeiros, P; Viana, M B; Barbosa-Silva, R C; Tonelli, L C; Melo-Thomas, L

    2014-07-15

    The inferior colliculus (IC) is an important midbrain relay station for the integration of descending and ascending auditory information. In addition, it has also been implicated in the processing of acoustic information of aversive nature, as well as in sensory-motor gating. There is evidence that glutamate-mediated mechanisms at the IC level influence haloperidol-induced catalepsy. The present study investigated the influence of glutamate-mediated mechanisms in the IC on catalepsy induced by intrastriatal microinjection of haloperidol (10 μg/0.5 μl). Male Wistar rats received bilateral intracollicular microinjections of the glutamate receptor agonist NMDA (10 or 20 nmol/0.5 μl), the NMDA receptor antagonists MK-801 (15 or 30 nmol/0.5 μl) or physiological saline (0.5 μl), followed by bilateral microinjections of haloperidol (10 μg/0.5 μl) or vehicle (0.5 μl) into the dorso-rostral or ventro-rostral striatum. The catalepsy test was performed positioning both forepaws of the rats on an elevated horizontal wooden bar and recording the time during which the animal remained in this position. The results showed that the administration of physiological saline in the IC followed by the microinjection of haloperidol in the dorso-rostral region of the striatum was not able to induce catalepsy. However, when the bilateral administration of NMDA into the IC was followed by microinjection of haloperidol into the dorso-rostral striatum, catalepsy was observed. The microinjection of haloperidol into the ventro-rostral striatum induced catalepsy, counteracted by previous administration of MK-801 into the IC. These findings suggest that glutamate-mediated mechanisms in the IC can influence the intrastriatal haloperidol-induced catalepsy and that the IC plays an important role as a sensorimotor interface.

  3. Convergent input from brainstem coincidence detectors onto delay-sensitive neurons in the inferior colliculus.

    PubMed

    McAlpine, D; Jiang, D; Shackleton, T M; Palmer, A R

    1998-08-01

    Responses of low-frequency neurons in the inferior colliculus (IC) of anesthetized guinea pigs were studied with binaural beats to assess their mean best interaural phase (BP) to a range of stimulating frequencies. Phase plots (stimulating frequency vs BP) were produced, from which measures of characteristic delay (CD) and characteristic phase (CP) for each neuron were obtained. The CD provides an estimate of the difference in travel time from each ear to coincidence-detector neurons in the brainstem. The CP indicates the mechanism underpinning the coincidence detector responses. A linear phase plot indicates a single, constant delay between the coincidence-detector inputs from the two ears. In more than half (54 of 90) of the neurons, the phase plot was not linear. We hypothesized that neurons with nonlinear phase plots received convergent input from brainstem coincidence detectors with different CDs. Presentation of a second tone with a fixed, unfavorable delay suppressed the response of one input, linearizing the phase plot and revealing other inputs to be relatively simple coincidence detectors. For some neurons with highly complex phase plots, the suppressor tone altered BP values, but did not resolve the nature of the inputs. For neurons with linear phase plots, the suppressor tone either completely abolished their responses or reduced their discharge rate with no change in BP. By selectively suppressing inputs with a second tone, we are able to reveal the nature of underlying binaural inputs to IC neurons, confirming the hypothesis that the complex phase plots of many IC neurons are a result of convergence from simple brainstem coincidence detectors.

  4. Circulating microRNA profile in patients with membranous obstruction of the inferior vena cava.

    PubMed

    Sun, Gui-Xiang; Su, Yong; Li, Ying; Zhang, Ya-Feng; Xu, Li-Chun; Zu, Mao-Heng; Huang, Shui-Ping; Zhang, Jin-Peng; Lu, Zhao-Jun

    2016-03-01

    Membranous obstruction of the inferior vena cava (MOVC) is a common type of Budd-Chiari syndrome. However, the pathogenesis of MOVC has not been fully elucidated. Recent studies demonstrated that microRNAs (miRNAs or miRs) are involved in multiple diseases. To the best of our knowledge, specific changes in the expression of miRNAs in MOVC patients have not been previously assessed. The present study used a microarray analysis, followed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) validation, with the aim to access the miRNA expression levels in the plasma of 34 MOVC patients, compared with those in healthy controls. The results revealed a total of 16 differentially expressed miRNAs in MOVC patients. Subsequently, RT-qPCR analysis verified the statistically consistent expression of 5 selected miRNAs (miR-125a-5p, miR-133b, miR-423-5p, miR-1228-5p and miR-1266), in line with the results of the microarray analysis. These 5 miRNAs, which were described as crucial regulators in numerous biological processes and vascular diseases, may play an important role in the pathogenesis of MOVC. Bioinformatics analysis of target genes of the differentially expressed miRNAs revealed that these predicted targets were significantly enriched and involved in several key signaling pathways important for MOVC, including the ErbB, Wnt, MAPK and VEGF signaling pathway. In conclusion, miRNAs may involve in multiple signaling pathways contributing to the pathological processes of MOVC. The present study offers an intriguing new perspective on the involvement of miRNAs in MOVC; however, the precise underlying mechanisms require further validation.

  5. Motor imagery-based skill acquisition disrupted following rTMS of the inferior parietal lobule.

    PubMed

    Kraeutner, Sarah N; Keeler, Laura T; Boe, Shaun G

    2016-02-01

    Motor imagery (MI), the mental rehearsal of motor tasks, has promise as a therapy in post-stroke rehabilitation. The potential effectiveness of MI is attributed to the facilitation of plasticity in numerous brain regions akin to those recruited for physical practice. It is suggested, however, that MI relies more heavily on regions commonly affected post-stroke, including left hemisphere parietal regions involved in visuospatial processes. However, the impact of parietal damage on MI-based skill acquisition that underlies rehabilitation remains unclear. Here, we examine the contribution of the left inferior parietal lobule (IPL) to MI using inhibitory transcranial magnetic stimulation (TMS) and an MI-based implicit sequence learning (ISL) paradigm. Participants (N = 27) completed the MI-based ISL paradigm after receiving continuous theta burst stimulation to the left IPL (TMS), or with the coil angled away from the scalp (sham). Reaction time differences (dRT) and effect sizes between implicit and random sequences assessed success of MI-based learning. Mean dRT for the sham group was 36.1 ± 28.2 ms (d = 0.71). Mean dRT in the TMS group was 7.7 ± 38.5 ms (d = 0.11). These results indicate that inhibition of the left IPL impaired MI-based learning. We conclude that the IPL and likely the visuospatial processes it mediates are critical for MI performance and thus MI-based skill acquisition or learning. Ultimately, these findings have implications for the use of MI in post-stroke rehabilitation.

  6. The inferior olive is essential for long-term maintenance of a simple motor skill.

    PubMed

    Chen, Xiang Yang; Wang, Yu; Chen, Yi; Chen, Lu; Wolpaw, Jonathan R

    2016-10-01

    The inferior olive (IO) is essential for operant down-conditioning of the rat soleus H-reflex, a simple motor skill. To evaluate the role of the IO in long-term maintenance of this skill, the H-reflex was down-conditioned over 50 days, the IO was chemically ablated, and down-conditioning continued for up to 102 more days. H-reflex size just before IO ablation averaged 62(±2 SE)% of its initial value (P < 0.001 vs. initial). After IO ablation, H-reflex size rose to 75-80% over ∼10 days, remained there for ∼30 days, rose over 10 days to above its initial value, and averaged 140(±14)% for the final 10 days of study (P < 0.01 vs. initial). This two-stage loss of down-conditioning maintenance correlated with IO neuronal loss (r = 0.75, P < 0.01) and was similar to the loss of down-conditioning that follows ablation of the cerebellar output nuclei dentate and interpositus. In control (i.e., unconditioned) rats, IO ablation has no long-term effect on H-reflex size. These results indicate that the IO is essential for long-term maintenance of a down-conditioned H-reflex. With previous data, they support the hypothesis that IO and cortical inputs to cerebellum combine to produce cerebellar plasticity that produces sensorimotor cortex plasticity that produces spinal cord plasticity that produces the smaller H-reflex. H-reflex down-conditioning appears to depend on a hierarchy of plasticity that may be guided by the IO and begin in the cerebellum. Similar hierarchies may underlie other motor learning.

  7. Clinical and electrophysiological assessment of inferior alveolar nerve function after lateral nerve transposition.

    PubMed

    Nocini, P F; De Santis, D; Fracasso, E; Zanette, G

    1999-04-01

    Inferior alveolar nerve (IAN) transposition surgery may cause some degree of sensory impairment. Accurate and reproducible tests are mandatory to assess IAN conduction capacity following nerve transposition. In this study subjective (heat, pain and tactile-discriminative tests) and objective (electrophysiological) assessments were performed in 10 patients receiving IAN transposition (bilaterally in 8 cases) in order to evaluate any impairment of the involved nerves one year post-operatively. All patients reported a tingling, well-tolerated sensation in the areas supplied by the mental nerve with no anaesthesia or burning paresthesia. Tactile discrimination was affected the most (all but 1 patient). No action potential was recorded in 4 patients' sides (23.5%); 12 sides showed a decreased nerve conduction velocity (NCV) (70.5%) and 1 side normal NCV values (6%). There was no significant difference in NCV decrease between partial and total transposition sides, if examined separately. Nerve conduction findings were related 2-point discrimination scores, but not to changes in pain and heat sensitivity. These findings show that lateral nerve transposition, though resulting in a high percentage of minor IAN injuries, as determined by electrophysiological testing, provides a viable surgical procedure to allow implant placement in the posterior mandible without causing severe sensory complaints. Considering ethical and forensic implications, patients should be fully informed that a certain degree of nerve injury might be expected to occur from the procedure. Electrophysiological evaluation is a reliable way to assess the degree of IAN dysfunction, especially if combined with a clinical examination. Intraoperative monitoring of IAN conduction might help identify the pathogenetic mechanisms of nerve injury and the surgical steps that are most likely to harm nerve integrity.

  8. Inferior Frontal Cortex Modulation with an Acute Dose of Heroin During Cognitive Control

    PubMed Central

    Schmidt, André; Walter, Marc; Gerber, Hana; Schmid, Otto; Smieskova, Renata; Bendfeldt, Kerstin; Wiesbeck, Gerhard A; Riecher-Rössler, Anita; Lang, Undine E; Rubia, Katya; McGuire, Philip; Borgwardt, Stefan

    2013-01-01

    Impairments in inhibitory control and in stimulus-driven attention are hallmarks of drug addiction and are associated with decreased activation in the right inferior frontal gyrus (IFG). Although previous studies indicate that the response inhibition function is impaired in abstinent heroin dependents, and that this is mediated by reduced IFG activity, it remains completely unknown whether and how an acute dose of heroin modulates IFG activity during cognitive control in heroin-dependent patients. This study investigates the acute effects of heroin administration on IFG activity during response inhibition and stimulus-driven attention in heroin-dependent patients. Using a cross-over, double-blind, placebo-controlled design, saline and heroin were administered to 26 heroin-dependent patients from stable heroin-assisted treatment, while performing a Go/No–Go event-related functional magnetic resonance imaging task to assess right IFG activity during motor response inhibition, as well as during oddball-driven attention allocation. Relative to saline, heroin significantly reduced right IFG activity during both successful response inhibition and oddball-driven attention allocation, whereas it did not change right IFG activity during response inhibition after correction for the effect of attention allocation. These heroin-induced effects were not related to changes in drug craving, state anxiety, behavioral performance, or co-consumption of psychostimulant drugs. This study demonstrates that heroin administration acutely impairs stimulus-driven attention allocation, as indicated by reduced IFG activity in response to infrequently presented stimuli, and does not specifically modulate IFG activity during response inhibition. PMID:23673865

  9. Differing contributions of inferior prefrontal and anterior temporal cortex to concrete and abstract conceptual knowledge.

    PubMed

    Hoffman, Paul; Binney, Richard J; Lambon Ralph, Matthew A

    2015-02-01

    Semantic cognition is underpinned by regions involved in representing conceptual knowledge and executive control areas that provide regulation of this information according to current task requirements. Using distortion-corrected fMRI, we investigated the contributions of these two systems to abstract and concrete word comprehension. We contrasted semantic decisions made either with coherent contextual support, which encouraged retrieval of a rich conceptual representation, or with irrelevant contextual information, which instead maximised demands on control processes. Inferior prefrontal cortex was activated more when decisions were made in the presence of irrelevant context, suggesting that this region is crucial for the semantic control functions required to select appropriate aspects of meaning in the face of competing information. It also exhibited greater activation for abstract words, which reflects the fact that abstract words tend to have variable, context-dependent meanings that place higher demands on control processes. In contrast, anterior temporal regions (ATL) were most active when decisions were made with the benefit of a coherent context, suggesting a representational role. There was a graded shift in concreteness effects in this region, with dorsolateral areas particularly active for abstract words and ventromedial areas preferentially activated by concrete words. This supports the idea that concrete concepts are closely associated with visual experience and abstract concepts with auditory-verbal information; and that sub-regions of the ATL display graded specialisation for these two types of knowledge. Between these two extremes, we identified significant activations for both word types in ventrolateral ATL. This area is known to be involved in representing knowledge for concrete concepts; here we established that it is also activated by abstract concepts. These results converge with data from rTMS and neuropsychological investigations in

  10. Information conveyed by inferior colliculus neurons about stimuli with aligned and misaligned sound localization cues

    PubMed Central

    Young, Eric D.

    2011-01-01

    Previous studies have demonstrated that single neurons in the central nucleus of the inferior colliculus (ICC) are sensitive to multiple sound localization cues. We investigated the hypothesis that ICC neurons are specialized to encode multiple sound localization cues that are aligned in space (as would naturally occur from a single broadband sound source). Sound localization cues including interaural time differences (ITDs), interaural level differences (ILDs), and spectral shapes (SSs) were measured in a marmoset monkey. Virtual space methods were used to generate stimuli with aligned and misaligned combinations of cues while recording in the ICC of the same monkey. Mutual information (MI) between spike rates and stimuli for aligned versus misaligned cues were compared. Neurons with best frequencies (BFs) less than ∼11 kHz mostly encoded information about a single sound localization cue, ITD or ILD depending on frequency, consistent with the dominance of ear acoustics by either ITD or ILD at those frequencies. Most neurons with BFs >11 kHz encoded information about multiple sound localization cues, usually ILD and SS, and were sensitive to their alignment. In some neurons MI between stimuli and spike responses was greater for aligned cues, while in others it was greater for misaligned cues. If SS cues were shifted to lower frequencies in the virtual space stimuli, a similar result was found for neurons with BFs <11 kHz, showing that the cue interaction reflects the spectra of the stimuli and not a specialization for representing SS cues. In general the results show that ICC neurons are sensitive to multiple localization cues if they are simultaneously present in the frequency response area of the neuron. However, the representation is diffuse in that there is not a specialization in the ICC for encoding aligned sound localization cues. PMID:21653729

  11. Low dimensional representation of face space by face-selective inferior temporal neurons.

    PubMed

    Salehi, Sina; Dehaqani, Mohammad-Reza A; Esteky, Hossein

    2017-03-07

    Representation of visual objects in primate brain is distributed and multiple neurons are involved in encoding each object. One way to understand the neural basis of object representation is to estimate the number of neural dimensions that are needed for veridical representation of object categories. In this study, the characteristics of the match between physical-shape and neural representational spaces in monkey inferior temporal (IT) cortex have been evaluated. Specifically, we examined how the number of neural dimensions, stimulus behavioral saliency and stimulus category selectivity of neurons affect the correlation between shape and neural representational spaces in IT cortex. Single unit recordings from monkey IT revealed that there was a significant match between face space and its neural representation at lower neural dimensions while the optimal match for the non-face objects was observed at higher neural dimensions. There was a statistically significant match between the face and neural spaces only in the face selective neurons while a significant match was observed for non-face objects in all neurons regardless of their category selectivity. Interestingly, the face neurons showed higher match for the non-face objects than for the faces at higher neural dimensions. The optimal representation of face space in the responses of the face neurons was a low dimensional map that emerged early (~ 150ms post stimulus onset) and was followed by a high dimensional and relatively late (~300ms) map for the non-face stimuli. These results support a multiplexing function for the face neurons in the representation of highly similar shape spaces, but with different dimensionality and timing scales. This article is protected by copyright. All rights reserved.

  12. Self-referential phase reset based on inferior olive oscillator dynamics

    PubMed Central

    Kazantsev, V. B.; Nekorkin, V. I.; Makarenko, V. I.; Llinás, R.

    2004-01-01

    The olivo-cerebellar network is a key neuronal circuit that provides high-level motor control in the vertebrate CNS. Functionally, its network dynamics is organized around the oscillatory membrane potential properties of inferior olive (IO) neurons and their electrotonic connectivity. Because IO action potentials are generated at the peaks of the quasisinusoidal membrane potential oscillations, their temporal firing properties are defined by the IO rhythmicity. Excitatory inputs to these neurons can produce oscillatory phase shifts without modifying the amplitude or frequency of the oscillations, allowing well defined time-shift modulation of action potential generation. Moreover, the resulting phase is defined only by the amplitude and duration of the reset stimulus and is independent of the original oscillatory phase when the stimulus was delivered. This reset property, henceforth referred to as selfreferential phase reset, results in the generation of organized clusters of electrically coupled cells that oscillate in phase and are controlled by inhibitory feedback loops through the cerebellar nuclei and the cerebellar cortex. These clusters provide a dynamical representation of arbitrary motor intention patterns that are further mapped to the motor execution system. Being supplied with sensory inputs, the olivo-cerebellar network is capable of rearranging the clusters during the process of movement execution. Accordingly, the phase of the IO oscillators can be rapidly reset to a desired phase independently of the history of phase evolution. The goal of this article is to show how this selfreferential phase reset may be implemented into a motor control system by using a biologically based mathematical model. PMID:15604140

  13. The inferior medial genicular artery and its vascularization of the pes anserinus superficialis: A cadaveric study

    PubMed Central

    Hirtler, Lena; Ederer, Manuel; Faber, Mike; Weninger, Patrick

    2016-01-01

    Background: A common method for reconstruction of the anterior cruciate ligament (ACL) is it's replacement by a free avascular graft, using the gracilis and/or semitendinosus tendons. These grafts pass a vulnerable phase in the ligamentization-process during the 1st year after reconstruction. The aims of this study were first to evaluate the vascularization of the pes anserinus superficialis (PAS) by the inferior medial genicular artery (IMGA) and second to develop a pedunculated surgical technique for ACL reconstruction, to preserve a maximal amount of natural vascularization of the tendons inserting at the PAS. Materials and Methods: First, the vascularization of the PAS was assessed in 12 fresh-frozen lower extremities. The IMGA was identified at its origin at the popliteal artery and perfused with a methylene blue solution. Second, a pedunculated ACL reconstruction was performed in 5 fresh-frozen lower extremities under maintenance of the distal tendon insertion at PAS. Results: The PAS is a highly vascularized structure. Vessels originate from the IMGA, running along the three tendons of the PAS in the paratendinous tissue. Histologically intratendinous vessels exist; however, perfusion of the inserting tendons through intratendinous vessels was not proven macroscopically. The pedunculated grafts could be positioned and fixed successfully into the bone tunnels in all knees. Conclusion: Although intratendinous vascularization of the tendons of the PAS via the IMGA was not proven, this study indicates a new possibility of ACL reconstruction. The described operation technique can be conducive to shorten the vulnerable phase of the graft-ligamentization after ACL reconstruction. PMID:27904225

  14. Therapeutic Progress in Treating Vertebral Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery

    PubMed Central

    Shi, Lei; Xu, Kan; Sun, Xiaofeng; Yu, Jinlu

    2016-01-01

    Among the variations of vertebral artery dissecting aneurysms (VDAs), VDAs involving the posterior inferior cerebellar artery (PICA), especially ruptured and high-risk unruptured aneurysms, are the most difficult to treat. Because the PICA is an important structure, serious symptoms may occur after its occlusion. Retained PICAs are prone to re-bleeding because VDAs are difficult to completely occlude. There is therefore confusion regarding the appropriate treatment for VDAs involving the PICA. Here, we used the PubMed database to review recent research concerning VDAs that involve the PICA, and we found that treatments for VDAs involving the PICA include (i) endovascular treatment involving the reconstruction of blood vessels and blood flow, (ii) occluding the aneurysm using an internal coil trapping or an assisted bypass, (iii) inducing reversed blood flow by occluding the proximal VDA or forming an assisted bypass, or (iv) the reconstruction of blood flow via a craniotomy. Although the above methods effectively treat VDAs involving the PICA, each method is associated with both a high degree of risk and specific advantages and disadvantages. The core problem when treating VDAs involving the PICA is to retain the PICA while occluding the aneurysm. Therefore, the method is generally selected on a case-by-case basis according to the characteristics of the aneurysm. In this study, we summarize the various current methods that are used to treat VDAs involving the PICA and provide schematic diagrams as our conclusion. Because there is no special field of research concerning VDAs involving the PICA, these cases are hidden within many multiple-cases studies. Therefore, this study does not review all relevant documents and may have some limitations. Thus, we have focused on the mainstream treatments for VDAs that involve the PICA. PMID:27429591

  15. Altered voltage-gated calcium channels in rat inferior colliculus neurons contribute to alcohol withdrawal seizures.

    PubMed

    N'Gouemo, Prosper

    2015-08-01

    We have previously reported that enhanced susceptibility to alcohol withdrawal seizures (AWS) parallels the enhancement of the current density of high-threshold voltage-gated Ca(2+) (CaV) channels in rat inferior colliculus (IC) neurons. However, whether this increased current density is a cause or consequence of AWS is unclear. Here, I report changes in the current density of CaV channels in IC neurons during the course of alcohol withdrawal and the potential anticonvulsant effect of intra-IC infusions of L- and P-type CaV channel antagonists. Whole-cell currents were activated by depolarizing pulses using barium as the charge carrier. Currents and seizure susceptibility were evaluated in control animals 3h after alcohol intoxication, as well as 3h (before AWS), 24h (when AWS susceptibility is maximal), and 48h (when AWS susceptibility is no longer present) after alcohol withdrawal. Nifedipine, nimodipine (L-type antagonists) or ω-agatoxin TK (P-type antagonist) were infused intra-IC to probe the role of CaV channels in the pathogenesis of AWS. CaV current density and conductance in IC neurons were significantly increased 3 and 24h after alcohol withdrawal compared with the control group or the group tested 3h following ethanol intoxication. Blockade of L-type CaV channels within the IC completely suppressed AWS, and inhibition of P-type channels reduced AWS severity. These findings suggest that the enhancement of CaV currents in IC neurons occurs prior to AWS onset and that alterations in L- and P-type CaV channels in these neurons may underlie the pathogenesis of AWS.

  16. Ten-year experience of retrievable inferior vena cava filters in a tertiary referral center

    PubMed Central

    Tse, George; Cleveland, Trevor; Goode, Stephen

    2017-01-01

    PURPOSE A significant proportion of patients undergoing surgery have an increased incidence of acute pulmonary embolus (PE). We analyzed all patients who had a retrievable inferior vena cava (IVC) filter placed preoperatively for PE prophylaxis and investigated the long-term outcomes of the patients who did not have their filter removed. METHODS Patients who underwent retrievable IVC filter insertion and attempted removal were identified from the radiology information systems database in a large tertiary referral university teaching hospital. Results of all clinical investigations (including computed tomography, magnetic resonance imaging, ultrasonography, and plain radiography) while the IVC filters were in situ were reviewed. RESULTS In total, 393 retrievable IVC filters were inserted, 254 with the indication of preoperative thromboembolic prophylaxis. Recurrent PE was reported in five patients (1.9%) despite the IVC filter. Of the 254 retrievable filters inserted prior to surgery, an attempt at retrieval was made in 168 filters (66.1%). Successful retrieval at the first attempt occurred in 143 cases (85.1%), while 25 cases failed or were aborted (14.9%). No attempt at retrieval was made in 86 (33.9%) patients and a significant proportion of these patients had undergone cancer surgery (P < 0.0107). In those patients where there was no attempt at retrieval, there was an association between cancer surgery and a shorter absolute survival time (P < 0.0001). CONCLUSION The majority of attempted filter retrievals were successful, and a proportion of nonretrieved IVC filters are accounted for in patients who underwent cancer surgery and ultimately died with the filter in situ. A departmental protocol is recommended to ensure the filter is removed where appropriate and possible. PMID:28093377

  17. Gunther Tulip Retrievable Inferior Vena Caval Filters: Indications, Efficacy, Retrieval, and Complications

    SciTech Connect

    Looby, S.; Given, M.F.; Geoghegan, T.; McErlean, A.; Lee, M.J.

    2007-02-15

    Purpose. We evaluated the Gunther Tulip (GT) retrievable inferior vena cava (IVC) filter with regard to indications, filtration efficacy, complications, retrieval window, and use of anticoagulation. Method. A retrospective study was performed of 147 patients (64 men, 83 women; mean age 58.8 years) who underwent retrievable GT filter insertion between 2001 and 2005. The indications for placement included a diagnosis of pulmonary embolism or deep venous thrombosis with a contraindication to anticoagulation (n = 68), pulmonary embolism or deep venous thrombosis while on anticoagulation (n = 49), prophylactic filter placement for high-risk surgical patients with a past history of pulmonary embolism or deep venous thrombosis (n = 20), and a high risk of pulmonary embolism or deep venous thrombosis (n = 10). Forty-nine of the 147 patients did not receive anticoagulation (33.7%) while 96 of 147 patients did, 82 of these receiving warfarin (56.5%), 11 receiving low-molecular weight heparins (7.58%), and 3 receiving antiplatelet agents alone (2.06%). Results. Filter placement was successful in 147 patients (100%). Two patients had two filters inserted. Of the 147 patients, filter deployment was on a permanent basis in 102 and with an intention to retrieve in 45 patients. There were 36 (80%) successful retrievals and 9 (20%) failed retrievals. The mean time to retrieval was 33.6 days. The reasons for failed retrieval included filter struts tightly adherent to the IVC wall (5/9), extreme filter tilt (2/9), and extensive filter thrombus (2/9). Complications included pneumothorax (n = 4), failure of filter expansion (n = 1), and breakthrough pulmonary embolism (n = 1). No IVC thrombotic episodes were recorded. Discussion. The Gunther Tulip retrievable filter can be used as a permanent or a retrievable filter. It is safe and efficacious. GT filters can be safely retrieved at a mean time interval of 33.6 days. The newly developed Celect filter may extend the retrieval interval.

  18. Cost-benefit analysis of establishing an inferior vena cava filter clinic

    PubMed Central

    Dowell, Joshua D.; Shah, Summit H.; Cooper, Kyle J.; Yıldız, Vedat; Pan, Xueliang

    2017-01-01

    PURPOSE Adverse events associated with retrievable inferior vena cava filters (IVCFs) have generated an increased interest in improving IVCF retrieval rates to improve patient safety and quality care. This study aims to demonstrate the cost-benefit of implementing an IVCF clinic to improve patient care in an institution in the United States. METHODS An IVCF clinic was established at a single institution in September 2012 and for ten months referring physicians were contacted to facilitate retrieval when appropriate. Additionally, a retrospective review was conducted on filter placements over the eight preclinic months. Cost-benefit analysis was conducted by creating a model, which incorporated the average cost and reimbursement for permanent and retrievable IVCFs. RESULTS A total of 190 IVCFs (152 retrievable IVCFs and 38 permanent IVCFs) were implanted during the IVCF clinic period. Twenty-nine percent of the retrievable IVCFs were successfully retrieved compared to 10 of 119 retrievable IVCFs placed during the preclinic period (8.4%). Cost-benefit analysis, using the average of the institution’s six most common reimbursement schedules, demonstrated an average net financial loss per permanent or retrievable IVCF not removed. However, a net financial gain was realized for each retrievable IVCF removed. The additional hospital cost to maintain the IVCF clinic was offset by removing an additional 3.1 IVCFs per year. CONCLUSION An IVCF clinic significantly increases retrieval rates, promotes patient safety, and is economically feasible. Given the adverse event profile of retrievable IVCFs, strategic efforts such as these ultimately can improve quality care for patients with in-dwelling IVCFs. PMID:27833068

  19. [Dissecting aneurysm of the posterior inferior cerebellar artery--a case report].

    PubMed

    Ueki, K; Teraoka, A; Yoshida, S; Hori, T

    1987-11-01

    The authors present a case of dissecting aneurysm of the right posterior inferior cerebellar artery (PICA) in a 47-year-old female, who suffered from mild subarachnoid hemorrhage. Right vertebral angiogram showed typical "pearl and string" sign of the PICA, but we could not fully understand the condition until a surgical exposure revealed a purple sausage-like dissecting aneurysm of the PICA. The aneurysm was wrapped with muscle pieces. Postoperatively she developed Wallenberg's syndrome, but it subsided gradually. No specific disorder concerning the mural dissection was found in this patient, except for a history of mild hypertension. This case is unusual because it affected not an arterial trunk but a small branch and we could find only one other case reported in the literature. Other formerly reported cases were of arterial trunks. The intracranial dissecting aneurysm has been known as a rare cause of cerebral infarct in children and adolescents. Infants are also affected and referred to as "infantile hemiplegia". It mainly affects one of the trunk arteries and cause a severe ischemic stroke, and surgically treatable case is rare. But as the typical angiographic findings are commonly known the number of the reported cases is increasing at an accelerating rate, and some of them are being noted to need surgical treatment because they cause subarachnoid hemorrhage. We here emphasize that not only trunk arteries but also small branch arteries can develop mural dissection, leading to subarachnoid hemorrhage. Dissecting aneurysm of a smaller artery would be milder in symptom, and would give more chance for surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Role of Temporal Processing Stages by Inferior Temporal Neurons in Facial Recognition

    PubMed Central

    Sugase-Miyamoto, Yasuko; Matsumoto, Narihisa; Kawano, Kenji

    2011-01-01

    In this review, we focus on the role of temporal stages of encoded facial information in the visual system, which might enable the efficient determination of species, identity, and expression. Facial recognition is an important function of our brain and is known to be processed in the ventral visual pathway, where visual signals are processed through areas V1, V2, V4, and the inferior temporal (IT) cortex. In the IT cortex, neurons show selective responses to complex visual images such as faces, and at each stage along the pathway the stimulus selectivity of the neural responses becomes sharper, particularly in the later portion of the responses. In the IT cortex of the monkey, facial information is represented by different temporal stages of neural responses, as shown in our previous study: the initial transient response of face-responsive neurons represents information about global categories, i.e., human vs. monkey vs. simple shapes, whilst the later portion of these responses represents information about detailed facial categories, i.e., expression and/or identity. This suggests that the temporal stages of the neuronal firing pattern play an important role in the coding of visual stimuli, including faces. This type of coding may be a plausible mechanism underlying the temporal dynamics of recognition, including the process of detection/categorization followed by the identification of objects. Recent single-unit studies in monkeys have also provided evidence consistent with the important role of the temporal stages of encoded facial information. For example, view-invariant facial identity information is represented in the response at a later period within a region of face-selective neurons. Consistent with these findings, temporally modulated neural activity has also been observed in human studies. These results suggest a close correlation between the temporal processing stages of facial information by IT neurons and the temporal dynamics of face recognition

  1. A Computational Model of Inferior Colliculus Responses to Amplitude Modulated Sounds in Young and Aged Rats

    PubMed Central

    Rabang, Cal F.; Parthasarathy, Aravindakshan; Venkataraman, Yamini; Fisher, Zachery L.; Gardner, Stephanie M.; Bartlett, Edward L.

    2012-01-01

    The inferior colliculus (IC) receives ascending excitatory and inhibitory inputs from multiple sources, but how these auditory inputs converge to generate IC spike patterns is poorly understood. Simulating patterns of in vivo spike train data from cellular and synaptic models creates a powerful framework to identify factors that contribute to changes in IC responses, such as those resulting in age-related loss of temporal processing. A conductance-based single neuron IC model was constructed, and its responses were compared to those observed during in vivo IC recordings in rats. IC spike patterns were evoked using amplitude-modulated tone or noise carriers at 20–40 dB above threshold and were classified as low-pass, band-pass, band-reject, all-pass, or complex based on their rate modulation transfer function tuning shape. Their temporal modulation transfer functions were also measured. These spike patterns provided experimental measures of rate, vector strength, and firing pattern for comparison with model outputs. Patterns of excitatory and inhibitory synaptic convergence to IC neurons were based on anatomical studies and generalized input tuning for modulation frequency. Responses of modeled ascending inputs were derived from experimental data from previous studies. Adapting and sustained IC intrinsic models were created, with adaptation created via calcium-activated potassium currents. Short-term synaptic plasticity was incorporated into the model in the form of synaptic depression, which was shown to have a substantial effect on the magnitude and time course of the IC response. The most commonly observed IC response sub-types were recreated and enabled dissociation of inherited response properties from those that were generated in IC. Furthermore, the model was used to make predictions about the consequences of reduction in inhibition for age-related loss of temporal processing due to a reduction in GABA seen anatomically with age. PMID:23129994

  2. Frequency tuning of synaptic inhibition underlying duration-tuned neurons in the mammalian inferior colliculus.

    PubMed

    Valdizón-Rodríguez, Roberto; Faure, Paul A

    2017-01-18

    Inhibition plays an important role in creating the temporal response properties of duration-tuned neurons (DTNs) in the mammalian inferior colliculus (IC). Neurophysiological and computational studies indicate that duration selectivity in the IC is created through the convergence of excitatory and inhibitory synaptic inputs offset in time. We used paired tone stimulation and extracellular recording to measure the frequency tuning of the inhibition acting on DTNs in the IC of the big brown bat (Eptesicus fuscus). We stimulated DTNs with pairs of tones differing in duration, onset time, and frequency. The onset time of a short, best duration (BD), probe tone set to the best excitatory frequency (BEF) was varied relative to the onset of a longer duration, non-excitatory (NE) tone whose frequency was varied. When the NE tone frequency was near or within the cell's excitatory bandwidth (eBW), BD tone evoked spikes were suppressed by an onset-evoked inhibition. The offset and duration of the suppression decreased as the NE tone frequency departed from the BEF. We measured the inhibitory frequency response area, best inhibitory frequency (BIF), and inhibitory bandwidth (iBW) of each cell. We found that the BIF closely matched the BEF, but the iBW was broader and usually overlapped the eBW measured from the same cell. These data suggest that temporal selectivity of midbrain DTNs is created and preserved by having cells receive an onset-evoked, constant-latency, broadband inhibition that largely overlaps the cell's excitatory receptive field. We conclude by discussing possible neural sources of the inhibition.

  3. Spontaneous cluster activity in the inferior olivary nucleus in brainstem slices from postnatal mice.

    PubMed

    Rekling, Jens C; Jensen, Kristian H R; Jahnsen, Henrik

    2012-04-01

    A distinctive property of the cerebellar system is olivocerebellar modules, where synchronized electrical activity in neurons in the inferior olivary nucleus (IO) evokes organized activity in the cerebellar cortex. However, the exact function of these modules, and how they are developed, is still largely unknown. Here we show that the IO in in vitro slices from postnatal mice spontaneously generates clusters of neurons with synchronous Ca(2+) transients. Neurons in the principal olive (PO), and the vestibular-related dorsomedial cell column (dmcc), showed an age-dependent increase in spontaneous calcium transients. The spatiotemporal activity pattern was occasionally organized in clusters of co-active neighbouring neurons,with regular (16 min-1) and irregular (2-3 min(-1)) repeating cluster activity in the dmcc and PO, respectively. IO clusters had a diameter of 100-170 μm, lasted~1 s, and increased in occurrence from postnatal day P5.5 to P12.5, followed by a sharp drop to near zero at P15.5. IO clusters were overlapping, and comprised nearly identical neurons at some time points, and a varied subset of neurons at others. Some neurons had hub-like properties, being co-active with many other neighbours, and some were co-active with separate clusters at different times. The coherence between calcium transients in IO neurons decreased with Euclidean distance between the cells reaching low values at 100-200 μm distances. Intracellular recordings from IO neurons during cluster formation revealed the presence of spikelet-like potentials, suggesting that electrical coupling between neighbouring IO neurons may serve as a synchronizing mechanism. In conclusion, the IO shows spontaneous cluster activity under in vitro conditions, coinciding with a critical postnatal period in olivocerebellar development. We propose that these clusters may be forerunners of the ensembles of IO neurons shown to be co-active in adult animals spontaneously and during motor acts.

  4. Mechanisms contributing to cluster formation in the inferior olivary nucleus in brainstem slices from postnatal mice.

    PubMed

    Kølvraa, Mathias; Müller, Felix C; Jahnsen, Henrik; Rekling, Jens C

    2014-01-01

    The inferior olivary nucleus (IO) in in vitro slices from postnatal mice (P5.5-P15.5) spontaneously generates clusters of neurons with synchronous calcium transients, and intracellular recordings from IO neurons suggest that electrical coupling between neighbouring IO neurons may serve as a synchronizing mechanism. Here, we studied the cluster-forming mechanism and find that clusters overlap extensively with an overlap distribution that resembles the distribution for a random overlap model. The average somatodendritic field size of single curly IO neurons was ∼6400 μm(2), which is slightly smaller than the average IO cluster size. Eighty-seven neurons with overlapping dendrites were estimated to be contained in the principal olive mean cluster size, and about six non-overlapping curly IO neurons could be contained within the largest clusters. Clusters could also be induced by iontophoresis with glutamate. Induced clusters were inhibited by tetrodotoxin, carbenoxelone and 18β-glycyrrhetinic acid, suggesting that sodium action potentials and electrical coupling are involved in glutamate-induced cluster formation, which could also be induced by activation of N-methyl-d-aspartate and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors. Spikelets and a small transient depolarizing response were observed during glutamate-induced cluster formation. Calcium transients spread with decreasing velocity during cluster formation, and somatic action potentials and cluster formation are accompanied by large dendritic calcium transients. In conclusion, cluster formation depends on gap junctions, sodium action potentials and spontaneous clusters occur randomly throughout the IO. The relative slow signal spread during cluster formation, combined with a strong dendritic influx of calcium, may signify that active dendritic properties contribute to cluster formation.

  5. Sounds and beyond: multisensory and other non-auditory signals in the inferior colliculus

    PubMed Central

    Gruters, Kurtis G.; Groh, Jennifer M.

    2012-01-01

    The inferior colliculus (IC) is a major processing center situated mid-way along both the ascending and descending auditory pathways of the brain stem. Although it is fundamentally an auditory area, the IC also receives anatomical input from non-auditory sources. Neurophysiological studies corroborate that non-auditory stimuli can modulate auditory processing in the IC and even elicit responses independent of coincident auditory stimulation. In this article, we review anatomical and physiological evidence for multisensory and other non-auditory processing in the IC. Specifically, the contributions of signals related to vision, eye movements and position, somatosensation, and behavioral context to neural activity in the IC will be described. These signals are potentially important for localizing sound sources, attending to salient stimuli, distinguishing environmental from self-generated sounds, and perceiving and generating communication sounds. They suggest that the IC should be thought of as a node in a highly interconnected sensory, motor, and cognitive network dedicated to synthesizing a higher-order auditory percept rather than simply reporting patterns of air pressure detected by the cochlea. We highlight some of the potential pitfalls that can arise from experimental manipulations that may disrupt the normal function of this network, such as the use of anesthesia or the severing of connections from cortical structures that project to the IC. Finally, we note that the presence of these signals in the IC has implications for our understanding not just of the IC but also of the multitude of other regions within and beyond the auditory system that are dependent on signals that pass through the IC. Whatever the IC “hears” would seem to be passed both “upward” to thalamus and thence to auditory cortex and beyond, as well as “downward” via centrifugal connections to earlier areas of the auditory pathway such as the cochlear nucleus. PMID:23248584

  6. The left inferior parietal lobe represents stored hand-postures for object use and action prediction.

    PubMed

    van Elk, Michiel

    2014-01-01

    Action semantics enables us to plan actions with objects and to predict others' object-directed actions as well. Previous studies have suggested that action semantics are represented in a fronto-parietal action network that has also been implicated to play a role in action observation. In the present fMRI study it was investigated how activity within this network changes as a function of the predictability of an action involving multiple objects and requiring the use of action semantics. Participants performed an action prediction task in which they were required to anticipate the use of a centrally presented object that could be moved to an associated target object (e.g., hammer-nail). The availability of actor information (i.e., presenting a hand grasping the central object) and the number of possible target objects (i.e., 0, 1, or 2 target objects) were independently manipulated, resulting in different levels of predictability. It was found that making an action prediction based on actor information resulted in an increased activation in the extrastriate body area (EBA) and the fronto-parietal action observation network (AON). Predicting actions involving a target object resulted in increased activation in the bilateral IPL and frontal motor areas. Within the AON, activity in the left inferior parietal lobe (IPL) and the left premotor cortex (PMC) increased as a function of the level of action predictability. Together these findings suggest that the left IPL represents stored hand-postures that can be used for planning object-directed actions and for predicting other's actions as well.

  7. Predictors of Reoperations in Deep Inferior Epigastric Perforator Flap Breast Reconstruction

    PubMed Central

    Unukovych, Dmytro; Gallego, Camilo Hernandez; Aineskog, Helena; Rodriguez-Lorenzo, Andres

    2016-01-01

    Background: The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure. Patients and Methods: A retrospective study of consecutive patients undergoing DIEP breast reconstruction 2007 to 2014 was performed and included a review of 433 medical charts. Surgical outcome was defined as any unanticipated reoperation requiring return to the operating room. Multivariate regression analysis was utilized to identify predictors of reoperation. The following factors were considered: age, body mass index, comorbidity, childbearing history, previous abdominal surgery, adjuvant therapy, reconstruction laterality and timing, flap and perforator characteristics, and number and size of veins. Results: In total, 503 free flaps were performed in 433 patients, 363 (83.8%) unilateral and 70 (16.2%) bilateral procedures. Mean age was 51 years; 15.0% were obese; 13.4% had hypertension; 2.3% had diabetes; 42.6% received tamoxifen; 58.8% had preoperative radiotherapy; 45.6% had abdominal scars. Reoperation rate was 15.9% (80/503) and included flap failure, 2.0%; partial flap loss, 1.2%; arterial thrombosis, 2.0%; venous thrombosis, 0.8%; venous congestion, 1.2%; vein kinking, 0.6%. Other complications included bleeding, 2.2%; hematoma, 3.0%; fat necrosis, 2.8%, and infection, 0.2%. Factors negatively associated with reoperation were childbearing history (odds ratio [OR]: 3.18, P = 0.001) and dual venous drainage (OR: 1.91, P = 0.016); however, only childbearing remained significant in the multivariate analyses (OR: 4.56, P = 0.023). Conclusions: The history of childbearing was found to be protective against reoperation. Number of venous anastomoses may also affect reoperation incidence, and dual venous drainage could be beneficial in

  8. Whole cell recordings of intrinsic properties and sound-evoked responses from the inferior colliculus.

    PubMed

    Xie, R; Gittelman, J X; Li, N; Pollak, G D

    2008-06-12

    Response features of inferior colliculus (IC) neurons to both current injections and tone bursts were studied with in vivo whole cell recordings in awake Mexican free-tailed bats. Of 160 cells recorded, 95% displayed one of three general types of discharge patterns in response to the injection of positive current: 1) sustained discharges; 2) adapting discharges; and 3) onset-bursting discharges. Sustained neurons were the most common type (N=78), followed by onset-bursting (N=57). The least common type was adapting (N=17). In 90 neurons the profiles of synaptic and discharge activity evoked by tones of different frequencies at 50 dB SPL were recorded. Three major tone-evoked response profiles were obtained; 1) neurons dominated by excitation (N=32) in which tones evoked excitatory post-synaptic potentials (EPSPs) or EPSPs with discharges over a range of frequencies with little or no evidence of inhibitory post-synaptic potentials (IPSPs) evoked by frequencies that flanked the excitation; 2) neurons that had an excitatory frequency region in which discharges were evoked that was flanked by frequencies that evoked predominantly IPSPs (N=26); 3) neurons in which all frequencies evoked IPSPs with little or no depolarizations (N=32). The question we asked is whether IC cells that express a particular profile of PSPs and discharges to acoustic stimulation also have the same current-evoked response profile. We show that, with one exception, the intrinsic features of an IC neuron are not correlated with the pattern of its synaptic innervation; the two features are unrelated in the majority of IC cells. The exception is a subtype of inhibitory dominated cell where most frequencies evoked IPSPs to both the onset and to the offset of the tone bursts. In those cells injected current steps always evoked an onset-bursting response.

  9. Serotonin differentially modulates responses to tones and frequency-modulated sweeps in the inferior colliculus.

    PubMed

    Hurley, L M; Pollak, G D

    1999-09-15

    Although almost all auditory brainstem nuclei receive serotonergic innervation, little is known about its effects on auditory neurons. We address this question by evaluating the effects of serotonin on sound-evoked activity of neurons in the inferior colliculus (IC) of Mexican free-tailed bats. Two types of auditory stimuli were used: tone bursts at the neuron's best frequency and frequency-modulated (FM) sweeps with a variety of spectral and temporal structures. There were two main findings. First, serotonin changed tone-evoked responses in 66% of the IC neurons sampled. Second, the influence of serotonin often depended on the type of signal presented. Although serotonin depressed tone-evoked responses in most neurons, its effects on responses to FM sweeps were evenly mixed between depression and facilitation. Thus in most cells serotonin had a different effect on tone-evoked responses than it did on FM-evoked responses. In some neurons serotonin depressed responses evoked by tone bursts but left the responses to FM sweeps unchanged, whereas in others serotonin had little or no effect on responses to tone bursts but substantially facilitated responses to FM sweeps. In addition, serotonin could differentially affect responses to various FM sweeps that differed in temporal or spectral structure. Previous studies have revealed that the efficacy of the serotonergic innervation is partially modulated by sensory stimuli and by behavioral states. Thus our results suggest that the population activity evoked by a particular sound is not simply a consequence of the hard wiring that connects the IC to lower and higher regions but rather is highly dynamic because of the functional reconfigurations induced by serotonin and almost certainly other neuromodulators as well.

  10. Inferior frontal cortex modulation with an acute dose of heroin during cognitive control.

    PubMed

    Schmidt, André; Walter, Marc; Gerber, Hana; Schmid, Otto; Smieskova, Renata; Bendfeldt, Kerstin; Wiesbeck, Gerhard A; Riecher-Rössler, Anita; Lang, Undine E; Rubia, Katya; McGuire, Philip; Borgwardt, Stefan

    2013-10-01

    Impairments in inhibitory control and in stimulus-driven attention are hallmarks of drug addiction and are associated with decreased activation in the right inferior frontal gyrus (IFG). Although previous studies indicate that the response inhibition function is impaired in abstinent heroin dependents, and that this is mediated by reduced IFG activity, it remains completely unknown whether and how an acute dose of heroin modulates IFG activity during cognitive control in heroin-dependent patients. This study investigates the acute effects of heroin administration on IFG activity during response inhibition and stimulus-driven attention in heroin-dependent patients. Using a cross-over, double-blind, placebo-controlled design, saline and heroin were administered to 26 heroin-dependent patients from stable heroin-assisted treatment, while performing a Go/No-Go event-related functional magnetic resonance imaging task to assess right IFG activity during motor response inhibition, as well as during oddball-driven attention allocation. Relative to saline, heroin significantly reduced right IFG activity during both successful response inhibition and oddball-driven attention allocation, whereas it did not change right IFG activity during response inhibition after correction for the effect of attention allocation. These heroin-induced effects were not related to changes in drug craving, state anxiety, behavioral performance, or co-consumption of psychostimulant drugs. This study demonstrates that heroin administration acutely impairs stimulus-driven attention allocation, as indicated by reduced IFG activity in response to infrequently presented stimuli, and does not specifically modulate IFG activity during response inhibition.

  11. Is IMRT Superior or Inferior to 3DCRT in Radiotherapy for NSCLC? A Meta-Analysis

    PubMed Central

    Wen, Shimin; Feng, Xuqin; Fu, Xi; Liu, Yusong; Pu, Ke

    2016-01-01

    Introduction There are no adequate data to determine whether intensity-modulated radiotherapy (IMRT) is superior to three-dimensional conformal radiotherapy (3DCRT) in the treatment of non-small cell lung cancer (NSCLC). This meta-analysis was conducted to compare the clinical outcomes of IMRT and 3DCRT in the treatment of NSCLC. Methods No exclusions were made based on types of study design. We performed a literature search in PubMed, EMBASE and the Cochrane library databases from their inceptions to April 30, 2015. The overall survival (OS) and relative risk (RR) of radiation pneumonitis and radiation oesophagitis were evaluated. Two authors independently assessed the methodological quality and extracted data. Publication bias was evaluated by funnel plot using Egger’s test results. Results From the literature search, 10 retrospective studies were collected, and of those, 5 (12,896 patients) were selected for OS analysis, 4 (981 patients) were selected for radiation pneumonitis analysis, and 4 (1339 patients) were selected for radiation oesophagitis analysis. Cox multivariate proportional hazards models revealed that 3DCRT and IMRT had similar OS (HR = 0.96, P = 0.477) but that IMRT reduced the incidence of grade 2 radiation pneumonitis (RR = 0.74, P = 0.009) and increased the incidence of grade 3 radiation oesophagitis (RR = 2.47, P = 0.000). Conclusions OS of IMRT for NSCLC is not inferior to that of 3DCRT, but IMRT significantly reduces the risk of radiation pneumonitis and increases the risk of radiation oesophagitis compared to 3DCRT. PMID:27100968

  12. Long-term modifications of synaptic efficacy in the human inferior and middle temporal cortex

    NASA Technical Reports Server (NTRS)

    Chen, W. R.; Lee, S.; Kato, K.; Spencer, D. D.; Shepherd, G. M.; Williamson, A.

    1996-01-01

    The primate temporal cortex has been demonstrated to play an important role in visual memory and pattern recognition. It is of particular interest to investigate whether activity-dependent modification of synaptic efficacy, a presumptive mechanism for learning and memory, is present in this cortical region. Here we address this issue by examining the induction of synaptic plasticity in surgically resected human inferior and middle temporal cortex. The results show that synaptic strength in the human temporal cortex could undergo bidirectional modifications, depending on the pattern of conditioning stimulation. High frequency stimulation (100 or 40 Hz) in layer IV induced long-term potentiation (LTP) of both intracellular excitatory postsynaptic potentials and evoked field potentials in layers II/III. The LTP induced by 100 Hz tetanus was blocked by 50-100 microM DL-2-amino-5-phosphonovaleric acid, suggesting that N-methyl-D-aspartate receptors were responsible for its induction. Long-term depression (LTD) was elicited by prolonged low frequency stimulation (1 Hz, 15 min). It was reduced, but not completely blocked, by DL-2-amino-5-phosphonovaleric acid, implying that some other mechanisms in addition to N-methyl-DL-aspartate receptors were involved in LTD induction. LTD was input-specific, i.e., low frequency stimulation of one pathway produced LTD of synaptic transmission in that pathway only. Finally, the LTP and LTD could reverse each other, suggesting that they can act cooperatively to modify the functional state of cortical network. These results suggest that LTP and LTD are possible mechanisms for the visual memory and pattern recognition functions performed in the human temporal cortex.

  13. The representation of sound localization cues in the barn owl's inferior colliculus

    PubMed Central

    Singheiser, Martin; Gutfreund, Yoram; Wagner, Hermann

    2012-01-01

    The barn owl is a well-known model system for studying auditory processing and sound localization. This article reviews the morphological and functional organization, as well as the role of the underlying microcircuits, of the barn owl's inferior colliculus (IC). We focus on the processing of frequency and interaural time (ITD) and level differences (ILD). We first summarize the morphology of the sub-nuclei belonging to the IC and their differentiation by antero- and retrograde labeling and by staining with various antibodies. We then focus on the response properties of neurons in the three major sub-nuclei of IC [core of the central nucleus of the IC (ICCc), lateral shell of the central nucleus of the IC (ICCls), and the external nucleus of the IC (ICX)]. ICCc projects to ICCls, which in turn sends its information to ICX. The responses of neurons in ICCc are sensitive to changes in ITD but not to changes in ILD. The distribution of ITD sensitivity with frequency in ICCc can only partly be explained by optimal coding. We continue with the tuning properties of ICCls neurons, the first station in the midbrain where the ITD and ILD pathways merge after they have split at the level of the cochlear nucleus. The ICCc and ICCls share similar ITD and frequency tuning. By contrast, ICCls shows sigmoidal ILD tuning which is absent in ICCc. Both ICCc and ICCls project to the forebrain, and ICCls also projects to ICX, where space-specific neurons are found. Space-specific neurons exhibit side peak suppression in ITD tuning, bell-shaped ILD tuning, and are broadly tuned to frequency. These neurons respond only to restricted positions of auditory space and form a map of two-dimensional auditory space. Finally, we briefly review major IC features, including multiplication-like computations, correlates of echo suppression, plasticity, and adaptation. PMID:22798945

  14. Inferior frontal gyrus preserves working memory and emotional learning under conditions of impaired noradrenergic signaling

    PubMed Central

    Becker, Benjamin; Androsch, Lucas; Jahn, Ralph T.; Alich, Therese; Striepens, Nadine; Markett, Sebastian; Maier, Wolfgang; Hurlemann, René

    2013-01-01

    Compensation has been widely applied to explain neuroimaging findings in neuropsychiatric patients. Functional compensation is often invoked when patients display equal performance and increased neural activity in comparison to healthy controls. According to the compensatory hypothesis increased activity allows the brain to maintain cognitive performance despite underlying neuropathological changes. Due to methodological and pathology-related issues, however, the functional relevance of the increased activity and the specific brain regions involved in the compensatory response remain unclear. An experimental approach that allows a transient induction of compensatory responses in the healthy brain could help to overcome these issues. To this end we used the non-selective beta-blocker propranolol to pharmacologically induce sub-optimal noradrenergic signaling in healthy participants. In two independent functional MRI (fMRI) experiments participants received either placebo or propranolol before they underwent a cognitive challenge (Experiment 1: working memory; Experiment 2: emotional learning: Pavlovian fear conditioning). In Experiment 1 propranolol had no effects on working memory performance, but evoked stronger activity in the left inferior frontal gyrus (IFG). In Experiment 2 propranolol produced no effects on emotional memory formation, but evoked stronger activity in the right IFG. The present finding that sub-optimal beta-adrenergic signaling did not disrupt performance and concomitantly increased IFG activity is consistent with, and extends, current perspectives on functional compensation. Together, our findings suggest that under conditions of impaired noradrenergic signaling, heightened activity in brain regions located within the cognitive control network, particularly the IFG, may reflect compensatory operations subserving the maintenance of behavioral performance. PMID:24381546

  15. Anesthetic Efficacy of Different Ropivacaine Concentrations for Inferior Alveolar Nerve Block

    PubMed Central

    El-Sharrawy, Eman; Yagiela, John A

    2006-01-01

    This study was conducted on 72 American Society of Anesthesiologists class 1 patients scheduled for extraction of a mandibular third molar after inferior alveolar nerve block. Each patient was randomly administered one of the following ropivacaine concentrations: 0.75%, 0.5%, 0.375%, or 0.25% (18 patients per group). Onset of block (mean ± SD) was rapid for both 0.75% (1.4 ± 0.4 minutes) and 0.5% (1.7 ± 0.5 minutes) ropivacaine but significantly slower for the 0.375% (4.2 ± 2.5 minutes) and 0.25% (10.7 ± 3.0 minutes) concentrations. Tooth extraction was performed successfully with the 0.5% and 0.75% concentrations, and supplemental injections were not required. Second injections, however, were required with 0.375% ropivacaine. Anesthesia was unsuccessful in 13 patients given 0.25% ropivacaine even after 3 injections. The mean durations of soft tissue anesthesia were 3.3 ± 0.3 hours and 3.0 ± 0.3 hours for the 0.75% and 0.5% concentrations, but significantly shorter with more dilute concentrations. The duration of analgesia showed a similar pattern, with the 0.75% and 0.5% concentrations producing prolonged analgesia of 6.0 ± 0.4 hours and 5.6 ± 0.4 hours. These results indicate that 0.5% and 0.75% concentrations were effective for intraoral nerve blockade, with both a rapid onset and prolonged duration of pain control. PMID:16722277

  16. Anesthetic efficacy of different ropivacaine concentrations for inferior alveolar nerve block.

    PubMed

    El-Sharrawy, Eman; Yagiela, John A

    2006-01-01

    This study was conducted on 72 American Society of Anesthesiologists class 1 patients scheduled for extraction of a mandibular third molar after inferior alveolar nerve block. Each patient was randomly administered one of the following ropivacaine concentrations: 0.75%, 0.5%, 0.375%, or 0.25% (18 patients per group). Onset of block (mean +/- SD) was rapid for both 0.75% (1.4 +/- 0.4 minutes) and 0.5% (1.7 +/- 0.5 minutes) ropivacaine but significantly slower for the 0.375% (4.2 +/- 2.5 minutes) and 0.25% (10.7 +/- 3.0 minutes) concentrations. Tooth extraction was performed successfully with the 0.5% and 0.75% concentrations, and supplemental injections were not required. Second injections, however, were required with 0.375% ropivacaine. Anesthesia was unsuccessful in 13 patients given 0.25% ropivacaine even after 3 injections. The mean durations of soft tissue anesthesia were 3.3 +/- 0.3 hours and 3.0 +/- 0.3 hours for the 0.75% and 0.5% concentrations, but significantly shorter with more dilute concentrations. The duration of analgesia showed a similar pattern, with the 0.75% and 0.5% concentrations producing prolonged analgesia of 6.0 +/- 0.4 hours and 5.6 +/- 0.4 hours. These results indicate that 0.5% and 0.75% concentrations were effective for intraoral nerve blockade, with both a rapid onset and prolonged duration of pain control.

  17. Variations in lung lymphatic drainage into the inferior tracheobronchial lymph nodes junction: Applications in lung cancer.

    PubMed

    Ndiaye, Assane; Dimarino, Vincent; Ndiaye, Aïnina; Gaye, Magaye; Ba, Papa Salmane; Nazarian, Serge

    2016-10-01

    The group of inferior tracheobronchial lymph nodes (ITB) is a lymphatic junction through which the lymph from both lungs is carried. Lymphatic activity in this area can be used to assess the lymphatic spreading of lung cancers. Our aim was to quantify lymph drainage from the lung segments towards the ITB group and to determine the direction of the lymph flow into other mediastinal and abdominal lymph nodes. We injected dye directly into the subpleural lymphatic vessels in 100 lung segments of 25 fresh cadaver subjects; the cadavers were then dissected. Thirty-eight segments (38%) drained into the ITB group in 18 subjects. The drainage into the ITB group involved 15.6% of the upper lobe segments, 87.5% of the middle lobe segments, and 70.6% of the lower lobe segments in the right lung. On the left, 6.9% of the upper lobe segments and 83.3% of the lower lobe segments were drained into the ITB group. For three subjects, the dye did not pass beyond the ITB group. The efferent vessels of the ITB group drained towards the right paratracheal and tracheoesophageal chains in 12 subjects and through the left ascending recurrent chain in five subjects. For six subjects, the efferent channels reached the abdominal lymph nodes. A contralateral drainage involved 14 segments (36%). The size and variety of the segments that drain into the ITB group, coupled with the efferent contralateral mediastinal and abdominal pathways, account for the severity of metastasis to this area. Clin. Anat. 29:955-962, 2016. © 2016 Wiley Periodicals, Inc.

  18. Functional topography of the right inferior parietal lobule structured by anatomical connectivity profiles.

    PubMed

    Wang, Jiaojian; Zhang, Jinfeng; Rong, Menglin; Wei, Xuehu; Zheng, Dingchen; Fox, Peter T; Eickhoff, Simon B; Jiang, Tianzi

    2016-12-01

    The nature of the relationship between structure and function is a fundamental question in neuroscience, especially at the macroscopic neuroimaging level. Although mounting studies have revealed that functional connectivity reflects structural connectivity, whether similar structural and functional connectivity patterns can reveal corresponding similarities in the structural and functional topography remains an open problem. In our current study, we used the right inferior parietal lobule (RIPL), which has been demonstrated to have similar anatomical and functional connectivity patterns at the subregional level, to directly test the hypothesis that similar structural and functional connectivity patterns can inform the corresponding topography of this area. In addition, since the association between the RIPL regions and particular functions and networks is still largely unknown, post-hoc functional characterizations and connectivity analyses were performed to identify the main functions and cortical networks in which each subregion participated. Anatomical and functional connectivity-based parcellations of the RIPL have consistently identified five subregions. Our functional characterization using meta-analysis-based behavioral and connectivity analyses revealed that the two anterior subregions (Cl1 and Cl2) primarily participate in interoception and execution, respectively; whereas the posterior subregion (Cl3) in the SMG primarily participates in attention and action inhibition. The two posterior subregions (Cl4, Cl5) in the AG were primarily involved in social cognition and spatial cognition, respectively. These results indicated that similar anatomical and functional connectivity patterns of the RIPL are reflected in corresponding structural and functional topographies. The identified cortical connectivity and functional characterization of each subregion may facilitate RIPL-related clinical research. Hum Brain Mapp 37:4316-4332, 2016. © 2016 Wiley Periodicals

  19. Short-Term Memory Trace in Rapidly Adapting Synapses of Inferior Temporal Cortex

    PubMed Central

    Sugase-Miyamoto, Yasuko; Liu, Zheng; Wiener, Matthew C.; Optican, Lance M.; Richmond, Barry J.

    2008-01-01

    Visual short-term memory tasks depend upon both the inferior temporal cortex (ITC) and the prefrontal cortex (PFC). Activity in some neurons persists after the first (sample) stimulus is shown. This delay-period activity has been proposed as an important mechanism for working memory. In ITC neurons, intervening (nonmatching) stimuli wipe out the delay-period activity; hence, the role of ITC in memory must depend upon a different mechanism. Here, we look for a possible mechanism by contrasting memory effects in two architectonically different parts of ITC: area TE and the perirhinal cortex. We found that a large proportion (80%) of stimulus-selective neurons in area TE of macaque ITCs exhibit a memory effect during the stimulus interval. During a sequential delayed matching-to-sample task (DMS), the noise in the neuronal response to the test image was correlated with the noise in the neuronal response to the sample image. Neurons in perirhinal cortex did not show this correlation. These results led us to hypothesize that area TE contributes to short-term memory by acting as a matched filter. When the sample image appears, each TE neuron captures a static copy of its inputs by rapidly adjusting its synaptic weights to match the strength of their individual inputs. Input signals from subsequent images are multiplied by those synaptic weights, thereby computing a measure of the correlation between the past and present inputs. The total activity in area TE is sufficient to quantify the similarity between the two images. This matched filter theory provides an explanation of what is remembered, where the trace is stored, and how comparison is done across time, all without requiring delay period activity. Simulations of a matched filter model match the experimental results, suggesting that area TE neurons store a synaptic memory trace during short-term visual memory. PMID:18464917

  20. Developmental PCB Exposure Increases Audiogenic Seizures and Decreases Glutamic Acid Decarboxylase in the Inferior Colliculus

    PubMed Central

    Bandara, Suren B.; Eubig, Paul A.; Sadowski, Renee N.; Schantz, Susan L.

    2016-01-01

    Previously, we observed that developmental polychlorinated biphenyl (PCB) exposure resulted in an increase in audiogenic seizures (AGSs) in rats. However, the rats were exposed to loud noise in adulthood, and were not tested for AGS until after 1 year of age, either of which could have interacted with early PCB exposure to increase AGS susceptibility. This study assessed susceptibility to AGS in young adult rats following developmental PCB exposure alone (without loud noise exposure) and investigated whether there was a decrease in GABA inhibitory neurotransmission in the inferior colliculus (IC) that could potentially explain this effect. Female Long-Evans rats were dosed orally with 0 or 6 mg/kg/day of an environmentally relevant PCB mixture from 28 days prior to breeding until the pups were weaned at postnatal day 21. One male-female pair from each litter was retained for the AGS study whilst another was retained for Western blot analysis of glutamic acid decarboxylase (GAD) and GABAAα1 receptor in the IC, the site in the auditory midbrain where AGS are initiated. There was a significant increase in the number and severity of AGSs in the PCB groups, with females somewhat more affected than males. GAD65 was decreased but there was no change in GAD67 or GABAAα1 in the IC indicating decreased inhibitory regulation in the PCB group. These results confirm that developmental PCB exposure alone is sufficient to increase susceptibility to AGS, and provide the first evidence for a possible mechanism of action at the level of the IC. PMID:26543103