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Sample records for synchronous bilateral breast

  1. Synchronous bilateral breast cancer in a male

    PubMed Central

    Rubio Hernández, María Caridad; Díaz Prado, Yenia Ivet; Pérez, Suanly Rodríguez; Díaz, Ronald Rodríguez; Aleaga, Zaili Gutiérrez

    2013-01-01

    Male breast cancer, which represents only 1% of all breast cancers, is occasionally associated with a family history of breast cancer. Sporadic male breast cancers presenting with another primary breast cancer are extremely rare. In this article, we report on a 70-year-old male patient with bilateral multifocal and synchronous breast cancer and without a family history of breast cancer. PMID:24319497

  2. [Synchronous bilateral breast cancer in a male].

    PubMed

    García-Mejido, José Antonio; Delgado-Jiménez, Carmen; Gutiérrez-Palomino, Laura; Sánchez-Sevilla, Miguel; Iglesias-Bravo, Eva; Caballero-Fernández, Virginia

    2013-01-01

    antecedentes: el cáncer de mama en el hombre es una enfermedad con baja incidencia, que se reduce aún más cuando es bilateral sincrónica. Existen pocas publicaciones en los últimos años. Objetivo: establecer pautas para el tratamiento de este cáncer, aunque sea infrecuente. Caso clínico: paciente masculino de 75 años de edad, con tumores en ambas mamas, que se le resecaron completamente con exéresis de ganglios palpables. El estudio histopatológico informó que se trataba de un carcinoma ductal infiltrante no especificado. Se indicó tratamiento adyuvante con tamoxifeno y radioterapia; en la actualidad está libre de enfermedad. Conclusiones: el carcinoma mamario bilateral sincrónico en el varón es una enfermedad poco frecuente. Su tratamiento principal es la cirugía, de ahí la importancia del diagnóstico temprano. En la mayoría de los casos se requiere quimioterapia y radioterapia adyuvante porque suelen diagnosticarse en un estadio avanzado.

  3. EVOLUTION OF SYNCHRONOUS BILATERAL BREAST CARCINOMA IN A YOUNG PATIENT.

    PubMed

    Manea, Elena; Munteanu, Anca

    2016-01-01

    Bilateral breast cancer incidence is appreciated to be between 0.3 to 12% and is determined either by a hereditary load associated with chromosomal instability under the effect of environmental factors, or by the evolution in a particular hormonal context which gives biological aggressiveness. We present the case of a patient, aged 38 years, clinically, imagistic and bioptic diagnosed with left axillary lymph node metastases of breast carcinoma NST invasive G3, IHC-RE = 60%, RP = 30%, HER2neu = 2 +, Ki67 = 20%, in August 2013. Patient followed neoadjuvant chemotherapy treatment during September-October 2013. In December 2013 she was clinically and imaging diagnosed with bilateral breast cancer, for which surgical intervention was done which consisted of bilateral radical Madden mastectomy with bilateral axillary lymphadenectomy. BAP-invasive carcinoma NST: left breast-pT2mN3a G2, right breast--pT3mN3a G2, IHC-RE = 90%, RP =70% HER2neu = 2 +, Ki67 = 50%. During the period of January-March 2014, the patient followed adjuvant chemotherapy and Herceptin. Bilateral breast ultrasound assessment in April 2014 revealed: left axilla--liquid blade 29 / 6mm; right axilla--oval ganglion 9/5 mm. Abdominal and pelvic ultrasound: empty uterine cavity, bosselated contour; at left ovary level multiple cystic formations. During the period of May-June 2014, adjuvant radiation therapy and ovarian irradiationwas administered to the patient. Subsequently hormone therapy was initiated. Following CHT / ovarian irradiation patient continues to experience intermittent uterine bleeding, which is why a total hysterectomy with bilateral ovariectomy was done, and BAP: cervical, endometrialand left ovary with tumor multifocal infiltration with histopathological aspect of invasive breast carcinoma NST. Periodic imaging evaluations do not reveal local or distant recurrence. The particularity of this case is synchronous bilateral breast cancer diagnosis in a young patient complicated in its

  4. Bilateral breast cancer, synchronous and metachronous; differences and outcome.

    PubMed

    Jobsen, J J; van der Palen, J; Ong, F; Riemersma, S; Struikmans, H

    2015-09-01

    The aims of this study were twofold: to analyze the incidence of patients having synchronous or metachronous bilateral invasive breast cancer (SBBC and MBBC) and to assess the characteristics and outcome compared to those having unilateral breast cancer (UBC). The used data were obtained from our prospective population-based cohort study which had been started in 1983. Bilateral breast cancer (BBC) was categorized as SBBC (≤3 months of the first primary) or MBBC (>3 months after the first primary). The incidence of SBBC was 1% and that of MBBC 7.0 %. Patients with UBC showed more ductal carcinoma compared to patients with BBC. MBBC status was an independent significant predictor of local failure (HR 1.9; 95% CI 1.3-2.7). SBBC status was an independent predictor of distant metastases (HR 2.6; 95% CI 1.4-4.5). Overall survival (OS) was better for MBBC (HR 0.6; 95% CI 0.4-0.8) and worse for SBBC (HR 2.3; 95% CI 1.5-3.6) compared to UBC. We noted: (1) MBBC showed a significant higher local failure compared to UBC, (2) SBBC, compared to MBBC and UBC had a significant higher distant metastases rate, (3) disease-specific survival and OS were significantly worse for SBBC compared to UBC and MBBC, and (4) that the OS for MBBC compared to UBC, was significantly better. PMID:26268697

  5. Synchronous, bilateral breast cancer: prognostic value and incidence.

    PubMed

    Jobsen, J J; van der Palen, J; Ong, F; Meerwaldt, J H

    2003-04-01

    The purpose of this study was to address the question whether patients with bilateral breast cancer (BBC) have a worse prognosis in terms of recurrence and survival than patients with primarily unilateral breast cancer (UBC) following breast-conserving treatment (BCT). From 1983 to 2000, a total of 1760 BCT were registered in the Radiotherapy Department of the Medisch Spectrum Twente. We defined synchronous a BBC as cancer diagnosed in both breasts at the same time or within a period of 3 months of diagnosis of the first tumor. One thousand seven hundred and sixty BCT were performed on 1705 patients, 26 of whom presented with BBC. Of these 26 patients, 18 had BCT for both breasts. A higher proportion of patients with BBC showed more tubular carcinoma (P=0.029) and medially located tumors (P=0.076) than those with UBC did. The 5- and 10-year local recurrence rates (LRRs) were 4.5% and 9.1%, respectively, in BBC patients, as against 3.3% and 7.6% for UBC after BCT. The 5- and 10-year distant metastasis rates were 26.9% and 50.7%, respectively, for BBC as against 13.4% and 21.1% for UBC after BCT (P=0.065 and P=0.014, respectively). The 5- and 10-year disease-specific survival (DSS) rates for the 1705 patients were 82.1% and 41%, respectively, after BBC, and 91.4% and 84% after UBC (P=0.086 and P=0.0045, respectively). Patients with BBC have a higher rate of distant metastasis and a worse DSS than those with UBC. As the LRR is similar for BBC and UBC, BCT is not contraindicated in BBC. The incidence of BBC is low, at 1.5% which makes it difficult to reach any more definitive conclusions on outcome and treatment. PMID:14659335

  6. Synchronous, bilateral breast cancer: prognostic value and incidence.

    PubMed

    Jobsen, J J; van der Palen, J; Ong, F; Meerwaldt, J H

    2003-04-01

    The purpose of this study was to address the question whether patients with bilateral breast cancer (BBC) have a worse prognosis in terms of recurrence and survival than patients with primarily unilateral breast cancer (UBC) following breast-conserving treatment (BCT). From 1983 to 2000, a total of 1760 BCT were registered in the Radiotherapy Department of the Medisch Spectrum Twente. We defined synchronous a BBC as cancer diagnosed in both breasts at the same time or within a period of 3 months of diagnosis of the first tumor. One thousand seven hundred and sixty BCT were performed on 1705 patients, 26 of whom presented with BBC. Of these 26 patients, 18 had BCT for both breasts. A higher proportion of patients with BBC showed more tubular carcinoma (P=0.029) and medially located tumors (P=0.076) than those with UBC did. The 5- and 10-year local recurrence rates (LRRs) were 4.5% and 9.1%, respectively, in BBC patients, as against 3.3% and 7.6% for UBC after BCT. The 5- and 10-year distant metastasis rates were 26.9% and 50.7%, respectively, for BBC as against 13.4% and 21.1% for UBC after BCT (P=0.065 and P=0.014, respectively). The 5- and 10-year disease-specific survival (DSS) rates for the 1705 patients were 82.1% and 41%, respectively, after BBC, and 91.4% and 84% after UBC (P=0.086 and P=0.0045, respectively). Patients with BBC have a higher rate of distant metastasis and a worse DSS than those with UBC. As the LRR is similar for BBC and UBC, BCT is not contraindicated in BBC. The incidence of BBC is low, at 1.5% which makes it difficult to reach any more definitive conclusions on outcome and treatment.

  7. [Synchronous bilateral breast cancer and pregnancy: about 3 cases at Joliot Curie institute of Dakar (Senegal)].

    PubMed

    Zongo, Nayi; Sawadogo, Yobi Alexis; Some, Some Ollo Roland; Bagre, Sidpawalmdé Carine; Ka, Sidy; Diouf, Doudou; Dieng, Mamadou Moustapha; Gaye, Papa Macoumba; Dem, Ahmadou

    2016-01-01

    To describe our diagnostic and therapeutic strategy against synchronous, bilateral breast cancer during the pregnancy. Gestational age at diagnosis of cancer was 7; 21 and 25 weeks respectively. Patients had stage IV and IIIA of breast cancer in two and one case respectively. They all received chemotherapy, two cases during pregnancy (6TEC and 3AC) and one case after delivery. Bilateral mastectomy was performed in one case. One patient died. The others were alive but all metastatic. Fetal growth restriction was noted in one case. This association leads to delayed diagnosis of cancer. Surgery is feasible and the type of intervention is only determined by the cancer stage. Chemotherapy is feasible and is associated with less foetal complications in the last two quarters of pregnancy.

  8. Mutational Profiling Can Establish Clonal or Independent Origin in Synchronous Bilateral Breast and Other Tumors

    PubMed Central

    Schwab, Richard; Harismendy, Olivier; Pu, Minya; Crain, Brian; Yost, Shawn; Frazer, Kelly A.; Rana, Brinda; Hasteh, Farnaz; Wallace, Anne; Parker, Barbara A.

    2015-01-01

    Background Synchronous tumors can be independent primary tumors or a primary-metastatic (clonal) pair, which may have clinical implications. Mutational profiling of tumor DNA is increasingly common in the clinic. We investigated whether mutational profiling can distinguish independent from clonal tumors in breast and other cancers, using a carefully defined test based on the Clonal Likelihood Score (CLS = 100 x # shared high confidence (HC) mutations/ # total HC mutations). Methods Statistical properties of a formal test using the CLS were investigated. A high CLS is evidence in favor of clonality; the test is implemented as a one-sided binomial test of proportions. Test parameters were empirically determined using 16,422 independent breast tumor pairs and 15 primary-metastatic tumor pairs from 10 cancer types using The Cancer Genome Atlas. Results We validated performance of the test with its established parameters, using five published data sets comprising 15,758 known independent tumor pairs (maximum CLS = 4.1%, minimum p-value = 0.48) and 283 known tumor clonal pairs (minimum CLS 13%, maximum p-value <0.01), across renal cell, testicular, and colorectal cancer. The CLS test correctly classified all validation samples but one, which it appears may have been incorrectly classified in the published data. As proof-of-concept we then applied the CLS test to two new cases of invasive synchronous bilateral breast cancer at our institution, each with one hormone receptor positive (ER+/PR+/HER2-) lobular and one triple negative ductal carcinoma. High confidence mutations were identified by exome sequencing and results were validated using deep targeted sequencing. The first tumor pair had CLS of 81% (p-value < 10–15), supporting clonality. In the second pair, no common mutations of 184 variants were validated (p-value >0.99), supporting independence. A plausible molecular mechanism for the shift from hormone receptor positive to triple negative was identified in the

  9. Synchronous bilateral primary breast malignant phyllodes tumor and carcinoma of the breast with Paget’s disease: a case report and review of the literature

    PubMed Central

    Zhao, Hongyuan; Cheng, Xiaoming; Sun, Suhong; Yang, Weiming; Kong, Fanli; Zeng, Feng

    2015-01-01

    Synchronous bilateral primary breast malignant phyllodes tumor or/and carcinoma of the breast with Paget’s disease is rare. In the article, we present a case of bilateral carcinoma of the breast with Paget’s disease of the right breast and malignant phyllodes tumor of the left breast. A 44-years-old Chinese woman presented with a 1 month history of the right breast nipple with eczema and fester and growing and palpable mass of left breast. Molybdenum target X-ray revealed microcalcification in the right breast, which was highly suspected of malignant tumor, and round-like mass with smooth surface and homogeneous density in the left breast. Color ultrasound showed a lobulated lump which circumferential blood flows around in the left breast, and which did not show any mass in the right breast. The patient was undertaken the bilateral modified radical mastectomy. The histological diagnosis was Paget’s disease associated with infiltrating ductal carcinoma in the right breast and malignant phyllodes tumor the left breast. The patient also received 6 cycles of the postoperative adjuvant chemotherapy by using T.T. regimen comprised docetaxel (100 mg) and pirarubicin (60 mg). PMID:26770378

  10. Volumetric modulated arc therapy for synchronous bilateral whole breast irradiation – A case study

    PubMed Central

    Seppälä, Jan; Heikkilä, Janne; Myllyoja, Kimmo; Koskela, Kristiina

    2015-01-01

    Purpose The treatment planning of bilateral breast irradiation (BBI) is a challenging task. The overlapping of tangential fields is usually unavoidable without compromising the target coverage. The purpose of this study was to investigate the technical feasibility and benefits of a single isocentre volumetric modulated arc therapy (VMAT) in BBI. Methods and materials Two women with bilateral breast cancer were included in this case study. The first patient (Pat#1) underwent a bilateral breast-conserving surgery and sentinel lymph node biopsy. The second patient (Pat#2) underwent a bilateral ablation and axillary lymph node dissection. Planning target volumes (PTV) and organs at risk were delineated on CT images. VMAT plans were created with four (two for both sides, Pat#1) or two (one for each breast, Pat#2) separate VMAT fields. Subsequently, traditional tangential field plans were generated for each patient and the dosimetric parameters were compared. Results The treatment times of the patients with VMAT were less than 15 min with daily CBCT imaging. When compared to the standard tangential field technique, the VMAT plans improved the PTV dose coverage and dose homogeneity with improved sparing of lungs and heart. With traditional field arrangement, the overlapping of the tangential fields was inevitable without significantly compromising the target coverage, whereas with VMAT the hotspots were avoided. The patients were treated with the VMAT technique and no acute skin toxicity was observed with either of the patients. Conclusions A single isocentre VMAT technique has been implemented clinically for BBI. With the VMAT techniques, the dose delivery was quick and the hotspots in the field overlapping areas were avoided. The PTV dose coverage was superior in VMAT plans when compared with conventional tangential technique plans. PMID:26549999

  11. Bilateral synchronous plasmacytoma of the testis.

    PubMed

    Narayanan, Geetha; Joseph, Rona; Soman, Lali V

    2016-04-01

    Extramedullary plasmacytoma (EMP) is usually seen in the head and neck regions and in the upper respiratory, gastrointestinal, and central nervous systems. Testis is a rare site for EMP, and bilateral synchronous testicular plasmacytoma occurring as an isolated event at initial presentation has been reported only once previously. We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy. PMID:27034568

  12. Discordant cellular response to presurgical letrozole in bilateral synchronous ER+ breast cancers with a KRAS mutation or FGFR1 gene amplification.

    PubMed

    Balko, Justin M; Mayer, Ingrid A; Sanders, Melinda E; Miller, Todd W; Kuba, Maria G; Meszoely, Ingrid M; Wagle, Nikhil; Garraway, Levi A; Arteaga, Carlos L

    2012-10-01

    We describe herein a patient presenting with bilateral estrogen-receptor-positive (ER+) breast tumors who was enrolled in a clinical trial exploring molecular aberrations associated with hormone-refractory tumor cell proliferation. Short-term (two week) hormonal therapy with the aromatase inhibitor letrozole substantially reduced proliferation as measured by Ki67 immunohistochemistry in one tumor, whereas the second was essentially unchanged. Extensive molecular and genetic work-up of the two tumors yielded divergent lesions in the two tumors: an activating KRAS mutation in the responsive tumor and an amplification of the fibroblast growth factor receptor-1 (FGFR1) locus in the treatment-refractory tumor. These findings provide an insight to possible mechanisms of resistance to antiestrogen therapy in ER+ breast cancers. First, they illustrate the necessity of clinically approved assays to identify FGFR1 gene amplification, which occur in approximately 5% of breast tumors and have been linked to antiestrogen resistance. It is quite possible that the addition of FGFR inhibitors to ER-targeted therapy will yield a superior antitumor effect and improved patient outcome. Second, they suggest that the role of activating mutations in RAS, although rare in breast cancer, may need to be explored in the context of ER+ breast tumors.

  13. Synchronous Bilateral Testicular Tumors with Different Histopathology

    PubMed Central

    Anastasiou, Ioannis; Deligiannis, Dimitrios; Skarmoutsos, Ioannis; Karaolanis, Georgios; Palla, Viktoria-Varvara; Nonni, Afrodite; Mitropoulos, Dionysios; Constantinides, Constantinos A.

    2015-01-01

    A 40-year-old male presented to our outpatient department with the chief complaint of a painless mass on his right testis with gradual size increase over the past two months. Physical examination and ultrasound revealed a firm and nontender mass both on the right and on the left testis. The only elevated biomarker was b-hcG (24,7 mIU/mL) and computer tomography (CT) did not reveal any pathology. Bilateral high orchiectomies were performed, without previous frozen storage of the sperm. Histology proved typical seminoma of the left testis and embryonal carcinoma of the right testis. He received two cycles of adjuvant combination chemotherapy with bleomycin, etoposide, and cisplatin. Six months after the operation no residual tumor or recurrence was observed. PMID:26060594

  14. [A Case of Synchronous Malignant Pheochromocytomas in Bilateral Adrenal Glands].

    PubMed

    Usui, Kimitsugu; Hirasawa, Terukazu; Kobayashi, Masataka; Shioi, Kouichi; Kobayashi, Kazuki; Sakai, Naoki; Noguchi, Sumio; Tsuura, Yukio

    2016-06-01

    We present a case of synchronous malignant pheochromocytoma in bilateral adrenal glands. A 73- year-old man presented to our hospital with bilateral adrenal masses incidentally found during abdominal ultrasonography examination for an unrelated issue. The patient had a 30-year history of hypertension and paroxysmal atrial fibrillation. Computed tomography and magnetic resonance imaging showed heterogeneous tumors in bilateral adrenal glands and an enlarged para-aortic lymph node. Hormonal examinations revealed a high value of urinary catecholamines. Metaiodobenzylguanidine (MIBG) scintigraphy showed increased uptake in bilateral adrenal glands and the lymph node. Both adrenal tumors and the node were surgically removed. Pathological examination revealed histologically distinct tissue between the two adrenal tumors. The patient received five cycles of adjuvant chemotherapy, consisting of cyclophosphamide, vincristine, and dacarbazine. The patient has been in remission for 32 months following surgical treatment. PMID:27452493

  15. [A Case of Synchronous Malignant Pheochromocytomas in Bilateral Adrenal Glands].

    PubMed

    Usui, Kimitsugu; Hirasawa, Terukazu; Kobayashi, Masataka; Shioi, Kouichi; Kobayashi, Kazuki; Sakai, Naoki; Noguchi, Sumio; Tsuura, Yukio

    2016-06-01

    We present a case of synchronous malignant pheochromocytoma in bilateral adrenal glands. A 73- year-old man presented to our hospital with bilateral adrenal masses incidentally found during abdominal ultrasonography examination for an unrelated issue. The patient had a 30-year history of hypertension and paroxysmal atrial fibrillation. Computed tomography and magnetic resonance imaging showed heterogeneous tumors in bilateral adrenal glands and an enlarged para-aortic lymph node. Hormonal examinations revealed a high value of urinary catecholamines. Metaiodobenzylguanidine (MIBG) scintigraphy showed increased uptake in bilateral adrenal glands and the lymph node. Both adrenal tumors and the node were surgically removed. Pathological examination revealed histologically distinct tissue between the two adrenal tumors. The patient received five cycles of adjuvant chemotherapy, consisting of cyclophosphamide, vincristine, and dacarbazine. The patient has been in remission for 32 months following surgical treatment.

  16. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report

    PubMed Central

    Leon-Soriano, Elena; Alfonso, Carolina; Yebenes, Laura; Garcia-Polo, Julio; Lassaletta, Luis; Gavilan, Javier

    2016-01-01

    Patient: Male, 41 Final Diagnosis: Olfactory neuroblastoma Symptoms: Left nasal obstruction • occasional left epistaxis • headache Medication: None Clinical Procedure: Nasal endoscopic examination • neck palpation • CT • bilateral endoscopic resection • MRI • PET-CT • postoperative radiotherapy Specialty: Otolaryngology Objective: Unusual clinical course Background: Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant head and neck cancer thought to originate from the olfactory epithelium. It typically invades contiguous structures at presentation. We report a very rare case of multifocal and ectopic ONB. Case Report: A 41-year-old man presented with left nasal obstruction and occasional left epistaxis associated with headache. Endoscopic examination of the nasal cavities and computed tomography suggested bilateral polypoid masses. Histopathological diagnosis after endoscopic resection established bilateral olfactory neuroblastoma of the ethmoid sinuses. The patient received postoperative radiotherapy. He remains free of disease 4 years after treatment. Conclusions: To the best of our knowledge this is the second documented case of multifocal ectopic olfactory neuroblastoma. Clinicians should consider ONB in the differential diagnosis of bilateral synchronous nasal and paranasal masses to avoid delayed diagnosis. Endoscopic resection of ONB could be an option in selected cases. PMID:27097989

  17. Synchronous luminescence spectroscopy of human breast tissues

    NASA Astrophysics Data System (ADS)

    Majumdar, S. K.; Gupta, P. K.

    1998-06-01

    We report, to our knowledge, the first use of synchronous luminescence (SL) spectroscopy for autofluorescence diagnosis of cancer. The spectral narrowing effect of the SL spectroscopy led to an easier identification of the different fluorophores present in human breast tissues and provided relative estimate of their concentration in qualitative agreement with the estimates obtained from conventional excitation and emission spectroscopy. Further, the SL spectra from human breast tissues could discriminate cancerous tissues from benign tumors and normal tissues with a sensitivity and specificity of 100% in a study involving 34 patients with breast tumor (19 ductal carcinomas and 15 fibroadenomas).

  18. Giant Bilateral Juvenile Fibroadenoma of the Breast in Prepubescent Girl.

    PubMed

    Khan, Salma; Khan, Momna; Rafique, Sadia

    2015-10-01

    Juvenile fibroadenoma accounts for 4% of the total fibroadenomas. Giant juvenile fibroadenoma is found in only 0.5% of all fibroadenomas. The authors report a 10-year girl presenting with progressive enlargement of both breasts for one year. Based on clinical findings and Fine Needle Aspiration Cytology (FNAC), a diagnosis of bilateral giant juvenile fibroadenomas of breast was made. She underwent bilateral lumpectomy with breast conservation and made uneventful postoperative recovery. PMID:26522216

  19. Breast MRI after bilateral mastectomy: is it indicated?

    PubMed

    Vanderwalde, Lindi H; Dang, Catherine M; Tabrizi, Robert; Saouaf, Rola; Phillips, Edward H

    2011-02-01

    Little is known about the use of breast MRI as a diagnostic or surveillance tool in patients after bilateral mastectomy. The objective of this study was to evaluate breast MRI after bilateral mastectomy. Participants consisted of 48 women with prior bilateral mastectomy who underwent breast MRI between 2003 and 2009. Seventy-nine breast MRIs were obtained. The median time between mastectomy and first MRI was 36 months. MRI was ordered most often by a medical oncologist (71%). Median age at bilateral mastectomy was 49 years (range, 33 to 72 years). Reasons for obtaining MRI included surveillance in 60 (76%), mass in eight (10%), lymph nodes in four (5%), pain in three (4%), and abscess in one (1%). Overall, 68 (86%) MRIs showed benign imaging findings only. Within the surveillance group, six patients had MRIs with findings that changed management; four patients had some residual breast tissue, and two patients had findings outside the breast that were better evaluated by CT or bone scan and were ultimately benign. MRI confirmed locoregional recurrence in two patients with highly suspicious physical findings. Overall, postmastectomy breast MRI had limited use, finding no unsuspected recurrences within our study group. Although MRI can be helpful to establish the presence of residual breast tissue after bilateral mastectomy, subsequent routine screening breast MRI should be questioned if no residual breast tissue is identified. PMID:21337876

  20. Bilateral giant juvenile fibroadenomas of the breasts-a rare indication for bilateral skin reducing mastectomy.

    PubMed

    Laitano, Francisco Felipe; Neto, Francisco Laitano; Zerwes, Felipe Pereira

    2016-08-01

    Fibroadenoma is the most common benign tumor of the breast but giant juvenile fibroadenoma represent only 0.5% of all fibroadenomas and when bilateral are much more rare. We describe the case of a 25 years old girl that presented with bilateral giant juvenile fibroadenomas and was treated by bilateral skin reducing mastectomy using the inferior dermal flap, implant, and free nipple graft. PMID:27563567

  1. Bilateral breast necrosis due to local injection of fish oil.

    PubMed

    Turk, Emin; Karagulle, Erdal; Koksal, Hande; Togan, Turhan; Erinanc, Ozgur Hilal; Dogru, Osman; Moray, Gokhan

    2013-01-01

    The breast is as aesthetically important as it is physiologically. Physicians and women have practiced various methods for breast aesthetics and augmentation. We report a female veterinarian who injected fish oil into her breast, which led to inflammation and necrosis of breast tissue. When all medical therapies failed, bilateral subcutaneous mastectomy was performed. We did not find a case in the literature where fish oil had been used for breast augmentation. However, we did find that many agents have been injected for breast augmentation, the results of which were tragic, just as the case presented herein.

  2. Synchronized computational architecture for generalized bilateral control of robot arms

    NASA Technical Reports Server (NTRS)

    Szakaly, Zoltan F. (Inventor)

    1991-01-01

    A master six degree of freedom Force Reflecting Hand Controller (FRHC) is available at a master site where a received image displays, in essentially real time, a remote robotic manipulator which is being controlled in the corresponding six degree freedom by command signals which are transmitted to the remote site in accordance with the movement of the FRHC at the master site. Software is user-initiated at the master site in order to establish the basic system conditions, and then a physical movement of the FRHC in Cartesean space is reflected at the master site by six absolute numbers that are sensed, translated and computed as a difference signal relative to the earlier position. The change in position is then transmitted in that differential signal form over a high speed synchronized bilateral communication channel which simultaneously returns robot-sensed response information to the master site as forces applied to the FRHC so that the FRHC reflects the feel of what is taking place at the remote site. A system wide clock rate is selected at a sufficiently high rate that the operator at the master site experiences the Force Reflecting operation in real time.

  3. A case of unilateral keloid after bilateral breast reduction

    PubMed Central

    Devalia, Haresh; Mansfield, Lucy; Minakaran, Neda; Banerjee, Dibyesh

    2008-01-01

    Keloid scar is a manifestation of abnormal wound healing in predisposed individuals. Many treatment modalities have been tried with varying degrees of success. Radiotherapy is one such modality that is widely recognised. We present a case report and literature review based on a patient who developed unilateral keloid scarring following bilateral breast reduction surgery. Some 4 years previously, she had undergone breast conserving surgery followed by adjuvant radiotherapy for breast cancer. After her breast reduction surgery, she developed keloid scarring on the non-irradiated breast only. This case highlights a possible 'preventative' effect of radiotherapy in keloid formation. PMID:18294403

  4. [Bilateral and synchronic testicular neoplasia. A report of a new case].

    PubMed

    Soto Delgado, M; Pedrero Márquez, G; Ramírez Chamorro, F; Rodríguez-Rubio Cortadellas, F; Sánchez Bernal, C; González Moreno, D

    2007-01-01

    Bilateral and synchronic testicular tumor is an unfrequent fact (0,17% of germinative tumors of testicle), being most cases seminomas. We present the case of a male, 25-year old patient underwent a bilateral radical orchiectomy for bilateral and synchronic testicular tumor. The result of anatomopathological examination revealed bilateral seminoma (pT2 in both testes). Patient received four courses of adjuvant chemotherapy (etoposide and cisplatin) for metastases (N2, M1). The patient is without evidence of disease two years after orchiectomy.

  5. Bilateral desmoid tumor of the breast: case seriesand literature review

    PubMed Central

    Wongmaneerung, Phanchaporn; Somwangprasert, Areewan; Watcharachan, Kirati; Ditsatham, Chagkrit

    2016-01-01

    Background Desmoid tumor of the breast is very rare and locally aggressive but has no distant metastasis. Bilateral lesions are extremely rare, found in only 4% of patients. Two cases of bilateral desmoid tumor of the breast are reported. The clinical presentation, diagnosis, imaging, treatment, and follow-up outcomes of recurrence as well as a brief literature review are provided. Case reports Case 1 is a 31-year-old woman who presented with nipple retraction. An ultrasound revealed BIRAD V in both breasts. She underwent a bilateral excisional biopsy under ultrasound mark with the pathology result of extra-abdominal desmoid tumor in both breasts. The patient had a bilateral mastectomy with silicone implantation due to the involved margins by excision. She remained tumor free after 7-year follow-up. Case 2 is a 28-year-old woman who presented with a lump on her right breast that she had discovered ~2 months earlier. An ultrasound showed a spiculated mass in the right breast and some circumscribed hypoechoic masses in both breasts. A bilateral breast excision was done. The pathology result was an extra-abdominal desmoid tumor. She had recurrence on both sides and underwent a mastectomy and silicone implantation. The tumor has not recurred after 1-year follow-up. Conclusion Imaging cannot distinguish between benign breast lesions and malignancy. Pathology results are helpful in making a definitive diagnosis. Given that the desmoid tumor is locally aggressive, a local excision with clear margins is recommended. Chemotherapy and hormonal treatment are controversial. PMID:27578999

  6. Bilateral anterolateral thigh flaps for large-volume breast reconstruction.

    PubMed

    Rosenberg, Jason J; Chandawarkar, Rajiv; Ross, Merrick I; Chevray, Pierre M

    2004-01-01

    Autologous tissue reconstruction of a large breast in patients who are not candidates for a TRAM flap is a difficult problem. We present a case report of the use of bilateral free anterolateral thigh (ALT) flaps for immediate reconstruction of a unilateral large breast in a patient who had a previous abdominoplasty. Use of ALT flaps allows two or three surgical teams to work simultaneously, does not require intraoperative patient repositioning, has minimal donor-site morbidity, and can provide ample malleable soft tissue for breast reconstruction. These are advantages compared to the use of gluteal donor sites. The disadvantages include more conspicuous donor-site scarring on the anterior thighs.

  7. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    NASA Astrophysics Data System (ADS)

    Williams, Alex C.; Hitt, Austin; Voisin, Sophie; Tourassi, Georgia

    2013-03-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists' manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  8. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    SciTech Connect

    Williams, Alex C; Hitt, Austin N; Voisin, Sophie; Tourassi, Georgia

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  9. Synchronous bilateral squamous cell carcinoma of the lung successfully treated using intensity-modulated radiotherapy

    PubMed Central

    Loo, S W; Smith, S; Promnitz, D A; Van Tornout, F

    2012-01-01

    We present a case of synchronous bilateral inoperable lung cancer which required treatment with external beam radiotherapy to a radical dose. Intensity-modulated radiotherapy (IMRT) was used. More conformal dose distribution within the planning target volume was obtained using IMRT than the conventional technique. Dose–volume constraints defined for the lungs were met. Treatment was subsequently delivered using a seven-field IMRT plan. The patient remains alive and disease-free 48 months after the completion of radiotherapy. IMRT can be considered an effective treatment for synchronous bilateral lung cancer. PMID:21937610

  10. Unilateral and Bilateral Breast Cancer in Women Surviving Pediatric Hodgkin's Disease

    SciTech Connect

    Basu, Swati K.; Schwartz, Cindy; Fisher, Susan G.; Hudson, Melissa M.; Tarbell, Nancy; Muhs, Ann; Marcus, Karen J.; Mendenhall, Nancy; Mauch, Peter; Kun, Larry E.; Constine, Louis S.

    2008-09-01

    Purpose: To define demographic and therapeutic associations with the risk of breast cancer in children treated for Hodgkin's disease (HD), particularly the frequency and interval to the development of contralateral breast cancer. Methods and Materials: All 398 female patients (<19 years) treated for HD in five institutions during the accrual period were evaluated. Mean follow-up was 16.9 years. The standardized incidence ratio (SIR) was calculated as the ratio of the observed number of cases to the expected number of cases, estimated using age-matched controls from the Surveillance, Epidemiology, and End Results database. Results: A total of 29 women developed breast cancer (25 invasive, 4 ductal carcinoma in situ; SIR, 37.25; 95% confidence interval, 24.96-53.64). Time to diagnosis was 9.4 to 36.1 years. Cumulative incidence was 24% at 30 years. Ten patients (34%) had bilateral disease (9 metachronous, 1 synchronous). The interval to contralateral breast cancer was 12 to 34 months. On univariate analysis, significant variables included stage of HD, mantle radiation dose, pelvic radiation (protective), and follow-up time. On multivariate analysis, early stage and older age at diagnosis of HD ({<=}12 vs. >12 years) were significant predictors of secondary breast cancer. Conclusions: Women surviving pediatric HD were found to have a 37-fold increase in the risk of breast cancer and a high likelihood of rapidly developing bilateral disease. Early-stage HD and age greater than 12 years at diagnosis of HD were independent risk factors. Higher radiation doses may augment risk, and pelvic radiation may be protective. Breast cancer screening methodology and frequency, plus the role of prophylaxis in patients with unilateral disease, require definition.

  11. A Synchronization Method of Visual and Tactile Senses for Bilateral Teleoperation over Network

    NASA Astrophysics Data System (ADS)

    Yashiro, Daisuke; Natori, Kenji; Ohnishi, Kouhei

    In bilateral teleoperation, the human operator manipulates the master robot while watching video images that are sent from the slave side. Live video streaming causes a significant communication delay to the system. However, a conventional definition of transparency for bilateral control does not consider this delay. In this paper, a novel definition of transparency is proposed. If perfect transparency is achieved, the visual sense and tactile sense synchronize. This transparency is nearly achieved by applying a compliance control to the slave controller. By using this structure, the slave robot contacts the environment safely even if there exist communication delay between the master side and the slave side. In addition, the visual sense and tactile sense synchronize. The validity of the proposed method is shown by numerical and experimental results.

  12. A case report on bilateral partial breast irradiation using SAVI

    SciTech Connect

    Gloi, Aime M.; Buchanan, Robert; Nuskind, Jeff; Zuge, Corrie; Goettler, Anndrea

    2012-07-01

    To assess dosimetric parameters in a case study where bilateral accelerated partial breast irradiation (APBI) is delivered using a strut-adjusted volume implant (SAVI) device. A 59-year-old female received APBI in both breasts over 5 days, with fractions of 3.4 Gy twice daily. A Vac-lok system was used for immobilization, and a C-arm was used for daily imaging. We generated dose-volume histograms (DVHs) for the brachytherapy plans to derive several important biologic factors. We calculated the normal tissue complication probability (NTCP), equivalent uniform dose (EUD), and tumor control probability (TCP) using the Lyman-Kutcher-Burman model parameters {alpha} = 0.3 Gy{sup -1}, {alpha}/{beta} = 4 Gy, n = 0.1, and m = 0.3. In addition, we assessed the dose homogeneity index (DHI), overdose index, and dose nonuniformity ratio. D95 was >95% and V150 was <50 mL for both breasts. The DHIs were 0.469 and 0.512 for the left and right breasts, respectively. The EUDs (normalized to 3.4 Gy b.i.d.) were 33.53 and 29.10 Gy. The TCPs were estimated at 99.2% and 99.9%, whereas the NTCP values were 4.2% and 2.57%. In this clinical case, we were able to quantify the dosimetric parameters of an APBI treatment performed with a SAVI device.

  13. Tamoxifen Citrate, Letrozole, Anastrozole, or Exemestane With or Without Chemotherapy in Treating Patients With Invasive RxPONDER Breast Cancer

    ClinicalTrials.gov

    2016-11-04

    Ductal Breast Carcinoma In Situ; Estrogen Receptor and/or Progesterone Receptor Positive; HER2/Neu Negative; Invasive Breast Carcinoma; Multicentric Breast Carcinoma; Multifocal Breast Carcinoma; Synchronous Bilateral Breast Carcinoma

  14. Independent Tumor Origin in Two Cases of Synchronous Bilateral Clear Cell Renal Cell Carcinoma

    PubMed Central

    Ji, Zhengguo; Zhao, Jialu; Zhao, Tian; Han, Yuying; Zhang, Yujun; Ye, Haihong

    2016-01-01

    Bilateral renal cell carcinomas (RCCs) pose a challenge for clinical treatment and management. Most bilateral RCCs are sporadic, and do not show a hereditary pattern indicative of VHL syndrome or other inherited cancers. The origin and evolution of these sporadic bilateral RCCs remains elusive. We obtained normal and tumor samples from two male patients suffering from early stage synchronous bilateral clear cell RCC (ccRCC), and analyzed genomic DNA using whole exome sequencing and bisulfite pyrosequencing. We detected distinct 3p loss of heterozygosity (LOH) in both tumors in each patient. Two tumors within the same patient harbored distinct driver mutations and different CpG hypermethylation sites in the VHL promoter. Moreover, tumors exhibit independent evolutionary trajectories. Therefore, distinct 3p LOH, combined with contingent driver gene mutations and independent VHL hypermethylation, led to independent tumor origin and parallel evolution of bilateral ccRCC in these two patients. Our results indicate that tumors in these two cases were not due to common germline oncogenic mutations. They were results of multiple de novo mutations in each kidney, rather than primary ccRCC with contralateral renal metastasis. Therefore, histopathologic and genetic profiling from single tumor specimen may underestimate the mutational burden and somatic heterogeneity of bilateral ccRCCs. PMID:27383411

  15. Independent Tumor Origin in Two Cases of Synchronous Bilateral Clear Cell Renal Cell Carcinoma.

    PubMed

    Ji, Zhengguo; Zhao, Jialu; Zhao, Tian; Han, Yuying; Zhang, Yujun; Ye, Haihong

    2016-01-01

    Bilateral renal cell carcinomas (RCCs) pose a challenge for clinical treatment and management. Most bilateral RCCs are sporadic, and do not show a hereditary pattern indicative of VHL syndrome or other inherited cancers. The origin and evolution of these sporadic bilateral RCCs remains elusive. We obtained normal and tumor samples from two male patients suffering from early stage synchronous bilateral clear cell RCC (ccRCC), and analyzed genomic DNA using whole exome sequencing and bisulfite pyrosequencing. We detected distinct 3p loss of heterozygosity (LOH) in both tumors in each patient. Two tumors within the same patient harbored distinct driver mutations and different CpG hypermethylation sites in the VHL promoter. Moreover, tumors exhibit independent evolutionary trajectories. Therefore, distinct 3p LOH, combined with contingent driver gene mutations and independent VHL hypermethylation, led to independent tumor origin and parallel evolution of bilateral ccRCC in these two patients. Our results indicate that tumors in these two cases were not due to common germline oncogenic mutations. They were results of multiple de novo mutations in each kidney, rather than primary ccRCC with contralateral renal metastasis. Therefore, histopathologic and genetic profiling from single tumor specimen may underestimate the mutational burden and somatic heterogeneity of bilateral ccRCCs. PMID:27383411

  16. Comparative genomic analysis reveals bilateral breast cancers are genetically independent.

    PubMed

    Song, Fangfang; Li, Xiangchun; Song, Fengju; Zhao, Yanrui; Li, Haixin; Zheng, Hong; Gao, Zhibo; Wang, Jun; Zhang, Wei; Chen, Kexin

    2015-10-13

    Bilateral breast cancer (BBC) poses a major challenge for oncologists because of the cryptic relationship between the two lesions. The purpose of this study was to determine the origin of the contralateral breast cancer (either dependent or independent of the index tumor). Here, we used ultra-deep whole-exome sequencing and array comparative genomic hybridization (aCGH) to study four paired samples of BBCs with different tumor subtypes and time intervals between the developments of each tumor. We used two paired primary breast tumors and corresponding metastatic liver lesions as the control. We tested the origin independent nature of BBC in three ways: mutational concordance, mutational signature clustering, and clonality analysis using copy number profiles. We found that the paired BBC samples had near-zero concordant mutation rates, which were much lower than those of the paired primary/metastasis samples. The results of a mutational signature analysis also suggested that BBCs are independent of one another. A clonality analysis using aCGH data further revealed that paired BBC samples was clonally independent, in contrast to clonal related origin found for paired primary/metastasis samples. Our preliminary findings show that BBCs in Han Chinese women are origin independent and thus should be treated separately. PMID:26378809

  17. Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

    SciTech Connect

    Peynircioglu, Bora Arslan, E. Bengi; Cil, Barbaros E.; Geyik, Serdar; Hazirolan, Tuncay; Konan, Ali; Balkanci, Ferhun

    2007-06-15

    The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up.

  18. Synchronous bilateral multifocal canalicular adenoma: a case report of an unusual finding.

    PubMed

    Mansueto, G; Falleti, J; De Cecio, R; Papa, F; De Rosa, G

    2009-12-01

    Canalicular adenoma is a benign neoplasm of the minor salivary glands. The most common site is the upper lip, and the adenoma usually appears as a single lesion. Few cases of multiple foci of canalicular adenoma (CA) have been reported in literature. We report a case of a 78-year-old woman with CA of the nasolabial wrinkle on both sides of the nose, which occurred at the same time. The lesions recurred after about 1 year. This report adds to the literature another case of multiple, bilateral CA with synchronous occurrence.

  19. Management of bilateral breast carcinoma: long-term results.

    PubMed

    Goksel, Hüsnü A; Yagmurdur, Mahmut C; Karakayali, Hamdi; Moray, Gokhan; Demirhan, Beyhan; Isiklar, Iclal; Bilgin, Nevzat; Haberal, Mehmet

    2004-01-01

    The aim of this study was to document the clinical features and long-term outcomes in 43 cases of bilateral breast carcinoma. All the women were diagnosed by a single surgeon who had evaluated 13,443 patients with breast-related complaints over a 40-year period. At the initial cancer diagnosis, 28 patients (65%) were of premenopausal age (< or = 46 years; group 1) and 15 (35%) were postmenopausal (> 46 years; group 2). The median interval between initial and subsequent cancer was 24 months (range, 12-288 months) in group 1 and 20 months (range, 14-252 months) in group 2 (P > 0.05). The distribution of initial cancer types based on pathological examination was ductal adenocarcinoma in 28 (65%) cases; lobular carcinoma in 5 (12%) cases; comedocarcinoma in 5 (12%) cases; papillary carcinoma in 2 (4.5%) cases; papillary combined with squamous cell carcinoma in 1 (2%) case; and lobular combined with medullary carcinoma in 2 (4.5%) cases. There were no significant differences between the groups with respect to the distribution of types of surgery used for the initial and subsequent carcinomas. Tumor locations were symmetrical in 26 (60%) patients. The mean palpable mass sizes for the initial and subsequent tumors in group 1 were 3 +/- 1.4 (range, 1-8 cm) and 1.3 +/- 0.5 cm (range, 1-2 cm), respectively. The corresponding means for group 2 were 2.3 +/- 1.8 (range, 0.9-7 cm) and 1.3 +/- 0.5 cm (range, 1-2 cm). The 10- and 20-year disease-free survival rates for group 1 versus group 2 were 32% versus 27% and 10% versus 8%, respectively. The rates of axillary lymph node metastasis from the primary cancer in groups 1 and 2 were statistically similar; however, the rate of axillary lymph node metastasis from subsequent cancer in group 1 was significantly higher than that in group 2 (P = 0.02). The lactation period (after each child born) in group 1 was significantly longer than that in group 2 (P = 0.04). Group 1 had a higher rate of distant metastasis at 20 years (P = 0

  20. Bilateral primary breast lymphoma in a teenage girl with multi-organ involvement.

    PubMed

    Poureisa, Masoud; Daghighi, Mohammad Hossein; Mazaheri-Khameneh, Ramin; Ghadirpour, Ali

    2013-09-09

    We present 16 years old girl with primary breast lymphoma involving the both breasts simultaneously and co-incidence of central nervous system (CNS) involvement which originated from the breast, in addition to evidence of lymphoma in multi-organ such as skin, mediastinum and some abdominal viscera. Bilaterality has been observed in some series, but reports are few and series are often very small. Radiologic features may be indistinguishable from those of the other breast malignancies, but it can be concluded that primary involvement of the breast with lymphoma should be considered when breast mass or inflammatory changes occur in a patient without any previously diagnosed lymphoma. The clinical behavior, imaging and therapeutic procedures are discussed. The findings of this report may have clinical impact on oncologists or that may alter the disease concept of bilateral breast lymphoma.

  1. Breast sensibility after bilateral risk-reducing mastectomy and immediate breast reconstruction: a prospective study.

    PubMed

    Gahm, Jessica; Hansson, Per; Brandberg, Yvonne; Wickman, Marie

    2013-11-01

    The demand for risk-reducing mastectomy (RRM) to avoid breast cancer has increased over the last several years, and knowledge of the outcome after this prophylactic surgical procedure is important. The primary aim of this study was to prospectively compare breast sensibility before and after RRM in a consecutive series of women. The study also investigated whether the nipples were less numb if the nipple areola complexes (NACs) were spared compared with regrafted nipple tips. Forty-six women who selected bilateral RRM with immediate reconstruction using implants at the Karolinska University Hospital, Solna, Stockholm, Sweden, were included in the study. The median patient age at the time of surgery was 39 years (range 26-58). All patients were evaluated preoperatively and at least 2 years postoperatively (median 29 months). Tactile, thermal and nociceptive cutaneous sensibilities were studied with quantitative techniques. The patients at the postoperative evaluation completed a questionnaire about subjective feelings in both breasts. The results showed that breast sensibility is significantly impaired after RRM. Additionally, the ability to experience sexual sensations in the breast is often lost. An NAC-sparing surgery did not result in better nipple sensibility. PMID:23953096

  2. Bilateral breast adenocarcinomas with EML4–ALK fusion in a patient with multiple metastases successfully treated with crizotinib: is lung the primary site?

    PubMed Central

    Liu, Chao; Ding, Lijuan; Sun, Bing; Wu, Shikai

    2016-01-01

    Breast metastases from non-mammary cancers are rare, especially when they appear synchronously. Clinically, it is vitally important to accurately diagnose these patients, as this will directly influence their treatment and survival. We present a very rare and complex case of bilateral breast adenocarcinomas with an EML4–ALK fusion, which was diagnosed as bilateral breast metastases of non-small-cell lung cancer by immunohistochemistry and comprehensive genomic investigation. The patient was successfully treated with an ALK inhibitor (crizotinib); symptoms improved quickly after initiation of crizotinib therapy, and a partial response was observed after 3 months. The experience of diagnosis and treatment of this case indicates the importance and necessity of genomic investigations in such patients, and suggests that we need to consider the rare possibility of this kind of metastasis in order to provide optimal treatment. PMID:27366096

  3. Computerized prediction of breast cancer risk: comparison between the global and local bilateral mammographic tissue asymmetry

    NASA Astrophysics Data System (ADS)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-03-01

    We have developed and preliminarily tested a new breast cancer risk prediction model based on computerized bilateral mammographic tissue asymmetry. In this study, we investigated and compared the performance difference of our risk prediction model when the bilateral mammographic tissue asymmetrical features were extracted in two different methods namely (1) the entire breast area and (2) the mirror-matched local strips between the left and right breast. A testing dataset including bilateral craniocaudal (CC) view images of 100 negative and 100 positive cases for developing breast abnormalities or cancer was selected from a large and diverse full-field digital mammography (FFDM) image database. To detect bilateral mammographic tissue asymmetry, a set of 20 initial "global" features were extracted from the entire breast areas of two bilateral mammograms in CC view and their differences were computed. Meanwhile, a pool of 16 local histogram-based statistic features was computed from eight mirror-matched strips between the left and right breast. Using a genetic algorithm (GA) to select optimal features, two artificial neural networks (ANN) were built to predict the risk of a test case developing cancer. Using the leave-one-case-out training and testing method, two GAoptimized ANNs yielded the areas under receiver operating characteristic (ROC) curves of 0.754+/-0.024 (using feature differences extracted from the entire breast area) and 0.726+/-0.026 (using the feature differences extracted from 8 pairs of local strips), respectively. The risk prediction model using either ANN is able to detect 58.3% (35/60) of cancer cases 6 to 18 months earlier at 80% specificity level. This study compared two methods to compute bilateral mammographic tissue asymmetry and demonstrated that bilateral mammographic tissue asymmetry was a useful breast cancer risk indicator with high discriminatory power.

  4. [Clinical presentations of the secondary bilateral synchronization syndrome in adults with epilepsy].

    PubMed

    Fedin, A I; Generalov, V O; Amcheslavskaia, E V; Mishniakova, L P; Sadykov, T R

    2008-01-01

    One thousand eight hundreds and eighty patients with symptomatic and cryptogenic forms of focal epilepsy have been studied. Ninety patients (4.7%) had the secondary bilateral synchronization (SBS) syndrome in the EEG. Criteria of the syndrome are the presence of focal epileptiform activity in the EEG and SBS detected during the long-term video-EEG monitoring. In this group of patients, secondary generalized tonic-clonic, myoclonic and complex partial seizures were found. The clinical presentations of focal epilepsy were similar to the syndromes of idiopathic epilepsy in most cases. Long-term video-EEG monitoring is a method of choice in the instrumental diagnostics of these forms of epilepsy which are different in genesis and prognosis but similar in the kinematic characteristics.

  5. Cutaneous Metastases of the Synchronous Primary Endometrial and Bilateral Ovarian Cancer: An Infrequent Presentation and Literature Review.

    PubMed

    Kanyilmaz, Gul; Aktan, Meryem; Koc, Mehmet; Findik, Siddika

    2016-01-01

    There are limited data about the cutaneous metastases of gynecological malignancies in the literature. Based on this limited number of studies, cutaneous metastases from gynecological malignancies are uncommon occurrences. Cutaneous metastases from the synchronous endometrioid carcinoma of the uterine corpus and bilateral ovaries arising from endometriosis are extremely rare. Herein, we report a 51-year-old woman with FIGO Stage 1A Grade 1 endometrial endometrioid-type adenocarcinoma and synchronous bilateral Stage 1B ovarian endometrioid-type adenocarcinoma who presented 34 months following total abdominal hysterectomy and bilateral salpingo-oophorectomy with skin metastases. After the patient underwent an excisional biopsy, we applied a palliative radiotherapy. The patient received the combination therapy with cisplatin and doxorubicin after the completion of radiotherapy but the disease evolution was rapidly fatal and the patient died 4 months after her admission to our department due to widely disseminated disease. PMID:27597911

  6. Cutaneous Metastases of the Synchronous Primary Endometrial and Bilateral Ovarian Cancer: An Infrequent Presentation and Literature Review

    PubMed Central

    Koc, Mehmet; Findik, Siddika

    2016-01-01

    There are limited data about the cutaneous metastases of gynecological malignancies in the literature. Based on this limited number of studies, cutaneous metastases from gynecological malignancies are uncommon occurrences. Cutaneous metastases from the synchronous endometrioid carcinoma of the uterine corpus and bilateral ovaries arising from endometriosis are extremely rare. Herein, we report a 51-year-old woman with FIGO Stage 1A Grade 1 endometrial endometrioid-type adenocarcinoma and synchronous bilateral Stage 1B ovarian endometrioid-type adenocarcinoma who presented 34 months following total abdominal hysterectomy and bilateral salpingo-oophorectomy with skin metastases. After the patient underwent an excisional biopsy, we applied a palliative radiotherapy. The patient received the combination therapy with cisplatin and doxorubicin after the completion of radiotherapy but the disease evolution was rapidly fatal and the patient died 4 months after her admission to our department due to widely disseminated disease. PMID:27597911

  7. A 12-year-old girl presenting with bilateral gigantic Burkitt's lymphoma of the breast.

    PubMed

    Lingohr, Philipp; Eidt, Sebastian; Rheinwalt, Karl Peter

    2009-05-01

    The female breast rarely constitutes the primary localization for non-Hodgkin's lymphoma (NHL). The incidence of primary breast lymphoma (PBL) lies between 0.04 and 1.1% for all breast tumors and 1.7-2.2% for all extranodal NHL. Mostly it occurs during the child-bearing period, during pregnancy or lactation. In general, children between the ages of 8 and 10 years are most frequently affected by Burkitt's lymphoma. Methods for classification, detection and especially treatment of this condition continue being a subject of discussions and research. We present and evaluate the rare case of a 12-year-old girl with bilateral gigantic breast tumors treated during a surgical mission with "Doctors without borders" (MSF, "médecins sans frontiers") in the zone of civil war in the Democratic Republic of Congo. The monstrous bilateral breast hypertrophy, symmetrical, rapidly growing, consequently ulcerating and severely bleeding had to be treated by bilateral mastectomy as a salvage procedure. Examinations through histopathology was not feasible and other facilities like ultrasound, CT, MRI and further laboratory examinations were not available.. The patient died 27 days after the surgical procedure. The histological result received by later examination in Germany showed a bilateral high malignant B cell lymphoma (Burkitt lymphoma) of the breast.

  8. Episode of massive pulmonary embolism after bilateral breast augmentation

    PubMed Central

    Schonauer, Fabrizio; Nele, Gisella; Di Martino, Annalena; Santoro, Mariangela; Santanelli di Pompeo, Fabio

    2015-01-01

    Pulmonary embolism is a rare postsurgical complication, even more so following breast augmentation. Herein we present a case of a 23-year-old woman who survived an episode of massive pulmonary embolism after breast implant surgery. Current literature about this subject is very scarce. PMID:27252978

  9. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

    PubMed Central

    Hansen, Keith S.; Hartman, Brett C.; Sood, Rajiv; Socas, Juan

    2016-01-01

    Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments. PMID:27689054

  10. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps.

    PubMed

    Hansen, Keith S; Gutwein, Luke G; Hartman, Brett C; Sood, Rajiv; Socas, Juan

    2016-09-01

    Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments. PMID:27689054

  11. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

    PubMed Central

    Hansen, Keith S.; Hartman, Brett C.; Sood, Rajiv; Socas, Juan

    2016-01-01

    Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

  12. Are bilateral breast cancers and breast cancers coexisting with ovarian cancer different from solitary tumors? A pair-matched immunohistochemical analysis aimed at intrinsic tumor phenotype.

    PubMed

    Senkus, Elżbieta; Szade, Jolanta; Pieczyńska, Beata; Zaczek, Anna; Świerblewski, Maciej; Biernat, Wojciech; Jassem, Jacek

    2014-10-01

    Patients with bilateral breast cancer (BBC) and breast-ovarian cancer syndrome (BOCS) constitute populations potentially enriched for molecular defects involved in the pathomechanisms of these malignancies. The aim of our study was to compare tumor morphology and expression of estrogen and progesterone receptor, HER2, Ki67, cytokeratin 5/6, E-cadherin, vimentin and epidermal growth factor receptor in tissue microarrays from 199 tumors from BBC or BOCS patients and 199 age-matched solitary tumors. Compared to controls, BBC and BOCS considered jointly had lower incidence of DCIS, lower expression of PgR and HER2, and higher expression of Ki67 and vimentin. BOCS tumors were of higher grade, had lower expression of ER and PgR and higher expression of Ki67, CK5/6, vimentin and EGFR. BBC had less DCIS component, lower HER2 expression and higher Ki67 expression. Metachronous BBC (mBBC) had lower expression of ER, PgR and HER2, and higher expression of Ki67 and vimentin. Synchronous BBC (sBBC) had less DCIS component, higher expression of ER, and lower expression of CK5/6, EGFR and E-cadherin. BBC and breast cancers in BOCS differ in many aspects from solitary tumors. BBC are a heterogeneous group of tumors, differing between sBBC and mBBC. mBBC phenotype shares many features with BOCS tumors. PMID:25296577

  13. A young woman with bilateral breast cancer: identifying a genetic cause and implications for management.

    PubMed

    de Bruin, Monique A; Ford, James M; Kurian, Allison W

    2013-05-01

    Breast cancer is a common manifestation of an underlying genetic susceptibility to cancer, and 5% to 10% of all breast cancers are associated with a germline mutation in a known risk allele. Detection of mutations has implications for targeted screening and prevention strategies for probands, and for genetic counseling and testing of their family members. This report presents a case involving a 35-year-old woman with no family history of breast or ovarian cancer who presented with a palpable right breast lump. Imaging revealed multiple bilateral breast masses and right axillary adenopathy, and core needle biopsies showed invasive ductal carcinoma in both the right and left breast. This report discusses the appropriate genetics evaluation for a patient with bilateral breast cancer at a young age, including testing for mutations in BRCA1 and BRCA2, followed, if negative, by consideration of testing for mutations in TP53 (Li-Fraumeni syndrome). Given the specialized counseling and testing needs of patients with Li-Fraumeni syndrome, and the implications for targeted screening strategies if a mutation is found, referral to a cancer genetics expert is strongly recommended.

  14. Increasing options in autologous microsurgical breast reconstruction: four free flaps for ‘stacked’ bilateral breast reconstruction

    PubMed Central

    Patel, Nakul Gamanlal; Ramakrishnan, Venkat V.

    2016-01-01

    For autologous breast reconstruction, there are cases where one free flap cannot provide the volume of tissue required, and the concept of ‘stacked’ bilateral deep inferior epigastric artery (DIEP) flaps was developed, in which hemi-abdominal flaps are raised on each deep inferior epigastric artery (DIEA), and both flaps transferred to the chest. In cases of bilateral breast reconstruction, stacked flaps may be required to achieve volume replacement, however options are not described. We demonstrate the use of stacked free flaps for bilateral breast reconstruction, using one DIEP flap stacked with one transverse upper gracilis (TUG) flap for each side. A 49-year-old woman, with BRCA1 mutation, presented for risk reduction mastectomies. Flap design was planned to achieve maximal projection and primary nipple reconstruction. This was able to be achieved by using the DIEP flap de-epithelialised and completely buried, with the flap orientated with the pedicle on its superficial surface, and the TUG flap lying superficially with its skin paddle used for nipple reconstruction and able to be monitored clinically. There were no flap or donor related complications and good aesthetic outcomes were achieved. This technique offers a further option in microsurgical breast reconstruction for patients in whom there is a paucity of abdominal tissue for reconstruction. PMID:27047791

  15. Areola Size and Jugulum Nipple Distance After Bilateral Mastectomy and Breast Reconstruction

    PubMed Central

    Pérez-Guisado, Joaquín; Rodríguez-Mérida, Consuelo; Rioja, Luis F.

    2013-01-01

    Objective: The combination of a single pedicle local flap with tattooing for complete nipple areola complex (NAC) reconstruction is currently the most supported method. Although many technical descriptions of NAC reconstruction exist in the medical literature, there are no data that define the ideal areola size (diameter of the areola) after bilateral mastectomy and breast reconstruction considering the previous areola size. Methods: This was a 3-year (2009-2012) observational, analytical, and longitudinal prospective study with 103 patients who had undergone NAC tattooing as the last process of bilateral breast reconstruction after surgery for breast cancer. Statistical differences in the areola size and the jugulum-nipple distance before mastectomy and after reconstruction were analyzed by paired Student t tests with a 95% confidence interval. Results: The jugulum-nipple distance before mastectomy was 4.23 cm larger than after bilateral reconstruction (mean jugulum-nipple distance: 23.89 cm vs 19.66 cm), and for that reason shorter (more cephalad). The areola size before mastectomy was 1.59 cm larger than the one chosen by the patient for reconstruction (mean diameter of the areola: 5.25 cm vs 3.65 cm). Conclusions: We conclude that, after bilateral mastectomy and reconstruction, the jugulum-nipple distance is smaller and women prefer smaller areola sizes. PMID:24324847

  16. Satisfaction with breast reconstruction in women with bilateral prophylactic mastectomy: a descriptive study.

    PubMed

    Metcalfe, Kelly A; Semple, John L; Narod, Steven A

    2004-08-01

    Prophylactic bilateral mastectomy is an option for women who are at an increased risk of developing breast cancer. Prophylactic mastectomy is often performed with immediate reconstruction (i.e., at the same time and under the same anesthetic as the mastectomy). Satisfaction with reconstruction has been described previously for women with mastectomy for breast cancer. However, the authors know of no previous research that has reported on satisfaction with reconstruction in patients who have electively sought mastectomy for the prevention of breast cancer. Women in the province of Ontario who had undergone prophylactic bilateral mastectomy plus breast reconstruction between 1991 and 2000 were asked to rate their level of satisfaction with the cosmetic results of their mastectomy and reconstruction and their overall satisfaction with their decision to have prophylactic mastectomy. Women were also asked whether they experienced complications associated with their surgery and what types of complications they experienced. Thirty-seven women completed questionnaires for this study, and all of them had immediate breast reconstruction after prophylactic mastectomy. The majority of women (70.3 percent) reported being satisfied or extremely satisfied with the cosmetic results of their breast reconstruction. Women with self-reported postsurgical complications (16.2 percent) were significantly less satisfied with reconstruction than those who did not report complications (p = 0.009). Personal subjective risk of breast cancer before prophylactic mastectomy was negatively correlated with satisfaction with reconstruction (r = -0.38, p = 0.024) and with subjective risk estimation after prophylactic surgery (r = -0.54, p = 0.001). Women who did not worry about developing breast cancer after prophylactic mastectomy had significantly higher levels of satisfaction with breast reconstruction than those who continued to worry (p < 0.001). Women who reported an improved body image after

  17. Femoral Placement of Totally Implantable Venous Access Ports in Patients with Bilateral Breast Cancer

    PubMed Central

    Almasi-Sperling, V.; Hieber, S.; Lermann, J.; Strahl, O.; Beckmann, M. W.; Lang, W.; Sagban, T. A.

    2016-01-01

    Purpose: Aim of this study was to determine the rate of complications following femoral placement of totally implantable venous access ports (f-TIVAP) in women with bilateral breast cancer, with a special focus on long-term function, deep vein thrombosis (DVT), and port infection. Methods: 73 patients with bilateral breast cancer treated between October 2000 and January 2013 with placement of an f-TIVAP using a transfemoral approach were retrospectively reviewed. All patients were followed up, and all complications of f-TIVAP were recorded. Results: The median age was 62.5 years (range: 35–86 years). Four patients received f-TIVAP under local anesthesia, and 69 underwent placement under general anesthesia. Mean follow-up was 33.7 months (SD 25.9; range: 0.2–93.5 months). Complications over the entire period of observation included infections in 21 %, DVT in 19 % and catheter occlusion in 12 %. Patients receiving chemotherapy who developed leukopenia were more likely to experience DVT at the access site (p = 0.037). There was a trend towards a higher infection rate when the device was used more often (p = 0.084). Conclusion: Although the rates of complications in the longer term, especially device infections and DVTs, appeared to be relatively high, TIVAP implantation using femoral vein access is recommended in patients with bilateral breast cancer not suitable for cephalic vein cut-down. PMID:26855441

  18. A new breast cancer risk analysis approach using features extracted from multiple sub-regions on bilateral mammograms

    NASA Astrophysics Data System (ADS)

    Sun, Wenqing; Tseng, Tzu-Liang B.; Zheng, Bin; Zhang, Jianying; Qian, Wei

    2015-03-01

    A novel breast cancer risk analysis approach is proposed for enhancing performance of computerized breast cancer risk analysis using bilateral mammograms. Based on the intensity of breast area, five different sub-regions were acquired from one mammogram, and bilateral features were extracted from every sub-region. Our dataset includes 180 bilateral mammograms from 180 women who underwent routine screening examinations, all interpreted as negative and not recalled by the radiologists during the original screening procedures. A computerized breast cancer risk analysis scheme using four image processing modules, including sub-region segmentation, bilateral feature extraction, feature selection, and classification was designed to detect and compute image feature asymmetry between the left and right breasts imaged on the mammograms. The highest computed area under the curve (AUC) is 0.763 ± 0.021 when applying the multiple sub-region features to our testing dataset. The positive predictive value and the negative predictive value were 0.60 and 0.73, respectively. The study demonstrates that (1) features extracted from multiple sub-regions can improve the performance of our scheme compared to using features from whole breast area only; (2) a classifier using asymmetry bilateral features can effectively predict breast cancer risk; (3) incorporating texture and morphological features with density features can boost the classification accuracy.

  19. Finite Time Control Design for Bilateral Teleoperation System With Position Synchronization Error Constrained.

    PubMed

    Yang, Yana; Hua, Changchun; Guan, Xinping

    2016-03-01

    Due to the cognitive limitations of the human operator and lack of complete information about the remote environment, the work performance of such teleoperation systems cannot be guaranteed in most cases. However, some practical tasks conducted by the teleoperation system require high performances, such as tele-surgery needs satisfactory high speed and more precision control results to guarantee patient' health status. To obtain some satisfactory performances, the error constrained control is employed by applying the barrier Lyapunov function (BLF). With the constrained synchronization errors, some high performances, such as, high convergence speed, small overshoot, and an arbitrarily predefined small residual constrained synchronization error can be achieved simultaneously. Nevertheless, like many classical control schemes only the asymptotic/exponential convergence, i.e., the synchronization errors converge to zero as time goes infinity can be achieved with the error constrained control. It is clear that finite time convergence is more desirable. To obtain a finite-time synchronization performance, the terminal sliding mode (TSM)-based finite time control method is developed for teleoperation system with position error constrained in this paper. First, a new nonsingular fast terminal sliding mode (NFTSM) surface with new transformed synchronization errors is proposed. Second, adaptive neural network system is applied for dealing with the system uncertainties and the external disturbances. Third, the BLF is applied to prove the stability and the nonviolation of the synchronization errors constraints. Finally, some comparisons are conducted in simulation and experiment results are also presented to show the effectiveness of the proposed method.

  20. Unilateral Arm Urticaria Presenting as a Paraneoplastic Manifestation of Metachronous Bilateral Breast Cancer

    PubMed Central

    Kasi, Pashtoon Murtaza; Hieken, Tina J.; Haddad, Tufia C.

    2016-01-01

    Various paraneoplastic syndromes (PNS) are reported to be associated with breast cancer and can range from mild dermatological symptoms to severe neurological complications. Neurological and dermatological manifestations tend to be the more commonly seen paraneoplastic manifestations, albeit both are relatively rare. Diagnosis of the underlying malignancy is often delayed since the presence and severity of paraneoplastic manifestations are not dependent on the tumor size or stage. Herein, we describe a unique case of unilateral arm urticaria presenting as a paraneoplastic manifestation of metachronous bilateral breast cancer. Similar reports and other PNS associated with breast cancer are described. Recognition of PNS associated with underlying malignancies and age-appropriate screening can facilitate diagnosis of the underlying occult malignancy. Resection of the underlying malignancy can lead to resolution and/or improvement of the PNS for some patients. PMID:26933416

  1. Bilateral orbital metastases from breast cancer: a case report of successful palliation using stereotactic radiotherapy.

    PubMed

    Kim, Jin Ho; Choi, Sang Yul; Cho, Chul Koo; Yang, Kwang Mo; Noh, Woo Chul; Kim, Mi-Sook

    2011-01-01

    Of ophthalmic involvement from metastatic breast cancer, extraocular/intraorbital metastases are extremely rare. External beam radiotherapy has been a mainstay palliation for symptomatic orbital metastases. We present a case of bilateral orbital metastases from breast cancer successfully treated with stereotactic radiotherapy (SRT). A 38-year-old woman presented with decreased vision in the right eye for 3 weeks. Eight months previously, she underwent whole-brain radiotherapy for multiple brain metastases from breast cancer. Visual acuity was hand motion, and the eyelid closed incompletely in the affected eye. Computed tomography scans showed a 3-cm extraconal mass in the right orbit. She underwent temporary tarsorrhaphy followed by SRT. A total dose of 39 Gy was delivered to the right orbital mass in three daily fractions. Four months later, her visual function was normal in both eyes and the right orbital mass disappeared. A new lesion was detected in the left orbit. She underwent SRT for the left orbital lesion using the same dose-fractionation schedule. No radiation-related toxicities were observed. She died 19 months after the first SRT. Our case suggests that SRT may be an effective and safe treatment option in patients with orbital metastases from breast cancer. PMID:21999613

  2. Gastric cancer in a pregnant woman presenting with low back pain and bilateral erythematous breast hypertrophy mimicking primary inflammatory breast carcinoma.

    PubMed

    Mandato, Vincenzo Dario; Pirillo, Debora; Gelli, Maria Carolina; Cavina, Maurizio; La Sala, Giovanni Battista

    2011-02-01

    This report describes the first case of a pregnant woman presenting low-back pain and breast pain associated with bilateral erythematous breast hypertrophy, proving to be the result of metastatic disease from a gastric carcinoma. A 30-year-old pregnant woman was admitted complaining of persistent severe low back pain, breast pain and concomitant bilateral erythematous breast hypertrophy, mimicking primary inflammatory breast carcinoma. During the caesarean section, widespread disease was found and finally metastatic gastric cancer was detected. Pregnant women with gastric cancer may present symptoms that are considered common during pregnancy. Common symptoms that present warning characteristics, such as the persistent severe pain observed in the presented case, should be carefully investigated as they may be the only warning signs and symptoms of rare ominous conditions such as gastric cancer.

  3. Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients.

    PubMed

    McAllister, Peter; Teo, Isabel; Chin, Kuen; Makubate, Boikanyo; Alexander Munnoch, David

    2016-01-01

    Breast reconstruction using free tissue transfer is an increasingly utilised oncoplastic procedure. The aim was to review all bilateral breast reconstructions using abdominal free flaps by a single surgeon over an 11-year period (2003-2014). A retrospective review was performed on all patients who underwent bilateral breast reconstruction using abdominal free flaps between 2003 and 2014 by the senior author (DAM). Data analysed included patient demographics, indication for reconstruction, surgical details, and complications. Fifty-five female patients (mean 48.6 years [24-71 years]) had bilateral breast reconstruction. The majority (41, 74.5%) underwent immediate reconstruction and DIEP flaps were utilised on 41 (74.5%) occasions. Major surgical complications occurred in 6 (10.9%) patients, all of which were postoperative vascular compromise of the flap. Failure to salvage the reconstruction occurred on 3 (5.5%) occasions resulting in a total flap failure rate of 2.7%. Obesity (>30 kg/m(2)) and age > 60 years were shown to have a statistically increased risk of developing postoperative complications (P < 0.05). Our experience demonstrates that abdominal free flaps for bilateral breast reconstruction fares well, with a flap failure rate of 2.7%. Increased body mass index and patient age (>60 years) were associated with higher complication rates. PMID:27504200

  4. Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients

    PubMed Central

    Teo, Isabel; Chin, Kuen; Makubate, Boikanyo; Alexander Munnoch, David

    2016-01-01

    Breast reconstruction using free tissue transfer is an increasingly utilised oncoplastic procedure. The aim was to review all bilateral breast reconstructions using abdominal free flaps by a single surgeon over an 11-year period (2003–2014). A retrospective review was performed on all patients who underwent bilateral breast reconstruction using abdominal free flaps between 2003 and 2014 by the senior author (DAM). Data analysed included patient demographics, indication for reconstruction, surgical details, and complications. Fifty-five female patients (mean 48.6 years [24–71 years]) had bilateral breast reconstruction. The majority (41, 74.5%) underwent immediate reconstruction and DIEP flaps were utilised on 41 (74.5%) occasions. Major surgical complications occurred in 6 (10.9%) patients, all of which were postoperative vascular compromise of the flap. Failure to salvage the reconstruction occurred on 3 (5.5%) occasions resulting in a total flap failure rate of 2.7%. Obesity (>30 kg/m2) and age > 60 years were shown to have a statistically increased risk of developing postoperative complications (P < 0.05). Our experience demonstrates that abdominal free flaps for bilateral breast reconstruction fares well, with a flap failure rate of 2.7%. Increased body mass index and patient age (>60 years) were associated with higher complication rates. PMID:27504200

  5. Body image issues after bilateral prophylactic mastectomy with breast reconstruction in healthy women at risk for hereditary breast cancer.

    PubMed

    Gopie, Jessica P; Mureau, Marc A M; Seynaeve, Caroline; Ter Kuile, Moniek M; Menke-Pluymers, Marian B E; Timman, Reinier; Tibben, Aad

    2013-09-01

    The outcome of bilateral prophylactic mastectomy with breast reconstruction (BPM-IBR) in healthy BRCA1/2 mutation carriers can be potentially burdensome for body image and the intimate relationship. Therefore, in the current analysis the impact on body image, sexual and partner relationship satisfaction was prospectively investigated in women opting for BPM-IBR as well as cancer distress and general quality of life. Healthy women undergoing BPM-IBR completed questionnaires preoperatively (T0, n = 48), at 6 months (T1, n = 44) and after finishing breast reconstruction (median 21 months, range 12-35) (T2, n = 36). With multi-level regression analyses the course of outcome variables was investigated and a statistically significant change in body image and/or sexual and partner relationship satisfaction was predicted by baseline covariates. Body image significantly decreased at T1. At T2 sexual relationship satisfaction and body image tended to be lower compared to baseline. The overall partner relationship satisfaction did not significantly change. At T2, 37 % of the women reported that their breasts felt unpleasantly, 29 % was not satisfied with their breast appearance and 21 % felt embarrassed for their naked body. Most body image issues remained unchanged in 30 % of the women. A negative body image was predicted by high preoperative cancer distress. BPM-IBR was associated with adverse impact on body image in a substantial subgroup, but satisfaction with the overall sexual and partner relationship did not significantly change in time. The psychosocial impact of BPM-IBR in unaffected women should not be underestimated. Psychological support should ideally be integrated both before and after BPM-IBR.

  6. Frequency-Specific Synchronization in the Bilateral Subthalamic Nuclei Depending on Voluntary Muscle Contraction and Relaxation in Patients with Parkinson’s Disease

    PubMed Central

    Kato, Kenji; Yokochi, Fusako; Iwamuro, Hirokazu; Kawasaki, Takashi; Hamada, Kohichi; Isoo, Ayako; Kimura, Katsuo; Okiyama, Ryoichi; Taniguchi, Makoto; Ushiba, Junichi

    2016-01-01

    The volitional control of muscle contraction and relaxation is a fundamental component of human motor activity, but how the processing of the subcortical networks, including the subthalamic nucleus (STN), is involved in voluntary muscle contraction (VMC) and voluntary muscle relaxation (VMR) remains unclear. In this study, local field potentials (LFPs) of bilateral STNs were recorded in patients with Parkinson’s disease (PD) while performing externally paced VMC and VMR tasks of the unilateral wrist extensor muscle. The VMC- or VMR-related oscillatory activities and their functional couplings were investigated over the theta (4–7 Hz), alpha (8–13 Hz), beta (14–35 Hz), and gamma (40–100 Hz) frequency bands. Alpha and beta desynchronizations were observed in bilateral STNs at the onset of both VMC and VMR tasks. On the other hand, theta and gamma synchronizations were prominent in bilateral STNs specifically at the onset of the VMC task. In particular, just after VMC, theta functional coupling between the bilateral STNs increased, and the theta phase became coupled to the gamma amplitude within the contralateral STN in a phase-amplitude cross-frequency coupled manner. On the other hand, the prominent beta-gamma cross-frequency couplings observed in the bilateral STNs at rest were reduced by the VMC and VMR tasks. These results suggest that STNs are bilaterally involved in the different performances of muscle contraction and relaxation through the theta-gamma and beta-gamma networks between bilateral STNs in patients with PD. PMID:27064969

  7. Bilateral image subtraction features for multivariate automated classification of breast cancer risk

    NASA Astrophysics Data System (ADS)

    Celaya-Padilla, Jose M.; Rodriguez-Rojas, Juan; Galván-Tejada, Jorge I.; Martínez-Torteya, Antonio; Treviño, Victor; Tamez-Peña, José G.

    2014-03-01

    Early tumor detection is key in reducing breast cancer deaths and screening mammography is the most widely available method for early detection. However, mammogram interpretation is based on human radiologist, whose radiological skills, experience and workload makes radiological interpretation inconsistent. In an attempt to make mammographic interpretation more consistent, computer aided diagnosis (CADx) systems has been introduced. This paper presents an CADx system aimed to automatically triage normal mammograms form suspicious mammograms. The CADx system co-reregister the left and breast images, then extracts image features from the co-registered mammographic bilateral sets. Finally, an optimal logistic multivariate model is generated by means of an evolutionary search engine. In this study, 440 subjects form the DDSM public data sets were used: 44 normal mammograms, 201 malignant mass mammograms, and 195 mammograms with malignant calci cations. The results showed a cross validation accuracy of 0.88 and an area under receiver operating characteristic (AUC) of 0.89 for the calci cations vs. normal mammograms. The optimal mass vs. normal mammograms model obtained an accuracy of 0.85 and an AUC of 0.88.

  8. Synchronous metastatic skull base chordoma to the breast: case report and literature review

    PubMed Central

    Shakir, S.I.; Pelmus, M.; Florea, A.; Boileau, J.F.; Guiot, M.C.; Di Maio, S.; Muanza, T.M.

    2016-01-01

    Clinical Scenario During routine staging work-up for a left breast mass, a 68-year-old woman complained of dysphagia and dysphonia. During further investigations, a left-sided lesion at the foramen magnum was observed on brain imaging. Both lesions were biopsied and showed a classical chordoma. Management The skull-base lesion and the breast lesion were surgically resected, and adjuvant radiotherapy was given. Summary Chordoma is a rare primary central nervous system tumour that seldom metastasizes. The lung is the most common site of metastasis. Synchronous breast metastasis from a skull-base chordoma is very rare, and a safe management option includes a maximum resection followed by adjuvant radiotherapy. PMID:27122985

  9. Bilateral ductal carcinoma in situ of the breast after radiation therapy for Ewing's sarcoma of the vertebra in a young woman: report of a case.

    PubMed

    Keskek, Mehmet; Kilic, Mehmet; Ertan, Tamer; Erdem, Adnan; Yoldas, Omer

    2008-01-01

    Thoracic radiation in the early years of life is a known risk factor for breast cancer later in life. A 21-year-old woman who had received thoracic radiation therapy for Ewing's sarcoma of the vertebra 9 years earlier was referred to our hospital for investigation of a palpable mass in her left breast. Ultrasonography and excisional biopsy showed ductal carcinoma in situ (DCIS) of the left breast, with no detectable pathology in the right breast except that it was more hypoplastic than the left breast. Considering the known risk factors for invasive breast cancer in both breasts, we performed bilateral skin-sparing mastectomy with immediate breast reconstruction using subpectoral implants. The final histopathological diagnosis was bilateral DCIS. PMID:18668319

  10. Detection of microcalcifications in breast tomosynthesis reconstructed with multiscale bilateral filtering regularization

    NASA Astrophysics Data System (ADS)

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiyski, Lubomir; Wei, Jun; Sahiner, Berkman; Helvie, Mark

    2013-03-01

    We are developing a CAD system to assist radiologists in detecting microcalcification clusters (MCs) in digital breast tomosynthesis (DBT). In this study, we investigated the feasibility of using as input to the CAD system an enhanced DBT volume that was reconstructed with the iterative simultaneous algebraic reconstruction technique (SART) regularized by a new multiscale bilateral filtering (MBiF) method. The MBiF method utilizes the multiscale structures of the breast to selectively enhance MCs and preserve mass spiculations while smoothing noise in the DBT images. The CAD system first extracted the enhancement-modulated calcification response (EMCR) in the DBT volume. Detection of the seed points for MCs and individual calcifications were guided by the EMCR. MC candidates were formed by dynamic clustering. FPs were further reduced by analysis of the feature characteristics of the MCs. With IRB approval, two-view DBT of 91 subjects with biopsy-proven MCs were collected. Seventy-eight views from 39 subjects with MCs were used for training and the remaining 52 cases were used for independent testing. For view-based detection, a sensitivity of 85% was achieved at 3.23 FPs/volume. For case-based detection, the same sensitivity was obtained at 1.63 FPs/volume. The results indicate that the new MBiF method is useful in improving the detection accuracy of clustered microcalcifications. An effective CAD system for microcalcification detection in DBT has the potential to eliminate the need for additional mammograms, thereby reducing patient dose and reading time.

  11. HIF2α contributes to antiestrogen resistance via positive bilateral crosstalk with EGFR in breast cancer cells

    PubMed Central

    Alam, Muhammad Wasi; Persson, Camilla Ulrika; Reinbothe, Susann; Kazi, Julhash U.; Rönnstrand, Lars; Wigerup, Caroline; Ditzel, Henrik Jorn; Lykkesfeldt, Anne E.; Påhlman, Sven; Jögi, Annika

    2016-01-01

    The majority of breast cancers express estrogen receptor α (ERα), and most patients with ERα-positive breast cancer benefit from antiestrogen therapy. The ERα-modulator tamoxifen and ERα-downregulator fulvestrant are commonly employed antiestrogens. Antiestrogen resistance remains a clinical challenge, with few effective treatments available for patients with antiestrogen-resistant breast cancer. Hypoxia, which is intrinsic to most tumors, promotes aggressive disease, with the hypoxia-inducible transcription factors HIF1 and HIF2 regulating cellular responses to hypoxia. Here, we show that the ERα-expressing breast cancer cells MCF-7, CAMA-1, and T47D are less sensitive to antiestrogens when hypoxic. Furthermore, protein and mRNA levels of HIF2α/HIF2A were increased in a panel of antiestrogen-resistant cells, and antiestrogen-exposure further increased HIF2α expression. Ectopic expression of HIF2α in MCF-7 cells significantly decreased sensitivity to antiestrogens, further implicating HIF2α in antiestrogen resistance. EGFR is known to contribute to antiestrogen resistance: we further show that HIF2α drives hypoxic induction of EGFR and that EGFR induces HIF2α expression. Downregulation or inhibition of EGFR led to decreased HIF2α levels. This positive and bilateral HIF2-EGFR regulatory crosstalk promotes antiestrogen resistance and, where intrinsic hypoxic resistance exists, therapy itself may exacerbate the problem. Finally, inhibition of HIFs by FM19G11 restores antiestrogen sensitivity in resistant cells. Targeting HIF2 may be useful for counteracting antiestrogen resistance in the clinic. PMID:26849233

  12. Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review

    PubMed Central

    Tashakkor, A Yashar; Macadam, Sheina A

    2012-01-01

    ‘Well leg compartment syndrome’ refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient. A case involving a 56-year-old woman who developed an anterior compartment syndrome of her right lower leg following a bilateral mastectomy with immediate breast reconstruction is presented. A detailed literature review is also included. PMID:23730157

  13. Performance of a Knowledge-Based Model for Optimization of Volumetric Modulated Arc Therapy Plans for Single and Bilateral Breast Irradiation

    PubMed Central

    Fogliata, Antonella; Nicolini, Giorgia; Bourgier, Celine; Clivio, Alessandro; De Rose, Fiorenza; Fenoglietto, Pascal; Lobefalo, Francesca; Mancosu, Pietro; Tomatis, Stefano; Vanetti, Eugenio; Scorsetti, Marta; Cozzi, Luca

    2015-01-01

    Purpose To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy, VMAT, applied to whole breast irradiation. Methods and Materials A set of 150 VMAT dose plans with simultaneous integrated boost were selected to train a model for the prediction of dose-volume constraints. The dosimetric validation was done on different groups of patients from three institutes for single (50 cases) and bilateral breast (20 cases). Results Quantitative improvements were observed between the model-based and the reference plans, particularly for heart dose. Of 460 analysed dose-volume objectives, 13% of the clinical plans failed to meet the constraints while the respective model-based plans succeeded. Only in 5 cases did the reference plans pass while the respective model-based failed the criteria. For the bilateral breast analysis, the model-based plans resulted in superior or equivalent dose distributions to the reference plans in 96% of the cases. Conclusions Plans optimised using a knowledge-based model to determine the dose-volume constraints showed dosimetric improvements when compared to earlier approved clinical plans. The model was applicable to patients from different centres for both single and bilateral breast irradiation. The data suggests that the dose-volume constraint optimisation can be effectively automated with the new engine and could encourage its application to clinical practice. PMID:26691687

  14. Genomic differences between pure ductal carcinoma in situ and synchronous ductal carcinoma in situ with invasive breast cancer

    PubMed Central

    Kim, Min Sung; Baek, In-Pyo; Lee, Sung Hak; Kim, Tae-Min; Chung, Yeun-Jun; Lee, Sug Hyung

    2015-01-01

    Although ductal carcinoma in situ (DCIS) precedes invasive ductal carcinoma (IDC), the related genomic alterations remain unknown. To identify the genomic landscape of DCIS and better understand the mechanisms behind progression to IDC, we performed whole-exome sequencing and copy number profiling for six cases of pure DCIS and five pairs of synchronous DCIS and IDC. Pure DCIS harbored well-known mutations (e.g., TP53, PIK3CA and AKT1), copy number alterations (CNAs) and chromothripses, but had significantly fewer driver genes and co-occurrence of mutation/CNAs than synchronous DCIS-IDC. We found neither recurrent nor significantly mutated genes with synchronous DCIS-IDC compared to pure DCIS, indicating that there may not be a single determinant for pure DCIS progression to IDC. Of note, synchronous DCIS genomes were closer to IDC than pure DCIS. Among the clinicopathologic parameters, progesterone receptor (PR)-negative status was associated with increased mutations, CNAs, co-occurrence of mutations/CNAs and driver mutations. Our results indicate that although pure DCIS has already acquired some drivers, more changes are needed to progress to IDC. In addition, IDC-associated DCIS is more aggressive than pure DCIS at genomic level and should really be considered IDC. Finally, the data suggest that PR-negativity could be used to predict aggressive breast cancer genotypes. PMID:25831047

  15. Computer-aided detection of clustered microcalcifications in multiscale bilateral filtering regularized reconstructed digital breast tomosynthesis volume

    PubMed Central

    Samala, Ravi K.; Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun; Sahiner, Berkman; Helvie, Mark A.

    2014-01-01

    Purpose: Develop a computer-aided detection (CADe) system for clustered microcalcifications in digital breast tomosynthesis (DBT) volume enhanced with multiscale bilateral filtering (MSBF) regularization. Methods: With Institutional Review Board approval and written informed consent, two-view DBT of 154 breasts, of which 116 had biopsy-proven microcalcification (MC) clusters and 38 were free of MCs, was imaged with a General Electric GEN2 prototype DBT system. The DBT volumes were reconstructed with MSBF-regularized simultaneous algebraic reconstruction technique (SART) that was designed to enhance MCs and reduce background noise while preserving the quality of other tissue structures. The contrast-to-noise ratio (CNR) of MCs was further improved with enhancement-modulated calcification response (EMCR) preprocessing, which combined multiscale Hessian response to enhance MCs by shape and bandpass filtering to remove the low-frequency structured background. MC candidates were then located in the EMCR volume using iterative thresholding and segmented by adaptive region growing. Two sets of potential MC objects, cluster centroid objects and MC seed objects, were generated and the CNR of each object was calculated. The number of candidates in each set was controlled based on the breast volume. Dynamic clustering around the centroid objects grouped the MC candidates to form clusters. Adaptive criteria were designed to reduce false positive (FP) clusters based on the size, CNR values and the number of MCs in the cluster, cluster shape, and cluster based maximum intensity projection. Free-response receiver operating characteristic (FROC) and jackknife alternative FROC (JAFROC) analyses were used to assess the performance and compare with that of a previous study. Results: Unpaired two-tailed t-test showed a significant increase (p < 0.0001) in the ratio of CNRs for MCs with and without MSBF regularization compared to similar ratios for FPs. For view-based detection, a

  16. Computer-aided detection of clustered microcalcifications in multiscale bilateral filtering regularized reconstructed digital breast tomosynthesis volume

    SciTech Connect

    Samala, Ravi K. Chan, Heang-Ping; Lu, Yao; Hadjiiski, Lubomir; Wei, Jun; Helvie, Mark A.; Sahiner, Berkman

    2014-02-15

    Purpose: Develop a computer-aided detection (CADe) system for clustered microcalcifications in digital breast tomosynthesis (DBT) volume enhanced with multiscale bilateral filtering (MSBF) regularization. Methods: With Institutional Review Board approval and written informed consent, two-view DBT of 154 breasts, of which 116 had biopsy-proven microcalcification (MC) clusters and 38 were free of MCs, was imaged with a General Electric GEN2 prototype DBT system. The DBT volumes were reconstructed with MSBF-regularized simultaneous algebraic reconstruction technique (SART) that was designed to enhance MCs and reduce background noise while preserving the quality of other tissue structures. The contrast-to-noise ratio (CNR) of MCs was further improved with enhancement-modulated calcification response (EMCR) preprocessing, which combined multiscale Hessian response to enhance MCs by shape and bandpass filtering to remove the low-frequency structured background. MC candidates were then located in the EMCR volume using iterative thresholding and segmented by adaptive region growing. Two sets of potential MC objects, cluster centroid objects and MC seed objects, were generated and the CNR of each object was calculated. The number of candidates in each set was controlled based on the breast volume. Dynamic clustering around the centroid objects grouped the MC candidates to form clusters. Adaptive criteria were designed to reduce false positive (FP) clusters based on the size, CNR values and the number of MCs in the cluster, cluster shape, and cluster based maximum intensity projection. Free-response receiver operating characteristic (FROC) and jackknife alternative FROC (JAFROC) analyses were used to assess the performance and compare with that of a previous study. Results: Unpaired two-tailedt-test showed a significant increase (p < 0.0001) in the ratio of CNRs for MCs with and without MSBF regularization compared to similar ratios for FPs. For view-based detection, a

  17. Prostate cancer in a man with a BRCA2 mutation and a personal history of bilateral breast cancer.

    PubMed

    Singer, C F; Rappaport-Fuerhauser, C; Sopik, V; Narod, S A

    2015-08-01

    Men with a BRCA2 mutation face substantial lifetime risks for the development of both breast and prostate cancer. A male who was initially diagnosed with breast cancer at the age of 32 was subsequently diagnosed at age 77 with both contralateral breast cancer and prostate cancer. He was found to be BRCA2 mutation carrier. The patient was treated with contralateral mastectomy, breast irradiation, prostate irradiation and adjuvant endocrine therapy. At age 83 he died of metastatic prostate cancer. Our case underscores the observation that BRCA2 mutation carriers are at risk for multiple cancers, including contralateral breast cancer, and illustrates the need for current practice recommendations for the early detection of breast and prostate cancer in men with BRCA2 mutations.

  18. Bilateral Breast Enlargement: An Unusual Presentation of Superior Vena Cava Obstruction in a Hemodialysis Patient with Fibrosing Mediastinitis

    SciTech Connect

    Goo, Dong Erk Kim, Yong Jae; Choi, Deuk Lin; Kwon, Kui Hyang; Yang, Seung Boo

    2011-02-15

    A 67-year-old woman with end-stage renal disease presented with profound edema of both breasts. The presence of a patent hemodialysis basilic transposition fistula and superior vena cava obstruction (SVC), due to fibrosing mediastinitis, was demonstrated by the use of fistulography. Endovascular treatment with a balloon and stent caused immediate resolution of the breast edema.

  19. Bilateral and symmetrical tinea mammae.

    PubMed

    Yilmaz, Murat; Kavak, Ayse; Yamaner, Nalan Jale

    2013-09-14

    Tinea corporis has rarely been reported in some locations such as on the breast skin as unilaterally. Herein, we present a case of bilateral tinea mammae, which has not been reported before in English language literature to our knowledge.

  20. A comparative study of postoperative pain for open thyroidectomy versus bilateral axillo-breast approach robotic thyroidectomy using a self-reporting application for iPad

    PubMed Central

    Chai, Young Jun; Song, Junho; Kang, Jiyoung; Woo, Jung-Woo; Song, Ra-Yeong; Kwon, Hyungju; Kim, Su-Jin; Choi, June Young

    2016-01-01

    Purpose Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients. Methods Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis. Results A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale. Conclusion Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients. PMID:27186567

  1. Synchronicity from synchronized chaos

    DOE PAGESBeta

    Duane, Gregory

    2015-04-01

    The synchronization of loosely-coupled chaotic oscillators, a phenomenon investigated intensively for the last two decades, may realize the philosophical concept of “synchronicity”—the commonplace notion that related events mysteriously occur at the same time. When extended to continuous media and/or large discrete arrays, and when general (non-identical) correspondences are considered between states, intermittent synchronous relationships indeed become ubiquitous. Meaningful synchronicity follows naturally if meaningful events are identified with coherent structures, defined by internal synchronization between remote degrees of freedom; a condition that has been posited as necessary for synchronizability with an external system. The important case of synchronization between mind andmore » matter is realized if mind is analogized to a computer model, synchronizing with a sporadically observed system, as in meteorological data assimilation. Evidence for the ubiquity of synchronization is reviewed along with recent proposals that: (1) synchronization of different models of the same objective process may be an expeditious route to improved computational modeling and may also describe the functioning of conscious brains; and (2) the nonlocality in quantum phenomena implied by Bell’s theorem may be explained in a variety of deterministic (hidden variable) interpretations if the quantum world resides on a generalized synchronization “manifold”.« less

  2. Synchronicity from synchronized chaos

    SciTech Connect

    Duane, Gregory

    2015-04-01

    The synchronization of loosely-coupled chaotic oscillators, a phenomenon investigated intensively for the last two decades, may realize the philosophical concept of “synchronicity”—the commonplace notion that related events mysteriously occur at the same time. When extended to continuous media and/or large discrete arrays, and when general (non-identical) correspondences are considered between states, intermittent synchronous relationships indeed become ubiquitous. Meaningful synchronicity follows naturally if meaningful events are identified with coherent structures, defined by internal synchronization between remote degrees of freedom; a condition that has been posited as necessary for synchronizability with an external system. The important case of synchronization between mind and matter is realized if mind is analogized to a computer model, synchronizing with a sporadically observed system, as in meteorological data assimilation. Evidence for the ubiquity of synchronization is reviewed along with recent proposals that: (1) synchronization of different models of the same objective process may be an expeditious route to improved computational modeling and may also describe the functioning of conscious brains; and (2) the nonlocality in quantum phenomena implied by Bell’s theorem may be explained in a variety of deterministic (hidden variable) interpretations if the quantum world resides on a generalized synchronization “manifold”.

  3. Bilateral parotid neoplasms.

    PubMed

    Williams, C

    1980-09-01

    We are reporting what we believe to be the second case of bilateral parotid neoplasm occuring synchronously with differing histologies. We believe that this neoplasm may represent a specific propensity of parotid tissue in a given individual to develop neoplasia in a multipotential glandular organ subject to many neoplastic diseases. There also exists the possibility that this condition may represent an immune deficiency specific to the parotid gland. The case reports that have been reviewed demonstrate that a secondary neoplasm may arise from benign mixed tumors. We question whether this is an example of monistic origin of acinic cell tumor from a mixed-cell tumor or, perhaps, dualistic expression for this salivary gland to develop a multiplicity of anaplastic and metaplastic growth variants. In approaching a case with bilateral parotid involvement, the physician must be aware of the rare possibility that benign and malignant tumors may coexist. He must be prepared to proceed with more radical extirpation than simple superficial parotidectomy.

  4. Influence of body habitus on the surgical outcomes of bilateral axillo-breast approach robotic thyroidectomy in papillary thyroid carcinoma patients

    PubMed Central

    Lee, Hee Seung; Chai, Young Jun; Kim, Su-Jin; Choi, June Young

    2016-01-01

    Purpose Obesity is associated with a number of medical comorbidities and is considered a risk factor for surgical complications. The purpose of this study was to analyze the influence of body habitus including obesity on the surgical outcomes of the Bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT) in papillary thyroid carcinoma (PTC) patients. Methods The medical records of 456 PTC patients who underwent BABA RoT between January 2011 and December 2012 were reviewed, and 310 women PTC patients who had undergone BABA robotic total thyroidectomy with central lymph node dissection were examined. Body habitus were evaluated by measuring body mass index (BMI), body surface area, and neck circumference. We divided the patients into BMI < 25 kg/m2 and BMI ≥ 25 kg/m2 groups. Clinicopathological data, surgical outcomes, and postoperative complications were evaluated. Results Clinicopathological characteristics did not differ between the 2 BMI groups. The creation of working space time (P = 0.210) and other surgical outcomes showed no significant differences between the groups. There were no statistically significant differences between body habitus indexes and postoperative length of hospital stay, number of retrieved central lymph nodes, postoperative thyroglobulin levels, occurrence of hypoparathyoidism, recurrent laryngeal nerve injury and wound complication. Conclusion Patient with large body habitus undergoing BABA RoT were not at an increased risk of surgical complications and showed good surgical outcomes. BABA RoT may be a good alternative operative method for PTC patients for whom cosmetic outcome is an important consideration. PMID:27433458

  5. Bilateral Neck of Femur Fractures in a Bilateral Below-Knee Amputee: A Unique Case.

    PubMed

    Lancer, Hannah R; Smitham, Peter; Ray, Pinak

    2016-01-01

    According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses. PMID:26881162

  6. Bilateral Neck of Femur Fractures in a Bilateral Below-Knee Amputee: A Unique Case

    PubMed Central

    Lancer, Hannah R.

    2016-01-01

    According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses. PMID:26881162

  7. Metabolic flare phenomenon on 18 fluoride-fluorodeoxy glucose positron emission tomography-computed tomography scans in a patient with bilateral breast cancer treated with second-line chemotherapy and bevacizumab.

    PubMed

    Balasubramanian Harisankar, Chidambaram Natrajan; Preethi, Rajalakshmi; John, Jijoe

    2015-01-01

    Increase in radiopharmaceutical uptake is an indicator of progression of disease. Paradoxical increase in the radiopharmaceutical uptake also occurs during favorable response to therapy, which is designated as flare phenomenon. Flare phenomenon is well documented on bone scinitgraphy when initially noted lesions show increased radiotracer uptake after therapy is instituted. This happens despite favorable response to the treatment. The osteoblastic activity associated with healing response of bone tumors is the cause of flare phenomenon. Recently, metabolic flare phenomenon has been described in patients with breast cancer who undergo hormonal therapy. Changes in the hormonal level during initial part of the treatment is the cause of metabolic flare. We describe a patient with bilateral breast cancer who underwent second line chemotherapy along with bevacizumab. Serial positron emission tomography scans done showed interesting phenomenon of metabolic flare. PMID:25829734

  8. Metabolic flare phenomenon on 18 fluoride-fluorodeoxy glucose positron emission tomography-computed tomography scans in a patient with bilateral breast cancer treated with second-line chemotherapy and bevacizumab

    PubMed Central

    Balasubramanian Harisankar, Chidambaram Natrajan; Preethi, Rajalakshmi; John, Jijoe

    2015-01-01

    Increase in radiopharmaceutical uptake is an indicator of progression of disease. Paradoxical increase in the radiopharmaceutical uptake also occurs during favorable response to therapy, which is designated as flare phenomenon. Flare phenomenon is well documented on bone scinitgraphy when initially noted lesions show increased radiotracer uptake after therapy is instituted. This happens despite favorable response to the treatment. The osteoblastic activity associated with healing response of bone tumors is the cause of flare phenomenon. Recently, metabolic flare phenomenon has been described in patients with breast cancer who undergo hormonal therapy. Changes in the hormonal level during initial part of the treatment is the cause of metabolic flare. We describe a patient with bilateral breast cancer who underwent second line chemotherapy along with bevacizumab. Serial positron emission tomography scans done showed interesting phenomenon of metabolic flare. PMID:25829734

  9. Comparative Study between Robotic Total Thyroidectomy with Central Lymph Node Dissection via Bilateral Axillo-breast Approach and Conventional Open Procedure for Papillary Thyroid Microcarcinoma

    PubMed Central

    He, Qing-Qing; Zhu, Jian; Zhuang, Da-Yong; Fan, Zi-Yi; Zheng, Lu-Ming; Zhou, Peng; Hou, Lei; Yu, Fang; Li, Yan-Ning; Xiao, Lei; Dong, Xue-Feng; Ni, Gao-Feng

    2016-01-01

    Background: A large proportion of the patients with papillary thyroid microcarcinoma are young women. Therefore, minimally invasive endoscopic thyroidectomy with central neck dissection (CND) emerged and showed well-accepted results with improved cosmetic outcome, accelerated healing, and comforting the patients. This study aimed to evaluate the safety and effectiveness of robotic total thyroidectomy with CND via bilateral axillo-breast approach (BABA), compared with conventional open procedure in papillary thyroid microcarcinoma. Methods: One-hundred patients with papillary thyroid microcarcinoma from March 2014 to January 2015 in Jinan Military General Hospital of People's Liberation Army (PLA) were randomly assigned to robotic group or conventional open approach group (n = 50 in each group). The total operative time, estimated intraoperative blood loss, numbers of lymph node removed, visual analog scale (VAS), postoperative hospital stay time, complications, and numerical scoring system (NSS, used to assess cosmetic effect) were analyzed. Results: The robotic total thyroidectomy with CND via BABA was successfully performed in robotic group. There were no conversion from the robotic surgeries to open or endoscopic surgery. The subclinical central lymph node metastasis rate was 35%. The mean operative time of the robotic group was longer than that of the conventional open approach group (118.8 ± 16.5 min vs. 90.7 ± 10.3 min, P < 0.05). The study showed significant differences between the two groups in terms of the VASs (2.1 ± 1.0 vs. 3.8 ± 1.2, P < 0.05) and NSS (8.9 ± 0.8 vs. 4.8 ± 1.7, P < 0.05). The differences between the two groups in the estimated intraoperative blood loss, postoperative hospital stay time, numbers of lymph node removed, postoperative thyroglobulin levels, and complications were not statistically significant (all P > 0.05). Neither iatrogenic implantation nor metastasis occurred in punctured porous channel or chest wall in both groups

  10. Bilateral vestibulopathy.

    PubMed

    Strupp, M; Feil, K; Dieterich, M; Brandt, T

    2016-01-01

    The leading symptoms of bilateral vestibulopathy (BVP) are postural imbalance and unsteadiness of gait that worsens in darkness and on uneven ground. There are typically no symptoms while sitting or lying under static conditions. A minority of patients also have movement-induced oscillopsia, in particular while walking. The diagnosis of BVP is based on a bilaterally reduced or absent function of the vestibulo-ocular reflex (VOR). This deficit is diagnosed for the high-frequency range of the angular VOR by a bilaterally pathologic bedside head impulse test (HIT) and for the low-frequency range by a bilaterally reduced or absent caloric response. If the results of the bedside HIT are unclear, angular VOR function should be quantified by a video-oculography system (vHIT). An additional test supporting the diagnosis is dynamic visual acuity. Cervical and ocular vestibular-evoked myogenic potentials (c/oVEMP) may also be reduced or absent, indicating impaired otolith function. There are different subtypes of BVP depending on the affected anatomic structure and frequency range of the VOR deficit: impaired canal function in the low- and/or high-frequency VOR range only and/or otolith function only; the latter is very rare. The etiology of BVP remains unclear in more than 50% of patients: in these cases neurodegeneration is assumed. Frequent known causes are ototoxicity mainly due to gentamicin, bilateral Menière's disease, autoimmune diseases, meningitis and bilateral vestibular schwannoma, as well as an association with cerebellar degeneration (cerebellar ataxia, neuropathy, vestibular areflexia syndrome=CANVAS). In general, in the long term there is no improvement of vestibular function. There are four treatment options: first, detailed patient counseling to explain the cause, etiology, and consequences, as well as the course of the disease; second, daily vestibular exercises and balance training; third, if possible, treatment of the underlying cause, as in bilateral

  11. [Synchronous and ipsilateral invasive ductal carcinoma of the breast occurring near a phyllodes tumor - a case report].

    PubMed

    Nagashima, Saki; Sakurai, Kenichi; Suzuki, Shuhei; Sakagami, Masashi; Enomoto, Katsuhisa; Amano, Sadao; Koshinaga, Tsugumichi

    2014-11-01

    We report 2 cases of invasive ductal carcinoma of the breast occurring near a phyllodes tumor. The first case was ofa 58- year-old woman who had a tumor in her right breast and visited our hospital. Following a core needle biopsy (CNB), a malignant phyllodes tumor was diagnosed. We performed a lumpectomy for the phyllodes tumor, with 1.5-cm surgical margins. Pathological diagnosis of the resected specimen confirmed the malignant phyllodes tumor. A ductal carcinoma in situ (DCIS) was also discovered near the phyllodes tumor. The second case was of another 58-year-old woman who had a big tumor in her right breast and visited our hospital. CNB resulted in pathological diagnosis ofa benign phyllodes tumor. The tumor was removed by a lumpectomy with 1.5-cm surgical margins. The pathological diagnosis from the resected specimen was borderline phyllodes tumor with invasive ductal carcinoma in the proximity. In both cases, DCIS could not have been diagnosed preoperatively. PMID:25731391

  12. Bilateral giant juvenile fibroadenomas of the breasts—a rare indication for bilateral skin reducing mastectomy

    PubMed Central

    Neto, Francisco Laitano; Zerwes, Felipe Pereira

    2016-01-01

    Fibroadenoma is the most common benign tumor of the breast but giant juvenile fibroadenoma represent only 0.5% of all fibroadenomas and when bilateral are much more rare. We describe the case of a 25 years old girl that presented with bilateral giant juvenile fibroadenomas and was treated by bilateral skin reducing mastectomy using the inferior dermal flap, implant, and free nipple graft. PMID:27563567

  13. A retrospective study examining the socioeconomic backgrounds of women undergoing bilateral breast augmentation at a private independent hospital in the United kingdom.

    PubMed

    Wong, Matthew; Moledina, Jamil; Park, Alan

    2007-01-01

    Cosmetic breast augmentation is becoming increasingly popular and acceptable to women in the United Kingdom. This study examined the socioeconomic backgrounds of women undergoing breast augmentation who live in North Warwickshire in the Midlands. The case notes of 98 consecutive breast augmentations performed at a private independent hospital were retrospectively reviewed. The average age of the patient was 34 years (range, 17-53 years). They were requesting, on the average, an increase of 2 bra cup sizes (range, 1-3 cup sizes). The preoperative bra cup size was A/B (range, AA-C), and the postoperative bra cup size was C/D (range, B-E). The average size of the implant used was 270 ml (range, 160-410 ml). The average implant size used currently is considerably larger than that reported in studies 30 years ago. What women perceive as a "natural-appearing" breast has changed over time. The findings show that women from all across the socioeconomic spectrum are undergoing breast augmentation. In particular, the authors found that the largest proportion (34%) of their patients have come from social class IIIn. This is particularly interesting in that this social class is not overrepresented in North Warwickshire. The findings of this study may have implications for cosmetic surgery providers and may document the change in the attitudes of the authors' society toward cosmetic breast augmentation. PMID:17700979

  14. Syncronized Warthin's tumor in bilateral parotid gland and nasopharynx.

    PubMed

    Güçlü, Oğuz; Muratlı, Aslı; Karatağ, Ozan; Dereköy, Fevzi Sefa; Uludağ, Ahmet

    2012-01-01

    Warthin's tumor is a benign salivary gland tumor of the parotid gland. Although bilateral or multicentric involvement of the parotid gland is common, extraparotid involvement is seen rarely. The nasopharynx is an unusual region for extraparotid involvement. In this article, we present a 52-year-old male case with a synchronized Warthin's tumor in the bilateral parotid gland and nasopharynx, and we discuss the clinical management of the disease.

  15. Synchronous demodulator

    NASA Technical Reports Server (NTRS)

    Sutton, John F. (Inventor)

    1991-01-01

    A synchronous demodulator includes a switch which is operated in synchronism with an incoming periodic signal and both divides and applies that signal to two signal channels. The two channels each include a network for computing and holding, for a predetermined length of time, the average signal value on that channel and applies those valves, in the form of two other signals, to the inputs of a differential amplifier. The networks may be R-C networks. The output of the differential amplifier may or may not form the output of the synchronous detector and may or may not be filtered. The output will not include a periodic signal due to the presence of a dc offset. Additionally, the output will not contain any substantial ripple due to periodic components in the input signal. In a somewhat more complex version, containing twice the structural components of the above synchronous demodulator with a more complex switching mechanism, essentially all ripple due to periodic components in the input signal are eliminated.

  16. Synchronizing Fireflies

    ERIC Educational Resources Information Center

    Zhou, Ying; Gall, Walter; Nabb, Karen Mayumi

    2006-01-01

    "Imagine a tenth of a mile of river front with an unbroken line of trees with fireflies on ever leaf flashing in synchronism. ... Then, if one's imagination is sufficiently vivid, he may form some conception of this amazing spectacle." So wrote the naturalist Hugh Smith. In this article we consider how one might model mathematically the…

  17. Occurrence of bilaterally independent epileptic spasms after a corpus callosotomy in West syndrome.

    PubMed

    Kobayashi, Katsuhiro; Endoh, Fumika; Toda, Yoshihiro; Oka, Makio; Baba, Hiroshi; Ohtsuka, Yoko; Yoshinaga, Harumi

    2016-01-01

    We report a patient with intractable West syndrome whose epileptic spasms (ESs) were initially bilaterally synchronous, as is typical; after a complete corpus callosotomy, however, bilaterally independent ESs originated in either hemisphere. Activity of probable cortical origin associated with ESs was detected by observing ictal gamma oscillations. Brain MRI revealed no structural abnormality before surgery. This case suggests that ESs with a hemispheric origin may appear generalized because of synchronizing effects in the corpus callosum in some patients.

  18. Thoracic outlet syndrome following breast implant rupture.

    PubMed

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  19. Thoracic Outlet Syndrome Following Breast Implant Rupture

    PubMed Central

    Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-01-01

    Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  20. microRNA miR-142-3p Inhibits Breast Cancer Cell Invasiveness by Synchronous Targeting of WASL, Integrin Alpha V, and Additional Cytoskeletal Elements

    PubMed Central

    Schwickert, Alexander; Weghake, Esther; Brüggemann, Kathrin; Engbers, Annika; Brinkmann, Benjamin F.; Kemper, Björn; Seggewiß, Jochen; Stock, Christian; Ebnet, Klaus; Kiesel, Ludwig; Riethmüller, Christoph; Götte, Martin

    2015-01-01

    MicroRNAs (miRNAs, micro ribonucleic acids) are pivotal post-transcriptional regulators of gene expression. These endogenous small non-coding RNAs play significant roles in tumorigenesis and tumor progression. miR-142-3p expression is dysregulated in several breast cancer subtypes. We aimed at investigating the role of miR-142-3p in breast cancer cell invasiveness. Supported by transcriptomic Affymetrix array analysis and confirmatory investigations at the mRNA and protein level, we demonstrate that overexpression of miR-142-3p in MDA-MB-231, MDA-MB-468 and MCF-7 breast cancer cells leads to downregulation of WASL (Wiskott-Aldrich syndrome-like, protein: N-WASP), Integrin-αV, RAC1, and CFL2, molecules implicated in cytoskeletal regulation and cell motility. ROCK2, IL6ST, KLF4, PGRMC2 and ADCY9 were identified as additional targets in a subset of cell lines. Decreased Matrigel invasiveness was associated with the miR-142-3p-induced expression changes. Confocal immunofluorescence microscopy, nanoscale atomic force microscopy and digital holographic microscopy revealed a change in cell morphology as well as a reduced cell volume and size. A more cortical actin distribution and a loss of membrane protrusions were observed in cells overexpressing miR-142-3p. Luciferase activation assays confirmed direct miR-142-3p-dependent regulation of the 3’-untranslated region of ITGAV and WASL. siRNA-mediated depletion of ITGAV and WASL resulted in a significant reduction of cellular invasiveness, highlighting the contribution of these factors to the miRNA-dependent invasion phenotype. While knockdown of WASL significantly reduced the number of membrane protrusions compared to controls, knockdown of ITGAV resulted in a decreased cell volume, indicating differential contributions of these factors to the miR-142-3p-induced phenotype. Our data identify WASL, ITGAV and several additional cytoskeleton-associated molecules as novel invasion-promoting targets of miR-142-3p in breast

  1. Bilateral Anterior Shoulder Dislocation

    PubMed Central

    Siu, Yuk Chuen; Lui, Tun Hing

    2014-01-01

    Introduction: Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare. Case Presentation: We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus. Conclusions: Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed. PMID:25685749

  2. [Bilateral operculum syndrome].

    PubMed

    Lerman-Sagie, T; Porat-Alkabetz, E; Meir, J J; Harel, S

    1996-09-01

    The bilateral operculum syndrome, is a unique developmental syndrome. It is characterized by spastic paralysis of the muscles of the face, pharynx, and of mastication, as well as by epilepsy and mental retardation. Imaging studies show bilateral, structural abnormalities in the frontal, perisylvian region consistent with polymicrogyria. These children are usually diagnosed as suffering from cerebral palsy, but in the bilateral operculum syndrome, intelligence is relatively preserved despite the severe motor involvement. Misdiagnosis may lead to improper estimation of rehabilitation potential preventing appropriate therapy, especially in the field of alternative communication. We present a 3-year-old boy, apparently the first case of this syndrome to be described in Israel. PMID:8940497

  3. Echinoderms Have Bilateral Tendencies

    PubMed Central

    Zhao, Wenchan; Wang, Sishuo; Lv, Jianhao

    2012-01-01

    Echinoderms take many forms of symmetry. Pentameral symmetry is the major form and the other forms are derived from it. However, the ancestors of echinoderms, which originated from Cambrian period, were believed to be bilaterians. Echinoderm larvae are bilateral during their early development. During embryonic development of starfish and sea urchins, the position and the developmental sequence of each arm are fixed, implying an auxological anterior/posterior axis. Starfish also possess the Hox gene cluster, which controls symmetrical development. Overall, echinoderms are thought to have a bilateral developmental mechanism and process. In this article, we focused on adult starfish behaviors to corroborate its bilateral tendency. We weighed their central disk and each arm to measure the position of the center of gravity. We then studied their turning-over behavior, crawling behavior and fleeing behavior statistically to obtain the center of frequency of each behavior. By joining the center of gravity and each center of frequency, we obtained three behavioral symmetric planes. These behavioral bilateral tendencies might be related to the A/P axis during the embryonic development of the starfish. It is very likely that the adult starfish is, to some extent, bilaterian because it displays some bilateral propensity and has a definite behavioral symmetric plane. The remainder of bilateral symmetry may have benefited echinoderms during their evolution from the Cambrian period to the present. PMID:22247765

  4. Multiple Symmetric Lipomatosis (Madelung's Disease) Presenting as Bilateral Huge Gynecomastia

    PubMed Central

    Jang, Jae Hoon; Lee, Anbok; Han, Sang-Ah; Ryu, Jung-Kyu

    2014-01-01

    Multiple symmetric lipomatosis (MSL), or Madelung's disease, is a rare disease of unknown etiology. It is characterized by the presence of loose adipose tissue deposits localized in the cervical region and upper body. MSL presenting as bilateral huge gynecomastia is an extremely rare phenomenon. The present report describes a case of MSL in a 66-year-old man. The patients presented with bilateral breast bulging. He had a history of cigarette and alcohol use. His condition was treated with a bilateral nipple-sparing mastectomy. MSL can present as a form of gynecomastia, for its accurate diagnosis and proper treatment of MSL, increasing awareness of the clinical characteristics of the disease is required, especially amongst breast surgeons. Herein, we review the literature and discuss the clinical characteristics, pathology, and surgical treatment of MSL. PMID:25548590

  5. Bilateral inferior turbinate osteoma

    PubMed Central

    Sahemey, R.; Warfield, A.T.; Ahmed, S.

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma. A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively. To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  6. Bilateral inferior turbinate osteoma.

    PubMed

    Sahemey, R; Warfield, A T; Ahmed, S

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma.A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively.To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  7. Subsequent bilateral thalamic haemorrhage

    PubMed Central

    Perez, Jesus; Scherle, Claudio; Machado, Calixto

    2009-01-01

    Simultaneous or subsequent bilateral thalamic haemorrhage is rare, and most reported cases are from Asian countries. An 80-year-old white Cuban man, with a history of arterial hypertension, suffered sudden onset of right hemiparesis. Computed tomography (CT) scan showed a left posteromedial thalamic haemorrhage. Two days later his condition suddenly deteriorated: blood pressure was 220/105 mm Hg, he was stuporous and tetraplegic, respiration was ataxic, and his gaze was fixed and deviated downward and inward. CT scan showed haemorrhages in both thalami, extending to the ventricles. 32 h later the patient died. There are few previous publications of simultaneous or subsequent bilateral thalamic haemorrhages and this is the first report involving a Hispanic patient. Prognosis in patients with bilateral thalamic haemorrhage is poor, and the mechanism underlying the development of subsequent and symmetrical bleeding is not clear. PMID:21709830

  8. NEPHRON-SPARING SURGERY FOR BILATERAL WILMS TUMOR

    PubMed Central

    Kieran, Kathleen; Davidoff, Andrew M.

    2015-01-01

    Synchronous bilateral disease occurs in approximately 5% of children with Wilms tumor (WT), and is independently associated with an increased risk of renal insufficiency. Nephron-sparing surgery (NSS) allows preservation of renal mass and improved renal function. Published oncologic and functional outcomes with NSS to date are generally good, likely reflecting proper patient selection and excellent surgical technique during tumor excision, as well as appropriate use of upfront and adjuvant therapies. Here we highlight important issues regarding the use of NSS in children with bilateral Wilms tumor (BWT). PMID:25633157

  9. Treatment of bilateral urolithiasis.

    PubMed

    Matsushita, K; Tanikawa, K; Masuda, A; Matsunaga, J; Matsuzaki, S

    1992-12-01

    Patients with bilateral urolithiasis diagnosed at their first visit were followed for at least one year after the start of treatment. In this retrospective study of 123 patients, the basic metabolic workup revealed no specific underlying cause of simultaneously occurring bilateral nephrolithiasis, and none of the currently used therapeutic regimes proved to be efficient in attaining clinically acceptable stone-free rates at the 3, 6 and 12-month follow-ups. Of 38 patients treated with extracorporeal shockwave lithotripsy (SWL), 21 underwent treatment of both kidneys and 10 (48%) were free of stones bilaterally after 12 months. All of the 17 patients treated with unilateral SWL failed to achieve a stone-free state on the contralateral side. In another group, treated with medication alone to minimize risks of stone recurrence, only 3 of 26 (11.5%) patients were stone-free on both sides 12 months after the start of medication. Since we achieved a stone-free state of both kidneys in no more than 12% of the non-medicated cases, it seems warranted to treat bilateral urolithiasis with SWL more frequently, particularly when patients cannot return regularly to the stone clinic for a longterm follow-up.

  10. Bilateral undescended testes.

    PubMed

    Snyder, H M

    1993-01-01

    The management of boys with undescended testes appears to be an increasingly common problem. While Scorer (1964) [11] reported an incidence of 0.8% of undescended testes in boys of one year of age, a recent survey (Radcliffe Hospital, Oxford, 1986) [18] suggests the incidence has risen to as high as 1.6%. While the etiology may be varied, it is quite clear that many cases represent disturbances of the hypothalamic-pituitary-gonadal axis and may represent a forme fruste of hypogonadotropic hypogonadism [3]. Bilateral undescended testes might logically appear to represent the worst end of such an endocrinopathy. Indeed, a review of the experience at The Children's Hospital of Philadelphia [12] of boys with bilateral undescended testes indicated a greater number of CNS abnormalities (P = 0.0000) than in boys with unilateral undescended testes (Table 1). Also consistent with bilateral cryptorchid testes representing the most severe end of the spectrum was the reported findings from that study that bilateral undescended testes also exhibit a significantly greater number of associated G-U anomalies (P = 0.0004).

  11. Bilateral renal lymphoangiomatosis

    PubMed Central

    Raed, Alqahtani; Sultan, Alkhateeb; Bader, Al-Mutairi

    2015-01-01

    Introduction Renal lymphangiomatosis is a rare congenital benign disease of renal lymphatic system, here we are presenting a very rare form of disease which is bilateral form. Presentation of the case A young adult presented to our clinic after being referred from primary care clinic with intermittent bilateral flank pain and no other symptoms after extensive radiological investigations diagnosis has been made and confirmed by radiological finding of disease. Active treatment usually preserved for complex cases and for the complications of the disease but in our patient as needed analgesia worked well in controlling his intermittent pain and his wish not to pursue any intervention. The vague presentation with initial imaging rising suspicion of renal tumor or complex renal cyst might cause psychological street on the patient, which our patient had, but reassurance after extensive radiological work up relive that's stress. Discussion Although it is very rare disease to be bilateral but wide variety of other differential diagnoses make importance of disease recognition and accurate diagnosis is the key. Conclusion Renal lymphangiomatosis is a rare benign disease of renal lymphatic, which usually affect one side, but bilateral form is very rare form, which may raise the suspicions of genetic form of renal malignancy. Accurate diagnosis requires work up to role out malignant and other renal tumor, which require active surgical management. PMID:26719997

  12. Clonality of lobular carcinoma in situ (LCIS) and metachronous invasive breast cancer.

    PubMed

    Aulmann, Sebastian; Penzel, Roland; Longerich, Thomas; Funke, Benjamin; Schirmacher, Peter; Sinn, Hans Peter

    2008-02-01

    Lobular carcinoma in situ (LCIS) of the breast is generally considered an indicator for a bilaterally increased risk of invasive breast cancer (IBC). However, as recent studies suggested a clonal relationship between a subset of synchronous LCIS and invasive lobular carcinomas (ILC), we aimed to examine a possible precursor role for LCIS and IBC occurring in the same breast at a later time. Out of a consecutive series of 88 LCIS, nine patients developed IBC (5 ILC and 4 invasive ductal carcinomas) between 2 and 10 years after initial biopsy. For each case, mitochondrial DNA heteroplasmy was analyzed in normal mammary gland epithelia, LCIS and IBC by PCR, direct DNA sequencing and phylogenetic tree clustering. Two cases of LCIS and ILC showed identical patterns of heteroplasmy. In one further case, additional mtDNA mutations were present in the ILC following LCIS. The remaining two cases of ILC and all 4 IDC were clonally unrelated to the previously diagnosed LCIS. While the overall risk for the development of invasive breast cancer following LCIS is relatively low and the majority of cases are clonally unrelated, our data clearly show that some LCIS eventually do progress to ILC. Thus, LCIS represents both an indicator lesion for an increased risk of subsequent invasive breast cancer and in some cases a precursor of ILC. PMID:17380381

  13. Bilateral compressive optic neuropathy secondary to bilateral sphenoethmoidal mucoceles.

    PubMed

    Newton, N; Baratham, G; Sinniah, R; Lim, A

    1989-01-01

    We have presented a rare case of bilateral posterior sphenoethmoidal sinus mucoceles with bilateral compressive optic neuropathy. While the duration of compression was variably present over a 10-month period, there were nevertheless significant improvements in visual acuity of the right eye and visual fields bilaterally following extensive optic nerve decompression.

  14. Current Status of Diagnosis And Treatment of Primary Breast Cancer in Beijing, 2008

    PubMed Central

    Yuan, Xiao-mei; Wang, Ning; Ouyang, Tao; Yang, Lei; Song, Ming-yang; Lin, Ben-yao; Xie, Yun-tao; Li, Jin-feng; Pan, Kai-feng; You, Wei-cheng; Zhang, Lian

    2011-01-01

    Objective To investigate the status of diagnosis and treatment of primary breast cancer in Beijing, 2008. Methods All the patients who were diagnosed as primary breast cancer in Beijing in 2008 were enrolled in this study. Information of these patients, including the features of tumors, clinical diagnosis and treatment was collected, and filled in the well-designed questionnaire forms by trained surveyors. The missing data was partly complemented through telephone interviews. Results A total of 3473 Beijing citizens were diagnosed as primary breast cancer (25 patients with synchronal bilateral breast cancer) in Beijing, 2008. Of them 82.09% were symptomatic. 19.02% and 34.11% were diagnosed using fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB), respectively. 15.92% received sentinel lymph node biopsy (SLNB) and 24.27% received breast conserving surgery (BCS). Among 476 cases with Her-2 positive, only 96 received anti-Her-2 therapy. We found that the standardization level varied in hospitals of different grades, with higher level in Grade-III hospitals. Of note, some breast cancer patients received non-standard primary tumor therapy: 65.63% of the patients with ductal carcinoma in situ (DCIS) received axillary lymph node dissection and 36.88% received chemotherapy; 25.89% of the patients underwent breast conserving surgery without margin status; 12.10% of the patients received chemotherapy less than 4 cycles. Conclusion Although most breast cancer patients received basic medical care, the mode of diagnosis and treatment should be improved and should be standardized in the future in Beijing. PMID:23467615

  15. Bilateral Presumed Tuberculous Choroiditis

    PubMed Central

    Mohammadi, Naseh; Ghassemi, Fariba; Shojaei, Esfandiar; Moradnejad, Pardis

    2016-01-01

    Purpose: To describe a case of bilateral presumed tuberculous choroiditis which resolved promptly with a short course of antituberculous therapy. Case Report: A 44-year-old lady presented with bilateral visual loss of 8 months’duration. Considering the presence of pan-uveitis, severe macular edema, multifocal leakage on fluorescein angiography, positive tuberculin skin test, and after excluding other diseases, she underwent anti-tuberculous therapy (ATT) for disseminated choroiditis due to presumed ocular tuberculosis. She improved promptly and completely. There were no signs of relapse 18 months after completion of the treatment course. In a young patient with disseminated choroiditis and relatively short duration of symptoms, a course of ATT for 6 months may effectively treat the disease preventing relapse for a considerable period of time. Conclusion: In Presumed Tuberculous chroiditis early diagnosis is crucial for prompt and complete improvement. PMID:27413507

  16. Bilateral combined laryngocele

    PubMed Central

    Suqati, Abrar A.; Alherabi, Ameen Z.; Marglani, Osama A.; Alaidarous, Tariq O.

    2016-01-01

    Laryngocele is an uncommon condition that represents a benign dilatation of the laryngeal saccule with air and/or fluid, arising in the region of the laryngeal ventricle. Laryngoceles, or laryngomucocele can be classified as internal, or combined. The aim of presenting this rare case of a bilateral combined laryngocele, are to emphasize the importance of diagnostic laryngoscopy in upper airway pathologies evaluation, increase awareness in the general otolaryngologist community, and to highlight the external surgical method. PMID:27464869

  17. [Spontaneous bilateral Petit hernia].

    PubMed

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  18. Multispectral bilateral video fusion.

    PubMed

    Bennett, Eric P; Mason, John L; McMillan, Leonard

    2007-05-01

    We present a technique for enhancing underexposed visible-spectrum video by fusing it with simultaneously captured video from sensors in nonvisible spectra, such as Short Wave IR or Near IR. Although IR sensors can accurately capture video in low-light and night-vision applications, they lack the color and relative luminances of visible-spectrum sensors. RGB sensors do capture color and correct relative luminances, but are underexposed, noisy, and lack fine features due to short video exposure times. Our enhanced fusion output is a reconstruction of the RGB input assisted by the IR data, not an incorporation of elements imaged only in IR. With a temporal noise reduction, we first remove shot noise and increase the color accuracy of the RGB footage. The IR video is then normalized to ensure cross-spectral compatibility with the visible-spectrum video using ratio images. To aid fusion, we decompose the video sources with edge-preserving filters. We introduce a multispectral version of the bilateral filter called the "dual bilateral" that robustly decomposes the RGB video. It utilizes the less-noisy IR for edge detection but also preserves strong visible-spectrum edges not in the IR. We fuse the RGB low frequencies, the IR texture details, and the dual bilateral edges into a noise-reduced video with sharp details, correct chrominances, and natural relative luminances. PMID:17491451

  19. Bilateral mammary duct ectasia induced by sulpiride-associated hyperprolactinemia: A case report

    PubMed Central

    CONG, YIZI; ZOU, HAIDONG; QIAO, GUANGDONG; LIN, JUN; WANG, XINGMIAO; LI, XIAOHUI; LI, YALUN; ZHU, SHIGUANG

    2015-01-01

    A 32 year old female diagnosed with schizophrenia was treated with sulpiride, trihexyphenidyl and alprazolam for 6 years. A physical examination revealed bilateral nipple retraction and a non-tender mass in the left breast, with little nipple discharge. Tests revealed high levels of carbohydrate antigen 125, serum prolactin and testosterone levels, and ultrasound revealed a number of masses in the bilateral breasts; the largest mass (2.2×1.3 cm) was located in the left breast. A rich blood flow signal was identified around the nodule. The ducts in the bilateral breasts exhibited cystic ectasia. Multiple enlarged lymph nodes were found in the bilateral axillae. Mammography revealed thickened breast tissue without an evident mass, and calcification. A segmental mastectomy was performed and subsequent histological examination revealed multiple dilated ducts, the largest of which contained eosinophilic material. The pathological diagnosis was of breast duct dilatation. Bacterial culture and drug sensitivity analysis of the secretions from the cystic cavity revealed no bacterial growth, and an acid fast bacillus stain was negative. Extravasation of the surgical wound occurred 1 month later, and Staphylococcus epidermidis was observed using a bacterial culture. This was treated with moxifloxacin for 1 week. It was suggested that the patient should switch to a prolactin sparing antipsychotic in view of the hyperprolactinemia, however, the patient refused. After a clinical follow-up of 16 months, the wound had healed well and no palpable mass was found in the breast. PMID:26137036

  20. Inverse anticipating chaos synchronization.

    PubMed

    Shahverdiev, E M; Sivaprakasam, S; Shore, K A

    2002-07-01

    We derive conditions for achieving inverse anticipating synchronization where a driven time-delay chaotic system synchronizes to the inverse future state of the driver. The significance of inverse anticipating chaos in delineating synchronization regimes in time-delay systems is elucidated. The concept is extended to cascaded time-delay systems.

  1. McCune-Albright syndrome presenting with unilateral macroorchidism and bilateral testicular masses.

    PubMed

    Khanna, Geetika; Kantawala, Kartikeya; Shinawi, Marwan; Sarwate, Sandhya; Dehner, Louis P

    2010-12-01

    Bilateral synchronous intratesticular masses are rare but can be caused by metastatic disease to the testicle, primary testicular masses or benign etiologies such as congenital adrenal hyperplasia and granulomatous orchitis. We present an unusual case of McCune-Albright syndrome presenting with unilateral testicular enlargement and bilateral testicular masses secondary to Sertoli cell hyperplasia. To our knowledge, this is a unique case of testicular masses secondary to McCune-Albright syndrome. PMID:20607225

  2. A new automatic synchronizer

    SciTech Connect

    Malm, C.F.

    1995-12-31

    A phase lock loop automatic synchronizer, PLLS, matches generator speed starting from dead stop to bus frequency, and then locks the phase difference at zero, thereby maintaining zero slip frequency while the generator breaker is being closed to the bus. The significant difference between the PLLS and a conventional automatic synchronizer is that there is no slip frequency difference between generator and bus. The PLL synchronizer is most advantageous when the penstock pressure fluctuates the grid frequency fluctuates, or both. The PLL synchronizer is relatively inexpensive. Hydroplants with multiple units can economically be equipped with a synchronizer for each unit.

  3. Synchronization of clocks

    NASA Astrophysics Data System (ADS)

    Kapitaniak, Marcin; Czolczynski, Krzysztof; Perlikowski, Przemysław; Stefanski, Andrzej; Kapitaniak, Tomasz

    2012-08-01

    In this report we recall the famous Huygens’ experiment which gave the first evidence of the synchronization phenomenon. We consider the synchronization of two clocks which are accurate (show the same time) but have pendula with different masses. It has been shown that such clocks hanging on the same beam can show the almost complete (in-phase) and almost antiphase synchronizations. By almost complete and almost antiphase synchronization we defined the periodic motion of the pendula in which the phase shift between the displacements of the pendula is respectively close (but not equal) to 0 or π. We give evidence that almost antiphase synchronization was the phenomenon observed by Huygens in XVII century. We support our numerical studies by considering the energy balance in the system and showing how the energy is transferred between the pendula via oscillating beam allowing the pendula’s synchronization. Additionally we discuss the synchronization of a number of different pendulum clocks hanging from a horizontal beam which can roll on the parallel surface. It has been shown that after a transient, different types of synchronization between pendula can be observed; (i) the complete synchronization in which all pendula behave identically, (ii) pendula create three or five clusters of synchronized pendula. We derive the equations for the estimation of the phase differences between phase synchronized clusters. The evidence, why other configurations with a different number of clusters are not observed, is given.

  4. Synchronization of chaotic systems

    SciTech Connect

    Pecora, Louis M.; Carroll, Thomas L.

    2015-09-15

    We review some of the history and early work in the area of synchronization in chaotic systems. We start with our own discovery of the phenomenon, but go on to establish the historical timeline of this topic back to the earliest known paper. The topic of synchronization of chaotic systems has always been intriguing, since chaotic systems are known to resist synchronization because of their positive Lyapunov exponents. The convergence of the two systems to identical trajectories is a surprise. We show how people originally thought about this process and how the concept of synchronization changed over the years to a more geometric view using synchronization manifolds. We also show that building synchronizing systems leads naturally to engineering more complex systems whose constituents are chaotic, but which can be tuned to output various chaotic signals. We finally end up at a topic that is still in very active exploration today and that is synchronization of dynamical systems in networks of oscillators.

  5. Synchronization of chaotic systems.

    PubMed

    Pecora, Louis M; Carroll, Thomas L

    2015-09-01

    We review some of the history and early work in the area of synchronization in chaotic systems. We start with our own discovery of the phenomenon, but go on to establish the historical timeline of this topic back to the earliest known paper. The topic of synchronization of chaotic systems has always been intriguing, since chaotic systems are known to resist synchronization because of their positive Lyapunov exponents. The convergence of the two systems to identical trajectories is a surprise. We show how people originally thought about this process and how the concept of synchronization changed over the years to a more geometric view using synchronization manifolds. We also show that building synchronizing systems leads naturally to engineering more complex systems whose constituents are chaotic, but which can be tuned to output various chaotic signals. We finally end up at a topic that is still in very active exploration today and that is synchronization of dynamical systems in networks of oscillators.

  6. Bilateral gustatory rhinorrhea following bilateral parotidectomy: a case report.

    PubMed

    Stevens, H E; Doyle, P J

    1988-06-01

    To the authors' knowledge, no cases of gustatory rhinorrhea following parotidectomy have been reported. A case is presented of a 28-year-old woman who underwent bilateral parotidectomies within a four-year period for congenital sialectasia and secondary infection. Both operations were complicated by Frey's syndrome and she also developed bilateral gustatory rhinorrhea. The successful management of this problem with bilateral vidian neurectomies and the refractory nature of her Frey's syndrome, finally controlled with tympanic neurectomies, are discussed. PMID:3398109

  7. Bilateral accessory thoracodorsal artery.

    PubMed

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  8. [Metachronous bilateral Wilms' tumor].

    PubMed

    Mambié Meléndez, M; Guibelalde Del Castillo, M; Nieto Del Rincón, N; Rodrigo Jiménez, D; Femenia Reus, A; Román Piñana, J M

    2002-03-01

    Wilms' tumor occurs in 5-10 % of all cases of nephroblastoma. The metachronous form represents 2-3 % of cases. Most (96.2 %) metachronous tumors appear within the first 5 years of the primary tumor. Associated malformations are more common in bilateral cases. Metachronous tumors are a therapeutic challenge. We describe the case of an 11-year-old girl with left hemihypertrophy. The diagnosis was metachronous relapse of Wilms' tumor 7 years after the first diagnosis. The patient received five courses of preoperative chemotherapy and tumorectomy was performed. Because of post-surgical complications, nephrectomy was performed on her only kidney. Since she is anephric, the patient is in chronic renal failure and is dependent on dialysis. Treatment with carboplatin and etoposide was continued after surgery and the patient is currently in complete remission. The appearance of a metachronous Wilms' tumor 5 years after that of the primary tumor is rare. When a contralateral tumour develops, chemotherapy must be given until the size of the tumor is reduced in order to preserve renal function and avoid dialysis. In patients with chronic renal failure caused by bilateral nephrectomy, ongoing treatment with dialysis support can be achieved through the choice of effective drugs and knowledge of their pharmacokinetics and pharmacodynamics.

  9. Influence of unilateral weight on bilateral cyclograms

    NASA Astrophysics Data System (ADS)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  10. A Rare Case of Synchronous Saree Cancer

    PubMed Central

    Naveen, N; Kumar, M Kamal; Babu, Ramesh K; Dhanraj, Prema

    2014-01-01

    Skin cancers are rather uncommon malignancies comprising less than 1% of all the cancers in India. Saree cancer is a rare type of squamous cell carcinoma (SCC). Saree and dhoti are traditional male and female costumes respectively, which is unique to the Indian subcontinent. Constant wear of this clothing tightly around the waist results in changes in pigmentation and scaling of the skin, acanthosis, scar and ulceration and subsequent, gradual malignant changes. The process of repeated trauma over a long time and consequent interference with the healing process may rationalise the reason for malignant transformation. Few papers have been published on saree cancer, in main stream medical journals. We are presenting a rare case of saree cancer in a 68-year-old woman, with two distant bilateral ulceroproliferative growths in loin (Synchronous), along the waistline, which showed well-differentiated SCC on biopsy. Wide excision with rhomboid transposition flap was done bilaterally. PMID:25538441

  11. Synchronizing large systolic arrays

    SciTech Connect

    Fisher, A.L.; Kung, H.T.

    1982-04-01

    Parallel computing structures consist of many processors operating simultaneously. If a concurrent structure is regular, as in the case of systolic array, it may be convenient to think of all processors as operating in lock step. Totally synchronized systems controlled by central clocks are difficult to implement because of the inevitable problem of clock skews and delays. An alternate means of enforcing necessary synchronization is the use of self-timed, asynchronous schemes, at the cost of increased design complexity and hardware cost. Realizing that different circumstances call for different synchronization methods, this paper provides a spectrum of synchronization models; based on the assumptions made for each model, theoretical lower bounds on clock skew are derived, and appropriate or best-possible synchronization schemes for systolic arrays are proposed. This paper represents a first step towards a systematic study of synchronization problems for large systolic arrays.

  12. Synchronization via Hydrodynamic Interactions

    NASA Astrophysics Data System (ADS)

    Kendelbacher, Franziska; Stark, Holger

    2013-12-01

    An object moving in a viscous fluid creates a flow field that influences the motion of neighboring objects. We review examples from nature in the microscopic world where such hydrodynamic interactions synchronize beating or rotating filaments. Bacteria propel themselves using a bundle of rotating helical filaments called flagella which have to be synchronized in phase. Other micro-organisms are covered with a carpet of smaller filaments called cilia on their surfaces. They beat highly synchronized so that metachronal waves propagate along the cell surfaces. We explore both examples with the help of simple model systems and identify generic properties for observing synchronization by hydrodynamic interactions.

  13. Synchronous Energy Technology

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The synchronous technology requirements for large space power systems are summarized. A variety of technology areas including photovoltaics, thermal management, and energy storage, and power management are addressed.

  14. Breast Cancer

    MedlinePlus

    ... version of this page please turn Javascript on. Breast Cancer What is Breast Cancer? How Tumors Form The body is made up ... tumors form in the breast tissue. Who Gets Breast Cancer? Breast cancer is one of the most common ...

  15. Pediatric isolated bilateral iliac aneurysm.

    PubMed

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  16. Frame synchronization in PCM telemetry.

    NASA Technical Reports Server (NTRS)

    Peavey, B.

    1971-01-01

    The frame synchronization performance characteristics are defined that can be measured under actual operating conditions. The frame synchronization process is explained, and test data on the performance of frame synchronizers and frame synchronization codes are presented. The application of frame synchronization methods in specific cases is considered in the light of code selection, frame length, and data recovery.

  17. Bilateral pseudogout 8 years after bilateral total knee arthroplasty.

    PubMed

    Levi, Gabriel S; Sadr, Kamran; Scuderi, Giles R

    2012-11-01

    This article presents the clinical features of crystal arthropathy after knee replacement. The current literature on pseudogout and gout after both total and partial knee replacement is summarized. A case of bilateral pseudogout 8 years after initial total knee arthroplasty (TKA) is used to highlight the clinical characteristics and treatment options for this underrecognized condition. Presentation mimicked a late septic joint arthroplasty with sudden onset of pain and effusion. The patient was treated successfully with an arthrotomy, debridement, synovectomy, polyethylene insert exchange, oral steroids, and nonsteroidal anti-inflammatories. There are no other reported cases of bilateral pseudogout after bilateral TKA.

  18. Body image after bilateral prophylactic mastectomy: an integrative literature review.

    PubMed

    McGaughey, Amy

    2006-01-01

    Bilateral prophylactic mastectomy (BPM) can reduce a woman's risk for breast cancer by 80%. Thus, women who are at high risk for familial breast cancer are increasingly opting for BPM as a preventative option. Research indicates that there are psychological benefits to BPM, including a reduction in anxiety about developing breast cancer. The purpose of this integrative review is to summarize the research that has examined the effect of prophylactic mastectomy on women's subsequent body image. Thirteen studies were reviewed. The majority of women were satisfied with their decision. However, the majority of studies indicate that up to one-half of the women suffer a negative effect on body image and changes in sexuality. Knowledge of these findings can improve the practitioner's ability to counsel women regarding this radical decision. Further research, particularly prospective studies, are needed to examine women's body image prior to BPM so that the impact of prophylactic mastectomy can be examined more thoroughly.

  19. Precise clock synchronization protocol

    NASA Astrophysics Data System (ADS)

    Luit, E. J.; Martin, J. M. M.

    1993-12-01

    A distributed clock synchronization protocol is presented which achieves a very high precision without the need for very frequent resynchronizations. The protocol tolerates failures of the clocks: clocks may be too slow or too fast, exhibit omission failures and report inconsistent values. Synchronization takes place in synchronization rounds as in many other synchronization protocols. At the end of each round, clock times are exchanged between the clocks. Each clock applies a convergence function (CF) to the values obtained. This function estimates the difference between its clock and an average clock and corrects its clock accordingly. Clocks are corrected for drift relative to this average clock during the next synchronization round. The protocol is based on the assumption that clock reading errors are small with respect to the required precision of synchronization. It is shown that the CF resynchronizes the clocks with high precision even when relatively large clock drifts are possible. It is also shown that the drift-corrected clocks remain synchronized until the end of the next synchronization round. The stability of the protocol is proven.

  20. EEG synchronization and migraine

    NASA Astrophysics Data System (ADS)

    Stramaglia, Sebastiano; Angelini, Leonardo; Pellicoro, Mario; Hu, Kun; Ivanov, Plamen Ch.

    2004-03-01

    We investigate phase synchronization in EEG recordings from migraine patients. We use the analytic signal technique, based on the Hilbert transform, and find that migraine brains are characterized by enhanced alpha band phase synchronization in presence of visual stimuli. Our findings show that migraine patients have an overactive regulatory mechanism that renders them more sensitive to external stimuli.

  1. Disorder induces explosive synchronization.

    PubMed

    Skardal, Per Sebastian; Arenas, Alex

    2014-06-01

    We study explosive synchronization, a phenomenon characterized by first-order phase transitions between incoherent and synchronized states in networks of coupled oscillators. While explosive synchronization has been the subject of many recent studies, in each case strong conditions on the heterogeneity of the network, its link weights, or its initial construction are imposed to engineer a first-order phase transition. This raises the question of how robust explosive synchronization is in view of more realistic structural and dynamical properties. Here we show that explosive synchronization can be induced in mildly heterogeneous networks by the addition of quenched disorder to the oscillators' frequencies, demonstrating that it is not only robust to, but moreover promoted by, this natural mechanism. We support these findings with numerical and analytical results, presenting simulations of a real neural network as well as a self-consistency theory used to study synthetic networks.

  2. Acute silicosis with bilateral pneumothorax

    PubMed Central

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  3. Synchronous invasive ductal carcinoma in encapsulated papillary ductal carcinoma

    PubMed Central

    Regan, J.P.; Casaubon, J.T.; Genelus-Dominique, E.

    2016-01-01

    Encapsulated papillary ductal carcinoma (EPC) of the breast is a rare form of cancer with defining histopathology of encapsulation. These lesions are typically indolent but may rarely have concomitant, synchronous invasive lesions. This report details a 56-year-old black female who presented with a palpable left breast mass. Adenosis with focal fibrous and ductal hyperplasia characteristics were found on core needle biopsy. Excisional biopsy showed EPC with invasive components. A simple mastectomy was performed and a second lesion was identified as invasive ductal carcinoma. EPC typically has good prognosis and a low incidence of invasion. The risk increases in the presence of a second, synchronous lesion as in our case. Management is typically performed with breast conserving methods; however, missing a second lesion is possible. This report provides an overview of the literature and discussion of the role of MRI in preoperative workup. PMID:27562577

  4. Standardization of infrared breast thermogram acquisition protocols and abnormality analysis of breast thermograms

    NASA Astrophysics Data System (ADS)

    Bhowmik, Mrinal Kanti; Gogoi, Usha Rani; Das, Kakali; Ghosh, Anjan Kumar; Bhattacharjee, Debotosh; Majumdar, Gautam

    2016-05-01

    The non-invasive, painless, radiation-free and cost-effective infrared breast thermography (IBT) makes a significant contribution to improving the survival rate of breast cancer patients by early detecting the disease. This paper presents a set of standard breast thermogram acquisition protocols to improve the potentiality and accuracy of infrared breast thermograms in early breast cancer detection. By maintaining all these protocols, an infrared breast thermogram acquisition setup has been established at the Regional Cancer Centre (RCC) of Government Medical College (AGMC), Tripura, India. The acquisition of breast thermogram is followed by the breast thermogram interpretation, for identifying the presence of any abnormality. However, due to the presence of complex vascular patterns, accurate interpretation of breast thermogram is a very challenging task. The bilateral symmetry of the thermal patterns in each breast thermogram is quantitatively computed by statistical feature analysis. A series of statistical features are extracted from a set of 20 thermograms of both healthy and unhealthy subjects. Finally, the extracted features are analyzed for breast abnormality detection. The key contributions made by this paper can be highlighted as -- a) the designing of a standard protocol suite for accurate acquisition of breast thermograms, b) creation of a new breast thermogram dataset by maintaining the protocol suite, and c) statistical analysis of the thermograms for abnormality detection. By doing so, this proposed work can minimize the rate of false findings in breast thermograms and thus, it will increase the utilization potentiality of breast thermograms in early breast cancer detection.

  5. Synchronous Discrete Harmonic Oscillator

    SciTech Connect

    Antippa, Adel F.; Dubois, Daniel M.

    2008-10-17

    We introduce the synchronous discrete harmonic oscillator, and present an analytical, numerical and graphical study of its characteristics. The oscillator is synchronous when the time T for one revolution covering an angle of 2{pi} in phase space, is an integral multiple N of the discrete time step {delta}t. It is fully synchronous when N is even. It is pseudo-synchronous when T/{delta}t is rational. In the energy conserving hyperincursive representation, the phase space trajectories are perfectly stable at all time scales, and in both synchronous and pseudo-synchronous modes they cycle through a finite number of phase space points. Consequently, both the synchronous and the pseudo-synchronous hyperincursive modes of time-discretization provide a physically realistic and mathematically coherent, procedure for dynamic, background independent, discretization of spacetime. The procedure is applicable to any stable periodic dynamical system, and provokes an intrinsic correlation between space and time, whereby space-discretization is a direct consequence of background-independent time-discretization. Hence, synchronous discretization moves the formalism of classical mechanics towards that of special relativity. The frequency of the hyperincursive discrete harmonic oscillator is ''blue shifted'' relative to its continuum counterpart. The frequency shift has the precise value needed to make the speed of the system point in phase space independent of the discretizing time interval {delta}t. That is the speed of the system point is the same on the polygonal (in the discrete case) and the circular (in the continuum case) phase space trajectories.

  6. Potential improvement of computerized mass detection on mammograms using a bilateral pairing technique

    NASA Astrophysics Data System (ADS)

    Paquerault, S.; Petrick, N.; Sahiner, B.; Myers, K. J.; Chan, H.-P.

    2006-03-01

    We are developing a bilateral pairing technique to help reduce false-positives identified by a single-view computer-aided detection (CAD) system for breast masses. In this study, we compare the performance of the proposed bilateral CAD to a single-view CAD. A database of 172 right/left breast pairs containing 205 biopsy-proven masses was used. Single-view CAD was run on each image using a lax selection threshold so that 5 objects per image were retained. The automated bilateral pairing algorithm identified all objects in a left breast mammogram "matching" a CAD detected object in the corresponding right breast image and visa-versa. Bilateral pairing was based on geometrical correspondence between objects with a matching score derived from a paired right/left object feature set and a linear discriminant analysis classifier. Leave-one out resampling was used to train/test the technique. We compared the FROC performances of the single-view CAD, the proposed bilateral technique and a modified CAD using manual pairing of bilateral structures. At a per-lesion detection sensitivity of 0.7, there were 3.8 FPs/image for the original CAD, 3.3 for the proposed technique, and 2.2 for the modified CAD using manual matching, a 12.6% and 42.1% reduction, respectively. At an FP rate of 1.0 per image, the sensitivities for the original CAD, the proposed technique and the modified CAD using manual matching were 0.47, 0.51 and 0.60, respectively. Preliminary results show that CAD with bilateral pairing did not achieve a significant FP-reduction.

  7. Synchronization of Swimming Microorganisms

    NASA Astrophysics Data System (ADS)

    Elfring, Gwynn; Lauga, Eric

    2009-11-01

    Flagellated eukaryotic cells (such as spermatozoa) have been observed to synchronize their flagella when swimming in close proximity. Using a 2D model, we find that hydrodynamic interactions alone can lead to synchronization if the waveforms of the flagella display front-back asymmetry. Depending on the nature of the asymmetry, the phase-locked conformation can minimize or maximize the energy dissipated by the co-swimming cells. We show that due to kinematic reversibility, this front-back asymmetry is necessary for synchronization in a Newtonian fluid, and discuss the differences in a non-Newtonian fluid.

  8. [Bilateral sarcoidosis of parotid glands].

    PubMed

    Hahn, Pernille; Krogdahl, Annelise; Godballe, Christian

    2012-04-23

    We describe an unusual case of sarcoidosis in which the patient presented with a bilateral swelling of the parotid salivary glands and no other manifestation of the disease. Sarcoidosis is a multisystem granulomatous disorder of unknown cause in which there may be multiple exocrine involvement, including the salivary glands. This case emphasises the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling. PMID:22533935

  9. Cancer Surgeons Advise Against Removal of Healthy Breast

    MedlinePlus

    ... disease-related anxiety; or concerns about breast reconstruction symmetry. "Typically, the decision to perform a contralateral procedure ... common reasons for a bilateral mastectomy is for symmetry, and this is still a legitimate reason to ...

  10. Synchronization in complex networks

    SciTech Connect

    Arenas, A.; Diaz-Guilera, A.; Moreno, Y.; Zhou, C.; Kurths, J.

    2007-12-12

    Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.

  11. Advanced synchronous luminescence system

    DOEpatents

    Vo-Dinh, Tuan

    1997-01-01

    A method and apparatus for determining the condition of tissue or otherwise making chemical identifications includes exposing the sample to a light source, and using a synchronous luminescence system to produce a spectrum that can be analyzed for tissue condition.

  12. Ultrasound - Breast

    MedlinePlus

    ... discharge) and to characterize potential abnormalities seen on mammography or breast magnetic resonance imaging (MRI). Ultrasound imaging ... supply in breast lesions . Supplemental Breast Cancer Screening Mammography is the only screening tool for breast cancer ...

  13. Breast pain

    MedlinePlus

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  14. Avoided Crossing and Synchronization

    NASA Astrophysics Data System (ADS)

    Sekii, T.; Shibahashi, H.

    2013-12-01

    We examine avoided crossing of stellar pulsations in the nonlinear regime, where synchronization may occur, based on a simple model of weakly coupled van der Pol oscillators with close frequencies. For this simple case, avoided crossing is unaffected in the sense that there is a frequency difference between the symmetric and antisymmetric modes, but as a result of synchronization, unlike the linear oscillations case, the system can vibrate in only one of the modes.

  15. Synchronization of cells.

    PubMed

    Sonoda, Eiichiro

    2006-01-01

    Synchronization of cells is essential to study cell cycle specific events. If, for example, one suspects that a given DNA repair pathway is used in a particular cell cycle phase, the protocol can be used to enrich cells in each phase of the cell cycle and analyze the cellular response to DNA damage. Synchronization is also useful, when a gene is essential for a particular phase of the cell cycle. If a gene is, for example, essential for mitosis, synchronization of the cells in G1 phase with concomitant inactivation of the gene enables us to study the function of the gene in interphase, and to follow synchronous cell cycle progression to M phase. Two synchronization methods: centrifugal elutriation to enrich G1, S or G2 phase cells and nocodazole-mimocine sequential treatment to enrich cells at the G1/S boundary are described. Centrifugal elutriation can be achieved in less time (0.5-2 h) and with very little physiological stress to the cells whereas synchronization by drugs, such as nocodazole and mimocine, may result in unfavorable side effects.

  16. Effect of bilateral oophorectomy on women's long-term health.

    PubMed

    Parker, William H; Jacoby, Vanessa; Shoupe, Donna; Rocca, Walter

    2009-09-01

    Bilateral oophorectomy at the time of hysterectomy for benign disease is commonly practiced in order to prevent the subsequent development of ovarian cancer or other ovarian pathology that might require additional surgery. At present, bilateral oophorectomy is performed in 78% of women aged between 45 and 64 years having a hysterectomy, and a total of approximately 300,000 prophylactic oophorectomies are performed in the USA every year. Estrogen deficiency resulting from pre- and post-menopausal oophorectomies has been associated with higher risks of coronary heart disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression and anxiety in many studies. While ovarian cancer accounts for 14,800 deaths per year in the USA, coronary heart disease accounts for 350,000 deaths per year. In addition, 100,000 cases of dementia may be attributable annually to prior bilateral oophorectomy. At present, observational studies suggest that bilateral oophorectomy may do more harm than good. In women who are not at high risk of developing ovarian or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution.

  17. Tumoral Calcinosis: An Uncommon Cause for a Mass in a Reconstructed Breast

    PubMed Central

    Dean, Nicola R.; Watson, David I.; Carter, Christopher D.

    2016-01-01

    Summary: Tumoral calcinosis is a rare clinical and histopathological syndrome whose exact etiology is unknown. We present a case of a 57-year-old woman who presents with a painful lump in her right chest after bilateral breast reconstructions for bilateral asynchronous breast cancers. It is important to be aware of all possible differential diagnoses in a patient presenting with a chest mass after mastectomy and reconstruction for breast cancer as not all lesions of this type represent recurrent cancer. PMID:27579225

  18. Tumoral Calcinosis: An Uncommon Cause for a Mass in a Reconstructed Breast.

    PubMed

    Koh, Eugene; Dean, Nicola R; Watson, David I; Carter, Christopher D

    2016-05-01

    Tumoral calcinosis is a rare clinical and histopathological syndrome whose exact etiology is unknown. We present a case of a 57-year-old woman who presents with a painful lump in her right chest after bilateral breast reconstructions for bilateral asynchronous breast cancers. It is important to be aware of all possible differential diagnoses in a patient presenting with a chest mass after mastectomy and reconstruction for breast cancer as not all lesions of this type represent recurrent cancer. PMID:27579225

  19. Trajectory Modulated Arc Therapy: A Fully Dynamic Delivery With Synchronized Couch and Gantry Motion Significantly Improves Dosimetric Indices Correlated With Poor Cosmesis in Accelerated Partial Breast Irradiation

    SciTech Connect

    Liang, Jieming; Atwood, Todd; Eyben, Rie von; Fahimian, Benjamin; Chin, Erika; Horst, Kathleen; Otto, Karl; Hristov, Dimitre

    2015-08-01

    Purpose: To develop planning and delivery capabilities for linear accelerator–based nonisocentric trajectory modulated arc therapy (TMAT) and to evaluate the benefit of TMAT for accelerated partial breast irradiation (APBI) with the patient in prone position. Methods and Materials: An optimization algorithm for volumetrically modulated arc therapy (VMAT) was generalized to allow for user-defined nonisocentric TMAT trajectories combining couch rotations and translations. After optimization, XML scripts were automatically generated to program and subsequently deliver the TMAT plans. For 10 breast patients in the prone position, TMAT and 6-field noncoplanar intensity modulated radiation therapy (IMRT) plans were generated under equivalent objectives and constraints. These plans were compared with regard to whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose. Results: For TMAT APBI, nonisocentric collision-free horizontal arcs with large angular span (251.5 ± 7.9°) were optimized and delivered with delivery time of ∼4.5 minutes. Percentage changes of whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose for TMAT relative to IMRT were −10.81% ± 6.91%, −27.81% ± 7.39%, −14.82% ± 9.67%, and 39.40% ± 10.53% (P≤.01). Conclusions: This is a first demonstration of end-to-end planning and delivery implementation of a fully dynamic APBI TMAT. Compared with IMRT, TMAT resulted in marked reduction of the breast tissue volume irradiated at high doses.

  20. Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules

    PubMed Central

    Yao, Feng; Yang, Haitang

    2016-01-01

    Background Surgical treatment is thought to be the most effective strategy for multiple small nodules. However, in general, one-stage bilateral resection is not recommended due to its highly invasive nature. Methods Clinical records of patients undergoing one-stage bilateral resections of multiple pulmonary nodules between January 2009 and September 2014 in a single institution were retrospectively reviewed. Results Simultaneous bilateral pulmonary resection by conventional video-assisted thoracic surgery (VATS) was undertaken in 29 patients. Ground glass opacity (GGO) accounted for 71.9% (46/64) of total lesions, including 26 pure GGO and 20 mixed GGO lesions. One case underwent bilateral lobectomy that was complicated by postoperative dyspnea. Lobar-sublobar (L/SL) resection and bilateral sublobar resection (SL-SL) were conducted in 16 and 12 cases, respectively, and most of these cases had uneventful postoperative courses. There was no significant difference with regard to postoperative complications (P=0.703), duration of use of chest drains (P=0.485), between one- and two-stage groups. Mean postoperative follow-up in cases of primary lung cancer was 31.4 (range, 10–51) months. There was neither recurrence nor deaths at final follow-up. Conclusions Single-stage bilateral surgery in selected cases with synchronous bilateral multiple nodules (SBMNs) is feasible and associated with satisfactory outcomes. PMID:27076942

  1. Synchronization between beating cilia.

    PubMed

    Gheber, L; Priel, Z

    1989-01-01

    A novel quantitative parameter is proposed to define and measure the degree of synchronization between two small ciliary areas. These areas can be close to or far from one another. The Pearson correlation factor is used to define the degree of synchronization by a single number. This approach is based on a computerized, dual photoelectric method which simulataneously measures the scattered light from two small areas on the ciliary epithelium or its tissue culture. The measurements were performed on tissue culture from frog's palate epithelium. It was found that: (a) the degree of synchronization decreases, as a function of distance; (b) the correlation is fairly high even at relatively large separations, when measured on the same patch; (c) on a given patch the synchronization factor is independent of the direction of the metachronal wave; (d) close disconnected ciliary cells exhibit fairly high correlation; (e) disconnected randomly choosen ciliary cells at relatively large separation distances exhibit relatively low correlation, smaller by a factor of 2 than the correlation factor at the same distances when measured along the metachronal wave; (f) the average frequencies' ratio and the metachronal wavelength can be used as first-order indicators of ciliary synchronization; (g) there is a spread of metachronal wavelengths even over a single well-organized patch.

  2. Synchronization between beating cilia.

    PubMed Central

    Gheber, L; Priel, Z

    1989-01-01

    A novel quantitative parameter is proposed to define and measure the degree of synchronization between two small ciliary areas. These areas can be close to or far from one another. The Pearson correlation factor is used to define the degree of synchronization by a single number. This approach is based on a computerized, dual photoelectric method which simulataneously measures the scattered light from two small areas on the ciliary epithelium or its tissue culture. The measurements were performed on tissue culture from frog's palate epithelium. It was found that: (a) the degree of synchronization decreases, as a function of distance; (b) the correlation is fairly high even at relatively large separations, when measured on the same patch; (c) on a given patch the synchronization factor is independent of the direction of the metachronal wave; (d) close disconnected ciliary cells exhibit fairly high correlation; (e) disconnected randomly choosen ciliary cells at relatively large separation distances exhibit relatively low correlation, smaller by a factor of 2 than the correlation factor at the same distances when measured along the metachronal wave; (f) the average frequencies' ratio and the metachronal wavelength can be used as first-order indicators of ciliary synchronization; (g) there is a spread of metachronal wavelengths even over a single well-organized patch. PMID:2930819

  3. Synchronic nasopharyngeal and intraparotid warthin tumors: A case report and literature review

    PubMed Central

    Domínguez-Malagon, Hugo-Ricardo; Mosqueda-Taylor, Adalberto; Cano-Valdez, Ana-María; Luna-Ortiz, Kuauhyama

    2014-01-01

    Warthin tumor is the second most frequent benign salivary gland tumor after pleomorphic adenoma; it occurs almost exclusively in the parotid gland and peri-parotideal lymph nodes, although it may rarely present in other locations. It may be multicentric and bilateral in a small percentage of cases. Nasopharyngeal Warthin tumor is very rare, and the presence of a synchronic WT involving nasopharynx and parotid is an exceptional event, as it has been described only twice in the literature. In this article we report an additional case of a synchronic Warthin tumor and review the related literature. Key words:Warthin tumor, synchronic WT, multicéntrico, nasopharynx. PMID:25593670

  4. Synchronic nasopharyngeal and intraparotid warthin tumors: A case report and literature review.

    PubMed

    Yáñez-Barraza, Karina-Lizbeth; Domínguez-Malagon, Hugo-Ricardo; Mosqueda-Taylor, Adalberto; Cano-Valdez, Ana-María; Luna-Ortiz, Kuauhyama

    2014-10-01

    Warthin tumor is the second most frequent benign salivary gland tumor after pleomorphic adenoma; it occurs almost exclusively in the parotid gland and peri-parotideal lymph nodes, although it may rarely present in other locations. It may be multicentric and bilateral in a small percentage of cases. Nasopharyngeal Warthin tumor is very rare, and the presence of a synchronic WT involving nasopharynx and parotid is an exceptional event, as it has been described only twice in the literature. In this article we report an additional case of a synchronic Warthin tumor and review the related literature. Key words:Warthin tumor, synchronic WT, multicéntrico, nasopharynx.

  5. Innovative combination of therapeutic mammoplasty and expandable-implant breast augmentation for immediate partial breast reconstruction

    PubMed Central

    Choo, A.M.H.; Forouhi, P.; Malata, C.M.

    2016-01-01

    Introduction Therapeutic mammoplasty is used in the treatment of suitably-sized and appropriately-located breast cancers to achieve adequate cancer excision, resulting in well-shaped but smaller breasts. In patients wishing to maintain or increase their breast size, simultaneous augmentation will be required. Presentation of case A 48-year-old female underwent an “augmentation-therapeutic mastopexy”. She required mastectomy for a multifocal cancer of the right breast and breast conservation for a unifocal localised cancer in the upper part of the left breast. She requested right immediate breast reconstruction and hoped for larger breasts than she had. Due to complications during neoadjuvant chemotherapy, the right reconstruction plan was changed from a deep inferior epigastric perforator (DIEP) flap to an implant-based technique. On the left, an extended superomedial pedicle therapeutic mammoplasty was combined with a subpectoral augmentation using an expandable-implant. Discussion The use of expandable-implants for reconstruction of partial mastectomy defects in combination with therapeutic mammoplasty has not been reported. This case report shows that such “augmentation-therapeutic mastopexy” is feasible. Conclusion A “novel” oncoplastic technique herein termed “augmentation-therapeutic mastopexy” is described for partial breast reconstruction during the treatment of a patient with bilateral breast cancer. It enabled adequate treatment of her cancer while reshaping the breast and achieving the desired larger breast size. It should be considered in selected breast-conservation patients who wish to maintain or increase their breast size. PMID:27132043

  6. What Is Breast Cancer?

    MedlinePlus

    ... Next Topic Types of breast cancers What is breast cancer? Breast cancer starts when cells in the breast ... breast cancer? ” and Non-cancerous Breast Conditions . How Breast Cancer Spreads Breast cancer can spread through the lymph ...

  7. Optimistic barrier synchronization

    NASA Technical Reports Server (NTRS)

    Nicol, David M.

    1992-01-01

    Barrier synchronization is fundamental operation in parallel computation. In many contexts, at the point a processor enters a barrier it knows that it has already processed all the work required of it prior to synchronization. The alternative case, when a processor cannot enter a barrier with the assurance that it has already performed all the necessary pre-synchronization computation, is treated. The problem arises when the number of pre-sychronization messages to be received by a processor is unkown, for example, in a parallel discrete simulation or any other computation that is largely driven by an unpredictable exchange of messages. We describe an optimistic O(log sup 2 P) barrier algorithm for such problems, study its performance on a large-scale parallel system, and consider extensions to general associative reductions as well as associative parallel prefix computations.

  8. Synchronous trifocal colorectal cancer

    PubMed Central

    Charalampoudis, Petros; Kykalos, Stylianos; Stamopoulos, Paraskevas; Kouraklis, Gregory

    2016-01-01

    Synchronous colorectal cancers (SCRCs) have been increasingly diagnosed due to emerging diagnostic modalities. The presence of three or more synchronous colorectal cancers has, however, only rarely been reported. A 76-year-old white man presented for management of two concurrent colorectal adenocarcinomas in the left colon evidenced on total colonoscopy. Preoperative abdominal ultrasonography and thoracoabdominal computed tomography were negative for metastatic disease. The patient underwent an elective left hemicolectomy. The pathology report ultimately showed the presence of three moderately differentiated, distinct colorectal cancers. The patient experienced an uneventful recovery. PMID:27695171

  9. Synchronous trifocal colorectal cancer

    PubMed Central

    Charalampoudis, Petros; Kykalos, Stylianos; Stamopoulos, Paraskevas; Kouraklis, Gregory

    2016-01-01

    Synchronous colorectal cancers (SCRCs) have been increasingly diagnosed due to emerging diagnostic modalities. The presence of three or more synchronous colorectal cancers has, however, only rarely been reported. A 76-year-old white man presented for management of two concurrent colorectal adenocarcinomas in the left colon evidenced on total colonoscopy. Preoperative abdominal ultrasonography and thoracoabdominal computed tomography were negative for metastatic disease. The patient underwent an elective left hemicolectomy. The pathology report ultimately showed the presence of three moderately differentiated, distinct colorectal cancers. The patient experienced an uneventful recovery.

  10. Heterogeneity of bilateral renal agenesis.

    PubMed Central

    Fitch, N.

    1977-01-01

    Bilateral and unilateral renal agenesis may be expressions of single dominant gene. Chromosome abnormalities may be present and the renal agenesis may be part of a syndrome of multiple abnormalities. Apparently normal relatives of affected individuals should be screened by intravenous pyelography before genetic counselling given. PMID:844022

  11. Spontaneous bilateral quadriceps tendon rupture.

    PubMed

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  12. Gallium-67 breast uptake in a patient with hypothalamic granuloma (sarcoid)

    SciTech Connect

    Vazquez, R.; Oates, E.; Sarno, R.C.; Fay, J.; Gale, D.R.

    1988-01-01

    An unusual case is presented of bilateral breast uptake of (/sup 67/Ga)citrate in a patient with a hypothalamic granuloma in the absence of galactorrhea is presented. A possible mechanism for this incidental finding is elevated prolactin levels, as other causes of gallium breast uptake such as drug therapy, and intrinsic breast disease, were not present.

  13. Synchronized time stamp support

    SciTech Connect

    Kowalkowski, J.

    1994-02-16

    New software has been added to IOC core to maintain time stamps. The new software has the ability to maintain time stamps over all IOCs on a network. The purpose of this paper is to explain how EPICS will synchronize the time stamps. In addition, this paper will explain how to configure and use the new EPICS time stamp support software.

  14. Advanced synchronous luminescence system

    DOEpatents

    Vo-Dinh, T.

    1997-02-04

    A method and apparatus are disclosed for determining the condition of tissue or otherwise making chemical identifications includes exposing the sample to a light source, and using a synchronous luminescence system to produce a spectrum that can be analyzed for tissue condition. 14 figs.

  15. Synchronous semiconductor memory device

    SciTech Connect

    Onno, C.; Hirata, M.

    1989-11-21

    This patent describes a synchronous semiconductor memory device. It comprises: first latch means for latching a write command in synchronism with clock signal; second latch means for latching a write data in synchronism with the clock signal and for outputting two write process signals based on the write data latched thereby; pulse generating means for generating an internal write pulse signal based on the write command latched by the first latch means. The internal write pulse signal having a semiconductor memory device; write control means supplied with the internal write pulse signal and the write process signals for controlling write and read operations of the synchronous semiconductor memory device; memory means for storing the write data latched by the second latch means; and noise preventing means coupled to the second latch means and the write control means for supplying the write process signals to the write control means only in the write mode responsive to the internal write pulse signal and for setting the write process signals to fixed potentials during a time other than the write mode.

  16. Estimating synchronization signal phase

    NASA Astrophysics Data System (ADS)

    Lyons, Robert G.; Lord, John D.

    2015-03-01

    To read a watermark from printed images requires that the watermarking system read correctly after affine distortions. One way to recover from affine distortions is to add a synchronization signal in the Fourier frequency domain and use this synchronization signal to estimate the applied affine distortion. Using the Fourier Magnitudes one can estimate the linear portion of the affine distortion. To estimate the translation one must first estimate the phase of the synchronization signal and then use phase correlation to estimate the translation. In this paper we provide a new method to measure the phase of the synchronization signal using only the data from the complex Fourier domain. This data is used to compute the linear portion, so it is quite convenient to estimate the phase without further data manipulation. The phase estimation proposed in this paper is computationally simple and provides a significant computational advantage over previous methods while maintaining similar accuracy. In addition, the phase estimation formula gives a general way to interpolate images in the complex frequency domain.

  17. Dense Breasts

    MedlinePlus

    ... woman’s breasts. It is most commonly determined using mammography, a diagnostic test that uses low dose x- ... woman’s breasts, which is most commonly determined through mammography. The breast is made up of glandular, connective, ...

  18. Breast lump

    MedlinePlus

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  19. Breast Diseases

    MedlinePlus

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  20. Coexistence of malignant phyllodes tumor and her2-positive locally advanced breast cancer in distinct breasts: A case report

    PubMed Central

    Sato, Tomoi; Muto, Ichiro; Sakai, Takeshi

    2016-01-01

    Introduction Phyllodes tumor of the breast is a rare biphasic neoplasm, accounting for less than 1% of all breast tumors. Coexistence of phyllodes tumor and breast cancer in distinct breasts is extremely rare. Case presentation A 47-year-old Japanese woman presented with bilateral breast lumps. A HER2-positive, unresectable invasive carcinoma in the right breast and fibroadenoma in the left were diagnosed via core needle biopsy. During chemotherapy with anti-HER2 therapy, the breast cancer shrank quickly, while the left breast lump suddenly enlarged. Under a diagnosis of malignant neoplasm of the breast, left mastectomy was performed. Malignant phyllodes tumor was diagnosed by postoperative histological examination and recurred in multiple areas as early as 2 months after surgery. Discussion Only 10 cases of coexisting phyllodes tumor and breast cancer in distinct breasts have been reported in the English literature. Phyllodes tumor associated with breast cancer in distinct breasts tends to be malignant. This is the first case of phyllodes tumor rapidly enlarging during anti-HER2 chemotherapy for locally advanced HER2-positive breast cancer. Conclusion Even during effective treatment of advanced or recurrent breast cancer, attention should also be paid to the contralateral breast for the possible association of a second malignancy such as phyllodes tumor. PMID:26773878

  1. A self-adjusting compliant bilateral control scheme for time-delay teleoperation in constrained environment

    NASA Astrophysics Data System (ADS)

    Chen, Zhang; Liang, Bin; Zhang, Tao

    2016-05-01

    When teleoperations are implemented in the constrained environment, the lack of environment information would lead to contacts and undesired excessive contact forces, which are more evident with the existence of time delays. In this paper, a hybrid compliant bilateral controller is proposed to deal with this problem. The controller adopts a self-adjusting selecting scheme to divide the subspaces online. The master and slave manipulators are synchronized in the position subspace through an adaptive bilateral control scheme. At the same time, the slave manipulator is controlled by a local sliding mode impedance controller in order to achieve the desired compliant motion when contacting with the environment. Theoretical analysis proves the stability of the hybrid bilateral controller and concludes the transient performance of the teleoperators. Simulations are carried out to verify the effectiveness of the proposed approach. The results show that the control goals are all achieved.

  2. Breast MRI scan

    MedlinePlus

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... the same breast or the other breast after breast cancer has been diagnosed Distinguish between scar tissue and ...

  3. Synchronization and hydrodynamic interactions

    NASA Astrophysics Data System (ADS)

    Powers, Thomas; Qian, Bian; Breuer, Kenneth

    2008-03-01

    Cilia and flagella commonly beat in a coordinated manner. Examples include the flagella that Volvox colonies use to move, the cilia that sweep foreign particles up out of the human airway, and the nodal cilia that set up the flow that determines the left-right axis in developing vertebrate embryos. In this talk we present an experimental study of how hydrodynamic interactions can lead to coordination in a simple idealized system: two nearby paddles driven with fixed torques in a highly viscous fluid. The paddles attain a synchronized state in which they rotate together with a phase difference of 90 degrees. We discuss how synchronization depends on system parameters and present numerical calculations using the method of regularized stokeslets.

  4. Bilateral Ureteral Obstruction in Children after Appendectomy

    PubMed Central

    Grande, M.; Lisi, G.; Bianchi, D.; Bove, P.; Miano, R.; Esser, A.; De Sanctis, F.; Neri, A.; Grande, S.; Villa, M.

    2015-01-01

    Acute renal failure due to bilateral ureteral obstruction is a rare complication after appendectomy in children. We report a case of bilateral ureteric obstruction in a 14-year-old boy nine days after surgery for an acute appendicitis. After saline-filling of the urinary bladder, transabdominal ultrasound demonstrated bilateral hydronephrosis of moderate degree. No abscess was found with CT but presence of millimetric stones on both distal ureters was shown, with bilateral calyceal dilatation. Cystoscopy revealed inflammatory changes in the bladder base. Following introduction of bilateral ureteric stents, there was rapid normalisation of urinary output and serum creatinine. PMID:26295001

  5. Socially synchronized circadian oscillators

    PubMed Central

    Bloch, Guy; Herzog, Erik D.; Levine, Joel D.; Schwartz, William J.

    2013-01-01

    Daily rhythms of physiology and behaviour are governed by an endogenous timekeeping mechanism (a circadian ‘clock’). The alternation of environmental light and darkness synchronizes (entrains) these rhythms to the natural day–night cycle, and underlying mechanisms have been investigated using singly housed animals in the laboratory. But, most species ordinarily would not live out their lives in such seclusion; in their natural habitats, they interact with other individuals, and some live in colonies with highly developed social structures requiring temporal synchronization. Social cues may thus be critical to the adaptive function of the circadian system, but elucidating their role and the responsible mechanisms has proven elusive. Here, we highlight three model systems that are now being applied to understanding the biology of socially synchronized circadian oscillators: the fruitfly, with its powerful array of molecular genetic tools; the honeybee, with its complex natural society and clear division of labour; and, at a different level of biological organization, the rodent suprachiasmatic nucleus, site of the brain's circadian clock, with its network of mutually coupled single-cell oscillators. Analyses at the ‘group’ level of circadian organization will likely generate a more complex, but ultimately more comprehensive, view of clocks and rhythms and their contribution to fitness in nature. PMID:23825203

  6. Synchronization of Eukaryotic Flagella

    NASA Astrophysics Data System (ADS)

    Goldstein, Raymond E.

    2012-11-01

    From unicellular organisms as small as a few microns to the largest vertebrates on earth we find groups of beating flagella or cilia that exhibit striking spatio-temporal organization. This may take the form of precise frequency and phase locking as frequently found in the swimming of green algae, or beating with long-wavelength phase modulations known as metachronal waves, seen in ciliates and in our respiratory systems. The remarkable similarity in the underlying molecular structure of flagella across the whole eukaryotic world leads naturally to the hypothesis that a similarly universal mechanism might be responsible for synchronization. Although this mechanism is poorly understood, one appealing hypothesis is that it results from hydrodynamic interactions between flagella. In this talk I will describe a synthesis of recent experimental and theoretical studies of this issue that have provided the strongest evidence to date for the hydrodynamic origin of flagellar synchronization. At the unicellular level this includes studies of the beating of the two flagella of the wild type unicellular alga Chlamydomonas reinhardtii in their native state and under conditions of regrowth following autotomy, and of the flagellar dominance mutant ptx1, which displays unusual anti-phase synchronization. Analysis of the related multicellular organism Volvox carteri shows it to be an ideal model organism for the study of metachronal waves. Supported by BBSRC, EPSRC, ERC, and The Wellcome Trust.

  7. Digital Synchronizer without Metastability

    NASA Technical Reports Server (NTRS)

    Simle, Robert M.; Cavazos, Jose A.

    2009-01-01

    A proposed design for a digital synchronizing circuit would eliminate metastability that plagues flip-flop circuits in digital input/output interfaces. This metastability is associated with sampling, by use of flip-flops, of an external signal that is asynchronous with a clock signal that drives the flip-flops: it is a temporary flip-flop failure that can occur when a rising or falling edge of an asynchronous signal occurs during the setup and/or hold time of a flip-flop. The proposed design calls for (1) use of a clock frequency greater than the frequency of the asynchronous signal, (2) use of flip-flop asynchronous preset or clear signals for the asynchronous input, (3) use of a clock asynchronous recovery delay with pulse width discriminator, and (4) tying the data inputs to constant logic levels to obtain (5) two half-rate synchronous partial signals - one for the falling and one for the rising edge. Inasmuch as the flip-flop data inputs would be permanently tied to constant logic levels, setup and hold times would not be violated. The half-rate partial signals would be recombined to construct a signal that would replicate the original asynchronous signal at its original rate but would be synchronous with the clock signal.

  8. Emergency Response Synchronization Matrix

    1999-06-01

    An emergency response to a disaster is complex, requiring the rapid integration, coordination, and synchronization of multiple levels of governmental and non-governmental organizations from numerous jurisdictions into a unified community response. For example, a community’s response actions to a fixed site hazardous materials incident could occur in an area extending from an on-site storage location to points 25 or more miles away. Response actions are directed and controlled by local governments and agencies situated withinmore » the response area, as well as by state and federal operaticns centers quite removed from the area of impact. Time is critical and the protective action decision-making process is greatly compressed. The response community must carefully plan and coordinate response operations in order to have confidence that they will be effectively implemented when faced with the potentially catastrophic nature of such releases. A graphical depiction of the entire response process via an emergency response synchronization matrix is an effective tool in optimizing the planning, exercising, and implementation of emergency plans. This system—based approach to emergency planning depicts how a community organizes its response tasks across space and time in relation to hazard actions. It provides the opportunity to make real—time adjustments as necessary for maximizing the often limited resources in protecting area residents. A response must involve the entire community and must not be limited by individual jurisdictions and organizations acting on their own without coordination, integration, and synchronization.« less

  9. Bilateral Advantages in Subitizing With Visual Masking.

    PubMed

    Pryor, Campbell G; Howe, Piers D L

    2015-01-01

    Performance on a range of visual-processing tasks has been shown to improve when information is split bilaterally across the left and right visual hemifields rather than being restricted to a single visual hemifield. However, a recent study by Delvenne et al. found no such bilateral advantage for subitizing, which is our ability to rapidly and accurately enumerate small quantities of objects. This finding is particularly surprising, as it contradicts the prediction of FINgers of INSTantiation theory that subitizing should benefit from bilateral presentation. Our study investigated the issue by determining if there are any circumstances where a bilateral advantage for subitization occurs. Contrary to Delvenne et al., we found that subitizing could show bilateral advantages, but only when the display was backward-masked. We discuss these findings in relation to how the rate of encoding and the time available for this encoding may affect bilateral advantages in subitizing. A general model is proposed under which bilateral advantages could be explained.

  10. Multiresolution Bilateral Filtering for Image Denoising

    PubMed Central

    Zhang, Ming; Gunturk, Bahadir K.

    2008-01-01

    The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contribution is an extension of the bilateral filter: multiresolution bilateral filter, where bilateral filtering is applied to the approximation (low-frequency) subbands of a signal decomposed using a wavelet filter bank. The multiresolution bilateral filter is combined with wavelet thresholding to form a new image denoising framework, which turns out to be very effective in eliminating noise in real noisy images. Experimental results with both simulated and real data are provided. PMID:19004705

  11. Fibroadenoma - breast

    MedlinePlus

    ... provider if you notice: Any new breast lumps A breast lump that your provider has checked before that grows or changes Bruising on your breast for no reason Dimpled or wrinkled skin (like an orange) on your breast Nipple changes or nipple discharge

  12. Bilateral ECT induces bilateral increases in regional cortical thickness.

    PubMed

    van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

    2016-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT. PMID:27552587

  13. Bilateral ECT induces bilateral increases in regional cortical thickness

    PubMed Central

    van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

    2016-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT. PMID:27552587

  14. Multistep joint bilateral depth upsampling

    NASA Astrophysics Data System (ADS)

    Riemens, A. K.; Gangwal, O. P.; Barenbrug, B.; Berretty, R.-P. M.

    2009-01-01

    Depth maps are used in many applications, e.g. 3D television, stereo matching, segmentation, etc. Often, depth maps are available at a lower resolution compared to the corresponding image data. For these applications, depth maps must be upsampled to the image resolution. Recently, joint bilateral filters are proposed to upsample depth maps in a single step. In this solution, a high-resolution output depth is computed as a weighted average of surrounding low-resolution depth values, where the weight calculation depends on spatial distance function and intensity range function on the related image data. Compared to that, we present two novel ideas. Firstly, we apply anti-alias prefiltering on the high-resolution image to derive an image at the same low resolution as the input depth map. The upsample filter uses samples from both the high-resolution and the low-resolution images in the range term of the bilateral filter. Secondly, we propose to perform the upsampling in multiple stages, refining the resolution by a factor of 2×2 at each stage. We show experimental results on the consequences of the aliasing issue, and we apply our method to two use cases: a high quality ground-truth depth map and a real-time generated depth map of lower quality. For the first use case a relatively small filter footprint is applied; the second use case benefits from a substantially larger footprint. These experiments show that the dual image resolution range function alleviates the aliasing artifacts and therefore improves the temporal stability of the output depth map. On both use cases, we achieved comparable or better image quality with respect to upsampling with the joint bilateral filter in a single step. On the former use case, we feature a reduction of a factor of 5 in computational cost, whereas on the latter use case, the cost saving is a factor of 50.

  15. Endoscopic Breast Surgery in Treating Patients With Breast Cancer

    ClinicalTrials.gov

    2014-02-05

    Male Breast Cancer; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

  16. [Congenital bilateral vocal cord paralysis].

    PubMed

    Meyer, Lars Christian; Godballe, Christian

    2009-01-12

    Congenital bilateral vocal cord paralysis (CBVCP) is a rare but potentially life-threatening condition and awareness of the condition is necessary to ensure early diagnosis and treatment. This case describes a 25-month-old boy suffering from CBVCP. The main symptoms at birth were inspiratory stridor combined with a normal voice and feeding problems. The difficulties in achieving the right diagnosis are demonstrated, and the treatment so far, including tracheotomy and a feeding tube, is outlined. The importance of fibre optic laryngoscopy in both diagnosis and control is stressed. PMID:19174021

  17. Independent bilateral primary bronchial carcinomas

    PubMed Central

    Chaudhuri, M. Ray

    1971-01-01

    Independent bilateral primary bronchial carcinomas are not common. Since Beyreuther's description in 1924, 16 well-documented cases of independent primary bronchial carcinomas of different histology have been described. From 1965 to 1970, eight cases were seen at the London Chest Hospital. In order to make the diagnosis of a second primary bronchial carcinoma, each tumour should be malignant and neither should be a metastasis from the other. To meet this last criterion, the histopathological features of the two tumours must be different. Many cases have been described in the literature as double primary bronchial carcinomas where the second primary had the same histological features as the first. Images PMID:4327711

  18. [Case report: bilateral Cushing's syndrome].

    PubMed

    Cheikhrouhou, Héla; Khiari, Karima; Chérif, Lotfi; Ben Abdallah, Néjib; Ben Maïz, Hédi

    2003-04-01

    The authors report a case of a 49-year-old woman presenting a Cushing's syndrome (January 1997). The Magnetic Resonance Image of the pituitary gland revealed a microadenoma without extension in the cavernous sinus and a partial empty sella. The computed tomography scan showed a discreet bilateral adrenal hyperplasia with a left nodule (23 mm in diameter) a second nodule was noted. These data suggested the eventuality of maconodular adrenocortical hyperplasia in long-standing Cushing's disease. We discuss the implications of this finding for diagnosis, treatment and follow-up.

  19. Amelogenesis imperfecta with bilateral nephrocalcinosis

    PubMed Central

    Poornima, P; Katkade, Shashikant; Mohamed, Roshan Noor; Mallikarjuna, Rachappa

    2013-01-01

    A 12-year-old patient presented with a severe delay of eruption in permanent maxillary and mandibular incisors. On examination, there was over-retained primary teeth and delayed eruption of permanent teeth. Retained primary teeth showed light yellow discolouration whereas permanent teeth were distinct yellow with thin or little enamel. Subsequent imaging revealed all the premolars except maxillary left first premolar showed signs of intra-alveolar coronal resorption, nephrocalcinosis with bilateral multiple calculi and small papillary tip calcifications, marked increase in alkaline phosphatase. Subsequent dental treatment for restoring the functional and aesthetic requirement followed by appropriate treatment for renal problem was undertaken. PMID:23709541

  20. Psychic energy and synchronicity.

    PubMed

    Zabriskie, Beverley

    2014-04-01

    Given Jung's interest in physics' formulations of psychic energy and the concept of time, overlaps and convergences in the themes addressed in analytical psychology and in quantum physics are to be expected. These are informed by the active intersections between the matter of mind and mindfulness re matter. In 1911, Jung initiated dinners with Einstein. Jung's definition of libido in the pivotal 1912 Fordham Lectures reveals the influence of these conversations. Twenty years later, a significant period in physics, Wolfgang Pauli contacted Jung. Their collaboration led to the theory of synchronicity.

  1. Sun synchronous solar refrigeration

    NASA Astrophysics Data System (ADS)

    The primary goal of this project was to prototype a complete Sun Synchronous Solar Powered Refrigerator. The key element to the technology is the development of the hermetic motor compressor assembly. The prototype was to be developed to either the stage where Polar Products could receive additional venture capital or to the point whereby Polar could use their own capital to manufacture the systems. Our goal was to construct a prototype which would be the next step to a proven and market ready product. To demonstrate the technology under laboratory conditions was a very minimal goal.

  2. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  3. [Simultaneous bilateral pneumothorax. Case report].

    PubMed

    Paolini, A; Caminiti, F; Tosato, F; Ruggieri, M; Paolini, G; Carnevale, L; Corsini, F; Marano, S; Monsellato, I

    2001-04-01

    A case report of a 44 year-old white man admitted to the surgical unit for a bilateral simultaneous pneumothorax is presented. The pneumothorax occurred on day one after a surgical operation for discal hernia; in the past the patient already presented a right spontaneous pneumothorax at 32 years of age and a left pneumothorax at 37 years of age, both treated with a pleural drainage. A thoracic drain was bilaterally positioned with a good result only in the right side. The persistence of the left pneumothorax induced the authors to perform a postero-lateral thoracotomy bullae excision and pleurectomy with a good postoperative course. After a few months a new right pneumothorax occurred and the patient was treated with a right postero-lateral thoracotomy, bullae resection and pleurectomy. On the basis of the case reported, the authors consider the different opportunities in the treatment of spontaneous pneumothorax in relation to the present knowledges and technologies. Surgical procedure is to be preferred in case of persistence of pneumothorax despite a pleural drain and in case of pneumothorax in high risk subjects. Even if thoracoscopy seems to give better results regarding postoperative pain, it is not always possible with such a method to perform a careful pleurectomy neither to obtain it in all cases (above all in secondary pneumothorax). Every case must then be carefully studied to choose the best treatment at present available. PMID:11353349

  4. [Bilateral occipital infarction with central homonymous hemianopia].

    PubMed

    Ishikawa, H; Tanabe, Y

    1991-09-01

    A 45-year-old man of bilateral occipital infarction with central homonymous hemianopia is reported. He was admitted to our hospital with complaints of visual loss and large central scotoma on both eyes. Pupillary light reaction and ocular fundi were normal. On admission, bilateral retrobulbar optic neuritis was suspected. However, congruous, irregular central scotomas with vertical step were observed in both eyes with Goldmann perimetry. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) revealed the infarction in bilateral occipital tips. Bilateral central homonymous hemianopia is considered to be rare and a case in which occipital lobe lesions were detected with X-ray CT and MRI has not been reported. We stress that bilateral central scotomas with vertical step indicate bilateral occipital lesions.

  5. Sensitivity to interaural envelope correlation changes in bilateral cochlear-implant users

    PubMed Central

    Goupell, Matthew J.; Litovsky, Ruth Y.

    2015-01-01

    Provision of bilateral cochlear implants (CIs) to people who are deaf is partially justified by improved abilities to understand speech in noise when comparing bilateral vs unilateral listening conditions. However, bilateral CI listeners generally show only monaural head shadow with little improvement in speech understanding due to binaural unmasking. Sensitivity to change in interaural envelope correlation, which is related to binaural speech unmasking, was investigated. Bilateral CI users were tested with bilaterally synchronized processors at single, pitch-matched electrode pairs. First, binaural masking level differences (BMLDs) were measured using 1000 pulse-per-second (pps) carriers, yielding BMLDs of 11.1 ± 6.5 and 8.5 ± 4.2 dB for 10- and 50-Hz bandwidth masking noises, respectively. Second, envelope correlation change just-noticeable differences (JNDs) were measured. Stimuli presented at 1000 pps yielded lower JNDs than those presented at 100 pps. Furthermore, perfectly correlated reference stimuli produced lower JNDs than uncorrelated references, and uncorrelated references generally produced immeasurable JNDs. About 25% of JNDs measured in the CI listeners were in the range of JNDs observed in normal-hearing listeners presented CI simulations. In conclusion, CI listeners can perceive changes in interaural envelope correlation, but the poor performance may be a major limiting factor in binaural unmasking tested to date in realistic listening environments. PMID:25618064

  6. Unusual Bilateral Paramolars Associated with Clinical Complications

    PubMed Central

    Sulabha, A. N.; Sameer, C.

    2015-01-01

    Paramolars are rare supernumerary structures of maxillofacial complex that occur buccally or lingually near the molar row. Predominantly these occur singly; bilateral presentation is very rare. This paper reports two unusual bilateral presentations of paramolars with clinical complication and its management. One of the cases in the present paper also documents the cooccurrence of bilateral paramolars and microdontia of single tooth and one of its paramolars presented with multilobed crown with an anomalous buccal tubercle. PMID:26078890

  7. System for simultaneous measurements of bilaterally symmetrical acupoints multifrequency impedances

    PubMed Central

    Su, Mi-Yong; Tan, Yong-Hong; Wang, Zi-Min; Gan, Cai-Jun; Chen, Shou-Hong

    2013-01-01

    Devices which can obtain comparable bilaterally symmetrical acupoints (BSA) multifrequency impedances (MFI) are often needed in the detection of the energy balance states of acupoints in traditional Chinese medicine. To satisfy these needs, a two-channel impedance measurement system has been introduced which is capable of accurately and simultaneously measuring BSA MFI. The system includes a set of five electrodes, two of which are injected with exciting current signal to synchronously and equally excite BSA; the other three electrodes are used as sensors to simultaneously sense the response signal from both sides. The system also includes a PC-based time-domain signal testing platform with arbitrary current waveform generation and three channels (one exciting current and two response voltages) simultaneously sampling, and a set of MFI simultaneously unbiased computing algorithms based on special odd multisine current signal input. Preliminary validating experiments suggest that the system allows accurate and synchronous measurement of BSA MFI at least in the frequency range of 10 Hz to 60 kHz, and the obtained BSA MFI are well comparable. PMID:24348077

  8. Digitized synchronous demodulator

    NASA Technical Reports Server (NTRS)

    Woodhouse, Christopher E. (Inventor)

    1990-01-01

    A digitized synchronous demodulator is constructed entirely of digital components including timing logic, an accumulator, and means to digitally filter the digital output signal. Indirectly, it accepts, at its input, periodic analog signals which are converted to digital signals by traditional analog-to-digital conversion techniques. Broadly, the input digital signals are summed to one of two registers within an accumulator, based on the phase of the input signal and medicated by timing logic. At the end of a predetermined number of cycles of the inputted periodic signals, the contents of the register that accumulated samples from the negative half cycle is subtracted from the accumulated samples from the positive half cycle. The resulting difference is an accurate measurement of the narrow band amplitude of the periodic input signal during the measurement period. This measurement will not include error sources encountered in prior art synchronous demodulators using analog techniques such as offsets, charge injection errors, temperature drift, switching transients, settling time, analog to digital converter missing code, and linearity errors.

  9. Synchronized dynamic dose reconstruction

    SciTech Connect

    Litzenberg, Dale W.; Hadley, Scott W.; Tyagi, Neelam; Balter, James M.; Ten Haken, Randall K.; Chetty, Indrin J.

    2007-01-15

    Variations in target volume position between and during treatment fractions can lead to measurable differences in the dose distribution delivered to each patient. Current methods to estimate the ongoing cumulative delivered dose distribution make idealized assumptions about individual patient motion based on average motions observed in a population of patients. In the delivery of intensity modulated radiation therapy (IMRT) with a multi-leaf collimator (MLC), errors are introduced in both the implementation and delivery processes. In addition, target motion and MLC motion can lead to dosimetric errors from interplay effects. All of these effects may be of clinical importance. Here we present a method to compute delivered dose distributions for each treatment beam and fraction, which explicitly incorporates synchronized real-time patient motion data and real-time fluence and machine configuration data. This synchronized dynamic dose reconstruction method properly accounts for the two primary classes of errors that arise from delivering IMRT with an MLC: (a) Interplay errors between target volume motion and MLC motion, and (b) Implementation errors, such as dropped segments, dose over/under shoot, faulty leaf motors, tongue-and-groove effect, rounded leaf ends, and communications delays. These reconstructed dose fractions can then be combined to produce high-quality determinations of the dose distribution actually received to date, from which individualized adaptive treatment strategies can be determined.

  10. Successful Bilateral Composite Ear Reattachment

    PubMed Central

    2014-01-01

    Summary: A successful bilateral ear composite graft nonmicrosurgical reattachment is presented. In cases where suitable vessels are unavailable for microsurgical revascularization, the reconstructive challenge can be formidable for salvaging the unique anatomic and aesthetic structure of the ear. The case is presented of an 18-year-old woman who was a victim of an assault wherein both of her ears were intentionally amputated by her attacker. She underwent successful surgical reattachment followed by a postoperative regimen of hyperbaric oxygen, cooling, and meticulous wound care. The patient achieved 100% survival of her left ear graft and 95% survival of her right ear graft. Clinical photographs at 18 months are presented, along with a discussion of the possible implications for other reconstructive applications. PMID:25289367

  11. Synchronization Dynamics in Complex Networks

    NASA Astrophysics Data System (ADS)

    Zhou, Changsong; Zemanová, Lucia; Kurths, Jürgen

    Previous chapters have discussed tools from graph theory and their contribution to our understanding of the structural organization of mammalian brains and its functional implications. The brain functions are mediated by complicated dynamical processes which arise from the underlying complex neural networks, and synchronization has been proposed as an important mechanism for neural information processing. In this chapter, we discuss synchronization dynamics on complex networks. We first present a general theory and tools to characterize the relationship of some structural measures of networks to their synchronizability (the ability of the networks to achieve complete synchronization) and to the organization of effective synchronization patterns on the networks. Then, we study synchronization in a realistic network of cat cortical connectivity by modeling the nodes (which are cortical areas composed of large ensembles of neurons) by a neural mass model or a subnetwork of interacting neurons. We show that if the dynamics is characterized by well-defined oscillations (neural mass model and subnetworks with strong couplings), the synchronization patterns can be understood by the general principles discussed in the first part of the chapter. With weak couplings, the model with subnetworks displays biologically plausible dynamics and the synchronization pattern reveals a hierarchically clustered organization in the network structure. Thus, the study of synchronization of complex networks can provide insights into the relationship between network topology and functional organization of complex brain networks.

  12. Robust Sliding Window Synchronizer Developed

    NASA Technical Reports Server (NTRS)

    Chun, Kue S.; Xiong, Fuqin; Pinchak, Stanley

    2004-01-01

    The development of an advanced robust timing synchronization scheme is crucial for the support of two NASA programs--Advanced Air Transportation Technologies and Aviation Safety. A mobile aeronautical channel is a dynamic channel where various adverse effects--such as Doppler shift, multipath fading, and shadowing due to precipitation, landscape, foliage, and buildings--cause the loss of symbol timing synchronization.

  13. RAM-Based frame synchronizer

    NASA Technical Reports Server (NTRS)

    Niswander, J. K.; Stattel, R. J.

    1980-01-01

    Frame synchronizer for serial telemetry is rapidly reconfigured for changing formats. Synchronizer generates signals marking data-word boundaries, beginning of each frame, and beginning of each paragraph. Also derived are search, check, and lock status signals. Existing unit is assembled from standard random-access memory elements and MOS and low-power-Schottky logic.

  14. Digital synchronization and communication techniques

    NASA Technical Reports Server (NTRS)

    Lindsey, William C.

    1992-01-01

    Information on digital synchronization and communication techniques is given in viewgraph form. Topics covered include phase shift keying, modems, characteristics of open loop digital synchronizers, an open loop phase and frequency estimator, and a digital receiver structure using an open loop estimator in a decision directed architecture.

  15. Chua's Circuit: Control and Synchronization

    NASA Astrophysics Data System (ADS)

    Irimiciuc, Stefan-Andrei; Vasilovici, Ovidiu; Dimitriu, Dan-Gheorghe

    Chaos-based data encryption is one of the most reliable methods used in secure communications. This implies a good control of a chaotic system and a good synchronization between the involved systems. Here, experimental results are shown on the control and synchronization of Chua's circuits. The control of the chaotic circuit was achieved by using the switching method. The influence of the control signal characteristics (amplitude, frequency and shape) on the system's states was also investigated. The synchronization of two similar chaotic circuits was studied, emphasizing the importance of the chaotic state characteristics of the Master system in respect to those of Slave system. It was shown that the synchronization does not depend on the chaotic state type, neither on the dimension (x, y or z) used for synchronization.

  16. Twin engine synchronizer

    SciTech Connect

    Kobus, J.R.

    1988-05-03

    This patent describes an apparatus for synchronizing the speeds of two engines, each having its own throttle level connected by an associated cable to a respective hand throttle lever, comprising moving means carried by the throttle lever of one of the engines for moving the throttle lever of the one engine independently of its associated cable and its respective hand throttle lever to increase or decrease the speed of the one engine until the speed of the one engine matches the speed of the other engine. The moving means moves the throttle lever of the one engine without moving its associated cable or its respective hand throttle lever, and actuating means mounted remote from the throttle lever of the one engine for actuating the moving means.

  17. Synchronization in neural nets

    NASA Technical Reports Server (NTRS)

    Vidal, Jacques J.; Haggerty, John

    1988-01-01

    The paper presents an artificial neural network concept (the Synchronizable Oscillator Networks) where the instants of individual firings in the form of point processes constitute the only form of information transmitted between joining neurons. In the model, neurons fire spontaneously and regularly in the absence of perturbation. When interaction is present, the scheduled firings are advanced or delayed by the firing of neighboring neurons. Networks of such neurons become global oscillators which exhibit multiple synchronizing attractors. From arbitrary initial states, energy minimization learning procedures can make the network converge to oscillatory modes that satisfy multi-dimensional constraints. Such networks can directly represent routing and scheduling problems that consist of ordering sequences of events.

  18. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    PubMed

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  19. Bilateral microperc in a severe kyphoscoliosis

    PubMed Central

    Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

    2016-01-01

    Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique. PMID:27011881

  20. Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts

    PubMed Central

    Cho, Sung Ik; Lee, Jung Hwan

    2016-01-01

    Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision. PMID:27799997

  1. CT demonstration of bilateral adrenal hemorrhage

    SciTech Connect

    Ling, D.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.

    1983-08-01

    Bilateral adrenal hemorrhage with subsequent adrenal insufficiency is a recognized complication of anticoagulant therapy. Because the clinical manifestations are often nonspecific, the antemortem diagnosis of adrenal hemorrhage has been a difficult clinical problem. Computed tomography (CT) provides detailed images of the adrenal glands that are not possible with conventional imaging methods. The CT findings of bilateral adrenal hemorrhage in an anticoagulated patient are reported.

  2. Stochastic Resonance Modulates Neural Synchronization within and between Cortical Sources

    PubMed Central

    Ward, Lawrence M.; MacLean, Shannon E.; Kirschner, Aaron

    2010-01-01

    Neural synchronization is a mechanism whereby functionally specific brain regions establish transient networks for perception, cognition, and action. Direct addition of weak noise (fast random fluctuations) to various neural systems enhances synchronization through the mechanism of stochastic resonance (SR). Moreover, SR also occurs in human perception, cognition, and action. Perception, cognition, and action are closely correlated with, and may depend upon, synchronized oscillations within specialized brain networks. We tested the hypothesis that SR-mediated neural synchronization occurs within and between functionally relevant brain areas and thus could be responsible for behavioral SR. We measured the 40-Hz transient response of the human auditory cortex to brief pure tones. This response arises when the ongoing, random-phase, 40-Hz activity of a group of tuned neurons in the auditory cortex becomes synchronized in response to the onset of an above-threshold sound at its “preferred” frequency. We presented a stream of near-threshold standard sounds in various levels of added broadband noise and measured subjects' 40-Hz response to the standards in a deviant-detection paradigm using high-density EEG. We used independent component analysis and dipole fitting to locate neural sources of the 40-Hz response in bilateral auditory cortex, left posterior cingulate cortex and left superior frontal gyrus. We found that added noise enhanced the 40-Hz response in all these areas. Moreover, added noise also increased the synchronization between these regions in alpha and gamma frequency bands both during and after the 40-Hz response. Our results demonstrate neural SR in several functionally specific brain regions, including areas not traditionally thought to contribute to the auditory 40-Hz transient response. In addition, we demonstrated SR in the synchronization between these brain regions. Thus, both intra- and inter-regional synchronization of neural activity are

  3. Unilateral parotid gland involvement with synchronous multiple Basal cell adenomas.

    PubMed

    Ozcan, Cengiz; Apa, Duygu Düsmez; Vayisoglu, Yusuf; Görür, Kemal

    2007-11-01

    Basal cell adenoma (BCA) is a rare benign epithelial tumor of the salivary gland. BCA is seen most frequently in the parotid gland and less commonly in the submandibular gland and minor glands of the upper lips, oral cavity, and hard palate. Salivary gland tumors are observed as single tumors in one salivary gland. Double or multiple tumors of the salivary gland tumors are unusual and metachronous or bilateral salivary gland tumors are more observed than synchronous or unilateral tumors. The most commonly seen multiple tumor unilaterally or bilaterally is the Warthin's tumor. A 65-year-old woman with a painful, slowly enlarging mass in front of the left ear, which was present for 6 months, was evaluated. Physical examination revealed two solid and well-delineated masses in the preauricular region, which were 1.5 x 1 cm in diameter and in the tail of the parotid gland, which is 2.5 x 2 cm in diameter. Excision of the superficial lobe of the parotid gland was performed. The macroscopic examination of the specimen showed the two discrete nodular masses. Histologic examination of the two nodular solid lesions was reported as BCA. Multiple synchronous nonmembranous-type BCAs of the unilateral parotid gland is a rare entity. More extensive excision of the parotid gland tumor, careful macroscopic perioperative examination of the surgical specimen, and histologic evaluation of all surgical specimens might be necessary for reducing revision operations and surgical complications.

  4. Breast Cancer

    MedlinePlus

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks that ... who have family members with breast or ovarian cancer may wish to be tested for the genes. ...

  5. Nutritional recommendations for synchronized swimming.

    PubMed

    Robertson, Sherry; Benardot, Dan; Mountjoy, Margo

    2014-08-01

    The sport of synchronized swimming is unique, because it combines speed, power, and endurance with precise synchronized movements and high-risk acrobatic maneuvers. Athletes must train and compete while spending a great amount of time underwater, upside down, and without the luxury of easily available oxygen. This review assesses the scientific evidence with respect to the physiological demands, energy expenditure, and body composition in these athletes. The role of appropriate energy requirements and guidelines for carbohydrate, protein, fat, and micronutrients for elite synchronized swimmers are reviewed. Because of the aesthetic nature of the sport, which prioritizes leanness, the risks of energy and macronutrient deficiencies are of significant concern. Relative Energy Deficiency in Sport and disordered eating/eating disorders are also of concern for these female athletes. An approach to the healthy management of body composition in synchronized swimming is outlined. Synchronized swimmers should be encouraged to consume a well-balanced diet with sufficient energy to meet demands and to time the intake of carbohydrate, protein, and fat to optimize performance and body composition. Micronutrients of concern for this female athlete population include iron, calcium, and vitamin D. This article reviews the physiological demands of synchronized swimming and makes nutritional recommendations for recovery, training, and competition to help optimize athletic performance and to reduce risks for weight-related medical issues that are of particular concern for elite synchronized swimmers. PMID:24667278

  6. Synchronization in growing heterogeneous media

    NASA Astrophysics Data System (ADS)

    Chen, W.; Cheng, S. C.; Avalos, E.; Drugova, O.; Osipov, G.; Lai, Pik-Yin; Chan, C. K.

    2009-04-01

    Synchronization of heterogeneous systems that consist of oscillatory and passive elements are studied in cardiac myocytes/fibroblasts co-cultures. It is found that beating clusters of cardiac myocytes surrounded by fibroblasts will be formed. The beatings of the cardiac myocyte clusters are not correlated at early times, but get synchronized as the cultures mature. This synchronization can be understood by a Kuramoto model with a time-increasing coupling strength. Our findings show that the growth of the coupling strength between clusters is linear, while the overall wave dynamics of the system is controlled by the passive fibroblast in the system which presumably is growing exponentially.

  7. Retroperitoneal laparoscopic bilateral lumbar sympathectomy.

    PubMed

    Segers, B; Himpens, J; Barroy, J P

    2007-06-01

    The first retroperitoneal lumbar sympathectomy was performed in 1924 by Julio Diez. The classic procedure for sympathectomy is open surgery. We report a unilateral laparoscopic retroperitoneal approach to perform bilateral lumbar sympathectomy. This approach was performed for a 43-year-old man with distal arterial occlusive disease and no indication for direct revascularization. His predominant symptoms were intermittent claudication at 100 metres and cold legs. The patient was placed in a left lateral decubitus position. The optical system was placed first in an intra-abdominal position to check that the trocars were well positioned in the retroperitoneal space. The dissection of retroperitoneum was performed by CO2 insufflation. The inferior vena cava was reclined and the right sympathetic chain was individualized. Two ganglia (L3-L4) were removed by bipolar electro-coagulation. The aorta was isolated on a vessel loop and careful anterior traction allowed a retro-aortic pre-vertebral approach between the lumbar vessels. The left sympathetic chain was dissected. Two ganglia (L3-L4) were removed by bipolar electro-coagulation. PMID:17685269

  8. Bilateral symmetry across Aphrodite Terra

    NASA Technical Reports Server (NTRS)

    Crumpler, L. S.; Head, J. W.; Campbell, D. B.

    1987-01-01

    There are three main highland areas on Venus: Beta Regio, Ishtar Terra and Aphrodite Terra. The latter is least known and the least mapped, yet existing analyses of Aphrodite Terra based on available Pioneer-Venus orbiter data suggest that it may be the site of extensive rifting. Some of the highest resolution (30 km) PV data (SAR) included most of the western half of Aphrodite Terra. Recent analysis of the SAR data together with Arecibo range-doppler topographic profiling (10 X 100 km horizontal and 10 m vertical resolution) across parts of Aphrodite, further characterized the nature of possible tectonic processes in the equatorial highlands. The existence of distinct topographic and radar morphologic linear discontinuities across the nearly east-west strike of Aphrodite Terra is indicated. Another prominent set of linear features is distinctly parallel to and orthogonal to the ground tracks of the PV spacecraft and are not included because of the possibility that they are artifacts. Study of the northwest trending cross-strike discontinuities (CSD's) and the nature of topographic and morphologic features along their strike suggest the presence of bilateral topographic and morphologic symmetry about the long axis of Aphrodite Terra.

  9. [True hermaphroditism with bilateral ovotestis].

    PubMed

    Güitrón, A; Forsbach, G; González, J M; Garza, J G; Vázquez, J; Espinoza, G

    1998-01-01

    A nineteen years old woman with ambiguous external genitalia was studied. This condition had been previously identified as a newborn, but her parents refused medical attention and it was reared as a girl. At 12-years, she began spontaneous mammary development, appearing pubic and axillary hair, and clitoral enlargement. The menarche occurred at 15-years and it was followed by irregular periods. Physical examination, showed absence of hirsutism and acne, normal mammary development equivalent to grade V of Tanner. The external genitalia showed fused labio-scrotal folds with an small introitus. The urethral meatus was absent and was later located inside the introitus. There was a big phallus similar to an adult penis with a normal glans, flexed by a chordee. Hormonal determinations discarded congenital adrenal hyperplasia. The karyotype was 46,XX and testosterone levels were in adult male range. Pelvic ultrasonography disclosed a normal uterus and both gonads in confirmed by laparoscopy identifying bilateral ovotestis. Testicular tissue was removed and plastic reconstruction of female genitals was done. PMID:9528217

  10. 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. PMID:27352844

  11. Retroperitoneal laparoscopic bilateral lumbar sympathectomy.

    PubMed

    Segers, B; Himpens, J; Barroy, J P

    2007-06-01

    The first retroperitoneal lumbar sympathectomy was performed in 1924 by Julio Diez. The classic procedure for sympathectomy is open surgery. We report a unilateral laparoscopic retroperitoneal approach to perform bilateral lumbar sympathectomy. This approach was performed for a 43-year-old man with distal arterial occlusive disease and no indication for direct revascularization. His predominant symptoms were intermittent claudication at 100 metres and cold legs. The patient was placed in a left lateral decubitus position. The optical system was placed first in an intra-abdominal position to check that the trocars were well positioned in the retroperitoneal space. The dissection of retroperitoneum was performed by CO2 insufflation. The inferior vena cava was reclined and the right sympathetic chain was individualized. Two ganglia (L3-L4) were removed by bipolar electro-coagulation. The aorta was isolated on a vessel loop and careful anterior traction allowed a retro-aortic pre-vertebral approach between the lumbar vessels. The left sympathetic chain was dissected. Two ganglia (L3-L4) were removed by bipolar electro-coagulation.

  12. Bilateral pneumothorax after orthognatic surgery

    PubMed Central

    Bertossi, Dario; Malchiodi, Luciano; Turra, Matteo; Bondi, Vincenzo; Albanese, Massimo; Lucchese, Alessandra; Carinci, Francesco; Nocini, Pierfrancesco

    2012-01-01

    Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28-year-old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post-surgical dispnea associated to sub-cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post-surgical orthognatic treatment can be extremely difficult requiring a multi-disciplinary approach. PMID:23814593

  13. 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.

  14. 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

  15. Heterochronic bilateral ectopic pregnancy after ovulation induction*

    PubMed Central

    Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan

    2014-01-01

    Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case. PMID:25091994

  16. Two case reports of bilateral adrenal myelolipomas

    PubMed Central

    Yang, Yu; Ye, Lin-Yang; Yu, Bo; Guo, Jia-Xiang; Liu, Qian; Chen, Yun

    2015-01-01

    Primary adrenal myelolipoma is a rare, non-functioning adrenal benign tumor that is composed of mature adipose tissue and a variable amount of haemopoietic elements. Clinically, it is difficult to get diagnosed with adrenal myelolipoma because the patient usually doesn’t have obvious symptoms and signs in early stage. In the present study, two cases of primary bilateral adrenal myelolipomas are reported. Clinical presentation, imaging diagnostic features, histopathological changes and surgical treatments of the two patients are discussed. Preoperative diagnostic imaging examinations (B-mode ultrasonography, computed tomography and magnetic resonance imaging sans) assisted getting a prediction diagnosis of bilateral adrenal myelolipomas. A two-stage surgery was used to successfully excise bilateral adrenal myelolipomas in the two patients. Conventional open adrenalectomy was applied to remove the adrenal myelolipomas greater than 6 cm, and laparoscopic adrenalectomy was performed to excise the adrenal tumors smaller than 6 cm. Bilateral adrenal myelolipomas of the two patients were finally confirmed by postoperative histopathological examinations. Understanding clinical, imaging diagnostic and histopathological features of bilateral adrenal myelolipomas will facilitate timely diagnosis and treatment of this condition. Surgical removal of bilateral adrenal myelolipomas is safe, curative and beneficial. The two-stage surgery appears to be the best treatment option for the patients with bilateral adrenal myelolipomas because it achieves optimal treatment effectiveness with minimized sequelae. PMID:26380835

  17. Bilateral motor tasks involve more brain regions and higher neural activation than unilateral tasks: an fMRI study.

    PubMed

    Noble, Jeremy W; Eng, Janice J; Boyd, Lara A

    2014-09-01

    Movements that involve simultaneous coordination of muscles of the right and left lower limbs form a large part of our daily activities (e.g., standing, rising from a chair). This study used functional magnetic resonance imaging to determine which brain areas are used to control coordinated lower-limb movements, specifically comparing regions that are activated during bilateral exertions to those performed unilaterally. Plantarflexor exertions were produced at a target force level of 15% of the participants' maximum voluntary contraction, in three conditions, with their right (dominant) foot, with their left foot, and with both feet simultaneously. A voxel-wise analysis determined which regions were active in the bilateral, but not in the unilateral conditions. In addition, a region of interest (ROI) approach was used to determine differences in the percent signal change (PSC) between the conditions within motor areas. The voxel-wise analysis showed a large number of regions (cortical, subcortical, and cerebellar) that were active during the bilateral condition, but not during either unilateral condition. The ROI analysis showed several motor regions with higher activation in the bilateral condition than unilateral conditions; further, the magnitude of bilateral PSC was more than the sum of the two unilateral conditions in several of these regions. We postulate that the greater levels of activation during bilateral exertions may arise from interhemispheric inhibition, as well as from the greater need for motor coordination (e.g., synchronizing the two limbs to activate together) and visual processing (e.g., monitoring of two visual stimuli).

  18. Time synchronized video systems

    NASA Technical Reports Server (NTRS)

    Burnett, Ron

    1994-01-01

    The idea of synchronizing multiple video recordings to some type of 'range' time has been tried to varying degrees of success in the past. Combining this requirement with existing time code standards (SMPTE) and the new innovations in desktop multimedia however, have afforded an opportunity to increase the flexibility and usefulness of such efforts without adding costs over the traditional data recording and reduction systems. The concept described can use IRIG, GPS or a battery backed internal clock as the master time source. By converting that time source to Vertical Interval Time Code or Longitudinal Time Code, both in accordance with the SMPTE standards, the user will obtain a tape that contains machine/computer readable time code suitable for use with editing equipment that is available off-the-shelf. Accuracy on playback is then determined by the playback system chosen by the user. Accuracies of +/- 2 frames are common among inexpensive systems and complete frame accuracy is more a matter of the users' budget than the capability of the recording system.

  19. Noncoherent Symbol Synchronization Techniques

    NASA Technical Reports Server (NTRS)

    Simon, Marvin

    2005-01-01

    Traditional methods for establishing symbol synchronization (sync) in digital communication receivers assume that carrier sync has already been established, i.e., the problem is addressed at the baseband level assuming that a 'perfect' estimate of carrier phase is available. We refer to this approach as coherent symbol sync. Since, for NRZ signaling, a suppressed carrier sync loop such as an I-Q Costas loop includes integrate-and-dump (I and D) filters in its in-phase (1) and quadrature (Q) arms, the traditional approach is to first track the carrier in the absence of symbol sync information, then feed back the symbol sync estimate to these filters, and then iterate between the two to a desirable operating level In this paper, we revisit the symbol sync problem by examining methods for obtaining such sync in the absence of carrier phase information, i.e., so-called noncoherent symbol sync loops. We compare the performance of these loops with that of a well-known coherent symbol sync loop and examine the conditions under which one is preferable over the other.

  20. Chemotherapy-resistant breast implant-associated anaplastic large cell lymphoma

    PubMed Central

    Parthasarathy, Muralidharan; Orrell, Julian; Mortimer, Caroline; Ball, Liz

    2013-01-01

    A 43-year-old woman presented with a few weeks’ history of discomfort and swelling in her left breast. She had undergone bilateral breast augmentation 8 years previously. There were no risk factors for breast cancer. Clinical examination, mammography and breast ultrasound revealed a large left breast mass adjacent to the breast implant with enlarged axillary lymph nodes. Owing to diagnostic uncertainty, core biopsies were sent to a specialist unit which confirmed breast implant-associated anaplastic large cell lymphoma with involved lymph nodes. Staging investigations confirmed no distant disease. The lymphoma multidisciplinary team recommended cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy, followed by implant removal and local radiotherapy. However, the patient's disease progressed on first-line, and then second-line chemotherapy. She therefore had a mastectomy and axillary node clearance followed by radiotherapy, with a planned delayed left breast reconstruction and removal of the right breast implant. PMID:24285813

  1. Bilateral dacryocystoceles in a pregnant woman.

    PubMed

    Hirabayashi, Kristin E; Yang, Elizabeth; Echegoyen, Julio; Yoon, Steven J; Tao, Jeremiah P

    2014-01-01

    The authors describe, for the first time, bilateral, sequential large dacryocystoceles during pregnancy and review the literature for this presentation. A 26-year-old, 15-week pregnant woman presented with OD epiphora, diplopia, and pain in the setting of an inferomedial orbital mass. Surgical exploration and histopathology were consistent with a dacryocystocele, and a dacryocystorhinostomy was curative. She returned at 34-week gestation, with an identical presentation on the left side. Review of the literature reveals that dacryocystoceles occasionally present in adults; however, bilateral involvement may be unusual. Bilateral dacryocystoceles have not been previously reported in a pregnant woman.

  2. Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction

    SciTech Connect

    Doody, O.; Adam, W. R.; Foley, P. T.; Lyon, S. M.

    2009-03-15

    Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

  3. Synchronization by small time delays

    NASA Astrophysics Data System (ADS)

    Pruessner, G.; Cheang, S.; Jensen, H. J.

    2015-02-01

    Synchronization is a phenomenon observed in all of the living and in much of the non-living world, for example in the heart beat, Huygens' clocks, the flashing of fireflies and the clapping of audiences. Depending on the number of degrees of freedom involved, different mathematical approaches have been used to describe it, most prominently integrate-and-fire oscillators and the Kuramoto model of coupled oscillators. In the present work, we study a very simple and general system of smoothly evolving oscillators, which continue to interact even in the synchronized state. We find that under very general circumstances, synchronization generically occurs in the presence of a (small) time delay. Strikingly, the synchronization time is inversely proportional to the time delay.

  4. Synchronous identification of friendly targets

    SciTech Connect

    Telle, John M.; Roger, Stutz A.

    1998-01-01

    A synchronous communication targeting system for use in battle. The present invention includes a transceiver having a stabilizing oscillator, a synchronous amplifier and an omnidirectional receiver, all in electrical communication with each other. A remotely located beacon is attached to a blackbody radiation source and has an amplitude modulator in electrical communication with a optical source. The beacon's amplitude modulator is set so that the optical source transmits radiation frequency at approximately the same or lower amplitude than that of the blackbody radiation source to which the beacon is attached. The receiver from the transceiver is adapted to receive frequencies approximately at or below blackbody radiation signals and sends such signals to the synchronous amplifier. The synchronous amplifier then rectifies and amplifies those signals which correspond to the predetermined frequency to therefore identify whether the blackbody radiation source is friendly or not.

  5. Optimistic barrier synchronization. Contractor report

    SciTech Connect

    Nicol, D.M.

    1992-07-01

    Barrier synchronization is a fundamental operation in parallel computation. In many contexts, at the point a processor enters a barrier it knows that is has already processed all work required of it prior to the synchronization. This paper treats the alternative case, when a processor cannot enter a barrier with the assurance that it has already performed all necessary pre-synchronization computation. The proble marises when the number of pre-synchronization messages to be received by a processor is unknown, for example, in a parallel discrete simulation or any other computation that is largely driven by an unpredictable exchange of messages. The authors describe an optimistic O(log2P) barrier algorithm for such problems, study its performance on a large-scale parallel system, and consider extensions to general associative reductions, as well as associative parallel prefix computations.

  6. Simultaneous bilateral decortications via video-assisted thoracic surgery for bilateral empyema

    PubMed Central

    Nose, Naohiro; Anami, Toshiki

    2014-01-01

    Introduction Bilateral empyema is a rare and life-threatening condition that is difficult to treat. We herein report a case of bilateral empyema that was treated with simultaneous bilateral decortications via video-assisted thoracic surgery (VATS). Presentation of case A 38-year-old female complained of chest pain, dyspnea, and high grade fever lasting two weeks. Computed tomography revealed bilateral notching pleural effusion and pneumonia with atelectasis. Bilateral thoracic drainage was performed. From the right chest, white pus was drained, and Streptococcus anginosus was identified. The left drainage fluid was serous, and no bacteria were identified. We diagnosed the patient with right empyema and left para-pneumonic effusion consequent to pneumonia. Because conservative therapies could not resolve the inflammatory findings, simultaneous bilateral VATS decortications were performed. Both thoracic cavities had loculated pleural effusion. In contrast to the preoperative findings, white pus was found in not only the right, but also the left thoracic cavity. She had an uncomplicated postoperative course and recovered. Discussion Bilateral empyema that has developed to the fibrinopleural phase is difficult to treat with drains alone. Bilateral VATS decortications helped to make a definitive diagnosis and treat both sides simultaneously. Conclusion Simultaneous bilateral VATS decortications should be considered as a feasible and effective procedure for bilateral empyema that is refractory to medical treatment. PMID:25528031

  7. Incidental finding of bilateral papillary thyroid carcinoma in a patient with primary hyperparathyroidism.

    PubMed

    Alavi, Mehr Sadat; Azarpira, Negar; Mojallal, Mehra

    2010-01-01

    Primary hyperparathyroidism (PHP) affects 0.5%-1% of the adult population and presents with classical signs of renal lithiasis, cholecystolithiasis, gastrointestinal ulcerations, depression, and osteoporosis. Parathyroid adenoma, hyperplasia and rarely carcinoma are the underlying pathology. Synchronous thyroid and parathyroid pathologies are described in multiple endocrine neoplasia. We report a case of a 47 years old woman with non-syndromic concomitant occurrence of bilateral non-medullary thyroid carcinoma diagnosed by histopathology, and with PHP confirmed by (99m)Tc-MIBI scintigraphy, hypercalcemia and elevated serum parathyroid hormone. A head and neck surgeon needs to be aware of the possible coexistence of thyroid and parathyroid lesions. To our knowledge, this is the first report of concomitant PHP and bilateral papillary thyroid cancer in the literature. In conclusion, it is optimal to remove both tumors in one operative procedure. Therefore careful thyroid evaluation should be considered for all patients with PHP.

  8. Engineering synchronization of chaotic oscillators

    SciTech Connect

    Padmanaban, E.; Dana, Syamal K.

    2011-04-19

    We propose a controller based coupling design for engineering synchronization in chaotic oscillators for unidirectional as well as bi-directional mode. In the synchronization regimes, it is possible to amplify/ attenuate a chaotic attractor with respect to other chaotic attractors. Numerical examples are presented for a Lorenz system, a Roessler oscillator, and a Sprott system. Physical implementation of the scheme is done in electronic circuit to design the controller for verification of the theory.

  9. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke. PMID:27630418

  10. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke.

  11. Synchronous reactive programming in Ptolemy

    SciTech Connect

    Boulanger, F.; Vidal-Naquet, G.

    1996-12-31

    Synchronous reactive languages allow a high level deterministic description of reactive systems such as control-command systems. Their well defined mathematical semantics makes it possible to check formal properties on the control of a system. In previous work, we developed an object-oriented execution model for synchronous reactive modules. This model is implemented as a set of tools and a C++ class library, and allows us to use object-oriented methodologies and tools for the design of complex applications with both transformational and reactive parts. Among these design tools, the Ptolemy system stands as an object-oriented framework that supports various execution models, or {open_quotes}domains{close_quotes}. We are currently working on a translator from the output format of the Lustre and Esterel compilers to the Ptolemy language. Since no existing domain matches the reactive synchronous execution model, we also plan to develop a SEC (Synchronous Execution and Communication) domain. Such a domain will provide support for the execution of synchronous modules in Ptolemy. One of the most interesting features of Ptolemy is the communication between domains. Therefore we discuss the interface of the SEC domain to other domains to determine the meaning of communications between them. The main goal is to allow the use of synchronous reactive modules for the control of the behavior of data-flow or discrete event processes.

  12. Cardiorespiratory synchronization during Zen meditation.

    PubMed

    Cysarz, Dirk; Büssing, Arndt

    2005-09-01

    The impact of meditation on cardiorespiratory synchronization with respect to breathing oscillations and the modulations of heart rate induced by respiration (respiratory sinus arrhythmia, RSA) was investigated in this study. Four different exercises (spontaneous breathing, mental task, Zen meditation, and Kinhin meditation) were consecutively performed by nine subjects mainly without any experience in meditation. An electrocardiogram and a respiratory trace were recorded simultaneously. On this basis the degree of cardiorespiratory synchronization was quantified by a technique which has been adopted from the analysis of weakly coupled chaotic oscillators. Both types of meditation showed a high degree of synchronization, whereas heartbeat and respiration were hardly synchronized during spontaneous breathing. During the mental task exercise the extent of synchronization was slightly higher than during spontaneous breathing. These results were largely determined by the breathing frequency because the two types of meditation induce low breathing frequencies which led to a pronounced and in-phase RSA. During the meditation the low breathing frequencies led to a decrease in the high frequency of heart rate variability, whereas the low frequency and the extent of RSA increased. The heart rate primarily reflected the degree of physical effort. The high degree of cardiorespiratory synchronization during meditation in unexperienced meditators suggests that the physiological implications of meditation does not require prior experience in meditation.

  13. Breast Cancer Prevention

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Prevention (PDQ®)–Patient Version What is prevention? Go ... to keep cancer from starting. General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  14. Types of Breast Cancers

    MedlinePlus

    ... the key statistics about breast cancer? Types of breast cancers Breast cancer can be separated into different types ... than invasive ductal carcinoma. Less common types of breast cancer Inflammatory breast cancer This uncommon type of invasive ...

  15. Breast self-exam

    MedlinePlus

    Self-examination of the breast; BSE; Breast cancer - BSE; Breast cancer screening - self exam ... American Cancer Society. Recommendations for early breast cancer detection in women without breast symptoms. Revised October 20, ... ...

  16. Environment-adaptive speech enhancement for bilateral cochlear implants using a single processor.

    PubMed

    Mirzahasanloo, Taher S; Kehtarnavaz, Nasser; Gopalakrishna, Vanishree; Loizou, Philipos C

    2013-05-01

    A computationally efficient speech enhancement pipeline in noisy environments based on a single-processor implementation is developed for utilization in bilateral cochlear implant systems. A two-channel joint objective function is defined and a closed form solution is obtained based on the weighted-Euclidean distortion measure. The computational efficiency and no need for synchronization aspects of this pipeline make it a suitable solution for real-time deployment. A speech quality measure is used to show its effectiveness in six different noisy environments as compared to a similar one-channel enhancement pipeline when using two separate processors or when using independent sequential processing.

  17. Environment-adaptive speech enhancement for bilateral cochlear implants using a single processor☆

    PubMed Central

    Mirzahasanloo, Taher S.; Kehtarnavaz, Nasser; Gopalakrishna, Vanishree; Loizou, Philipos C.

    2013-01-01

    A computationally efficient speech enhancement pipeline in noisy environments based on a single-processor implementation is developed for utilization in bilateral cochlear implant systems. A two-channel joint objective function is defined and a closed form solution is obtained based on the weighted-Euclidean distortion measure. The computational efficiency and no need for synchronization aspects of this pipeline make it a suitable solution for real-time deployment. A speech quality measure is used to show its effectiveness in six different noisy environments as compared to a similar one-channel enhancement pipeline when using two separate processors or when using independent sequential processing. PMID:24610967

  18. Localized neurofibromas in the bilateral orbits.

    PubMed

    Takeuchi, Satoru; Wada, Kojiro; Nagatani, Kimihiro; Nawashiro, Hiroshi

    2013-10-01

    Localized neurofibromas are rare in the orbit and, unlike the more common plexiform neurofibromas, are not typically associated with von Recklinghausen neurofibromatosis. We present a rare case of localized neurofibromas in the bilateral orbits.

  19. Bilateral areolar and periareolar pityriasis versicolor.

    PubMed

    Sárdy, Miklós; Korting, Hans Christian; Ruzicka, Thomas; Wolff, Hans

    2010-08-01

    An adolescent boy presented with isolated, symmetrical, bilateral areolar and periareolar pityriasis versicolor. This extremely rare condition should be considered in the differential diagnosis of light brown patches on the areolae.

  20. Bilateral giant abdominoscrotal hydroceles in childhood.

    PubMed

    Serels, S; Kogan, S

    1996-05-01

    There is a paucity of cases in the literature describing the abdominoscrotal hydrocele (ASH). We report the diagnostic and therapeutic aspects of a rapidly expanding giant bilateral ASH in a 4-month-old boy.

  1. Early-onset cortico-cortical synchronization in the hemiparkinsonian rat model.

    PubMed

    Jávor-Duray, B N; Vinck, M; van der Roest, M; Mulder, A B; Stam, C J; Berendse, H W; Voorn, P

    2015-02-01

    Changes in synchronized neuronal oscillatory activity are reported in both cortex and basal ganglia of Parkinson's disease patients. The origin of these changes, in particular their relationship with the progressive nigrostriatal dopaminergic denervation, is unknown. Therefore, in the present study we studied interregional neuronal synchronization in motor cortex and basal ganglia during the development of dopaminergic degeneration induced by a unilateral infusion of 6-hydroxydopamine (6-OHDA) into the rat medial forebrain bundle. We performed serial local field potential recordings bilaterally in the motor cortex and the subthalamic nucleus of the lesioned hemisphere prior to, during, and after development of the nigrostriatal dopaminergic cell loss. We obtained signal from freely moving rats in both resting and walking conditions, and we computed local spectral power, interregional synchronization (using phase lag index), and directionality (using Granger causality). After neurotoxin injection the first change in phase lag index was an increment in cortico-cortical synchronization. We observed increased bidirectional Granger causality in the beta frequency band between cortex and subthalamic nucleus within the lesioned hemisphere. In the walking condition, the 6-OHDA lesion-induced changes in synchronization resembled that of the resting state, whereas the changes in Granger causality were less pronounced after the lesion. Considering the relatively preserved connectivity pattern of the cortex contralateral to the lesioned side and the early emergence of increased cortico-cortical synchronization during development of the 6-OHDA lesion, we suggest a putative compensatory role of cortico-cortical coupling. PMID:25392174

  2. Bilateral giant abdominoscrotal hydroceles complicated by appendicitis.

    PubMed

    Yarram, Sai G; Dipietro, Michael A; Graziano, Kathleen; Mychaliska, George B; Strouse, Peter J

    2005-12-01

    Abdominoscrotal hydrocele is a rare entity, with fewer than 100 cases reported in children. Bilateral abdominoscrotal hydroceles are even less common, with 14 cases reported in children. Various complications of abdominoscrotal hydrocele have been reported in the literature. We present a 4-month-old boy with bilateral giant abdominoscrotal hydroceles who developed appendicitis apparently because of obstruction from the right hydrocele. We discuss the various imaging modalities used to establish the diagnosis and plan the operative approach.

  3. [Multiple bilateral renal hydatidosis. A case report].

    PubMed

    Bennani, S; Ait Bolbarod, A; el Mrini, M; Benjelloun, S

    1995-01-01

    The authors report one case of multiple bilateral hydatid cyst of kidney associated to brain and spleen localizations, after intra cardiac rupture. They point out the rarity of the bilateral kidney localization of hydatidosis, explain the dissemination mode, and stress the role of computed tomography for the pre-operative diagnosis. The treatment is above all surgical and adapted to each case. The post-operative results are satisfying. Complementary medical treatment could be useful. PMID:7486851

  4. [Bilateral rupture of the quadriceps tendon].

    PubMed

    Modrego, Francisco J; Molina, Juan

    2004-01-01

    Simultaneous, bilateral, and spontaneous rupture of the quadriceps tendon is a very rare injury. Individuals with this injury are usually predisposed by chronic renal disease with secondary hyperparathyroidism, gout, diabetes, and lupus erythematosus. Often, primary diagnostic confusion can lead to a delay in treatment. Two cases of a bilateral lesion of the quadriceps tendon, that were treated surgically using the technique of Scuderi, followed by an intense rehabilitation programme, are presented. Surgical treatment yields satisfactory results.

  5. Simultaneous bilateral tibial tubercle avulsion fracture.

    PubMed

    Maar, D C; Kernek, C B; Pierce, R O

    1988-11-01

    Bilateral simultaneous tibial tubercle avulsion fractures are extremely rare. The present case was a 16-year-old boy who sustained bilateral simultaneous tibial tubercle avulsion fractures (Watson-Jones Type III) from jumping while playing basketball. Both fractures were treated successfully by open reduction and internal fixation with screws. Three years later, the patient had the screws removed because of knee pain and tenderness over the screws.

  6. Sequential presentation of bilateral Brown syndrome.

    PubMed

    Sekeroğlu, Hande Taylan; Türkçüoğlu, Peykan; Sanaç, Ali Şefik; Sener, Emin Cumhur

    2012-04-01

    Brown syndrome, characterized by a limitation of elevation in adduction and positive forced duction testing, is usually unilateral but occurs bilaterally in 10% of all cases. It may present as a congenital condition in one eye and develop in the other eye with no apparent cause. We present a case of bilateral Brown syndrome in which the right eye became involved within 1 year of surgery on the left eye for congenital Brown syndrome.

  7. Synchronization configurations of two coupled double pendula

    NASA Astrophysics Data System (ADS)

    Koluda, Piotr; Perlikowski, Przemyslaw; Czolczynski, Krzysztof; Kapitaniak, Tomasz

    2014-04-01

    We consider the synchronization of two self-excited double pendula hanging from a horizontal beam which can roll on the parallel surface. We show that such pendula can obtain four different robust synchronous configurations. Our approximate analytical analysis allows to derive the synchronization conditions and explains the observed types of synchronizations. We consider the energy balance in the system and show how the energy is transferred between the pendula via the oscillating beam allowing the pendula' synchronization.

  8. Exploration of Circadian Rhythms in Patients with Bilateral Vestibular Loss

    PubMed Central

    Martin, Tristan; Moussay, Sébastien; Bulla, Ingo; Bulla, Jan; Toupet, Michel; Etard, Olivier; Denise, Pierre; Davenne, Damien; Coquerel, Antoine; Quarck, Gaëlle

    2016-01-01

    Background New insights have expanded the influence of the vestibular system to the regulation of circadian rhythmicity. Indeed, hypergravity or bilateral vestibular loss (BVL) in rodents causes a disruption in their daily rhythmicity for several days. The vestibular system thus influences hypothalamic regulation of circadian rhythms on Earth, which raises the question of whether daily rhythms might be altered due to vestibular pathology in humans. The aim of this study was to evaluate human circadian rhythmicity in people presenting a total bilateral vestibular loss (BVL) in comparison with control participants. Methodology and Principal Findings Nine patients presenting a total idiopathic BVL and 8 healthy participants were compared. Their rest-activity cycle was recorded by actigraphy at home over 2 weeks. The daily rhythm of temperature was continuously recorded using a telemetric device and salivary cortisol was recorded every 3 hours from 6:00AM to 9:00PM over 24 hours. BVL patients displayed a similar rest activity cycle during the day to control participants but had higher nocturnal actigraphy, mainly during weekdays. Sleep efficiency was reduced in patients compared to control participants. Patients had a marked temperature rhythm but with a significant phase advance (73 min) and a higher variability of the acrophase (from 2:24 PM to 9:25 PM) with no correlation to rest-activity cycle, contrary to healthy participants. Salivary cortisol levels were higher in patients compared to healthy people at any time of day. Conclusion We observed a marked circadian rhythmicity of temperature in patients with BVL, probably due to the influence of the light dark cycle. However, the lack of synchronization between the temperature and rest-activity cycle supports the hypothesis that the vestibular inputs are salient input to the circadian clock that enhance the stabilization and precision of both external and internal entrainment. PMID:27341473

  9. The Transverse Musculocutaneous Gracilis Free Flap: Virtual Animation-Assisted Dissection and Application in Breast Reconstruction.

    PubMed

    Gabert, Pierre-Elliott; Bodin, Frederic; Aljudaibi, Nawaf; Duquennoy-Martinot, Veronique; Guerreschi, Pierre

    2016-05-01

    The transverse musculocutaneous gracilis free flap is a valuable choice for autologous tissue, unilateral or bilateral breast reconstruction. This procedure is an excellent and customized option for immediate or delayed breast reconstruction in patients with small to moderate size breasts. Few descriptions of flap dissection and breast mound shaping are available. In this first educational video, the authors report the original dissection of the transverse musculocutaneous gracilis free flap used for breast reconstruction. Virtual animations insist on surgical key points and relevant details of the harvesting of the flap.

  10. Noncoherent DTTLs for Symbol Synchronization

    NASA Technical Reports Server (NTRS)

    Simon, Marvin; Tkacenko, Andre

    2007-01-01

    Noncoherent data-transition tracking loops (DTTLs) have been proposed for use as symbol synchronizers in digital communication receivers. [Communication- receiver subsystems that can perform their assigned functions in the absence of synchronization with the phases of their carrier signals ( carrier synchronization ) are denoted by the term noncoherent, while receiver subsystems that cannot function without carrier synchronization are said to be coherent. ] The proposal applies, more specifically, to receivers of binary phase-shift-keying (BPSK) signals generated by directly phase-modulating binary non-return-to-zero (NRZ) data streams onto carrier signals having known frequencies but unknown phases. The proposed noncoherent DTTLs would be modified versions of traditional DTTLs, which are coherent. The symbol-synchronization problem is essentially the problem of recovering symbol timing from a received signal. In the traditional, coherent approach to symbol synchronization, it is necessary to establish carrier synchronization in order to recover symbol timing. A traditional DTTL effects an iterative process in which it first generates an estimate of the carrier phase in the absence of symbol-synchronization information, then uses the carrier-phase estimate to obtain an estimate of the symbol-synchronization information, then feeds the symbol-synchronization estimate back to the carrier-phase-estimation subprocess. In a noncoherent symbol-synchronization process, there is no need for carrier synchronization and, hence, no need for iteration between carrier-synchronization and symbol- synchronization subprocesses. The proposed noncoherent symbolsynchronization process is justified theoretically by a mathematical derivation that starts from a maximum a posteriori (MAP) method of estimation of symbol timing utilized in traditional, coherent DTTLs. In that MAP method, one chooses the value of a variable of interest (in this case, the offset in the estimated symbol

  11. A case of occult contralateral breast cancer incidentally detected by contrast-enhanced MRI; report of a case with review of literature.

    PubMed

    Komatsu, Shuhei; Lee, Chol Joo; Hosokawa, Yohei; Hamashima, Takashi; Shirono, Koichi; Ichikawa, Daisuke; Okabe, Harumi; Kurioka, Hideaki; Yamagishi, Hisakazu; Oka, Takahiro

    2005-01-01

    We encountered a case of occult contralateral breast cancer, previously undetected by conventional imaging such as mammography (MMG) and ultrasonography (US), but incidentally detected by contrast-enhanced magnetic resonance imaging (CE-MRI). We present it here with a review of the literature. A 67-year-old Japanese woman was referred to our hospital in October 2000 because of a 1.5 cm right breast lump detected in a medical checkup. MMG, US and fine needle aspiration cytology revealed a cancerous lesion during the right breast. No mass lesion was palpable nor was any detected by MMG or US in the left breast. Bilateral breast CE-MRI was performed for more detailed evaluation. Consequently, an occult contralateral breast cancerous lesion was detected incidentally by CE-MRI, with the images showing rapid initial enhancement of time to signal intensity curves. Before surgery, bilateral breast lesions were diagnosed as invasive ductal carcinoma by open biopsy. She underwent bilateral breast conserving surgery with bilateral axillary lymph node dissection. The postoperative course was uneventful and no recurrence has been noted as of January 18th, 2004. CE-MRI of the contralateral breast should be of value as a routine screen in those patients with a known or suspected malignancy in one breast considering the limits of breast cancer detection by such conventional modalities as MMG and US. PMID:16286918

  12. Intramuscular pressure-induced inhibition of cardiac contraction: implications for cardiac-locomotor synchronization.

    PubMed

    Niizeki, Kyuichi

    2005-03-01

    The synchronization of cardiac and locomotor rhythms has been suggested to enhance the efficiency of arterial delivery to active muscles during rhythmic exercise, but direct evidence showing such a functional role has not been provided. In this study, we tested the hypothesis that the heartbeat is coupled with intramuscular pressure (IMP) changes so as to time the delivery of blood through peripheral tissues when the IMP is lower. To this end, we developed a computer-controlled, dynamic, thigh cuff occlusion device that enables bilateral thigh cuffs to repeatedly inflate and deflate, one side after the other, to simulate rhythmic IMP changes during bipedal locomotion. Nine healthy subjects were examined, and three different occlusion pressures (50, 80, and 120 mmHg) were applied separately to the thigh cuffs of normal subjects while they were sitting. Alternate occlusions of the bilateral thigh cuffs administered at the frequency of the mean heart rate produced significant phase synchronization between the cardiac and cuff-occlusion rhythms when 120 mmHg pressure was applied. However, synchronization was not observed when the occlusion pressure was 50 or 80 mmHg. During synchronization, heartbeats were most likely to occur in phases that did not include overlap between the peak arterial flow velocity in the thigh and elevated cuff pressure. We believe that phase synchronization occurs so that the cardiac cycle is timed to deliver blood through the lower legs when IMP is not maximal. If this can be extrapolated to natural locomotion, synchronization between cardiac and locomotor activities may be associated with the improved perfusion of exercising muscles.

  13. Inter-subject synchronization of brain responses during natural music listening.

    PubMed

    Abrams, Daniel A; Ryali, Srikanth; Chen, Tianwen; Chordia, Parag; Khouzam, Amirah; Levitin, Daniel J; Menon, Vinod

    2013-05-01

    Music is a cultural universal and a rich part of the human experience. However, little is known about common brain systems that support the processing and integration of extended, naturalistic 'real-world' music stimuli. We examined this question by presenting extended excerpts of symphonic music, and two pseudomusical stimuli in which the temporal and spectral structure of the Natural Music condition were disrupted, to non-musician participants undergoing functional brain imaging and analysing synchronized spatiotemporal activity patterns between listeners. We found that music synchronizes brain responses across listeners in bilateral auditory midbrain and thalamus, primary auditory and auditory association cortex, right-lateralized structures in frontal and parietal cortex, and motor planning regions of the brain. These effects were greater for natural music compared to the pseudo-musical control conditions. Remarkably, inter-subject synchronization in the inferior colliculus and medial geniculate nucleus was also greater for the natural music condition, indicating that synchronization at these early stages of auditory processing is not simply driven by spectro-temporal features of the stimulus. Increased synchronization during music listening was also evident in a right-hemisphere fronto-parietal attention network and bilateral cortical regions involved in motor planning. While these brain structures have previously been implicated in various aspects of musical processing, our results are the first to show that these regions track structural elements of a musical stimulus over extended time periods lasting minutes. Our results show that a hierarchical distributed network is synchronized between individuals during the processing of extended musical sequences, and provide new insight into the temporal integration of complex and biologically salient auditory sequences.

  14. Myoepithelial carcinoma with contralateral invasive micropapillary carcinoma of the breast.

    PubMed

    Kwon, Sun Young; Bae, Young Kyung; Cho, Jihyong; Kang, Sun Hee

    2011-09-01

    Adenomyoepithelioma (AME) is a rare benign tumor composed of myoepithelial cells (MECs) which are located beneath the epithelial cells of exocrine glands, especially in breast and salivary glands. These tumor cells show biphasic proliferation of epithelial and MECs. Malignant AME is characterized by distant metastasis, local recurrence, cytologic atypia, high mitotic activity and infiltrating tumor margins. A 51-year-old woman presented with an 8 months growth in the left breast. She underwent core-needle biopsy and consecutively mammotome assisted biopsy at a local clinic. After resection, she complained about re-growing remnant lesion and a newly developed solid mass in the right breast. Finally, the remnant mass in the left breast was diagnosed with myoepithelial carcinoma. Concurrently, contralateral breast mass was diagnosed with invasive micropapillary carcinoma. Herein we report an unusual case of synchronous myoepithelial carcinoma and invasive micropapillary carcinoma of the breast with a review of literatures.

  15. Preoperative Breast Magnetic Resonance Imaging and Contralateral Breast Cancer Occurrence Among Older Women With Breast Cancer

    PubMed Central

    Long, Jessica B.; Killelea, Brigid K.; Evans, Suzanne B.; Roberts, Kenneth B.; Silber, Andrea; Gross, Cary P.

    2016-01-01

    Purpose Preoperative magnetic resonance imaging (MRI) detects occult contralateral breast cancers (CBCs) in women with breast cancer, but the impact of detection on long-term CBC events is unclear. We examined whether MRI use decreases the occurrence of CBCs and the detection of stages II to IV disease among women who develop a CBC. Patients and Methods Analyzing the SEER-Medicare database, we assessed overall, synchronous (< 6 months after primary cancer diagnosis), and subsequent (ie, metachronous) stage-specific CBC occurrences in women who were diagnosed with stages I and II breast cancer during 2004-2009 and who were observed through 2011. Results Among 38,971 women with breast cancer, 6,377 (16.4%) received preoperative MRI. After propensity score matching, and compared with women who did not undergo MRI, preoperative MRI use was significantly associated with a higher synchronous CBC detection rate (126.4 v 42.9 per 1,000 person-years, respectively; hazard ratio, 2.85; P < .001) but a lower subsequent CBC detection rate (3.3 v 4.5 per 1,000 person-years, respectively; hazard ratio, 0.68; P = .002). However, the 5-year cumulative incidence of CBC remained significantly higher among women undergoing MRI compared with those not undergoing MRI (7.2% v 4.0%, respectively; P < .001). The analyses of projected CBC events for 10,000 patients who receive MRI indicated that, after a 5-year follow-up, MRI use would detect an additional 192 in situ CBCs (95% CI, 125 to 279) and 120 stage I CBCs (95% CI, 62 to 193) but would not have a significant impact on stages II to IV CBC occurrences (∼ 6; 95% CI, −21 to 47). Conclusion An increased synchronous CBC detection rate, attributable to MRI, was not offset by a decrease of subsequent CBC occurrence among older women with early-stage breast cancer, suggesting that preoperative MRI in women with breast cancer may lead to overdiagnosis. PMID:26628465

  16. How Synchronization Protects from Noise

    PubMed Central

    Tabareau, Nicolas; Slotine, Jean-Jacques; Pham, Quang-Cuong

    2010-01-01

    The functional role of synchronization has attracted much interest and debate: in particular, synchronization may allow distant sites in the brain to communicate and cooperate with each other, and therefore may play a role in temporal binding, in attention or in sensory-motor integration mechanisms. In this article, we study another role for synchronization: the so-called “collective enhancement of precision”. We argue, in a full nonlinear dynamical context, that synchronization may help protect interconnected neurons from the influence of random perturbations—intrinsic neuronal noise—which affect all neurons in the nervous system. More precisely, our main contribution is a mathematical proof that, under specific, quantified conditions, the impact of noise on individual interconnected systems and on their spatial mean can essentially be cancelled through synchronization. This property then allows reliable computations to be carried out even in the presence of significant noise (as experimentally found e.g., in retinal ganglion cells in primates). This in turn is key to obtaining meaningful downstream signals, whether in terms of precisely-timed interaction (temporal coding), population coding, or frequency coding. Similar concepts may be applicable to questions of noise and variability in systems biology. PMID:20090826

  17. Bodily synchronization underlying joke telling

    PubMed Central

    Schmidt, R. C.; Nie, Lin; Franco, Alison; Richardson, Michael J.

    2014-01-01

    Advances in video and time series analysis have greatly enhanced our ability to study the bodily synchronization that occurs in natural interactions. Past research has demonstrated that the behavioral synchronization involved in social interactions is similar to dynamical synchronization found generically in nature. The present study investigated how the bodily synchronization in a joke telling task is spread across different nested temporal scales. Pairs of participants enacted knock–knock jokes and times series of their bodily activity were recorded. Coherence and relative phase analyses were used to evaluate the synchronization of bodily rhythms for the whole trial as well as at the subsidiary time scales of the whole joke, the setup of the punch line, the two-person exchange and the utterance. The analyses revealed greater than chance entrainment of the joke teller’s and joke responder’s movements at all time scales and that the relative phasing of the teller’s movements led those of the responder at the longer time scales. Moreover, this entrainment was greater when visual information about the partner’s movements was present but was decreased particularly at the shorter time scales when explicit gesturing in telling the joke was performed. In short, the results demonstrate that a complex interpersonal bodily “dance” occurs during structured conversation interactions and that this “dance” is constructed from a set of rhythms associated with the nested behavioral structure of the interaction. PMID:25177287

  18. Remote synchronization in star networks.

    PubMed

    Bergner, A; Frasca, M; Sciuto, G; Buscarino, A; Ngamga, E J; Fortuna, L; Kurths, J

    2012-02-01

    We study phase synchronization in a network motif with a starlike structure in which the central node's (the hub's) frequency is strongly detuned against the other peripheral nodes. We find numerically and experimentally a regime of remote synchronization (RS), where the peripheral nodes form a phase synchronized cluster, while the hub remains free with its own dynamics and serves just as a transmitter for the other nodes. We explain the mechanism for this RS by the existence of a free amplitude and also show that systems with a fixed or constant amplitude, such as the classic Kuramoto phase oscillator, are not able to generate this phenomenon. Further, we derive an analytic expression which supports our explanation of the mechanism.

  19. Cluster synchronization in oscillatory networks

    NASA Astrophysics Data System (ADS)

    Belykh, Vladimir N.; Osipov, Grigory V.; Petrov, Valentin S.; Suykens, Johan A. K.; Vandewalle, Joos

    2008-09-01

    Synchronous behavior in networks of coupled oscillators is a commonly observed phenomenon attracting a growing interest in physics, biology, communication, and other fields of science and technology. Besides global synchronization, one can also observe splitting of the full network into several clusters of mutually synchronized oscillators. In this paper, we study the conditions for such cluster partitioning into ensembles for the case of identical chaotic systems. We focus mainly on the existence and the stability of unique unconditional clusters whose rise does not depend on the origin of the other clusters. Also, conditional clusters in arrays of globally nonsymmetrically coupled identical chaotic oscillators are investigated. The design problem of organizing clusters into a given configuration is discussed.

  20. Chaotic synchronization system and electrocardiogram

    NASA Astrophysics Data System (ADS)

    Pei, Liuqing; Dai, Xinlai; Li, Baodong

    1997-01-01

    A mathematical model of chaotic synchronization of the heart-blood flow coupling dynamics is proposed, which is based on a seven dimension nonlinear dynamical system constructed by three subsystems of the sinoatrial node natural pacemaker, the cardiac relaxation oscillator and the dynamics of blood-fluid in heart chambers. The existence and robustness of the self-chaotic synchronization of the system are demonstrated by both methods of theoretical analysis and numerical simulation. The spectrum of Lyapunov exponent, the Lyapunov dimension and the Kolmogorov entropy are estimated when the system was undergoing the state of self-chaotic synchronization evolution. The time waveform of the dynamical variable, which represents the membrane potential of the cardiac integrative cell, shows a shape which is similar to that of the normal electrocardiogram (ECG) of human, thus implies that the model possesses physiological significance functionally.

  1. Digital data detection and synchronization

    NASA Technical Reports Server (NTRS)

    Noack, T. L.; Morris, J. F.

    1973-01-01

    The primary accomplishments have been in the analysis and simulation of receivers and bit synchronizers. It has been discovered that tracking rate effects play, a rather fundamental role in both receiver and synchronizer performance, but that data relating to recorder time-base-error, for the proper characterization of this phenomenon, is in rather short supply. It is possible to obtain operationally useful tape recorder time-base-error data from high signal-to-noise ratio tapes using synchronizers with relatively wideband tracking loops. Low signal-to-noise ratio tapes examined in the same way would not be synchronizable. Additional areas of interest covered are receiver false lock, cycle slipping, and other unusual phenomena, which have been described to some extent in this and earlier reports and simulated during the study.

  2. Breast Feeding.

    ERIC Educational Resources Information Center

    International Children's Centre, Paris (France).

    This set of documents consists of English, French, and Spanish translations of four pamphlets on breast-feeding. The pamphlets provide information designed for lay persons, academics and professionals, health personnel and educators, and policy-makers. The contents cover health-related differences between breast and bottle milk; patterns of…

  3. State observer for synchronous motors

    DOEpatents

    Lang, Jeffrey H.

    1994-03-22

    A state observer driven by measurements of phase voltages and currents for estimating the angular orientation of a rotor of a synchronous motor such as a variable reluctance motor (VRM). Phase voltages and currents are detected and serve as inputs to a state observer. The state observer includes a mathematical model of the electromechanical operation of the synchronous motor. The characteristics of the state observer are selected so that the observer estimates converge to the actual rotor angular orientation and velocity, winding phase flux linkages or currents.

  4. Synchronization with sound propagation delays

    NASA Astrophysics Data System (ADS)

    Haché, A.

    2010-04-01

    Complex systems that synchronize with acoustic signals, like chanting crowds and musical ensembles, have the intrinsic ability to maintain synchrony without external aid or visual cues, even when spread over wide areas. According to two models, the counterintuitive self-synchronization happens when the system's components have a spatial distribution that is sufficiently uniform. The roles of system size and density are examined for arrangements in 1, 2 and 3 dimensions. Asynchrony is predicted to become vanishingly small at high densities, and results suggest ways on how to minimize asynchrony in real-world situations.

  5. Optimized multiparty quantum clock synchronization

    SciTech Connect

    Ben-Av, Radel; Exman, Iaakov

    2011-07-15

    A multiparty protocol for distributed quantum clock synchronization has been claimed to provide universal limits on the clock accuracy, viz., that accuracy monotonically decreases with the number n of party members. But this is only true for synchronization when one limits oneself to W states. This work shows that the usage of Z (Symmetric Dicke) states, a generalization of W states, results in improved accuracy, having a maximum when Left-Floor n/2 Right-Floor of its members have their qubits with a |1> eigenstate.

  6. Bilateral self-inflicted infectious dacryoadenitis.

    PubMed

    Latasiewicz, Marta; Chang-Sotomayor, Meilin; Alonso-Caldarelli, Claudia; Farias-Plazas, Fabian; Leszczynska, Anna; Gonzalez-Candial, Miguel

    2014-12-01

    The aim of this report is to present a case of a patient with bilateral lacrimal gland abscesses in the course of dacryoadenitis. A 45-year-old female patient with a long history of cocaine abuse presented with bilateral bacterial dacryoadenitis and upper lid inflammation with purulent discharge from a palpebral wound of the right upper lid. The diagnosis was confirmed with microbiology culture and an orbital CT scan, which revealed lacrimal gland abscesses. The patient admitted to vigorous eye scratching, which we believe was the mechanism responsible for the process. The infection resolved on targeted antibiotic therapy. This is the first reported case of bilateral infectious dacryoadenitis produced in a self-inflicted mechanism in a cocaine addict. PMID:25208047

  7. Bilateral Sequential Pneumolabyrinth Resulting from Nose Blowing

    PubMed Central

    Lee, Joong Seob; Kwon, Sae Young; Kim, Ji Heui

    2015-01-01

    Pneumolabyrinth describes a condition with entrapped air in the labyrinth and usually occurs in temporal bone fractures that involve the otic capsule. While sporadic cases of bilateral pneumolabyrinth have been reported, cases lacking head trauma are very rare. We report the case of a 43-year-old man who had sudden hearing loss bilaterally after blowing his nose at an interval of 1 year. Although conservative management for the right ear and exploratory tympanotomy with sealing of the possible site of perilymphatic leakage in the left ear were performed, hearing outcome was poor in both ears. To our knowledge, this is the first case of bilateral pneumolabyrinth occurring as a result of nose blowing. PMID:26771019

  8. Bilateral Sequential Pneumolabyrinth Resulting from Nose Blowing.

    PubMed

    Lee, Joong Seob; Kwon, Sae Young; Kim, Ji Heui; Kim, Hyung-Jong

    2015-12-01

    Pneumolabyrinth describes a condition with entrapped air in the labyrinth and usually occurs in temporal bone fractures that involve the otic capsule. While sporadic cases of bilateral pneumolabyrinth have been reported, cases lacking head trauma are very rare. We report the case of a 43-year-old man who had sudden hearing loss bilaterally after blowing his nose at an interval of 1 year. Although conservative management for the right ear and exploratory tympanotomy with sealing of the possible site of perilymphatic leakage in the left ear were performed, hearing outcome was poor in both ears. To our knowledge, this is the first case of bilateral pneumolabyrinth occurring as a result of nose blowing. PMID:26771019

  9. Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy.

    PubMed

    Coulson, Susan E; O'Dwyer, Nicholas J; Adams, Roger D; Croxson, Glen R

    2006-08-01

    Voluntary eyelid closure and smiling were studied in 11 normal subjects and 11 patients with long-term unilateral facial nerve palsy (FNP). The conjugacy of eyelid movements shown previously for blinks was maintained for voluntary eye closures in normal subjects, with movement onset being synchronous in both eyes. Bilateral onset synchrony of the sides of the mouth was also observed in smiling movements in normal subjects. In FNP patients, initiation of movement of the paretic and non-paretic eyelids was also synchronous, but markedly delayed relative to normal (by 136 ms = 32%). The initiation of bilateral movements at the mouth was similarly delayed, but in contrast to the eyes, it was not synchronous. Central neural processing in the FNP subjects was normal, however, since unilateral movements at the mouth were not delayed. The delays therefore point to considerable additional information processing needed for initiating bilateral facial movements after FNP. The maintenance of bilateral onset synchrony in eyelid closure and its loss in smiling following FNP is an important difference in the neural control of these facial regions. Bilateral conjugacy of eyelid movements is probably crucial for coordinating visual input and was achieved apparently without conscious effort on the part of the patients. Bilateral conjugacy of movements at the sides of the mouth may be less critical for normal function, although patients would very much like to achieve it in order to improve the appearance of their smile. Since the everyday frequency of eyelid movements is considerably greater than that of smiling, it is possible that the preserved eyelid conjugacy in these patients with long-term FNP is merely a product of greater experience. However, if synchrony of movement onset is found to be preserved in patients with acute FNP, then it would suggest that eyelid conjugacy has a privileged status in the neural organisation of the face.

  10. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    SciTech Connect

    Kowalchik, Kristin V.; Vallow, Laura A.; McDonough, Michelle; Thomas, Colleen S.; Heckman, Michael G.; Peterson, Jennifer L.; Adkisson, Cameron D.; Serago, Christopher; McLaughlin, Sarah A.

    2013-09-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  11. [Bilateral choroidal osteoma--a case report].

    PubMed

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  12. Bilateral Atrial Myxoma: A Case Report.

    PubMed

    Susupaus, Attapoom; Foofuengmonkolkit, Kumpoo

    2016-02-01

    Among the rare cardiac tumors, myxoma, which is mostly located in the left atrium, is the most common type. Bilateral atrial myxoma is extremely rare, and requires urgent surgery. The authors report the case of a 34-year-old male, who presented with one month of right hemiparesis and aphasia and subsequently diagnosed with bilateral atrial myxoma based on transthoracic echocardiography. An urgent operation for intra-cardiac tumor removal was performed with the biatrial approach. Once a diagnosis of myxoma has been made, an urgent operation for tumor removal is necessary due to the risk of serious complications, including sudden death from normal blood flow obstruction. PMID:27266240

  13. Inducing comprehension in the bilateral poor reader.

    PubMed

    Rattan, G; Dean, R S; Lowrie, R E

    1987-09-01

    The comprehension effects of changes in the spatial configuration of prose were examined with reading disabled children who differed in laterality preference. Specifically, 24 learning disabled boys were presented with prose materials in a standard, phrased, and backward (right to left) fashion. Measures of comprehension showed that text in the phrased and backward conditions differentially facilitated comprehension for the more bilateral subjects but had little effect on more right lateralized subjects. The results were discussed in terms of the instructional implications of alterations in the visual-spatial arrangement of prose materials for bilateral readers.

  14. Fermi Timing and Synchronization System

    SciTech Connect

    Wilcox, R.; Staples, J.; Doolittle, L.; Byrd, J.; Ratti, A.; Kaertner, F.X.; Kim, J.; Chen, J.; Ilday, F.O.; Ludwig, F.; Winter, A.; Ferianis, M.; Danailov, M.; D'Auria, G.

    2006-07-19

    The Fermi FEL will depend critically on precise timing of its RF, laser and diagnostic subsystems. The timing subsystem to coordinate these functions will need to reliably maintain sub-100fs synchronicity between distant points up to 300m apart in the Fermi facility. The technology to do this is not commercially available, and has not been experimentally demonstrated in a working facility. Therefore, new technology must be developed to meet these needs. Two approaches have been researched by different groups working with the Fermi staff. At MIT, a pulse transmission scheme has been developed for synchronization of RF and laser devices. And at LBL, a CW transmission scheme has been developed for RF and laser synchronization. These respective schemes have advantages and disadvantages that will become better understood in coming years. This document presents the work done by both teams, and suggests a possible system design which integrates them both. The integrated system design provides an example of how choices can be made between the different approaches without significantly changing the basic infrastructure of the system. Overall system issues common to any synchronization scheme are also discussed.

  15. Synchronization by elastic neuronal latencies

    NASA Astrophysics Data System (ADS)

    Vardi, Roni; Timor, Reut; Marom, Shimon; Abeles, Moshe; Kanter, Ido

    2013-01-01

    Psychological and physiological considerations entail that formation and functionality of neuronal cell assemblies depend upon synchronized repeated activation such as zero-lag synchronization. Several mechanisms for the emergence of this phenomenon have been suggested, including the global network quantity, the greatest common divisor of neuronal circuit delay loops. However, they require strict biological prerequisites such as precisely matched delays and connectivity, and synchronization is represented as a stationary mode of activity instead of a transient phenomenon. Here we show that the unavoidable increase in neuronal response latency to ongoing stimulation serves as a nonuniform gradual stretching of neuronal circuit delay loops. This apparent nuisance is revealed to be an essential mechanism in various types of neuronal time controllers, where synchronization emerges as a transient phenomenon and without predefined precisely matched synaptic delays. These findings are described in an experimental procedure where conditioned stimulations were enforced on a circuit of neurons embedded within a large-scale network of cortical cells in vitro, and are corroborated and extended by simulations of circuits composed of Hodgkin-Huxley neurons with time-dependent latencies. These findings announce a cortical time scale for time controllers based on tens of microseconds stretching of neuronal circuit delay loops per spike. They call for a reexamination of the role of the temporal periodic mode in brain functionality using advanced in vitro and in vivo experiments.

  16. Tweaking synchronization by connectivity modifications

    NASA Astrophysics Data System (ADS)

    Schultz, Paul; Peron, Thomas; Eroglu, Deniz; Stemler, Thomas; Ramírez Ávila, Gonzalo Marcelo; Rodrigues, Francisco A.; Kurths, Jürgen

    2016-06-01

    Natural and man-made networks often possess locally treelike substructures. Taking such tree networks as our starting point, we show how the addition of links changes the synchronization properties of the network. We focus on two different methods of link addition. The first method adds single links that create cycles of a well-defined length. Following a topological approach, we introduce cycles of varying length and analyze how this feature, as well as the position in the network, alters the synchronous behavior. We show that in particular short cycles can lead to a maximum change of the Laplacian's eigenvalue spectrum, dictating the synchronization properties of such networks. The second method connects a certain proportion of the initially unconnected nodes. We simulate dynamical systems on these network topologies, with the nodes' local dynamics being either discrete or continuous. Here our main result is that a certain number of additional links, with the relative position in the network being crucial, can be beneficial to ensure stable synchronization.

  17. Tweaking synchronization by connectivity modifications.

    PubMed

    Schultz, Paul; Peron, Thomas; Eroglu, Deniz; Stemler, Thomas; Ramírez Ávila, Gonzalo Marcelo; Rodrigues, Francisco A; Kurths, Jürgen

    2016-06-01

    Natural and man-made networks often possess locally treelike substructures. Taking such tree networks as our starting point, we show how the addition of links changes the synchronization properties of the network. We focus on two different methods of link addition. The first method adds single links that create cycles of a well-defined length. Following a topological approach, we introduce cycles of varying length and analyze how this feature, as well as the position in the network, alters the synchronous behavior. We show that in particular short cycles can lead to a maximum change of the Laplacian's eigenvalue spectrum, dictating the synchronization properties of such networks. The second method connects a certain proportion of the initially unconnected nodes. We simulate dynamical systems on these network topologies, with the nodes' local dynamics being either discrete or continuous. Here our main result is that a certain number of additional links, with the relative position in the network being crucial, can be beneficial to ensure stable synchronization.

  18. Tweaking synchronization by connectivity modifications.

    PubMed

    Schultz, Paul; Peron, Thomas; Eroglu, Deniz; Stemler, Thomas; Ramírez Ávila, Gonzalo Marcelo; Rodrigues, Francisco A; Kurths, Jürgen

    2016-06-01

    Natural and man-made networks often possess locally treelike substructures. Taking such tree networks as our starting point, we show how the addition of links changes the synchronization properties of the network. We focus on two different methods of link addition. The first method adds single links that create cycles of a well-defined length. Following a topological approach, we introduce cycles of varying length and analyze how this feature, as well as the position in the network, alters the synchronous behavior. We show that in particular short cycles can lead to a maximum change of the Laplacian's eigenvalue spectrum, dictating the synchronization properties of such networks. The second method connects a certain proportion of the initially unconnected nodes. We simulate dynamical systems on these network topologies, with the nodes' local dynamics being either discrete or continuous. Here our main result is that a certain number of additional links, with the relative position in the network being crucial, can be beneficial to ensure stable synchronization. PMID:27415259

  19. PCM synchronization by word stuffing

    NASA Technical Reports Server (NTRS)

    Butman, S.

    1969-01-01

    When a transmitted word, consisting of a number of pulses, is detected and removed from the data stream, the space left by the removal is eliminated by a memory buffer. This eliminates the need for a clock synchronizer thereby removing instability problems.

  20. Sports Medicine Meets Synchronized Swimming.

    ERIC Educational Resources Information Center

    Wenz, Betty J.; And Others

    This collection of articles contains information about synchronized swimming. Topics covered include general physiology and cardiovascular conditioning, flexibility exercises, body composition, strength training, nutrition, coach-athlete relationships, coping with competition stress and performance anxiety, and eye care. Chapters are included on…

  1. Speed control for synchronous motors

    NASA Technical Reports Server (NTRS)

    Packard, H.; Schott, J.

    1981-01-01

    Feedback circuit controls fluctuations in speed of synchronous ac motor. Voltage proportional to phase angle is developed by phase detector, rectified, amplified, compared to threshold, and reapplied positively or negatively to motor excitation circuit. Speed control reduces wow and flutter of audio turntables and tape recorders, and enhances hunting in gyroscope motors.

  2. Subthalamic stimulation modulates cortical motor network activity and synchronization in Parkinson’s disease

    PubMed Central

    Klotz, Rosa; Govindan, Rathinaswamy B.; Scholten, Marlieke; Naros, Georgios; Ramos-Murguialday, Ander; Bunjes, Friedemann; Meisner, Christoph; Plewnia, Christian; Krüger, Rejko

    2015-01-01

    Dynamic modulations of large-scale network activity and synchronization are inherent to a broad spectrum of cognitive processes and are disturbed in neuropsychiatric conditions including Parkinson’s disease. Here, we set out to address the motor network activity and synchronization in Parkinson’s disease and its modulation with subthalamic stimulation. To this end, 20 patients with idiopathic Parkinson’s disease with subthalamic nucleus stimulation were analysed on externally cued right hand finger movements with 1.5-s interstimulus interval. Simultaneous recordings were obtained from electromyography on antagonistic muscles (right flexor digitorum and extensor digitorum) together with 64-channel electroencephalography. Time-frequency event-related spectral perturbations were assessed to determine cortical and muscular activity. Next, cross-spectra in the time-frequency domain were analysed to explore the cortico-cortical synchronization. The time-frequency modulations enabled us to select a time-frequency range relevant for motor processing. On these time-frequency windows, we developed an extension of the phase synchronization index to quantify the global cortico-cortical synchronization and to obtain topographic differentiations of distinct electrode sites with respect to their contributions to the global phase synchronization index. The spectral measures were used to predict clinical and reaction time outcome using regression analysis. We found that movement-related desynchronization of cortical activity in the upper alpha and beta range was significantly facilitated with ‘stimulation on’ compared to ‘stimulation off’ on electrodes over the bilateral parietal, sensorimotor, premotor, supplementary-motor, and prefrontal areas, including the bilateral inferior prefrontal areas. These spectral modulations enabled us to predict both clinical and reaction time improvement from subthalamic stimulation. With ‘stimulation on’, interhemispheric cortico

  3. Bilateral Poly Implant Prothèse Implant Rupture: An Uncommon Presentation

    PubMed Central

    Mallon, Peter; Ganachaud, François; Malhaire, Caroline; Brunel, Raphael; Sigal-Zafrani, Brigitte; Feron, Jean-Guillaume; Couturaud, Benoit; Fitoussi, Alfred

    2013-01-01

    Summary: A woman in her 50s underwent delayed bilateral Poly Implant Prothèse implant reconstruction following mastectomy for breast cancer. Symptoms of implant rupture developed 43 months after surgery with an erythematous rash on her trunk. The rash then spread to her reconstructed breast mounds. Initial ultrasound scan and magnetic resonance imaging were normal; however, subsequent magnetic resonance imaging demonstrated left implant rupture only. In theater, following removal of both implants, both were found to be ruptured. The rash on her trunk resolved within 3 weeks in the postoperative period. Chemical analyses of silicone in both implants confirmed a nonauthorized silicone source; in addition, the chemical structure was significantly different between the left and right implant, perhaps explaining the variation in presentation. PMID:25289223

  4. Sensorimotor Synchronization across the Life Span

    ERIC Educational Resources Information Center

    Drewing, Knut; Aschersleben, Gisa; Li, Shu-Chen

    2006-01-01

    The present study investigates the contribution of general processing resources as well as other more specific factors to the life-span development of sensorimotor synchronization and its component processes. Within a synchronization tapping paradigm, a group of 286 participants, 6 to 88 years of age, were asked to synchronize finger taps with…

  5. High speed synchronizer card utilizing VLSI technology

    NASA Technical Reports Server (NTRS)

    Speciale, Nicholas; Wunderlich, Kristin

    1988-01-01

    A generic synchronizer card capable of providing standard NASA communication block telemetry frame synchronization and quality control was fabricated using VLSI technology. Four VLSI chip sets are utilized to shrink all the required functions into a single synchronizer card. The application of VLSI technology to telemetry systems resulted in an increase in performance and a decrease in cost and size.

  6. Delay synchronization of temporal Boolean networks

    NASA Astrophysics Data System (ADS)

    Wei, Qiang; Xie, Cheng-jun; Liang, Yi; Niu, Yu-jun; Lin, Da

    2016-01-01

    This paper investigates the delay synchronization between two temporal Boolean networks base on semi-tensor product method, which improve complete synchronization. Necessary and sufficient conditions for delay synchronization are drawn base on algebraic expression of temporal Boolean networks. A example is presented to show the effectiveness of theoretical analysis.

  7. Varicosity of a single breast: a rare entity

    PubMed Central

    Jain, Vinod; Misra, Samir; Jaiswal, Vaibhav; Singh, Saumya

    2014-01-01

    Varicosity of the breasts is a rare clinical entity that may lead to symptoms such as prominent vascular markings over the breasts and may be painless; in long-standing cases it can lead to recurrent bleeding episodes. Bilateral venous affection in the breasts has been described in the literature; however, unilateral affection is a rarely documented phenomenon. Since vascular affliction of a single breast is rare and there is inherent difficulty in obtaining a histopathological diagnosis against a background of suspicion of malignancy, it is always challenging to provide optimal management to the patient. We are reporting a rare case of a 42-year-old, postmenopausal Indian woman with a long-standing history of unilateral varicosity of the left breast, who was treated successfully with a simple mastectomy; postoperative histopathology was consistent with benign vascular lesion, that is, angiomatosis. PMID:25240001

  8. Breast Cancer Overview

    MedlinePlus

    ... Breast Cancer - Overview Request Permissions Print to PDF Breast Cancer - Overview Approved by the Cancer.Net Editorial Board , ... bean-shaped organs that help fight infection. About breast cancer Cancer begins when healthy cells in the breast ...

  9. Surgery for Breast Cancer

    MedlinePlus

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  10. Learning about Breast Cancer

    MedlinePlus

    ... genetic terms used on this page Learning About Breast Cancer What do we know about heredity and breast ... Cancer What do we know about heredity and breast cancer? Breast cancer is a common disease. Each year, ...

  11. Fibrocystic breast disease

    MedlinePlus

    Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes ... FF, Fort GG, et al, eds. Fibrocystic breast disease. In: Ferri FF, ed. Ferri's Clinical Advisor 2015 . ...

  12. Premenstrual breast changes

    MedlinePlus

    Premenstrual tenderness and swelling of the breasts; Breast tenderness - premenstrual; Breast swelling - premenstrual ... Symptoms of premenstrual breast tenderness may range from mild to ... most severe just before each menstrual period Improve during ...

  13. Breast enlargement in males

    MedlinePlus

    Gynecomastia; Breast enlargement in a male ... The condition may occur in one or both breasts. It begins as a small lump beneath the nipple, which may be tender. One breast may be larger than the other. Enlarged breasts ...

  14. The right hippocampus leads the bilateral integration of gamma-parsed lateralized information

    PubMed Central

    Benito, Nuria; Martín-Vázquez, Gonzalo; Makarova, Julia; Makarov, Valeri A; Herreras, Oscar

    2016-01-01

    It is unclear whether the two hippocampal lobes convey similar or different activities and how they cooperate. Spatial discrimination of electric fields in anesthetized rats allowed us to compare the pathway-specific field potentials corresponding to the gamma-paced CA3 output (CA1 Schaffer potentials) and CA3 somatic inhibition within and between sides. Bilateral excitatory Schaffer gamma waves are generally larger and lead from the right hemisphere with only moderate covariation of amplitude, and drive CA1 pyramidal units more strongly than unilateral waves. CA3 waves lock to the ipsilateral Schaffer potentials, although bilateral coherence was weak. Notably, Schaffer activity may run laterally, as seen after the disruption of the connecting pathways. Thus, asymmetric operations promote the entrainment of CA3-autonomous gamma oscillators bilaterally, synchronizing lateralized gamma strings to converge optimally on CA1 targets. The findings support the view that interhippocampal connections integrate different aspects of information that flow through the left and right lobes. DOI: http://dx.doi.org/10.7554/eLife.16658.001 PMID:27599221

  15. Bilateral dacryoceles associated with bilateral alacrimia with punctal and canalicular agenesis

    PubMed Central

    Gupta, Himika; Kane, Shubhada; Balasubramaniam, Vidyashankar

    2013-01-01

    To report a rare case of a 19 year old female presenting with bilateral dacryocele and punctal and canalicular agenesis without epiphora. After clinical and radiological examination, the patient was found to have bilateral lacrimal gland agenesis as well. No other dental, otological or systemic abnormality suggestive of lacrimo-auricular-dento-digital syndrome was detected. She was managed with bilateral dacryocystectomy. Algorithm for managing such nonconventional lacrimal outflow dysgenesis based on presenting symptoms and co existing epiphora is proposed. Rationale of preferring lacrimal sac excision instead of dacryocystorhinostomy in this case is also discussed. PMID:24526864

  16. Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993-2001.

    PubMed

    Robinson, Whitney R; Nichols, Hazel B; Tse, Chiu Kit; Olshan, Andrew F; Troester, Melissa A

    2016-09-01

    Black women experience higher rates of hysterectomy than other women in the United States. Although research indicates that premenopausal hysterectomy with bilateral oophorectomy decreases the risk of breast cancer in black women, it remains unclear how hysterectomy without ovary removal affects risk, whether menopausal hormone therapy use attenuates inverse associations, and whether associations vary by cancer subtype. In the population-based, case-control Carolina Breast Cancer Study of invasive breast cancer in 1,391 black (725 cases, 666 controls) and 1,727 white (939 cases, 788 controls) women in North Carolina (1993-2001), we investigated the associations of premenopausal hysterectomy and oophorectomy with breast cancer risk. Compared with no history of premenopausal surgery, bilateral oophorectomy and hysterectomy without oophorectomy were associated with lower odds of breast cancer (for bilateral oophorectomy, multivariable-adjusted odds ratios = 0.60, 95% confidence interval: 0.47, 0.77; for hysterectomy without oophorectomy, multivariable-adjusted odds ratios = 0.68, 95% confidence interval: 0.55, 0.84). Estimates did not vary by race and were similar for hormone receptor-positive and hormone receptor-negative cancers. Use of estrogen-only menopausal hormone therapy did not attenuate the associations. Premenopausal hysterectomy, even without ovary removal, may reduce the long-term risk of hormone receptor-positive and hormone receptor-negative breast cancers. Varying rates of hysterectomy are a potentially important contributor to differences in breast cancer incidence among racial/ethnic groups. PMID:27555487

  17. Bilateral renal agenesis in an alpaca cria

    PubMed Central

    Gerard, Mathew P.; Spaulding, Kathy A.; Geissler, Kyleigh A.; Anderson, Kevin L.

    2006-01-01

    Abstract A 3-day-old male alpaca cria was presented for lack of vigor and failure to urinate since birth. Based on the history, laboratory data, ultrasonographs, surgical findings, and postmortem examination, the cria was diagnosed with bilateral renal agenesis and hypoplastic bladder, a congenital condition rarely seen in veterinary medicine. PMID:16579043

  18. Bilateral low condylectomy of the mandible.

    PubMed

    Worthington, P

    1980-03-01

    The operation of low condylectomy of the mandible is seldom performed bilaterally. The indications and consequences are reviewed, and a case is reported in which the adverse sequelae commonly attributed to this procedure were avoided over an 11-year follow-up period. PMID:6928301

  19. [Congenital lumbar hernia and bilateral renal agenesis].

    PubMed

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia. PMID:17650728

  20. Bilateral maxillary paramolars: a case report.

    PubMed

    Dhull, Kanika Singh; Acharya, Sonu; Ray, Prayas; Yadav, Shweta; Prabhakaran, Sheeja Devi

    2012-01-01

    Supernumerary teeth are a common clinical and radiographic finding and may produce occlusal and dental problems. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. The purpose of this paper was to present a case of supernumerary teeth located in the maxillary molar region bilaterally. PMID:22828764

  1. Bilateral chylothorax, chylopericardium and chylous ascitis

    PubMed Central

    Kashyap, Anil; Mahajan, Vineet; Whig, Jagdeep; Gupta, Sushil

    2011-01-01

    Non-Hodgkin’s lymphoma (NHL) can commonly present as chylothorax and rarely as chylopericardium. Here we are presenting a case of a 21-years-old female with bilateral chylothorax, chylopericardium and chylous ascites all together finally diagnosed to have NHL as the etiology. To the best of our knowledge, it has been reported very infrequently. PMID:21712926

  2. "Ostrich sign" indicates bilateral vertebral artery dissection.

    PubMed

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign."

  3. Management of Bilateral Carotid Occlusive Disease

    PubMed Central

    Jadhav, Ashutosh P.; Ducruet, Andrew F.; Jankowitz, Brian T.; Jovin, Tudor G.

    2016-01-01

    Background Symptomatic bilateral internal carotid occlusive disease is a rare but potentially devastating entity. Medical therapy alone is associated with high rates of mortality and recurrent stroke. The optimal management of this disease remains poorly understood. Methods A retrospective review of a prospectively maintained database was conducted for patients who presented with an acute stroke in the setting of bilateral carotid occlusive disease between May and October 2013. Results We identified 3 patients. The admission National Institutes of Health Stroke Scale score ranged from 4 to 7. All patients had small- to moderate-sized infarcts in the anterior circulation on presentation. Angiography confirmed bilateral internal carotid occlusions with collateral filling via the posterior communicating artery and retrograde filling via external carotid artery supply to the ophthalmic artery. All patients were initially managed with permissive hypertension and anticoagulation followed by carotid angioplasty and stenting. At 1-year follow-up, all patients demonstrated a modified Rankin scale score of 0-1. Conclusions Carotid stenting may be a safe and effective therapy for patients presenting with symptomatic bilateral carotid occlusions. PMID:27051405

  4. A case of bilateral temporal lobe agenesis

    PubMed Central

    Lang, C; Lehrl, S; Huk, W

    1981-01-01

    A 76-year-old man with bilateral temporal lobe agenesis producing clinical features resembling the Robinson syndrome is described. The malformation was discovered during a routine CT examination after the appearance of a homonymous visual field defect. The patient was examined by (neuro) psychological testing. The findings are compared with other reported cases and discussed with regard to cerebral localisation. Images PMID:7288451

  5. Bilateral carpal tunnel syndrome in Graves' disease.

    PubMed

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  6. Fast and Provably Accurate Bilateral Filtering.

    PubMed

    Chaudhury, Kunal N; Dabhade, Swapnil D

    2016-06-01

    The bilateral filter is a non-linear filter that uses a range filter along with a spatial filter to perform edge-preserving smoothing of images. A direct computation of the bilateral filter requires O(S) operations per pixel, where S is the size of the support of the spatial filter. In this paper, we present a fast and provably accurate algorithm for approximating the bilateral filter when the range kernel is Gaussian. In particular, for box and Gaussian spatial filters, the proposed algorithm can cut down the complexity to O(1) per pixel for any arbitrary S . The algorithm has a simple implementation involving N+1 spatial filterings, where N is the approximation order. We give a detailed analysis of the filtering accuracy that can be achieved by the proposed approximation in relation to the target bilateral filter. This allows us to estimate the order N required to obtain a given accuracy. We also present comprehensive numerical results to demonstrate that the proposed algorithm is competitive with the state-of-the-art methods in terms of speed and accuracy. PMID:27093722

  7. [Congenital lumbar hernia and bilateral renal agenesis].

    PubMed

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  8. Bilateral subclavian steal syndrome with vertigo.

    PubMed

    Yamanaka, Toshiaki; Sawai, Yachiyo; Hosoi, Hiroshi

    2014-06-01

    Subclavian steal syndrome (SSS) is usually caused by unilateral subclavian artery (SA) occlusion, and bilateral SSS is very rare. Takayasu's arteritis (TA) is a chronic granulomatous form of vasculitis that affects the SA, most commonly in women aged 15-40 years. We report a rare case of bilateral SSS due to TA in a 52-year-old woman, who exhibited severe vertigo. Although her blood pressure was within the normal range and did not differ between her arms, Doppler ultrasonography revealed low antegrade blood flow in the right SA and retrograde flow in the left SA. Computed tomography angiography demonstrated complete obstruction of the bilateral SA proximal to the vertebral artery origin. The more marked decrease in the blood flow of the vertebrobasilar artery experienced in bilateral SSS compared with unilateral SSS is considered to have caused the severe rotatory vertigo in the present patient. Since the vascular conditions of TA progressively deteriorate, delayed diagnosis and treatment could result in poor outcomes and unfavorable prognosis. We suggest that SSS with TA might require an early detection and treatment as well as careful follow-up for preventing vertigo and other neurological deficits in the vertebrobasilar arterial region.

  9. Computed tomographic findings in bilateral adrenal tuberculosis

    SciTech Connect

    Wilms, G.E.; Baert, A.L.; Kint, E.J.; Pringot, J.H.; Goddeeris, P.G.

    1983-03-01

    The computed tomographic (CT) features of bilateral adrenal tuberculosis are reported in two cases that demonstrate two typical different clinical and morphological manifestations of the disease. The incidence and CT appearance of adrenal tuberculosis are discussed, with emphasis on differential diagnosis.

  10. Bilateral canalicular adenoma of the parotid gland.

    PubMed

    Liess, Benjamin D; Lane, Robert V; Frazier, Shellaine; Zitsch, Robert P

    2006-03-01

    Canalicular adenoma is a rare benign salivary gland tumor that occurs almost exclusively in the upper lip. Rarely, this benign tumor may occur multifocally in the oral cavity. We report a case of canalicular adenoma in bilateral parotid glands, discuss histological characteristics, and review this tumor.

  11. Bilateral nasolabial cysts: a case report.

    PubMed

    Lee, Jennifer; Christmas, Peter I

    2009-06-01

    The nasolabial cyst is one of the rarer soft tissue cysts, and presents beneath the alae of the nose. There have been few reports of an association between nasolabial cysts and dacryocystitis (an infection of the nasolacrimal sac). This case report describes a female who presented with bilateral nasolabial cysts and longstanding symptoms of epiphora (watery eye).

  12. Bilateral nonfistulous congenital coronary arterial aneurysms.

    PubMed

    Wilson, C S; Weaver, W F; Zeman, E D; Forker, A D

    1975-02-01

    A 15 year old boy collapsed and died after participating in a basketball game. Autopsy revealed bilateral congenital coronary arterial aneurysms. The diagnosis was made post mortem but, retrospectively, might have been suspected during life, even before angiography. The clues to the correct diagnosis were chest pain, a systolic and diastolic murmur and a mass on the right heart border in the chest roentgenogram.

  13. Breast ultrasound

    MedlinePlus

    Hacker NF, Friedland ML. Breast disease. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 30. Harvey ...

  14. Breast lift

    MedlinePlus Videos and Cool Tools

    ... are made to accommodate a higher position for the areola and nipple, as well as to remove excess skin and breast tissue. Stitches usually follow the circumference of the areola, the natural lower crease ...

  15. Breast cancer

    MedlinePlus

    ... drink per day (women at high risk for breast cancer should not drink alcohol at all) ... Services Task Force. Risk assessment, genetic counseling, and ... cancer treatment. Bethesda, MD: National Cancer Institute. Date ...

  16. Breast Density and Your Breast Mammogram Report

    MedlinePlus

    Breast Density and Your Mammogram Report Regular mammograms are the best way to find breast cancer early. But if ... But in some women, there’s little change. Breast density is very common, and is not abnormal. How ...

  17. Bilateral Choroidal Metastasis from Non-Small Cell Lung Cancer

    PubMed Central

    Namad, Tariq; Wang, Jiang; Tilton, Annemarie; Abdel Karim, Nagla

    2014-01-01

    Breast and lung cancers are the most common primary neoplasms to manifest with choroidal metastases. The incidence of choroidal metastases from metastatic lung cancer was reported to be 2–6.7%. We report a case of bilateral choroidal metastasis from non-small cell lung cancer. A 59-year-old Caucasian female patient, never a smoker, was diagnosed with stage IV lung adenocarcinoma metastatic to the pleura, bones, and the brain. Her initial scan of the chest showed innumerable soft tissue nodules and mediastinal adenopathy compatible with metastatic disease. Her initial brain MRI showed numerous small enhancing lesions consistent with extensive disease. Unfortunately, during her follow-up visits, she presented with bulge on her left eye. Simultaneously, her follow-up chest scan showed increase in the size of the lung nodules. She continued to have a reasonable performance status at that time, except for mild increase in her dyspnea. The choroidal metastases require a multidisciplinary care and should be among the differential patients with malignancy who present with ocular symptoms. PMID:25295203

  18. Bilateral Choroidal Metastases from Lung Adenocarcinoma: A Case Report

    PubMed Central

    Ergenc, Hasan; Onmez, Attila; Oymak, Ezgi; Tanriseven, Ramiser; Celik, Erkan; Onmez, Funda Ebru; Tamer, Ali; Baykara, Meltem

    2016-01-01

    The most common malignancy of the eye is metastatic tumors, with choroidal metastases being the majority of them. In women, breast cancer is the most common cause of orbital metastases, and in men, it is lung cancer. Despite the fact that there are efficient treatment options for orbital metastases, the benefit of procedures to detect choroidal metastases is debatable due to the quick progression and poor prognosis of lung cancer. In choroidal metastases resulting from lung cancer, patients are usually presented with decreased sight. Defects in the field of vision, flashes of light and floating bodies generally follow. Treatment options of choroidal metastases include many methods including laser photocoagulation, cryotherapy, chemotherapy, radiotherapy, surgical resection, enucleation and photodynamic therapy. There are reports emphasizing radiotherapy as the most efficient treatment option. In this case report, we sum up the case of a male patient presenting with blurry vision in both eyes, who was subsequently detected to have bilateral choroidal metastatic tumor and was diagnosed with primary lung adenocarcinoma.

  19. Increased cardiovascular mortality following early bilateral oophorectomy

    PubMed Central

    Rivera, Cathleen M.; Grossardt, Brandon R.; Rhodes, Deborah J.; Brown, Robert D.; Roger, Véronique L.; Melton, L. Joseph; Rocca, Walter A.

    2008-01-01

    Objective To investigate the mortality associated with cardiovascular diseases and the effect of estrogen treatment in women who underwent unilateral or bilateral oophorectomy before menopause. Design We conducted a cohort study with long-term follow-up of women in Olmsted County, MN, who underwent either unilateral or bilateral oophorectomy before the onset of menopause from 1950 through 1987. Each member of the oophorectomy cohort was matched by age to a referent woman from the same population who had not undergone any oophorectomy. We studied the mortality associated with cardiovascular disease in a total of 1,274 women with unilateral oophorectomy, 1,091 women with bilateral oophorectomy, and 2,383 referent women. Results Women who underwent unilateral oophorectomy experienced a reduced mortality associated with cardiovascular disease compared with referent women (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.67–0.99; P = 0.04). By contrast, women who underwent bilateral oophorectomy before age 45 years experienced an increased mortality associated with cardiovascular disease compared with referent women (HR, 1.44; 95% CI, 1.01–2.05; P = 0.04). Within this age stratum, the HR for mortality was significantly elevated in women who were not treated with estrogen through age 45 years or longer (HR, 1.84; 95% CI, 1.27–2.68; P = 0.001) but not in women treated (HR, 0.65; 95% CI, 0.30–1.41; P = 0.28; test of interaction, P = 0.01). Mortality was further increased after excluding deaths associated with cerebrovascular causes. Conclusions Bilateral oophorectomy performed before age 45 years is associated with increased cardiovascular mortality, especially with cardiac mortality. However, estrogen treatment may reduce this risk. PMID:19034050

  20. The emergence of synchronization behavior in Physarum polycephalum and its particle approximation.

    PubMed

    Tsuda, Soichiro; Jones, Jeff

    2011-03-01

    The regeneration process of contractile oscillation in the plasmodium of Physarum polycephalum is investigated experimentally and modelled computationally. When placed in a well, the Physarum cell restructures the body (fusion of small granule-like cells) and shows various complex oscillation patterns. After it completed the restructuring and regained synchronized oscillation within the body, the cell shows bilateral oscillation or rotating wave pattern. This regeneration process did not depend on the well size and all the cases tested here showed similar time course. Phase synchronization analysis based on Hilbert Transform also suggested that the cell can develop a fully synchronized oscillation within a fixed time no matter what the cell size is. A particle-based computational model was developed in order to model the emergence of oscillation patterns. Particles employing very simple and identical sensory and motor behaviors interacted with each other via the sensing and deposition of chemoattractants in a diffusive environment. From a random and almost homogeneous distribution, emergent domains of oscillatory activity emerged. By increasing the sensory radius the model simulated the regeneration process of the real plasmodium. In addition, the model replicated the rotating wave and bilateral oscillation pattern when the sensory radius was increased. The results suggest that complex emergent oscillatory behaviors (and thus the high-level systems which may utilize them, such as pumping and transport mechanisms) may be developed from simple materials inspired by Physarum slime mold. PMID:21070831

  1. Targeting engineering synchronization in chaotic systems

    NASA Astrophysics Data System (ADS)

    Bhowmick, Sourav K.; Ghosh, Dibakar

    2016-07-01

    A method of targeting engineering synchronization states in two identical and mismatch chaotic systems is explained in detail. The method is proposed using linear feedback controller coupling for engineering synchronization such as mixed synchronization, linear and nonlinear generalized synchronization and targeting fixed point. The general form of coupling design to target any desire synchronization state under unidirectional coupling with the help of Lyapunov function stability theory is derived analytically. A scaling factor is introduced in the coupling definition to smooth control without any loss of synchrony. Numerical results are done on two mismatch Lorenz systems and two identical Sprott oscillators.

  2. Experience dependent plasticity alters cortical synchronization

    PubMed Central

    Kilgard, M.P.; Vazquez, J.L.; Engineer, N.D.; Pandya, P.K.

    2008-01-01

    Theories of temporal coding by cortical neurons are supported by observations that individual neurons can respond to sensory stimulation with millisecond precision and that activity in large populations is often highly correlated. Synchronization is highest between neurons with overlapping receptive fields and modulated by both sensory stimulation and behavioral state. It is not yet clear whether cortical synchronization is an epiphenomenon or a critical component of efficient information transmission. Experimental manipulations that generate receptive field plasticity can be used to test the relationship between synchronization and receptive fields. Here we demonstrate that increasing receptive field size in primary auditory cortex by repeatedly pairing a train of tones with nucleus basalis (NB) stimulation increases synchronization, and decreasing receptive field size by pairing different tone frequencies with NB stimulation decreases synchronization. These observations seem to support the conclusion that neural synchronization is simply an artifact caused by common inputs. However, pairing tone trains of different carrier frequencies with NB stimulation increases receptive field size without increasing synchronization, and environmental enrichment increases synchronization without increasing receptive field size. The observation that receptive fields and synchronization can be manipulated independently suggests that common inputs are only one of many factors shaping the strength and temporal precision of cortical synchronization and supports the hypothesis that precise neural synchronization contributes to sensory information processing. PMID:17317055

  3. Analysis of remote synchronization in complex networks.

    PubMed

    Gambuzza, Lucia Valentina; Cardillo, Alessio; Fiasconaro, Alessandro; Fortuna, Luigi; Gómez-Gardeñes, Jesus; Frasca, Mattia

    2013-12-01

    A novel regime of synchronization, called remote synchronization, where the peripheral nodes form a phase synchronized cluster not including the hub, was recently observed in star motifs [Bergner et al., Phys. Rev. E 85, 026208 (2012)]. We show the existence of a more general dynamical state of remote synchronization in arbitrary networks of coupled oscillators. This state is characterized by the synchronization of pairs of nodes that are not directly connected via a physical link or any sequence of synchronized nodes. This phenomenon is almost negligible in networks of phase oscillators as its underlying mechanism is the modulation of the amplitude of those intermediary nodes between the remotely synchronized units. Our findings thus show the ubiquity and robustness of these states and bridge the gap from their recent observation in simple toy graphs to complex networks. PMID:24387542

  4. Synchronous clock stopper for microprocessor

    NASA Technical Reports Server (NTRS)

    Kitchin, David A. (Inventor)

    1985-01-01

    A synchronous clock stopper circuit for inhibiting clock pulses to a microprocessor in response to a stop request signal, and for reinstating the clock pulses in response to a start request signal thereby to conserve power consumption of the microprocessor when used in an environment of limited power. The stopping and starting of the microprocessor is synchronized, by a phase tracker, with the occurrences of a predetermined phase in the instruction cycle of the microprocessor in which the I/O data and address lines of the microprocessor are of high impedance so that a shared memory connected to the I/O lines may be accessed by other peripheral devices. The starting and stopping occur when the microprocessor initiates and completes, respectively, an instruction, as well as before and after transferring data with a memory. Also, the phase tracker transmits phase information signals over a bus to other peripheral devices which signals identify the current operational phase of the microprocessor.

  5. Multiobjective synchronization of coupled systems

    NASA Astrophysics Data System (ADS)

    Tang, Yang; Wang, Zidong; Wong, W. K.; Kurths, Jürgen; Fang, Jian-an

    2011-06-01

    In this paper, multiobjective synchronization of chaotic systems is investigated by especially simultaneously minimizing optimization of control cost and convergence speed. The coupling form and coupling strength are optimized by an improved multiobjective evolutionary approach that includes a hybrid chromosome representation. The hybrid encoding scheme combines binary representation with real number representation. The constraints on the coupling form are also considered by converting the multiobjective synchronization into a multiobjective constraint problem. In addition, the performances of the adaptive learning method and non-dominated sorting genetic algorithm-II as well as the effectiveness and contributions of the proposed approach are analyzed and validated through the Rössler system in a chaotic or hyperchaotic regime and delayed chaotic neural networks.

  6. Parallel integrated frame synchronizer chip

    NASA Technical Reports Server (NTRS)

    Ghuman, Parminder Singh (Inventor); Solomon, Jeffrey Michael (Inventor); Bennett, Toby Dennis (Inventor)

    2000-01-01

    A parallel integrated frame synchronizer which implements a sequential pipeline process wherein serial data in the form of telemetry data or weather satellite data enters the synchronizer by means of a front-end subsystem and passes to a parallel correlator subsystem or a weather satellite data processing subsystem. When in a CCSDS mode, data from the parallel correlator subsystem passes through a window subsystem, then to a data alignment subsystem and then to a bit transition density (BTD)/cyclical redundancy check (CRC) decoding subsystem. Data from the BTD/CRC decoding subsystem or data from the weather satellite data processing subsystem is then fed to an output subsystem where it is output from a data output port.

  7. Synchronous network of distant telescopes

    NASA Astrophysics Data System (ADS)

    Zhilyaev, B.; Svyatogorov, O.; Verlyuk, I.; Andreev, M.; Sergeev, A.; Lovkaya, M.; Antov, A.; Konstantinova-Antova, R.; Bogdanovski, R.; Avgoloupis, S.; Seiradakis, J.; Contadakis, M. E.

    The Synchronous Network of distant Telescopes (SNT) represents an innovative approach in observational astrophysics. The authors present an unique existing realization of the SNT-conception. It was founded within the international collaboration between astronomical observatories of Ukraine, Russia, Bulgaria and Greece. All the telescopes of the Network are equipped with standardized photometric systems (based on photo-multipliers). The unified timing systems (based on GPS-receivers) synchronize all the apertures to UTC with an accuracy of 1 microsecond and better. The essential parts of the SNT are the original software for operating and data processing. The described international Network successfully works for more than 10 years. The obtained unique observational data made it possible to discover new fine-scale features and flare-triggered phenomena in flaring red dwarfs, as well as the recently found high-frequency variability in some chromospherically active stars.

  8. Producing Newborn Synchronous Mammalian Cells

    NASA Technical Reports Server (NTRS)

    Gonda, Steve R.; Helmstetter, Charles E.; Thornton, Maureen

    2008-01-01

    A method and bioreactor for the continuous production of synchronous (same age) population of mammalian cells have been invented. The invention involves the attachment and growth of cells on an adhesive-coated porous membrane immersed in a perfused liquid culture medium in a microgravity analog bioreactor. When cells attach to the surface divide, newborn cells are released into the flowing culture medium. The released cells, consisting of a uniform population of synchronous cells are then collected from the effluent culture medium. This invention could be of interest to researchers investigating the effects of the geneotoxic effects of the space environment (microgravity, radiation, chemicals, gases) and to pharmaceutical and biotechnology companies involved in research on aging and cancer, and in new drug development and testing.

  9. Reaction to Koppad SN et al. Bilateral spermatocytic seminoma: an update on “synchronous” and “sequential” presentation of this rare variant of testicular tumour

    PubMed Central

    Kalakoti, Piyush; Sahu, Suman; Syed, Aarif

    2014-01-01

    We read with interest the report of Koppad and colleagues in the Pan African Medical Journal describing a case of bilateral synchronous presentation of spermatocytic seminoma in an elderly Indian male. While we appreciate their efforts in documenting this rare presentation, we disagree with the reported figures as outlined in the report and wish to draw attention of the authors as well as the readers of the journal to the gross inaccuracies in the reported statistics. We present our data, following a comprehensive literature review, to unveil the magnitude of bilateral presentation (synchronous and sequential) of this unique variant of testicular tumor as reported in medical literature to facilitate dissemination of precise information on the topic. PMID:25309648

  10. Bilateral Diffuse Fluorodeoxyglucose Uptake in Thyroid Gland Diagnosed by Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    PubMed Central

    Win, Aung Zaw; Aparici, Carina Mari

    2014-01-01

    Our patient is a female who was first diagnosed with breast cancer at the age of 23. A follow-up fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) at age 44 revealed diffuse high FDG uptake in an enlarged thyroid gland. Fine-needle aspiration (FNA) of the thyroid mass revealed estrogen receptor/progesterone receptor negative, human epidermal growth factor receptor 2+ breast cancer. To the best of our knowledge, this is the first case to report breast cancer metastasis to the thyroid in a diffuse pattern on FDG-PET/CT. Bilateral diffuse uptake of FDG in thyroid is the most commonly associated with benign conditions. However, FNA biopsies need to be done to rule out metastatic disease in thyroid lesions with diffuse high FDG uptake, especially for patients with history of cancer. PMID:25191131

  11. Conveyor-belt clock synchronization

    SciTech Connect

    Giovannetti, Vittorio; Maccone, Lorenzo; Shapiro, Jeffrey H.; Wong, Franco N.C.; Lloyd, Seth

    2004-10-01

    A protocol for synchronizing distant clocks is proposed that does not rely on the arrival times of the signals which are exchanged, and an optical implementation based on coherent-state pulses is described. This protocol is not limited by any dispersion that may be present in the propagation medium through which the light signals are exchanged. Possible improvements deriving from the use of quantum-mechanical effects are also addressed.

  12. The LASSO experiment. [clock synchronization

    NASA Technical Reports Server (NTRS)

    Serene, B.

    1979-01-01

    An international coordinated experimental assessment of a system which promises to provide a synchronization of clocks bound to time and frequency standard laboratories, with an accuracy of one nanosecond using existing or near ground-based laser stations via a geostationary satellite (SIRIO-2) is detailed. The system performance and the technical details concerning the on-board equiment, the ground segment, and the operational configuration are discussed. Finally, the future prospects of the LASSO experiment and possible implementations are examined together.

  13. Digital-data receiver synchronization

    DOEpatents

    Smith, Stephen F.; Turner, Gary W.

    2005-08-02

    Digital-data receiver synchronization is provided with composite phase-frequency detectors, mutually cross-connected comparison feedback or both to provide robust reception of digital data signals. A single master clock can be used to provide frequency signals. Advantages can include fast lock-up time in moderately to severely noisy conditions, greater tolerance to noise and jitter when locked, and improved tolerance to clock asymmetries.

  14. Hardware Implementation of a Bilateral Subtraction Filter

    NASA Technical Reports Server (NTRS)

    Huertas, Andres; Watson, Robert; Villalpando, Carlos; Goldberg, Steven

    2009-01-01

    A bilateral subtraction filter has been implemented as a hardware module in the form of a field-programmable gate array (FPGA). In general, a bilateral subtraction filter is a key subsystem of a high-quality stereoscopic machine vision system that utilizes images that are large and/or dense. Bilateral subtraction filters have been implemented in software on general-purpose computers, but the processing speeds attainable in this way even on computers containing the fastest processors are insufficient for real-time applications. The present FPGA bilateral subtraction filter is intended to accelerate processing to real-time speed and to be a prototype of a link in a stereoscopic-machine- vision processing chain, now under development, that would process large and/or dense images in real time and would be implemented in an FPGA. In terms that are necessarily oversimplified for the sake of brevity, a bilateral subtraction filter is a smoothing, edge-preserving filter for suppressing low-frequency noise. The filter operation amounts to replacing the value for each pixel with a weighted average of the values of that pixel and the neighboring pixels in a predefined neighborhood or window (e.g., a 9 9 window). The filter weights depend partly on pixel values and partly on the window size. The present FPGA implementation of a bilateral subtraction filter utilizes a 9 9 window. This implementation was designed to take advantage of the ability to do many of the component computations in parallel pipelines to enable processing of image data at the rate at which they are generated. The filter can be considered to be divided into the following parts (see figure): a) An image pixel pipeline with a 9 9- pixel window generator, b) An array of processing elements; c) An adder tree; d) A smoothing-and-delaying unit; and e) A subtraction unit. After each 9 9 window is created, the affected pixel data are fed to the processing elements. Each processing element is fed the pixel value for

  15. Bilateral congenital pseudoarthrosis of the clavicles in a newborn

    PubMed Central

    Kalagiri, Ram R.; Hemingway, Martha; Beeram, Madhava R.

    2016-01-01

    Bilateral congenital pseudoarthrosis of the clavicles is extremely rare. We report a case of this entity presenting in the neonatal period. We highlight the importance of the differential diagnosis when clavicular fracture shows no evidence of healing or occurs bilaterally.

  16. Network synchronization in hippocampal neurons.

    PubMed

    Penn, Yaron; Segal, Menahem; Moses, Elisha

    2016-03-22

    Oscillatory activity is widespread in dynamic neuronal networks. The main paradigm for the origin of periodicity consists of specialized pacemaking elements that synchronize and drive the rest of the network; however, other models exist. Here, we studied the spontaneous emergence of synchronized periodic bursting in a network of cultured dissociated neurons from rat hippocampus and cortex. Surprisingly, about 60% of all active neurons were self-sustained oscillators when disconnected, each with its own natural frequency. The individual neuron's tendency to oscillate and the corresponding oscillation frequency are controlled by its excitability. The single neuron intrinsic oscillations were blocked by riluzole, and are thus dependent on persistent sodium leak currents. Upon a gradual retrieval of connectivity, the synchrony evolves: Loose synchrony appears already at weak connectivity, with the oscillators converging to one common oscillation frequency, yet shifted in phase across the population. Further strengthening of the connectivity causes a reduction in the mean phase shifts until zero-lag is achieved, manifested by synchronous periodic network bursts. Interestingly, the frequency of network bursting matches the average of the intrinsic frequencies. Overall, the network behaves like other universal systems, where order emerges spontaneously by entrainment of independent rhythmic units. Although simplified with respect to circuitry in the brain, our results attribute a basic functional role for intrinsic single neuron excitability mechanisms in driving the network's activity and dynamics, contributing to our understanding of developing neural circuits.

  17. Network synchronization in hippocampal neurons

    PubMed Central

    Penn, Yaron; Segal, Menahem; Moses, Elisha

    2016-01-01

    Oscillatory activity is widespread in dynamic neuronal networks. The main paradigm for the origin of periodicity consists of specialized pacemaking elements that synchronize and drive the rest of the network; however, other models exist. Here, we studied the spontaneous emergence of synchronized periodic bursting in a network of cultured dissociated neurons from rat hippocampus and cortex. Surprisingly, about 60% of all active neurons were self-sustained oscillators when disconnected, each with its own natural frequency. The individual neuron’s tendency to oscillate and the corresponding oscillation frequency are controlled by its excitability. The single neuron intrinsic oscillations were blocked by riluzole, and are thus dependent on persistent sodium leak currents. Upon a gradual retrieval of connectivity, the synchrony evolves: Loose synchrony appears already at weak connectivity, with the oscillators converging to one common oscillation frequency, yet shifted in phase across the population. Further strengthening of the connectivity causes a reduction in the mean phase shifts until zero-lag is achieved, manifested by synchronous periodic network bursts. Interestingly, the frequency of network bursting matches the average of the intrinsic frequencies. Overall, the network behaves like other universal systems, where order emerges spontaneously by entrainment of independent rhythmic units. Although simplified with respect to circuitry in the brain, our results attribute a basic functional role for intrinsic single neuron excitability mechanisms in driving the network’s activity and dynamics, contributing to our understanding of developing neural circuits. PMID:26961000

  18. Network synchronization in hippocampal neurons.

    PubMed

    Penn, Yaron; Segal, Menahem; Moses, Elisha

    2016-03-22

    Oscillatory activity is widespread in dynamic neuronal networks. The main paradigm for the origin of periodicity consists of specialized pacemaking elements that synchronize and drive the rest of the network; however, other models exist. Here, we studied the spontaneous emergence of synchronized periodic bursting in a network of cultured dissociated neurons from rat hippocampus and cortex. Surprisingly, about 60% of all active neurons were self-sustained oscillators when disconnected, each with its own natural frequency. The individual neuron's tendency to oscillate and the corresponding oscillation frequency are controlled by its excitability. The single neuron intrinsic oscillations were blocked by riluzole, and are thus dependent on persistent sodium leak currents. Upon a gradual retrieval of connectivity, the synchrony evolves: Loose synchrony appears already at weak connectivity, with the oscillators converging to one common oscillation frequency, yet shifted in phase across the population. Further strengthening of the connectivity causes a reduction in the mean phase shifts until zero-lag is achieved, manifested by synchronous periodic network bursts. Interestingly, the frequency of network bursting matches the average of the intrinsic frequencies. Overall, the network behaves like other universal systems, where order emerges spontaneously by entrainment of independent rhythmic units. Although simplified with respect to circuitry in the brain, our results attribute a basic functional role for intrinsic single neuron excitability mechanisms in driving the network's activity and dynamics, contributing to our understanding of developing neural circuits. PMID:26961000

  19. Intonation contour in synchronous speech

    NASA Astrophysics Data System (ADS)

    Wang, Bei; Cummins, Fred

    2003-10-01

    Synchronous Speech (Syn-S), obtained by having pairs of speakers read a prepared text together, has been shown to result in interesting properties in the temporal domain, especially in the reduction of inter-speaker variability in supersegmental timing [F. Cummins, ARLO 3, 7-11 (2002)]. Here we investigate the effect of synchronization among speakers on the intonation contour, with a view to informing models of intonation. Six pairs of speakers (all females) read a short text (176 words) both synchronously and solo. Results show that (1) the pitch accent height above a declining baseline is reduced in Syn-S, compared with solo speech, while the pitch accent location is consistent across speakers in both conditions; (2) in contrast to previous findings on duration matching, there is an asymmetry between speakers, with one speaker exerting a stronger influence on the observed intonation contour than the other; (3) agreement on the boundaries of intonational phrases is greater in Syn-S and intonation contours are well matched from the first syllable of the phrase and throughout.

  20. Synchronizer of transmission for vehicles

    SciTech Connect

    Katayama, N.

    1986-02-25

    A synchronizer of a transmission for vehicles is described comprising: a double-mesh prevention member provided on a shift-and-select lever shaft and adapted to restrict the movement of fork shafts of the transmission. The double-mesh prevention member has at least two engaging portions for engaging first and second forward fork shafts, a first gap between the first engaging portion and the first forward fork shaft is greater than a second gap between the second engaging portion and the second forward fork shaft; a pin carried by the first forward fork shaft and biased substantially radially outwardly from the first forward fork shaft by resilient means; and a cam provided on the shift-and-select lever shaft, the cam is shaped and adapted to engage the pin, when the shift-and-select lever shaft is operated to shift to the reverse position, to press the pin so as to move the first forward fork shaft axially until the first forward fork shaft engages the first engaging portion, and thereafter to press the pin radially into the first forward fork shaft; whereby, upon shifting to the reverse position, the first forward fork shaft is moved by the pin and cam to put a synchronizer for forward gears into effect, thereby to attain synchronization between an input shaft and an output shaft of the transmission, but is prevented by the first engaging portion from moving far enough to engage a forward gear.

  1. Temporal integration in sensorimotor synchronization.

    PubMed

    Mates, J; Müller, U; Radil, T; Pöppel, E

    1994-01-01

    Abstract The concept of a temporal integration process in the timing mechanisms in the brain, postulated on the basis of experimental observations from various paradigms (for a review see P$oUppel, 1978), has been explored in a sensorimotor synchronization task. Subjects synchronized their finger taps to sequences of auditory stimuli with interstimulus-onset intervals (ISIs) between 300 and 4800 msec in different trials. Each tonal sequence consisted of 110 stimuli; the tones had a frequency of 500 Hz and a duration of 100 msec. As observed previously, response onsets preceded onsets of the stimuli by some tens of milliseconcls for ISIs in the range from about 600 to 1800 msec. For ISIs longer than or equal to 2400 msec, the ability to time the response sequence in such a way that the response 5 were placed right ahead of the stimuli started to break clown, i.e., the task was fulfilled by reactions to the stimuli rather than by advanced responses. This observation can he understood within the general framework of a temporal integration puce 55 that is supposed to have a maximal capacity (integration interval) of approximately 3 sec. Only if successive stimuli fall within one integration period, can motor programs be initiated properly by a prior stimulus and thus lead to an appropriate synchronization between the stimulus sequence and corresponding motor acts.

  2. A Switched-Mode Breast Coil for 7 T MRI Using Forced-Current Excitation

    PubMed Central

    Bosshard, John C.; Rispoli, Joseph V.; Dimitrov, Ivan E.; Cheshkov, Sergey; McDougall, Mary Preston; Malloy, Craig; Wright, Steven M.

    2015-01-01

    In high-field magnetic resonance imaging, the radio frequency wavelength within the human body is comparable to anatomical dimensions, resulting in B1 inhomogeneity and nonuniform sensitivity patterns. Thus, this relatively short wavelength presents engineering challenges for RF coil design. In this study, a bilateral breast coil for 1H imaging at 7 T was designed and constructed using forced-current excitation. By forcing equal current through the coil elements, we reduce the effects of coupling between the elements to simplify tuning and to ensure a uniform field across both breasts. To combine the benefits of the higher power efficiency of a unilateral coil with the bilateral coverage of a bilateral coil, a switching circuit was implemented to allow the coil to be reconfigured for imaging the left, right, or both breasts. PMID:25706501

  3. Synchronization transition in networked chaotic oscillators: the viewpoint from partial synchronization.

    PubMed

    Fu, Chenbo; Lin, Weijie; Huang, Liang; Wang, Xingang

    2014-05-01

    Synchronization transition in networks of nonlocally coupled chaotic oscillators is investigated. It is found that in reaching the state of global synchronization the networks can stay in various states of partial synchronization. The stability of the partial synchronization states is analyzed by the method of eigenvalue analysis, in which the important roles of the network topological symmetry on synchronization transition are identified. Moreover, for networks possessing multiple topological symmetries, it is found that the synchronization transition can be divided into different stages, with each stage characterized by a unique synchronous pattern of the oscillators. Synchronization transitions in networks of nonsymmetric topology and nonidentical oscillators are also investigated, where the partial synchronization states, although unstable, are found to be still playing important roles in the transitions.

  4. [Bilateral testicular metastasis of cancer of the prostate].

    PubMed

    el Moussaoui, A; Sarf, I; Dakir, M; Zamiati, S; Benjelloun, S

    1997-01-01

    Testicular metastasis of prostate cancer rarely occurs. Bilateral localization is exceptional. We report a new case of prostate adenocarcinoma with bilateral testicular metastasis. The diagnosis was made on clinical and ultrasonic arguments, and confirmed on the pathological specimen. Treatment consisted in a bilateral orchidectomy, associated with nonsteroid androgens.

  5. Bilateral internal jugular vein ectasia: a report of two cases.

    PubMed

    Gendeh, B S; Dhillon, M K; Hamzah, M

    1994-03-01

    Internal jugular vein ectasia is a venous anomaly commonly presenting as a unilateral neck swelling in children and adults. Literature reports of bilateral presentation are rare. Bilateral Doppler ultrasonography is the diagnostic investigation of choice. The possible pathology, aetiology and management are discussed. Conservative management of bilateral cases is recommended in uncomplicated cases.

  6. Low speed maneuvering flight of the rose-breasted cockatoo (Eolophus roseicapillus). I. Kinematic and neuromuscular control of turning.

    PubMed

    Hedrick, T L; Biewener, A A

    2007-06-01

    Maneuvering flight has long been recognized as an important component of the natural behavior of many bird species, but has been the subject of little experimental work. Here we examine the kinematics and neuromuscular control of turning flight in the rose-breasted cockatoo Eolophus roseicapillus (N=6), testing predictions of maneuvering flight and control based on aerodynamic theory and prior kinematic and neuromuscular studies. Six cockatoos were trained to navigate between two perches placed in an L-shaped flight corridor, making a 90 degrees turn midway through each flight. Flights were recorded with three synchronized high-speed video cameras placed outside the corridor, allowing a three-dimensional reconstruction of wing and body kinematics through the turn. We simultaneously collected electromyography recordings from bilateral implants in the pectoralis, supracoracoideus, biceps brachii and extensor metacarpi radialis muscles. The cockatoos maneuvered using flapping, banked turns with an average turn radius of 0.92 m. The mean rate of change in heading during a complete wingbeat varied through the turn and was significantly correlated to roll angle at mid-downstroke. Changes in roll angle were found to include both within-wingbeat and among-wingbeat components that bear no direct relationship to one another. Within-wingbeat changes in roll were dominated by the inertial effects while among-wingbeat changes in roll were likely the result of both inertial and aerodynamic effects.

  7. Simultaneous, Isolated Traumatic Bilateral Patella Fractures

    PubMed Central

    Madi, Sandesh; Naik, Monappa; Rao, Sharath; Vijayan, Sandeep

    2016-01-01

    Introduction Isolated traumatic fractures of both Patellae, occurring at the same time, in an otherwise healthy person, are very rare. The Patella, as a subcutaneous and a cancellous bone, is vulnerable to injury. However, simultaneous injury to both Patellae without the involvement of any other bony injuries occurs infrequently, and only a few cases have been reported in the literature. Case Presentation We report a rare case of isolated, traumatic bilateral Patella fracture with unusual fracture patterns and briefly review the literature. Conclusions In simultaneous bilateral Patella fractures, good functional outcome can be expected following a stable surgical fixation and a structured rehabilitation regime. However, personality of the fracture determines salvage versus sacrifice of the Patella. PMID:27218047

  8. The cerebral hemispheres and bilateral neural nets.

    PubMed

    Cook, N D; Beech, A R

    1990-06-01

    A high-level cognitive dichotomy ("language and context") is reviewed in relation to empirical findings concerning the functions of the human cerebral hemispheres. We argue that the right hemisphere's involvement in the generation of connotative and contextual information in parallel with the denotative and literal language functions of the left hemisphere provides an important insight into the organization of viable cognitive systems. The role of the corpus callosum in producing the dichotomy is discussed. Finally, the generation of asymmetrical activity in structurally symmetrical, bilateral neural nets is described. The model demonstrates how complementary memory states can be generated in bilateral nets without assuming different modes of information processing, provided that the nets have inhibitory, homotopic connections. Unlike excitatory connections, inhibitory connections are sufficient to generate asymmetric hemispheric activity without postulating intrinsic differences between the cerebral hemispheres.

  9. Bilateral traumatic facial paralysis. Case report.

    PubMed

    Undabeitia, Jose; Liu, Brian; Pendleton, Courtney; Nogues, Pere; Noboa, Roberto; Undabeitia, Jose Ignacio

    2013-01-01

    Although traumatic injury of the facial nerve is a relatively common condition in neurosurgical practice, bilateral lesions related to fracture of temporal bones are seldom seen. We report the case of a 38-year-old patient admitted to Intensive Care Unit after severe head trauma requiring ventilatory support (Glasgow Coma Scale of 7 on admission). A computed tomography (CT) scan confirmed a longitudinal fracture of the right temporal bone and a transversal fracture of the left. After successful weaning from respirator, bilateral facial paralysis was observed. The possible aetiologies for facial diplegia differ from those of unilateral injury. Due to the lack of facial asymmetry, it can be easily missed in critically ill patients, and both the high resolution CT scan and electromyographic studies can be helpful for correct diagnosis.

  10. Neuropsychological sequelae of bilateral posteroventral pallidotomy

    PubMed Central

    Turner, K; Reid, W; Homewood, J; Cook, R

    2002-01-01

    Methods: 17 patients with Parkinson's disease were evaluated with a neuropsychological battery before and six months after bilateral pallidotomy. A comparison group (n = 8) was also assessed at six month intervals. Outcome variables were tests of memory, language, visuospatial function, attention, executive skills, and depression. Results: Despite a large number of variables studied, a significant postsurgical change was found only in performance of the tower of London task, a measure of planning abilities. The effect size of this change was larger than that of the comparison group, and a reliable change index score established that 5 of 13 surgical patients had statistically reliable reductions in planning performance. Conclusions: Patients with a young age of onset and long duration of Parkinson's disease who underwent bilateral pallidotomy had a relatively circumscribed reduction in neuropsychological functioning, being limited to motor planning efficiency. These data suggest that the cognitive role of the posteroventral globus pallidus is limited, at least in people with Parkinson's disease. PMID:12235317

  11. [Bilateral acetabulum fracture after suffering sport trauma].

    PubMed

    Trost, P; Kollersbeck, C; Pelitz, M; Walcher, T; Genelin, F

    2013-07-01

    This case study describes a 37-year-old male who suffered a bilateral transverse acetabulum fracture with a fracture of the posterior wall and a double-sided dorsal hip dislocation in combination with a left-sided femoral head fracture (Pipkin IV) while skiing in a "fun park". The accurate diagnosis and presurgical planning was made by means of a computed tomography (CT) scan and a subsequent 3D reconstruction. After a primarily executed shielded repositioning of the bilateral hip dislocationearly secondary and anatomical reconstruction of the double-sided acetabulum fracture was possible using the Kocher-Langenbeck approach. A consistent physiotherapy as well as rehabilitation finally led to a positive clinical result for the patient.

  12. BILATERAL LUXATIO ERECTA, A CASE REPORT

    PubMed Central

    Acosta, César Augusto Xavier; da Silva Resch, Elemar; Rodrigues, Rafael

    2015-01-01

    Inferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was also advised to receive physiotherapy. PMID:27047840

  13. Peribulbar anesthesia causing bilateral orbital hemorrhage

    PubMed Central

    Garft, Kyla; Burt, Peter; Burt, Benjamin

    2016-01-01

    We report a case of bilateral orbital hemorrhage as a complication of peribulbar anesthesia in a 78 year old man. Initially, unilateral orbital hemorrhage occurred but quickly spread to the contralateral side. Neuroophthalmological assessment revealed a proptosed tense globe with normal retinovascular findings. Visual acuity was adversely affected and this was conservatively managed with no lasting ophthalmic sequela. This patient’s case was reported as it illustrates an unusual complication of bilateral spread of orbital hemorrhage secondary to peribulbar anesthesia. It highlights how early ophthalmic assessment can ensure a good visual outcome in the setting of appropriate ophthalmic monitoring. The mechanisms of orbital hemorrhage spread and appropriate management options are discussed. PMID:27013899

  14. Risk-reducing Surgery in Women at Risk for Familial Breast or Ovarian Cancer

    PubMed Central

    Rhiem, K.; Pfeifer, K.; Schmutzler, R. K.; Kiechle, M.

    2012-01-01

    An estimated 5 % of breast cancers and 10 % of ovarian cancers may be due to inherited autosomal dominant breast and ovarian cancer alleles BRCA1 und BRCA2. According to population-based studies 1 or 2 women per 1000 carry such a risk allele. The cumulative cancer risk for healthy women with a BRCA-mutation is between 60 and 85 % for breast cancer and between 20 and 60 % for ovarian cancer. Recent studies have reported an increased risk for contralateral breast cancer in women after unilateral breast cancer. Since 1997 the German Cancer Aid has supported an interdisciplinary approach for high-risk women consisting of genetic testing, counselling and prevention in 12 specialised centres. Since 2005 this concept has received additional support from health insurance companies, and results have been assessed with regard to outcomes (e.g. reduced mortality due to more intensive early diagnosis). The number of centres has increased to 15 at various university hospitals. These interdisciplinary centres offer women the opportunity to participate in a structured screening programme for the early diagnosis of breast cancer and provide non-directive counselling on the options for risk-reducing surgery, e.g., prophylactic bilateral salpingo-oophorectomy, prophylactic bilateral mastectomy or contralateral prophylactic mastectomy after unilateral breast cancer. Such surgical interventions can significantly reduce the risk of disease, the respective disease-specific mortality and – particularly prophylactic bilateral salpingo-oophorectomy – total mortality in BRCA-mutation carriers. PMID:26640291

  15. Spectral Analysis of Synchronization in Mobile Networks

    NASA Astrophysics Data System (ADS)

    Fujiwara, Naoya; Kurths, Jürgen; Díaz-Guilera, Albert

    2011-09-01

    We here analyze a system consisting of agents moving in a two-dimensional space that interact with other agents if they are within a finite range. Considering the motion and the interaction of the agents, the system can be understood as a network with a time-dependent topology. Dynamically, the agents are assumed to be identical oscillators, and the system will eventually reach a state of complete synchronization. In a previous work, we have shown that two qualitatively different mechanisms leading to synchronization in such mobile networks exist, namely global synchronization and local synchronization, depending on the parameters that characterize the oscillatory dynamics and the motion of the agents [1]. In this contribution we show that the spectral pattern differs between the two synchronization mechanisms. For global synchronization the spectrum is flat, which means that all eigenmodes contribute identically. For local synchronization, instead, the synchronization dynamics is determined mostly by the eigenmodes whose eigenvalues are close to zero. This result suggests that the global synchronization mechanism achieves fast synchronization by efficiently using the fast decaying eigenmodes (larger eigenvalues).

  16. Bilateral synergies in foot force production tasks.

    PubMed

    Sarabon, Nejc; Markovic, Goran; Mikulic, Pavle; Latash, Mark L

    2013-05-01

    We analysed the effects of task symmetry during bilateral accurate force production tasks performed by the two feet. In particular, we tested a hypothesis that bilateral deficit would lead to higher indices of synergies defined as co-varied adjustments in the two forces across trials that reduced total force variability. The subjects produced steady-state force followed by a quick force pulse into the target. The two feet could be acting both into plantar flexion and into dorsiflexion (symmetrical tasks), or in opposite directions (asymmetrical task). We used the framework of the uncontrolled manifold hypothesis to quantify two variance components, one of which did not change total force (V UCM), while the other did (V ORT). Synergy indices during the asymmetrical task were higher than in either symmetrical task. The difference was due to higher V UCM (compared to the symmetrical plantar flexion task) or lower V ORT (compared to the symmetrical dorsiflexion task). The synergy index showed a drop (anticipatory synergy adjustment, ASA) starting 100-150 ms prior to the force pulse initiation. The ASA tended to be shorter and of a smaller magnitude for the asymmetrical task. This is the first demonstration of bilateral synergies during accurate force production by the legs. We conclude that bilateral deficit has no or weak effects on two-leg synergies. The results fit the earlier introduced scheme with two groups of neural variables defining average performance of a redundant system and patterns of co-variation among its elemental variables, respectively. PMID:23568657

  17. Bilateral optic neuritis due to malaria.

    PubMed

    Chacko, Joseph G; Onteddu, Sanjeeva; Rosenbaum, Eric R

    2013-09-01

    Malaria is a mosquito-borne infectious disease caused by protists of the genus Plasmodium. Malaria is widespread in tropical regions around the equator, including much of sub-Saharan Africa, Asia, and the Americas, and uncommonly seen in the developed world. Although a variety of ocular manifestations have been linked to malaria, optic neuritis is rare. We report a patient who developed bilateral optic neuritis after he was treated successfully for acute falciparum malaria.

  18. Idiopathic Bilateral External Jugular Vein Thrombosis

    PubMed Central

    Hindi, Zakaria; Fadel, Ehab

    2015-01-01

    Patient: Male, 21 Final Diagnosis: Idiopathic bilateral external jugular vein thrombosis Symptoms: Face engorgement • neck swelling Medication: — Clinical Procedure: None Specialty: Hematology Objective: Unknown ethiology Background: Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow’s triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. Case Report: This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Conclusions: Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present

  19. Ovarian remnant with bilateral duplicate ureters.

    PubMed

    Lyons, Thomas L; Adolph, Allyson J; Winer, Wendy K

    2003-08-01

    A 27-year-old woman had a history of acute chronic pelvic pain. She had had a previous salpingo-oophorectomy for an endometrioma. A computerized tomographic scan showed a left adnexal mass. She was known to have bilateral duplicate ureters shown on intravenous pyelogram. She underwent laparoscopy and retroperitoneal dissection of endometriosis with excision of the mass from the pelvic sidewall. The final pathology was consistent with a hemorrhagic corpus luteal cyst.

  20. Bilateral Brodie's abscess at the proximal tibia.

    PubMed

    Buldu, Halil; Bilen, Fikri Erkal; Eralp, Levent; Kocaoglu, Mehmet

    2012-08-01

    Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.

  1. Erlotinib-related bilateral anterior uveitis

    PubMed Central

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  2. Bilateral leg edema in an older woman.

    PubMed

    Thaler, H W; Pienaar, S; Wirnsberger, G; Roller-Wirnsberger, R E

    2015-01-01

    Bilateral leg edema is a frequent symptom in older people and an important concern in geriatric medicine. Further evaluation is frequently not performed and simple therapy with diuretics is prescribed. Particularly in older patients, long-term use of diuretics can lead to severe electrolyte imbalances, volume depletion, and falls. In this case report we want to focus the physicians' attention on the necessity to determine the cause and show a correspondingly effective treatment for bilateral leg edema in older people. A thorough approach is required to recognize diseases and to avoid adverse drug events as geriatric patients often show an atypical presentation or minor symptoms. The cause of swollen legs is often multifactorial; therefore, the patient's individual history and an appropriate physical examination are important. Depending on the clinical symptoms, evaluation including basic laboratory tests, urinalysis, chest radiography, and echocardiogram may be indicated. The most probable cause of bilateral edema in older patients is chronic venous insufficiency. Heart failure is also a common cause. Other systemic causes such as renal disease or liver disease are much rarer. Antihypertensive and anti-inflammatory drugs can frequently cause leg edema, but the incidence of drug-induced leg swelling is unknown. With the help of this special case we tried to develop an approach to the diagnosis of symmetric leg edema in older patients, a problem frequently neglected in geriatric medicine.

  3. High Performance, Three-Dimensional Bilateral Filtering

    SciTech Connect

    Bethel, E. Wes

    2008-06-05

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  4. Bilateral limbic system destruction in man

    PubMed Central

    Feinstein, Justin S.; Rudrauf, David; Khalsa, Sahib S.; Cassell, Martin D.; Bruss, Joel; Grabowski, Thomas J.; Tranel, Daniel

    2010-01-01

    We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called “limbic system.” The patient, Roger, has been studied in our laboratory for over 14 years and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations. PMID:19763994

  5. Multilateral, regional and bilateral energy trade governance

    SciTech Connect

    Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany )

    2014-12-01

    The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

  6. Acute bilateral spontaneous forearm compartment syndrome.

    PubMed

    Dalton, David M; Munigangaiah, Sudarshan; Subramaniam, Tava; McCabe, John P

    2014-01-01

    Acute spontaneous compartment syndrome of the forearm is rarely reported in the literature. It is typically associated with trauma or thromboembolism in the acute setting and repetitive exertional stress in the chronic setting. However it is rare for it to present bilaterally with no apparent underlying cause. We report the case of a young 31-year-old lady who presented to our Emergency Department with bilateral compartment syndrome of the forearm. Her presenting complaints included acute severe pain and swelling of the forearms bilaterally, with a decreased range of movement of the wrist and fingers. She also complained of numbness in all fingers. She had no history of recent trauma and ultrasound scans showed no evidence of vascular compromise. Past medical history was notable only for idiopathic hypertension and coeliac disease. The patient was taken to theatre urgently where flexor and extensor compartments and carpal tunnel were decompressed. Pronator Teres was found to be dusky initially but turned pink after decompression. All other muscles were normal. An interesting fact of this case was that combination of the high compartment pressures and anaesthetic related hypotension caused the forearm pulses to become impalpable at induction, these returned intra-operatively. The patient has been seen in the outpatient department following discharge. She is well apart from some mildly reduced grip strength in her right hand likely due to carpal tunnel decompression. No cause was found for the scenario after extensive medical investigation.

  7. Mastopexy for breast ptosis: Utility outcomes of population preferences

    PubMed Central

    Ibrahim, Ahmed MS; Sinno, Hani H; Izadpanah, Ali; Vorstenbosch, Joshua; Dionisopoulos, Tassos; Markarian, Mark K; Lee, Bernard T; Lin, Samuel J

    2015-01-01

    BACKGROUND: Breast ptosis can occur with aging, and after weight loss and breastfeeding. Mastopexy is a procedure used to modify the size, contour and elevation of sagging breasts without changing breast volume. To gain more knowledge on the health burden of living with breast ptosis requiring mastectomy, validated measures can be used to compare it with other health states. OBJECTIVE: To quantify the health state utility assessment of individuals living with breast ptosis who could benefit from a mastopexy procedure; and to determine whether utility scores vary according to participant demographics. METHODS: Utility assessments using a visual analogue scale (VAS), time trade-off (TTO) and standard gamble (SG) methods were used to obtain utility scores for breast ptosis, monocular blindness and binocular blindness from a sample of the general population and medical students. Linear regression and the Student’s t test were used for statistical analysis; P<0.05 was considered to be statistically significant. RESULTS: Mean (± SD) measures for breast ptosis in the 107 volunteers (VAS: 0.80±0.14; TTO: 0.87±0.18; SG: 0.90±0.14) were significantly different (P<0.0001) from the corresponding measures for monocular blindness and binocular blindness. When compared with a sample of the general population, having a medical education demonstrated a statistically significant difference in being less likely to trade years of life and less likely to gamble risk of a procedure such as a mastopexy. Race and sex were not statistically significant independent predictors of risk acceptance. DISCUSSION: For the first time, the burden of living with breast ptosis requiring surgical intervention was determined using validated metrics (ie, VAS, TTO and SG). The health burden of living with breast ptosis was found to be comparable with that of breast hypertrophy, unilateral mastectomy, bilateral mastectomy, and cleft lip and palate. Furthermore, breast ptosis was considered to be

  8. Synchronous epidermoid cyst and mature teratoma of the testis: an unusual association.

    PubMed

    Huyghe, Eric; Mazerolles, Catherine; Moran, Cesar; Khedis, Mehdi; Khoury, Elias; Nohra, Joe; Soulié, Michel; Plante, Pierre

    2007-01-01

    We describe here the first case of a synchronous epidermoid cyst and mature teratoma of the testis occurring in a young man presenting a with bilateral testicular tumor. After a clinical, biological and ultrasound evaluation, testis-sparing surgery was performed on the left testis and a total orchiectomy on the right side in accordance with oncological principles. Histopathological examination revealed a simple epidermoid cyst on the left side and a mature teratoma on the right side, following Price's criteria. No metastasis was detected, and the patient was closely followed. The patient remains disease-free and has normal postoperative testosterone levels 3 years after the surgery.

  9. Synchronizing noisy nonidentical oscillators by transient uncoupling

    NASA Astrophysics Data System (ADS)

    Tandon, Aditya; Schröder, Malte; Mannattil, Manu; Timme, Marc; Chakraborty, Sagar

    2016-09-01

    Synchronization is the process of achieving identical dynamics among coupled identical units. If the units are different from each other, their dynamics cannot become identical; yet, after transients, there may emerge a functional relationship between them—a phenomenon termed "generalized synchronization." Here, we show that the concept of transient uncoupling, recently introduced for synchronizing identical units, also supports generalized synchronization among nonidentical chaotic units. Generalized synchronization can be achieved by transient uncoupling even when it is impossible by regular coupling. We furthermore demonstrate that transient uncoupling stabilizes synchronization in the presence of common noise. Transient uncoupling works best if the units stay uncoupled whenever the driven orbit visits regions that are locally diverging in its phase space. Thus, to select a favorable uncoupling region, we propose an intuitive method that measures the local divergence at the phase points of the driven unit's trajectory by linearizing the flow and subsequently suppresses the divergence by uncoupling.

  10. A chimeric path to neuronal synchronization

    SciTech Connect

    Essaki Arumugam, Easwara Moorthy; Spano, Mark L.

    2015-01-15

    Synchronization of neuronal activity is associated with neurological disorders such as epilepsy. This process of neuronal synchronization is not fully understood. To further our understanding, we have experimentally studied the progression of this synchronization from normal neuronal firing to full synchronization. We implemented nine FitzHugh-Nagumo neurons (a simplified Hodgkin-Huxley model) via discrete electronics. For different coupling parameters (synaptic strengths), the neurons in the ring were either unsynchronized or completely synchronized when locally coupled in a ring. When a single long-range connection (nonlocal coupling) was introduced, an intermediate state known as a chimera appeared. The results indicate that (1) epilepsy is likely not only a dynamical disease but also a topological disease, strongly tied to the connectivity of the underlying network of neurons, and (2) the synchronization process in epilepsy may not be an “all or none” phenomenon, but can pass through an intermediate stage (chimera)

  11. Spatio-temporal synchronization of recurrent epidemics.

    PubMed Central

    He, Daihai; Stone, Lewi

    2003-01-01

    Long-term spatio-temporal datasets of disease incidences have made it clear that many recurring epidemics, especially childhood infections, tend to synchronize in-phase across suburbs. In some special cases, epidemics between suburbs have been found to oscillate in an out-of-phase ('antiphase') relationship for lengthy periods. Here, we use modelling techniques to help explain the presence of in-phase and antiphase synchronization. The nonlinearity of the epidemic dynamics is often such that the intensity of the outbreak influences the phase of the oscillation thereby introducing 'shear', a factor that is found to be important for generating antiphase synchronization. By contrast, the coupling between suburbs via the immigration of infectives tends to enhance in-phase synchronization. The emerging synchronization depends delicately on these opposite factors. We use theoretical results from continuous time models to provide a framework for understanding the relationship between synchronization patterns for different model structures. PMID:12965019

  12. A chimeric path to neuronal synchronization

    NASA Astrophysics Data System (ADS)

    Essaki Arumugam, Easwara Moorthy; Spano, Mark L.

    2015-01-01

    Synchronization of neuronal activity is associated with neurological disorders such as epilepsy. This process of neuronal synchronization is not fully understood. To further our understanding, we have experimentally studied the progression of this synchronization from normal neuronal firing to full synchronization. We implemented nine FitzHugh-Nagumo neurons (a simplified Hodgkin-Huxley model) via discrete electronics. For different coupling parameters (synaptic strengths), the neurons in the ring were either unsynchronized or completely synchronized when locally coupled in a ring. When a single long-range connection (nonlocal coupling) was introduced, an intermediate state known as a chimera appeared. The results indicate that (1) epilepsy is likely not only a dynamical disease but also a topological disease, strongly tied to the connectivity of the underlying network of neurons, and (2) the synchronization process in epilepsy may not be an "all or none" phenomenon, but can pass through an intermediate stage (chimera).

  13. Explosive synchronization coexists with classical synchronization in the Kuramoto model.

    PubMed

    Danziger, Michael M; Moskalenko, Olga I; Kurkin, Semen A; Zhang, Xiyun; Havlin, Shlomo; Boccaletti, Stefano

    2016-06-01

    Explosive synchronization has recently been reported in a system of adaptively coupled Kuramoto oscillators, without any conditions on the frequency or degree of the nodes. Here, we find that, in fact, the explosive phase coexists with the standard phase of the Kuramoto oscillators. We determine this by extending the mean-field theory of adaptively coupled oscillators with full coupling to the case with partial coupling of a fraction f. This analysis shows that a metastable region exists for all finite values of f > 0, and therefore explosive synchronization is expected for any perturbation of adaptively coupling added to the standard Kuramoto model. We verify this theory with GPU-accelerated simulations on very large networks (N ∼ 10(6)) and find that, in fact, an explosive transition with hysteresis is observed for all finite couplings. By demonstrating that explosive transitions coexist with standard transitions in the limit of f → 0, we show that this behavior is far more likely to occur naturally than was previously believed. PMID:27369869

  14. Explosive synchronization coexists with classical synchronization in the Kuramoto model.

    PubMed

    Danziger, Michael M; Moskalenko, Olga I; Kurkin, Semen A; Zhang, Xiyun; Havlin, Shlomo; Boccaletti, Stefano

    2016-06-01

    Explosive synchronization has recently been reported in a system of adaptively coupled Kuramoto oscillators, without any conditions on the frequency or degree of the nodes. Here, we find that, in fact, the explosive phase coexists with the standard phase of the Kuramoto oscillators. We determine this by extending the mean-field theory of adaptively coupled oscillators with full coupling to the case with partial coupling of a fraction f. This analysis shows that a metastable region exists for all finite values of f > 0, and therefore explosive synchronization is expected for any perturbation of adaptively coupling added to the standard Kuramoto model. We verify this theory with GPU-accelerated simulations on very large networks (N ∼ 10(6)) and find that, in fact, an explosive transition with hysteresis is observed for all finite couplings. By demonstrating that explosive transitions coexist with standard transitions in the limit of f → 0, we show that this behavior is far more likely to occur naturally than was previously believed.

  15. Explosive synchronization coexists with classical synchronization in the Kuramoto model

    NASA Astrophysics Data System (ADS)

    Danziger, Michael M.; Moskalenko, Olga I.; Kurkin, Semen A.; Zhang, Xiyun; Havlin, Shlomo; Boccaletti, Stefano

    2016-06-01

    Explosive synchronization has recently been reported in a system of adaptively coupled Kuramoto oscillators, without any conditions on the frequency or degree of the nodes. Here, we find that, in fact, the explosive phase coexists with the standard phase of the Kuramoto oscillators. We determine this by extending the mean-field theory of adaptively coupled oscillators with full coupling to the case with partial coupling of a fraction f. This analysis shows that a metastable region exists for all finite values of f > 0, and therefore explosive synchronization is expected for any perturbation of adaptively coupling added to the standard Kuramoto model. We verify this theory with GPU-accelerated simulations on very large networks (N ˜ 106) and find that, in fact, an explosive transition with hysteresis is observed for all finite couplings. By demonstrating that explosive transitions coexist with standard transitions in the limit of f → 0, we show that this behavior is far more likely to occur naturally than was previously believed.

  16. Molecular Testing in Multiple Synchronous Lung Adenocarcinomas: Case Report and Literature Review.

    PubMed

    Rafael, Oana C; Lazzaro, Richard; Hasanovic, Adnan

    2016-02-01

    Discovery of driver mutations in pulmonary adenocarcinoma has revolutionized the field of thoracic oncology with major impact on therapy and diagnosis. Testing for EGFR, ALK, and KRAS mutations has become part of everyday practice. We report a case with multiple synchronous primary pulmonary adenocarcinomas in a 72-year-old female with previous history of smoking. The patient presented with cough and bilateral lung ground glass opacities. A positron emission tomography/computed tomography scan showed no activity in mediastinal lymph nodes. She underwent a left upper lobe biopsy and a right upper lobe wedge resection. Pathology revealed 4 morphologically distinct adenocarcinoma foci, suggestive of synchronous primary lung tumors. Molecular testing demonstrated no mutation in the left tumor. Three different driver mutations were present in the right lung tumors: KRAS codon 12 G12D and G12V and EGFR exon 21 L858R mutation, confirming the initial histologic impression. Subsequently, left upper lobe lobectomy showed 3 additional foci of adenocarcinoma with different morphologies, suggestive of synchronous primaries as well. No additional molecular testing was performed. Synchronous pulmonary adenocarcinomas are not uncommon; however, 4 or more synchronous tumors are rare. Distinguishing multiple primary tumors from intrapulmonary metastases is a common problem in thoracic oncology with major implications for staging, prognosis, and treatment. Lung adenocarcinoma subclassification based on predominant and coexisting histologic patterns can greatly facilitate differentiation between intrapulmonary metastases and multiple synchronous tumors. Use of molecular profiling is recommended since it further increases confidence in the diagnostic workup of multiple pulmonary adenocarcinomas and helps guiding therapy.

  17. Breast-feeding in preterm twins: Development of feeding behavior and milk intake during hospital stay and related caregiving practices.

    PubMed

    Nyqvist, Kerstin Hedberg

    2002-08-01

    In a prospective study of 13 preterm twins still in the hospital, 85% were breast-fed, of which 46% were breast-fed exclusively. Most mothers preferred simultaneous breast-feeding, using the football hold. Observations and maternal descriptions showed differences between the twins in their development of breast-feeding behavior, especially in sucking. The mothers' suggestions regarding special support for the breast-feeding mothers of preterm twins involved synchronizing feeding with the twins' behavioral states; twin cobedding; appropriate armchairs and breast-feeding pillows; experimenting with breast-feeding positions; information about breast milk production; nurses' spontaneous practical assistance, encouragement, and emotional support; the provision of privacy; the availability of parent rooms; and opportunities for fathers' presence in the hospital. PMID:12219324

  18. Nondestructive synchronous beam current monitor

    SciTech Connect

    Covo, Michel Kireeff

    2014-12-15

    A fast current transformer is mounted after the deflectors of the Berkeley 88-Inch Cyclotron. The measured signal is amplified and connected to the input of a lock-in amplifier. The lock-in amplifier performs a synchronous detection of the signal at the cyclotron second harmonic frequency. The magnitude of the signal detected is calibrated against a Faraday cup and corresponds to the beam intensity. It has exceptional resolution, long term stability, and can measure the beam current leaving the cyclotron as low as 1 nA.

  19. Synchronous Sampling for Distributed Experiments

    NASA Astrophysics Data System (ADS)

    Wittkamp, M.; Ettl, J.

    2015-09-01

    Sounding Rocket payloads, especially for atmospheric research, often consists of several independent sensors or experiments with different objectives. The data of these sensors can be combined in the post processing to improve the scientific results of the flight. One major requirement for this data-correlation is a common timeline for the measurements of the distributed experiments. Within this paper we present two ways to achieve absolute timing for asynchronously working experiments. The synchronization process is using the Global Positioning System (GPS) and a standard serial communication protocol for transport of timestamps and flight-states.

  20. Mutual synchronization of weakly coupled gyrotrons

    SciTech Connect

    Rozental, R. M.; Glyavin, M. Yu.; Sergeev, A. S.; Zotova, I. V.; Ginzburg, N. S.

    2015-09-15

    The processes of synchronization of two weakly coupled gyrotrons are studied within the framework of non-stationary equations with non-fixed longitudinal field structure. With the allowance for a small difference of the free oscillation frequencies of the gyrotrons, we found a certain range of parameters where mutual synchronization is possible while a high electronic efficiency is remained. It is also shown that synchronization regimes can be realized even under random fluctuations of the parameters of the electron beams.

  1. Desynchronization of stochastically synchronized chemical oscillators

    SciTech Connect

    Snari, Razan; Tinsley, Mark R. E-mail: kshowalt@wvu.edu; Faramarzi, Sadegh; Showalter, Kenneth E-mail: kshowalt@wvu.edu; Wilson, Dan; Moehlis, Jeff; Netoff, Theoden Ivan

    2015-12-15

    Experimental and theoretical studies are presented on the design of perturbations that enhance desynchronization in populations of oscillators that are synchronized by periodic entrainment. A phase reduction approach is used to determine optimal perturbation timing based upon experimentally measured phase response curves. The effectiveness of the perturbation waveforms is tested experimentally in populations of periodically and stochastically synchronized chemical oscillators. The relevance of the approach to therapeutic methods for disrupting phase coherence in groups of stochastically synchronized neuronal oscillators is discussed.

  2. Complexity and synchronization in stochastic chaotic systems

    NASA Astrophysics Data System (ADS)

    Son Dang, Thai; Palit, Sanjay Kumar; Mukherjee, Sayan; Hoang, Thang Manh; Banerjee, Santo

    2016-02-01

    We investigate the complexity of a hyperchaotic dynamical system perturbed by noise and various nonlinear speech and music signals. The complexity is measured by the weighted recurrence entropy of the hyperchaotic and stochastic systems. The synchronization phenomenon between two stochastic systems with complex coupling is also investigated. These criteria are tested on chaotic and perturbed systems by mean conditional recurrence and normalized synchronization error. Numerical results including surface plots, normalized synchronization errors, complexity variations etc show the effectiveness of the proposed analysis.

  3. Improving Performance of Computer-Aided Detection of Masses by Incorporating Bilateral Mammographic Density Asymmetry: An Assessment

    PubMed Central

    Wang, Xingwei; Li, Lihua; Xu, Weidong; Liu, Wei; Lederman, Dror; Zheng, Bin

    2011-01-01

    Rationale and Objectives Bilateral mammographic density asymmetry is a promising indicator in assessing risk of having or developing breast cancer. This study aims to assess the performance improvement of a computer-aided detection (CAD) scheme in detecting masses by incorporating bilateral mammographic density asymmetrical information. Materials and Methods A testing dataset containing 2400 full-field digital mammograms (FFDM) acquired from 600 examination cases was established. Among them, 300 are positive cases with verified cancer associated with malignant masses and 300 are negative cases. Two computerized schemes were applied to process images of each case. The first single-image based CAD scheme detected suspicious mass regions and the second scheme computed average and difference of mammographic tissue density depicted between the left and right breast. A fusion method based on rotation of the CAD scoring projection reference axis was then applied to combine CAD-generated mass detection scores and either the computed average or difference (asymmetry) of bilateral mammographic density scores. The CAD performance levels with and without incorporating mammographic density information were evaluated and compared using a free-response receiver operating characteristic (FROC) type data analysis method. Results CAD achieved a case-based mass detection sensitivity of 0.74 and a region-based sensitivity of 0.56 at a false-positive rate of 0.25 per image. By fusing the CAD and bilateral mammographic density asymmetry scores, the case-based and region-based sensitivity levels of the CAD scheme were increased to 0.84 and 0.69, respectively, at the same false-positive rate. Fusion with average mammographic density only slightly increased CAD sensitivity to 0.75 (case-based) and 0.57 (region-based). Conclusions This study indicated that (1) bilateral mammographic density asymmetry was a stronger indicator of the case depicting suspicious masses than the average density

  4. Breast biopsy - stereotactic

    MedlinePlus

    ... you have breast cancer . Two main types of breast cancer may be found: Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this ... Lobular carcinoma starts in parts of the breast called lobules, ...

  5. Breast biopsy - ultrasound

    MedlinePlus

    ... you have breast cancer. Two main types of breast cancer may be found: Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this ... Lobular carcinoma starts in parts of the breast called lobules, ...

  6. Tape-recorded Lectures With Slide Synchronization

    ERIC Educational Resources Information Center

    Goodhue, D.

    1969-01-01

    Describes "Taped Explanation Slide Synchronization" programs used for individual study or group showing in college zoology. Discusses preparation of programs, class organization, equipment, and costs. (EB)

  7. Phase synchronization of two anharmonic nanomechanical oscillators.

    PubMed

    Matheny, Matthew H; Grau, Matt; Villanueva, Luis G; Karabalin, Rassul B; Cross, M C; Roukes, Michael L

    2014-01-10

    We investigate the synchronization of oscillators based on anharmonic nanoelectromechanical resonators. Our experimental implementation allows unprecedented observation and control of parameters governing the dynamics of synchronization. We find close quantitative agreement between experimental data and theory describing reactively coupled Duffing resonators with fully saturated feedback gain. In the synchronized state we demonstrate a significant reduction in the phase noise of the oscillators, which is key for sensor and clock applications. Our work establishes that oscillator networks constructed from nanomechanical resonators form an ideal laboratory to study synchronization--given their high-quality factors, small footprint, and ease of cointegration with modern electronic signal processing technologies. PMID:24483899

  8. Robustness of optimal synchronization in real networks.

    PubMed

    Ravoori, Bhargava; Cohen, Adam B; Sun, Jie; Motter, Adilson E; Murphy, Thomas E; Roy, Rajarshi

    2011-07-15

    Experimental studies can provide powerful insights into the physics of complex networks. Here, we report experimental results on the influence of connection topology on synchronization in fiber-optic networks of chaotic optoelectronic oscillators. We find that the recently predicted nonmonotonic, cusplike synchronization landscape manifests itself in the rate of convergence to the synchronous state. We also observe that networks with the same number of nodes, same number of links, and identical eigenvalues of the coupling matrix can exhibit fundamentally different approaches to synchronization. This previously unnoticed difference is determined by the degeneracy of associated eigenvectors in the presence of noise and mismatches encountered in real-world conditions. PMID:21838362

  9. Phase synchronization of two anharmonic nanomechanical oscillators.

    PubMed

    Matheny, Matthew H; Grau, Matt; Villanueva, Luis G; Karabalin, Rassul B; Cross, M C; Roukes, Michael L

    2014-01-10

    We investigate the synchronization of oscillators based on anharmonic nanoelectromechanical resonators. Our experimental implementation allows unprecedented observation and control of parameters governing the dynamics of synchronization. We find close quantitative agreement between experimental data and theory describing reactively coupled Duffing resonators with fully saturated feedback gain. In the synchronized state we demonstrate a significant reduction in the phase noise of the oscillators, which is key for sensor and clock applications. Our work establishes that oscillator networks constructed from nanomechanical resonators form an ideal laboratory to study synchronization--given their high-quality factors, small footprint, and ease of cointegration with modern electronic signal processing technologies.

  10. Calculation principles for a synchronous electromagnetic clutch

    NASA Technical Reports Server (NTRS)

    Panasenkov, M. A.

    1978-01-01

    A detailed explanation of the calculation principles, for a synchronous salient-pole electromagnetic clutch with lumped excitation windings is supplied by direct current. Practical recommendations are given.

  11. Pilotless Frame Synchronization Using LDPC Code Constraints

    NASA Technical Reports Server (NTRS)

    Jones, Christopher; Vissasenor, John

    2009-01-01

    A method of pilotless frame synchronization has been devised for low- density parity-check (LDPC) codes. In pilotless frame synchronization , there are no pilot symbols; instead, the offset is estimated by ex ploiting selected aspects of the structure of the code. The advantag e of pilotless frame synchronization is that the bandwidth of the sig nal is reduced by an amount associated with elimination of the pilot symbols. The disadvantage is an increase in the amount of receiver data processing needed for frame synchronization.

  12. Coupled lasers: phase versus chaos synchronization.

    PubMed

    Reidler, I; Nixon, M; Aviad, Y; Guberman, S; Friesem, A A; Rosenbluh, M; Davidson, N; Kanter, I

    2013-10-15

    The synchronization of chaotic lasers and the optical phase synchronization of light originating in multiple coupled lasers have both been extensively studied. However, the interplay between these two phenomena, especially at the network level, is unexplored. Here, we experimentally compare these phenomena by controlling the heterogeneity of the coupling delay times of two lasers. While chaotic lasers exhibit deterioration in synchronization as the time delay heterogeneity increases, phase synchronization is found to be independent of heterogeneity. The experimental results are found to be in agreement with numerical simulations for semiconductor lasers.

  13. Variety of synchronous regimes in neuronal ensembles

    NASA Astrophysics Data System (ADS)

    Komarov, M. A.; Osipov, G. V.; Suykens, J. A. K.

    2008-09-01

    We consider a Hodgkin-Huxley-type model of oscillatory activity in neurons of the snail Helix pomatia. This model has a distinctive feature: It demonstrates multistability in oscillatory and silent modes that is typical for the thalamocortical neurons. A single neuron cell can demonstrate a variety of oscillatory activity: Regular and chaotic spiking and bursting behavior. We study collective phenomena in small and large arrays of nonidentical cells coupled by models of electrical and chemical synapses. Two single elements coupled by electrical coupling show different types of synchronous behavior, in particular in-phase and antiphase synchronous regimes. In an ensemble of three inhibitory synaptically coupled elements, the phenomenon of sequential synchronous dynamics is observed. We study the synchronization phenomena in the chain of nonidentical neurons at different oscillatory behavior coupled with electrical and chemical synapses. Various regimes of phase synchronization are observed: (i) Synchronous regular and chaotic spiking; (ii) synchronous regular and chaotic bursting; and (iii) synchronous regular and chaotic bursting with different numbers of spikes inside the bursts. We detect and study the effect of collective synchronous burst generation due to the cluster formation and the oscillatory death.

  14. Synchronization and Partial Synchronization Experiments with Networks of Time-Delay Coupled Hindmarsh-Rose Neurons

    NASA Astrophysics Data System (ADS)

    Steur, Erik; Murguia, Carlos; Fey, Rob H. B.; Nijmeijer, Henk

    2016-06-01

    We study experimentally synchronization and partial synchronization in networks of Hindmarsh-Rose model neurons that interact through linear time-delay couplings. Our experimental setup consists of electric circuit board realizations of the Hindmarsh-Rose model neuron and a coupling interface in which the interaction between the circuits is defined. With this experimental setup we test the predictive value of theoretical results about synchronization and partial synchronization in networks.

  15. Breast Reconstruction

    MedlinePlus

    If you need a mastectomy, you have a choice about whether or not to have surgery to rebuild the shape of the breast. Instead of ... be done at the same time as the mastectomy, or it may be done later on. If ...

  16. Breast pain

    PubMed Central

    2007-01-01

    Introduction Breast pain may be cyclical (worse before a period) or non-cyclical, originating from the breast or the chest wall, and occurs at some time in 70% of women. Cyclical breast pain resolves spontaneously in 20-30% of women, but tends to recur in 60% of women. Non-cyclical pain responds poorly to treatment but tends to resolve spontaneously in half of women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for breast pain? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 22 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: a low-fat diet, antibiotics, bromocriptine, danazol, diuretics, evening primrose oil, gestrinone, gonadorelin analogues, hormone replacement therapy, lisuride, progestogens, pyridoxine, tamoxifen, tibolone, topical non-steroidal anti-inflammatory drugs, toremifene, and vitamin E. PMID:19454068

  17. Breast pain

    PubMed Central

    2011-01-01

    Introduction Breast pain may be cyclical (worse before a period) or non-cyclical, originating from the breast or the chest wall, and occurs at some time in 70% of women. Cyclical breast pain resolves spontaneously in 20% to 30% of women, but tends to recur in 60% of women. Non-cyclical pain responds poorly to treatment but tends to resolve spontaneously in half of women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for breast pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, bromocriptine, combined oral contraceptive pill, danazol, diuretics, evening primrose oil, gestrinone, gonadorelin analogues, hormone replacement therapy (HRT), lisuride, low-fat diet, progestogens, pyridoxine, tamoxifen, tibolone, topical or oral non-steroidal anti-inflammatory drugs (NSAIDs), toremifene, and vitamin E. PMID:21477394

  18. Breast pain

    PubMed Central

    2014-01-01

    Introduction Breast pain may be cyclical (worse before a period) or non-cyclical, originating from the breast or the chest wall, and occurs at some time in 70% of women. Cyclical breast pain resolves spontaneously in 20% to 30% of women, but tends to recur in 60% of women. Non-cyclical pain responds poorly to treatment but tends to resolve spontaneously in half of women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for breast pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 11 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: bra wearing, combined oral contraceptive pill, danazol, gonadorelin analogues, progestogens, tamoxifen, and topical or oral non-steroidal anti-inflammatory drugs (NSAIDs).

  19. Gait synchronization in Caenorhabditis elegans

    PubMed Central

    Yuan, Jinzhou; Raizen, David M.; Bau, Haim H.

    2014-01-01

    Collective motion is observed in swarms of swimmers of various sizes, ranging from self-propelled nanoparticles to fish. The mechanisms that govern interactions among individuals are debated, and vary from one species to another. Although the interactions among relatively large animals, such as fish, are controlled by their nervous systems, the interactions among microorganisms, which lack nervous systems, are controlled through physical and chemical pathways. Little is known, however, regarding the mechanism of collective movements in microscopic organisms with nervous systems. To attempt to remedy this, we studied collective swimming behavior in the nematode Caenorhabditis elegans, a microorganism with a compact nervous system. We evaluated the contributions of hydrodynamic forces, contact forces, and mechanosensory input to the interactions among individuals. We devised an experiment to examine pair interactions as a function of the distance between the animals and observed that gait synchronization occurred only when the animals were in close proximity, independent of genes required for mechanosensation. Our measurements and simulations indicate that steric hindrance is the dominant factor responsible for motion synchronization in C. elegans, and that hydrodynamic interactions and genotype do not play a significant role. We infer that a similar mechanism may apply to other microscopic swimming organisms and self-propelled particles. PMID:24778261

  20. High accuracy time transfer synchronization

    NASA Technical Reports Server (NTRS)

    Wheeler, Paul J.; Koppang, Paul A.; Chalmers, David; Davis, Angela; Kubik, Anthony; Powell, William M.

    1995-01-01

    In July 1994, the U.S. Naval Observatory (USNO) Time Service System Engineering Division conducted a field test to establish a baseline accuracy for two-way satellite time transfer synchronization. Three Hewlett-Packard model 5071 high performance cesium frequency standards were transported from the USNO in Washington, DC to Los Angeles, California in the USNO's mobile earth station. Two-Way Satellite Time Transfer links between the mobile earth station and the USNO were conducted each day of the trip, using the Naval Research Laboratory(NRL) designed spread spectrum modem, built by Allen Osborne Associates(AOA). A Motorola six channel GPS receiver was used to track the location and altitude of the mobile earth station and to provide coordinates for calculating Sagnac corrections for the two-way measurements, and relativistic corrections for the cesium clocks. This paper will discuss the trip, the measurement systems used and the results from the data collected. We will show the accuracy of using two-way satellite time transfer for synchronization and the performance of the three HP 5071 cesium clocks in an operational environment.

  1. High accuracy time transfer synchronization

    NASA Astrophysics Data System (ADS)

    Wheeler, Paul J.; Koppang, Paul A.; Chalmers, David; Davis, Angela; Kubik, Anthony; Powell, William M.

    1995-05-01

    In July 1994, the U.S. Naval Observatory (USNO) Time Service System Engineering Division conducted a field test to establish a baseline accuracy for two-way satellite time transfer synchronization. Three Hewlett-Packard model 5071 high performance cesium frequency standards were transported from the USNO in Washington, DC to Los Angeles, California in the USNO's mobile earth station. Two-Way Satellite Time Transfer links between the mobile earth station and the USNO were conducted each day of the trip, using the Naval Research Laboratory(NRL) designed spread spectrum modem, built by Allen Osborne Associates(AOA). A Motorola six channel GPS receiver was used to track the location and altitude of the mobile earth station and to provide coordinates for calculating Sagnac corrections for the two-way measurements, and relativistic corrections for the cesium clocks. This paper will discuss the trip, the measurement systems used and the results from the data collected. We will show the accuracy of using two-way satellite time transfer for synchronization and the performance of the three HP 5071 cesium clocks in an operational environment.

  2. Coronal Modeling and Synchronic Maps

    NASA Astrophysics Data System (ADS)

    Linker, Jon A.; Lionello, R.; Mikic, Z.; Riley, P.; Downs, C.; Henney, C. J.; Arge, C.

    2013-07-01

    MHD simulations of the solar corona rely on maps of the solar magnetic field (typically measured at the photosphere) for input as boundary conditions. These "synoptic" maps (available from a number of ground-based and space-based solar observatories), which are perhaps better described as "diachronic," are built up over a solar rotation. A well-known problem with this approach is that the maps contain data that is as much as 27 days old. The Sun's magnetic flux is always evolving, and these changes in the flux affect coronal and heliospheric structure. Flux evolution models can in principle provide a more accurate specification, by estimating the likely state of the photospheric magnetic field on unobserved portions of the Sun. The Air Force Data Assimilative Photospheric flux Transport (ADAPT) model (Arge et al. 2010), which incorporates data assimilation techniques into the Worden and Harvey (2000) flux evolution model, is especially well-suited for this purpose. In this presentation we describe the use of such "synchronic" maps with coronal models. We compare results using synchronic maps versus the traditional synoptic maps. Research supported by AFOSR, NASA, and NSF.

  3. Synchronously pumped nuclear magnetic oscillator

    NASA Astrophysics Data System (ADS)

    Korver, Anna; Thrasher, Daniel; Bulatowicz, Michael; Walker, Thad

    2015-05-01

    We present progress towards a synchronously pumped nuclear magnetic oscillator. Alkali frequency shifts and quadrupole shifts are the dominant systematic effects in dual Xe isotope co-magnetometers. By synchronously pumping the Xe nuclei using spin-exchange with an oscillating Rb polarization, the Rb and Xe spins precess transverse to the longitudinal bias field. This configuration is predicted to be insensitive to first order quadrupole interactions and alkali spin-exchange frequency shifts. A key feature that allows co-precession of the Rb and Xe spins, despite a ~ 1000 fold ratio of their gyromagnetic ratios, is to apply the bias field in the form of a sequence of Rb 2 π pulses whose repetition frequency is equal to the Rb Larmor frequency. The 2 π pulses result in an effective Rb magnetic moment of zero, while the Xe precession depends only on the time average of the pulsed field amplitude. Polarization modulation of the pumping light at the Xe NMR frequency allows co-precession of the Rb and Xe spins. We will present our preliminary experimental studies of this new approach to NMR of spin-exchange pumped Xe. Support by the NSF and Northrop Grumman Co.

  4. Lobular Carcinoma in Situ: A 29-Year Longitudinal Experience Evaluating Clinicopathologic Features and Breast Cancer Risk

    PubMed Central

    King, Tari A.; Pilewskie, Melissa; Muhsen, Shirin; Patil, Sujata; Mautner, Starr K.; Park, Anna; Oskar, Sabine; Guerini-Rocco, Elena; Boafo, Camilla; Gooch, Jessica C.; De Brot, Marina; Reis-Filho, Jorge S.; Morrogh, Mary; Andrade, Victor P.; Sakr, Rita A.; Morrow, Monica

    2015-01-01

    Purpose The increased breast cancer risk conferred by a diagnosis of lobular carcinoma in situ (LCIS) is poorly understood. Here, we review our 29-year longitudinal experience with LCIS to evaluate factors associated with breast cancer risk. Patients and Methods Patients participating in surveillance after an LCIS diagnosis are observed in a prospectively maintained database. Comparisons were made among women choosing surveillance, with or without chemoprevention, and those undergoing bilateral prophylactic mastectomies between 1980 and 2009. Results One thousand sixty patients with LCIS without concurrent breast cancer were identified. Median age at LCIS diagnosis was 50 years (range, 27 to 83 years). Fifty-six patients (5%) underwent bilateral prophylactic mastectomy; 1,004 chose surveillance with (n = 173) or without (n = 831) chemoprevention. At a median follow-up of 81 months (range, 6 to 368 months), 150 patients developed 168 breast cancers (63% ipsilateral, 25% contralateral, 12% bilateral), with no dominant histology (ductal carcinoma in situ, 35%; infiltrating ductal carcinoma, 29%; infiltrating lobular carcinoma, 27%; other, 9%). Breast cancer incidence was significantly reduced in women taking chemoprevention (10-year cumulative risk: 7% with chemoprevention; 21% with no chemoprevention; P < .001). In multivariable analysis, chemoprevention was the only clinical factor associated with breast cancer risk (hazard ratio, 0.27; 95% CI, 0.15 to 0.50). In a subgroup nested case-control analysis, volume of disease, which was defined as the ratio of slides with LCIS to total number of slides reviewed, was also associated with breast cancer development (P = .008). Conclusion We observed a 2% annual incidence of breast cancer among women with LCIS. Common clinical factors used for risk prediction, including age and family history, were not associated with breast cancer risk. The lower breast cancer incidence in women opting for chemoprevention highlights the

  5. General Information about Breast Cancer

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  6. Risks of Breast Cancer Screening

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Screening (PDQ®)–Patient Version What is screening? Go ... cancer screening: Cancer Screening Overview General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  7. Thyroid metastasis from breast cancer presenting with diffuse microcalcifications on sonography: a case report.

    PubMed

    Liu, Yi-Pei; Tiu, Chui-Mei; Chou, Yi-Hong; Hsu, Chih-Yi; King, Kuang-Liang; Lai, Yi-Chen; Wang, Hsin-Kai; Chiou, Hong-Jen; Chang, Cheng-Yen

    2014-09-01

    Microcalcifications are frequently associated with papillary thyroid cancers. Metastatic nodules from extrathyroid malignancies may mimic primary thyroid neoplasm on sonography, but do not present with microcalcifications. We report the case of a 45-year-old woman with a history of invasive ductal carcinomas of bilateral breasts, status post surgery and neoadjuvant chemotherapy. Four years after surgery, thyroid sonography revealed diffuse microcalcifications without nodular component. Core needle biopsy confirmed thyroid metastasis from primary breast cancer. PMID:24752943

  8. Evolving paradigms in multifocal breast cancer.

    PubMed

    Salgado, Roberto; Aftimos, Philippe; Sotiriou, Christos; Desmedt, Christine

    2015-04-01

    The 7th edition of the TNM defines multifocal breast cancer as multiple simultaneous ipsilateral and synchronous breast cancer lesions, provided they are macroscopically distinct and measurable using current traditional pathological and clinical tools. According to the College of American Pathologists (CAP), the characterization of only the largest lesion is considered sufficient, unless the grade and/or histology are different between the lesions. Here, we review three potentially clinically relevant aspects of multifocal breast cancers: first, the importance of a different intrinsic breast cancer subtype of the various lesions; second, the emerging awareness of inter-lesion heterogeneity; and last but not least, the potential introduction of bias in clinical trials due to the unrecognized biological diversity of these cancers. Although the current strategy to assess the lesion with the largest diameter has clearly its advantages in terms of costs and feasibility, this recommendation may not be sustainable in time and might need to be adapted to be compliant with new evolving paradigms in breast cancer.

  9. High satisfaction rate ten years after bilateral prophylactic mastectomy - a longitudinal study.

    PubMed

    Wasteson, E; Sandelin, K; Brandberg, Y; Wickman, M; Arver, B

    2011-07-01

    Women from families with an increased risk for breast/ovarian cancer have undergone bilateral prophylactic mastectomy (BPM) since the early 1990s at the Karolinska University Hospital in Sweden. Perceptions of BPM as reported by the first women who underwent the procedure have previously been evaluated on a short-term basis (1-3 years). The present study aims to evaluate the long-term (10 years) physical and psychological consequences of BPM in the same cohort of women. Some of the very first women to undergo BPM participated in the present interview study (n= 13). The semi-structured interviews focused on the women's long-term experiences related to BPM and immediate breast reconstruction. Overall, the women were satisfied with their decision to undergo BPM and perceived a negligible remaining risk of getting breast cancer. For most women, the operation had not resulted in changes in family life or lifestyle (n= 8), although some described that the relationship with their spouse was affected (8/13), either in a negative (n= 5) or positive (n= 3) way. The cosmetic results were mainly positive (n= 10). Recurrent counselling and support during the whole process of decision, treatment and follow up is recommended.

  10. Bilateral maculopathy associated with Pierre Robin sequence.

    PubMed

    Witmer, Matthew T; Vasan, Ryan; Levy, Richard; Davis, Jessica; Chan, R V Paul

    2012-08-01

    Pierre Robin sequence has been associated with a number of ocular complications, including myopia, strabismus, Möbius syndrome, nasolacrimal duct obstruction, glaucoma, cataract, microphthalmos, coloboma of choroid, and retinal detachment. We report a 10-day-old boy who presented with micrognathia, glossoptosis, and cleft palate as well as multiple congenital anomalies. Ophthalmic examination was notable for bilateral maculopathy, with focal areas of retinal and retinal pigment epithelial atrophy. The association of Pierre Robin sequence and maculopathy has been reported only twice previously.

  11. [Bilateral jugular thrombosis in Lemierre syndrome].

    PubMed

    Benhayoun, M; Llor, J; Van-Den-Abbeele, T; Elmaleh, M; Mariani, P; Beaufils, F; Dauger, S

    2003-12-01

    An adolescent presented with a rhinosinusitis complicated with bilateral jugular veins and left superior ophthalmic vein thrombosis and respiratory distress with pulmonary hypertension. Blood culture was positive for Haemophilus influenzae and sinus puncture for Streptococcus constellatus. Evolution was under control after 1 week of appropriate antibiotherapy, antithrombotic and anti-inflammatory treatment. He had no neurologic, respiratory or ophthalmologic sequelae 6 months later. Despite lack of pharyngitis or isolation of anaerobic species on blood cultures, the picture was considered compatible with Lemierre syndrome. The risk for such a complication should be considered in cases of severe otorhinolaryngologic infection in young adults. PMID:14643536

  12. Bilateral Symmetry in Morphogenesis of Embryos

    PubMed Central

    Jehle, Herbert

    1970-01-01

    It is suggested that differentiated embryonic cells have a high specificity of molecular constitution as regards the surface layers surrounding their cellular membranes. Correspondingly, specific interface energies may characterize the early contacts between different cell types. The question is raised whether the morphology of the developing embryo may be understood in terms of cellular arrangements which minimize the total interface energy. Bilateral symmetry prevalent in early embryonic development of higher animals might be understood on the basis of the adoption of such a minimum energy principle if, in addition, one assumes that embryonic development is uniquely determined for a particular species. PMID:5272310

  13. Congenital bilateral perisylvian syndrome: a case study.

    PubMed

    Donders, Jacobus; Mullarkey, Sr Kathryn; Allchin, Joel

    2009-02-01

    We report the case of a 14-year-old boy with bilateral congenital perisylvian syndrome as evidenced by polymicrogyria in the left and right frontotemporal regions, pseudobulbar paresis, seizures, and spastic diplegia. This is the first description of comprehensive neuropsychological assessment in a child with this syndrome. The results reflect significant impairments in auditory processing and independent learning and retention, but relatively preserved cognitive performance on interactive tasks involving frequent feedback and redirection. The findings are interpreted in the context of the neuropathology of this syndrome, with an emphasis on pragmatic implications for rehabilitation. PMID:18618376

  14. Progressive bilateral thinning of the parietal bones

    SciTech Connect

    Cederlund, C.G.; Andren, L.; Olivecrona, H.

    1982-03-01

    Observation of a case of progressive bilateral parietal thinning within a period of 14 years induced us to study skull films of 3 636 consecutive patients. Parietal thinning was found in 86 patients (2.37%). It was more common in women, with a sex ratio of 1:1.9. The mean age of the females was 72 years, and that of the males 63 years. Previous skull films of 25 of these patients were available and showed progression in 10. It is concluded that parietal thinning is a slowly progressive disease of middle-aged and old patients and is not an anatomical variant or congenital dysplasia of the dipole.

  15. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    PubMed Central

    Bonafonte Marquez, Elena; Bonafonte Royo, Sergio

    2015-01-01

    We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma. PMID:25713742

  16. Acute quadriplegia due to bilateral cerebral metastases.

    PubMed

    Levine, D N; Black, P M; Kleinman, G M; Ojemann, R

    1981-03-01

    A 51-year-old man developed severe quadriparesis without sensory loss after a fall on the occiput. When he was treated with corticosteroids, the weakness worsened slightly for 2 days, but he then progressively improved and ultimately walked unassisted. Two months later, postmortem examination disclosed metastatic tumors in the superior portion of each precentral gyrus. The subjacent white matter was edematous. No spinal cord abnormalities were found. The clinical, radiologic, and neuropathologic findings suggest that the quadriplegia resulted from these bilateral cerebral lesions and not from spinal cord dysfunction. The rapid development of cerebral edema, perhaps precipitated by trauma, seemed to account for the acute onset of symptoms in this case.

  17. A Retrospective Study Evaluating the Impact of Preoperative Breast MRI on Surgical Decision-Making in Young Patients (≤50 Years) with Invasive Breast Cancer

    PubMed Central

    Mukherjee, Som D.; Hodgson, Nicole; Lovrics, Peter J.; Dhamanaskar, Kavita; Minuk, Terry; Chambers, Shelley; Sussman, Jonathan

    2016-01-01

    INTRODUCTION Breast magnetic resonance imaging (MRI) is considered a more sensitive diagnostic test for detecting invasive breast cancer than mammography or breast ultrasound. Breast MRI may be particularly useful in younger premenopausal women with higher density breast tissue for differentiating between dense fibroglandular breast tissue and breast malignancies. The main objective of this study was to determine the impact of preoperative breast MRI on surgical decision-making in young women with breast cancer. METHODS A retrospective review of patients with newly diagnosed invasive breast cancer and age of ≤50 years was performed. All patients underwent physical examination, preoperative mammogram, breast ultrasound, and bilateral breast MRI. Two breast cancer surgeons reviewed the preoperative mammogram report, breast ultrasound report, and physical examination summary and were asked if they would recommend a lumpectomy, a quandrantectomy, or a mastectomy. A few weeks later, the two surgeons were shown the same information with the breast MRI report and were asked what type of surgery they would now recommend. In each case, MRI was classified by two adjudicators as having affected the surgical outcome in a positive, negative, or neutral fashion. A positive impact was defined as the situation where breast MRI detected additional disease that was not found on physical examination, mammogram, or breast ultrasound and led to an appropriate change in surgical management. A negative impact was defined as the situation where breast MRI led the surgeon to recommend more extensive surgery, with less extensive disease actually found at pathology. No impact was defined as the situation where MRI findings did not alter surgical recommendations or outcomes. RESULTS Of 37 patients whose charts were reviewed, five patients were deemed to be ineligible due to having received neoadjuvant chemotherapy, having previous breast implants, or having had their tumor fully excised

  18. Breast Cancer (For Kids)

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Breast Cancer KidsHealth > For Kids > Breast Cancer Print A A ... for it when they are older. What Is Breast Cancer? The human body is made of tiny building ...

  19. Breast Cancer Disparities

    MedlinePlus

    ... 2.65 MB] Read the MMWR Science Clips Breast Cancer Black Women Have Higher Death Rates from Breast ... of Page U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

  20. Risks of Breast Implants

    MedlinePlus

    ... larger and longer than these conducted so far. Breastfeeding Some women who undergo breast augmentation can successfully ... breast implant silicone shell into breast milk during breastfeeding. Although there are currently no established methods for ...

  1. Male Breast Cancer

    MedlinePlus

    Although breast cancer is much more common in women, men can get it too. It happens most often to men between ... 60 and 70. Breast lumps usually aren't cancer. However, most men with breast cancer have lumps. ...

  2. Breast lump removal

    MedlinePlus

    Lumpectomy; Wide local excision; Breast conservation surgery; Breast-sparing surgery; Partial mastectomy ... If the breast cancer can be seen on imaging tests but the doctor cannot feel it when examining you, a wire ...

  3. Oncological safety of prophylactic breast surgery: skin-sparing and nipple-sparing versus total mastectomy

    PubMed Central

    Maijers, Marike C.; van Deurzen, Carolien H.M.; Koppert, Linetta B.

    2015-01-01

    Women with a BRCA1/2 gene mutation and others with a high breast cancer risk may opt for bilateral prophylactic mastectomy. To allow for immediate breast reconstruction the skin envelope is left in situ with or without the nipple-areola complex (NAC). Although possibly leading to a more natural aesthetic outcome than the conventional total mastectomy, so-called skin-sparing mastectomies (SSM) and nipple-sparing mastectomies (NSM) may leave some breast glandular tissue in situ. The oncological risk associated with remaining breast glandular tissue is unclear. We present a case of primary breast cancer after prophylactic mastectomy followed by a review of the literature on remaining breast glandular tissue after various mastectomy techniques and oncological safety of prophylactic mastectomies. PMID:26645001

  4. Neoadjuvant tamoxifen synchronizes ERα binding and gene expression profiles related to outcome and proliferation

    PubMed Central

    Severson, Tesa M.; Nevedomskaya, Ekaterina; Peeters, Justine; Kuilman, Thomas; Krijgsman, Oscar; van Rossum, Annelot; Droog, Marjolein; Kim, Yongsoo; Koornstra, Rutger; Beumer, Inès; Glas, Annuska M.; Peeper, Daniel; Wesseling, Jelle; Simon, Iris M.; Wessels, Lodewyk; Linn, Sabine C.; Zwart, Wilbert

    2016-01-01

    Estrogen receptor alpha (ERα)-positive breast cancers are frequently treated with tamoxifen, but resistance is common. It remains elusive how tamoxifen resistance occurs and predictive biomarkers for treatment outcome are needed. Because most biomarker discovery studies are performed using pre-treatment surgical resections, the effects of tamoxifen therapy directly on the tumor cell in vivo remain unexamined. In this study, we assessed DNA copy number, gene expression profiles and ERα/chromatin binding landscapes on breast tumor specimens, both before and after neoadjuvant tamoxifen treatment. We observed neoadjuvant tamoxifen treatment synchronized ERα/chromatin interactions and downstream gene expression, indicating that hormonal therapy reduces inter-tumor molecular variability. ERα-synchronized sites are associated with dynamic FOXA1 action at these sites, which is under control of growth factor signaling. Genes associated with tamoxifen-synchronized sites are capable of differentiating patients for tamoxifen benefit. Due to the direct effects of therapeutics on ERα behavior and transcriptional output, our study highlights the added value of biomarker discovery studies after neoadjuvant drug exposure. PMID:27129152

  5. Using Synchronous Technology to Enrich Student Learning

    ERIC Educational Resources Information Center

    Wang, Charles Xiaoxue; Jaeger, David; Liu, Jinxia; Guo, Xiaoning; Xie, Nan

    2013-01-01

    To explore the potential applications of synchronous technology to enrich student learning, faculty members from an American regional state university and a Chinese regional university collaborated to find appropriate ways to integrate synchronous technology (e.g., Adobe Connect) into an educational technology program in the American university…

  6. Examining Interactivity in Synchronous Virtual Classrooms

    ERIC Educational Resources Information Center

    Martin, Florence; Parker, Michele A.; Deale, Deborah F.

    2012-01-01

    Interaction is crucial to student satisfaction in online courses. Adding synchronous components (virtual classroom technologies) to online courses can facilitate interaction. In this study, interaction within a synchronous virtual classroom was investigated by surveying 21 graduate students in an instructional technology program in the…

  7. Synchronization Properties of Random Piecewise Isometries

    NASA Astrophysics Data System (ADS)

    Gorodetski, Anton; Kleptsyn, Victor

    2016-08-01

    We study the synchronization properties of the random double rotations on tori. We give a criterion that show when synchronization is present in the case of random double rotations on the circle and prove that it is always absent in dimensions two and higher.

  8. Interference, Integration and the Synchronic Fallacy.

    ERIC Educational Resources Information Center

    Mackey, William F.

    The purposes of this paper are to examine the effects of synchronic description in distinguishing between interference and integration in cases of language contact, and to suggest alternative methods of description suitable for the analysis of systems in motion. The "synchronic fallacy" is defined here as the belief that one can describe a…

  9. Quasars as very-accurate clock synchronizers

    NASA Technical Reports Server (NTRS)

    Hurd, W. J.; Goldstein, R. M.

    1975-01-01

    Quasars can be employed to synchronize global data communications, geophysical measurements, and atomic clocks. It is potentially two to three orders of magnitude better than presently-used Moon-bounce system. Comparisons between quasar and clock pulses are used to develop correction or synchronization factors for station clocks.

  10. Development of Network Synchronization Predicts Language Abilities.

    PubMed

    Doesburg, Sam M; Tingling, Keriann; MacDonald, Matt J; Pang, Elizabeth W

    2016-01-01

    Synchronization of oscillations among brain areas is understood to mediate network communication supporting cognition, perception, and language. How task-dependent synchronization during word production develops throughout childhood and adolescence, as well as how such network coherence is related to the development of language abilities, remains poorly understood. To address this, we recorded magnetoencephalography while 73 participants aged 4-18 years performed a verb generation task. Atlas-guided source reconstruction was performed, and phase synchronization among regions was calculated. Task-dependent increases in synchronization were observed in the theta, alpha, and beta frequency ranges, and network synchronization differences were observed between age groups. Task-dependent synchronization was strongest in the theta band, as were differences between age groups. Network topologies were calculated for brain regions associated with verb generation and were significantly associated with both age and language abilities. These findings establish the maturational trajectory of network synchronization underlying expressive language abilities throughout childhood and adolescence and provide the first evidence for an association between large-scale neurophysiological network synchronization and individual differences in the development of language abilities.

  11. Complete synchronization and generalized synchronization of one-way coupled time-delay systems.

    PubMed

    Zhan, Meng; Wang, Xingang; Gong, Xiaofeng; Wei, G W; Lai, C-H

    2003-09-01

    The complete synchronization and generalized synchronization (GS) of one-way coupled time-delay systems are studied. We find that GS can be achieved by a single scalar signal, and its synchronization threshold for different delay times shows the parameter resonance effect, i.e., we can obtain stable synchronization at a smaller coupling if the delay time of the driven system is chosen such that it is in resonance with the driving system. Near chaos synchronization, the desynchronization dynamics displays periodic bursts with the period equal to the delay time of the driven system. These features can be easily applied to the recovery of time-delay systems.

  12. Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125

    PubMed Central

    Loué, Védi André Serges; Gbary, Eléonore; Koui, Sylvanus; Akpa, Bédi; Kouassi, Adélaide

    2013-01-01

    Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs' syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL) in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs' syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices. PMID:23431489

  13. Bilateral Spontaneous Midsubstance Patellar Tendon Rupture after Bilateral Total Knee Arthroplasty

    PubMed Central

    Rajani, Amyn; Dash, Kumar Kaushik; Mahajan, Neetin P; Kumar, Ritesh

    2016-01-01

    Introduction: Patellar tendon rupture can occur due to multiple causes ranging from inflammatory pathologies to episodes of trauma. Extensor mechanism rupture is a rare complication of total knee arthroplasty (TKA). In most of these cases, the failure occurs as avulsion of patellar tendon from tibial tuberosity. We report a rare case with bilateral mid-substance patellar tendon rupture one month after bilateral total knee arthroplasty. Case Presentation: A 69-year-old male was operated for bilateral grade 4 osteoarthritis. On day 30 post-operative, he sustained bilateral patellar tendon rupture while getting up from toilet. He had a history of multiple steroid injections in the knee, which could have affected the tendon. The other etiologies could be inherent weakness of tendon due to diabetes and old age and micro-trauma/stretch associated with sudden correction of previous deformity by TKA. The management in our case was done by primary repair along with augmentation by autologous semitendinosus graft and suture anchor. Conclusion: The operating surgeon must be aware of the possibility of patellar tendon rupture following total knee arthroplasty. This will help the surgeon in early recognition and preparedness to handle such complications, should they arise. Surgeons may consider advising caution to both patient and rehabilitation team in cases with old age, chronic diabetes mellitus, and with a history of steroid injections. PMID:27703942

  14. Breast MRI in Community Practice: Equipment and Imaging Techniques at Facilities in the Breast Cancer Surveillance Consortium (BCSC)

    PubMed Central

    DeMartini, Wendy B.; Ichikawa, Laura; Yankaskas, Bonnie C.; Buist, Diana; Kerlikowske, Karla; Geller, Berta; Onega, Tracy; Rosenberg, Robert D.; Lehman, Constance D.

    2010-01-01

    Purpose MRI is increasingly used for detection of breast carcinoma. Little is known about breast MRI techniques among community practice facilities. This study evaluated equipment and acquisition techniques used by community facilities across the U.S., including compliance with minimum standards by the American College of Radiology Imaging Network (ACRIN) 6667 Trial and the European Society of Breast Imaging (EUSOBI). Methods Breast Cancer Surveillance Consortium (BCSC) facilities performing breast MRI were identified and queried by survey regarding breast MRI equipment and technical parameters. Variables included scanner field strength, coil type, acquisition coverage, slice thickness and timing of initial post-contrast sequence. Results were tallied and percentages of facilities meeting ACRIN and EUSOBI standards were calculated Results From 23 facilities performing breast MRI, results were obtained from 14 (61%) facilities with 16 MRI scanners reporting 18 imaging parameters. Compliance with equipment recommendations of ≥1.5T field strength was 94% and of a dedicated breast coil was 100%. Eight-three percent of acquisitions used bilateral post-contrast technique and 78% used slice thickness <= 3 mm. Timing of initial post-contrast sequences ranged from 58 seconds to eight minutes 30 seconds, with 63% meeting recommendations for completion within four minutes. Conclusions Nearly all surveyed facilities met ACRIN and EUSOBI standards for breast MRI equipment. The majority met standards for acquisition parameters, although techniques varied, in particular for timing of initial post-contrast imaging. Further guidelines by the ACR Breast MRI Accreditation Program will be of importance in facilitating standardized and high quality breast MRI. PMID:21040870

  15. Noninvasive testing of asymptomatic bilateral hilar adenopathy

    SciTech Connect

    Carr, P.L.; Singer, D.E.; Goldenheim, P.; Bernardo, J.; Mulley, A.G. )

    1990-03-01

    The diagnostic strategy for asymptomatic patients with persistent bilateral bilar adenopathy often involves invasive procedures. The authors used Bayesian analysis to: (1) estimate the relative prevalences of diseases causing bilateral bilar adenopathy; (2) assess changes in the prevalence of disease by race, the presence of other clinical symptoms, and geography; and (3) determine the value of relevant noninvasive tests, including the angiotensin-converting enzyme (ACE) assay, gallium scan, and purified protein derivative (PPD), in order to assess when a strategy of watchful waiting is appropriate. The analysis indicated that the ACE assay, particularly when paired with the PPD, can identify many patients who might safely be managed without immediate invasive biopsy. Patients who are ACE+ and PPD- have an estimated probability of sarcoidosis of 0.95 or greater; patients who are ACE- and PPD+ have a probability of tuberculosis of 0.86 if black, 0.79 if white. In contrast, gallium scanning has no diagnostic role in this clinical situation. Bronchoscopic or mediastinoscopic biopsy has a limited role for patients who are ACE+ PPD- or ACE- PPD+ because of limited sensitivity. Patients who are both ACE- and PPD-, particularly if white, may have a high enough risk of lymphoma to consider invasive biopsy.

  16. Bilateral song production in domestic canaries.

    PubMed

    Suthers, Roderick A; Vallet, Eric; Tanvez, Aurélie; Kreutzer, Michel

    2004-09-01

    We studied the mechanism of song production in the outbred common or domestic canary (Serinus canaria). The contribution that each side of the syrinx makes to song was investigated by observing the effect of unilaterally occluding the left or right primary bronchus, followed by section of the ipsilateral branch of the tracheosyringeal nerve. In other birds with a bilaterally intact vocal system we monitored airflow through each side of the syrinx, together with subsyringeal pressure, during spontaneous song. Song production by domestic canaries is not strongly lateralized as it is in the conspecific song-bred waterslager strain. Some syllables are produced entirely on the left or right side of the syrinx, whereas others contain sequential contributions from each side. Low fundamental frequencies are produced with the left syrinx and high frequencies by the right syrinx, increasing the frequency range of domestic canary song compared to that of the waterslager strain. Midrange frequencies can be generated by either side. Syllables at repetition rates below about 25 s(-1) were accompanied by minibreaths, which were usually bilateral. Unilateral minibreaths were typically on the left side. At higher syllable repetition rates, minibreaths were replaced by a respiratory pattern of pulsatile expiration. Our data show that strong unilateral dominance in song production, present in the waterslager strain, is not a trait of the species as a whole and that the pattern of song lateralization can be altered by selective breeding for particular song characteristics.

  17. Hiatus Hernia Repair with Bilateral Oesophageal Fixation.

    PubMed

    Mendis, Rajith; Cheung, Caran; Martin, David

    2015-01-01

    Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence. Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL), PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy. Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38, P < 0.01), Visick (3 to 1), and RSI (17.45 to 5, P < 0.01). PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%). 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation. Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability. PMID:26065030

  18. Bilateral Comparison in Chemosensory-Mediated Foraging

    NASA Astrophysics Data System (ADS)

    Webster, D. R.; Rahman, S.; Dasi, L. P.

    2000-11-01

    Motivation is drawn from the need to determine the sensory cues that animals such as blue crabs and lobsters use to track chemical odor plumes to locate food or mates. Major steps forward with this difficult problem can only be achieved through an appreciation of the spatial and temporal variation of concentration fields and the information content available to a forager in the plume. Here we discuss the usefulness of bilateral comparison to an animal tracking a turbulent plume. Instantaneous concentration fields of a chemical plume diffusing in a fully-developed turbulent open channel flow are measured using planar laser-induced fluorescence (PLIF). The plume is released iso-kinetically 25 mm above the smooth bed (z+ = 90), thus transport is mainly due to advection and ambient turbulence. A spatial correlation function in the spanwise direction is a dramatic indicator of the relative position of the centerline and distance from the source. The relative direction of the plume centerline can be estimated from an instantaneous bilateral comparison provided the sensors are separated by a distance that is relatively large compared to the spanwise integral length scale based on the spatial correlation function.

  19. Amplitude dynamics favors synchronization in complex networks

    NASA Astrophysics Data System (ADS)

    Gambuzza, Lucia Valentina; Gómez-Gardeñes, Jesus; Frasca, Mattia

    2016-04-01

    In this paper we study phase synchronization in random complex networks of coupled periodic oscillators. In particular, we show that, when amplitude dynamics is not negligible, phase synchronization may be enhanced. To illustrate this, we compare the behavior of heterogeneous units with both amplitude and phase dynamics and pure (Kuramoto) phase oscillators. We find that in small network motifs the behavior crucially depends on the topology and on the node frequency distribution. Surprisingly, the microscopic structures for which the amplitude dynamics improves synchronization are those that are statistically more abundant in random complex networks. Thus, amplitude dynamics leads to a general lowering of the synchronization threshold in arbitrary random topologies. Finally, we show that this synchronization enhancement is generic of oscillators close to Hopf bifurcations. To this aim we consider coupled FitzHugh-Nagumo units modeling neuron dynamics.

  20. Amplitude dynamics favors synchronization in complex networks

    PubMed Central

    Gambuzza, Lucia Valentina; Gómez-Gardeñes, Jesus; Frasca, Mattia

    2016-01-01

    In this paper we study phase synchronization in random complex networks of coupled periodic oscillators. In particular, we show that, when amplitude dynamics is not negligible, phase synchronization may be enhanced. To illustrate this, we compare the behavior of heterogeneous units with both amplitude and phase dynamics and pure (Kuramoto) phase oscillators. We find that in small network motifs the behavior crucially depends on the topology and on the node frequency distribution. Surprisingly, the microscopic structures for which the amplitude dynamics improves synchronization are those that are statistically more abundant in random complex networks. Thus, amplitude dynamics leads to a general lowering of the synchronization threshold in arbitrary random topologies. Finally, we show that this synchronization enhancement is generic of oscillators close to Hopf bifurcations. To this aim we consider coupled FitzHugh-Nagumo units modeling neuron dynamics. PMID:27108847

  1. Clustering versus non-clustering phase synchronizations

    SciTech Connect

    Liu, Shuai; Zhan, Meng

    2014-03-15

    Clustering phase synchronization (CPS) is a common scenario to the global phase synchronization of coupled dynamical systems. In this work, a novel scenario, the non-clustering phase synchronization (NPS), is reported. It is found that coupled systems do not transit to the global synchronization until a certain sufficiently large coupling is attained, and there is no clustering prior to the global synchronization. To reveal the relationship between CPS and NPS, we further analyze the noise effect on coupled phase oscillators and find that the coupled oscillator system can change from CPS to NPS with the increase of noise intensity or system disorder. These findings are expected to shed light on the mechanism of various intriguing self-organized behaviors in coupled systems.

  2. Synchronization of oscillators coupled through an environment

    NASA Astrophysics Data System (ADS)

    Katriel, Guy

    2008-11-01

    We study synchronization of oscillators that are indirectly coupled through their interaction with an environment. We give criteria for the stability or instability of a synchronized oscillation. Using these criteria we investigate synchronization of systems of oscillators which are weakly coupled, in the sense that the influence of the oscillators on the environment is weak. We prove that arbitrarily weak coupling will synchronize the oscillators, provided that this coupling is of the ‘right’ sign. We illustrate our general results by applications to a model of coupled GnRH neuron oscillators proposed by Khadra and Li [A. Khadra, Y.X. Li, A model for the pulsatile secretion of gonadotropin-releasing hormone from synchronized hypothalamic neurons, Biophys. J. 91 (2006) 74-83.], and to indirectly weakly-coupled λ- ω oscillators.

  3. Hydrodynamic synchronization of colloidal oscillators

    PubMed Central

    Kotar, Jurij; Leoni, Marco; Bassetti, Bruno; Lagomarsino, Marco Cosentino; Cicuta, Pietro

    2010-01-01

    Two colloidal spheres are maintained in oscillation by switching the position of an optical trap when a sphere reaches a limit position, leading to oscillations that are bounded in amplitude but free in phase and period. The interaction between the oscillators is only through the hydrodynamic flow induced by their motion. We prove that in the absence of stochastic noise the antiphase dynamical state is stable, and we show how the period depends on coupling strength. Both features are observed experimentally. As the natural frequencies of the oscillators are made progressively different, the coordination is quickly lost. These results help one to understand the origin of hydrodynamic synchronization and how the dynamics can be tuned. Cilia and flagella are biological systems coupled hydrodynamically, exhibiting dramatic collective motions. We propose that weakly correlated phase fluctuations, with one of the oscillators typically precessing the other, are characteristic of hydrodynamically coupled systems in the presence of thermal noise. PMID:20385848

  4. Pulse code modulated signal synchronizer

    NASA Technical Reports Server (NTRS)

    Kobayashi, H. S. (Inventor)

    1974-01-01

    A bit synchronizer for a split phase PCM transmission is reported that includes three loop circuits which receive incoming phase coded PCM signals. In the first loop, called a Q-loop, a generated, phase coded, PCM signal is multiplied with the incoming signals, and the frequency and phase of the generated signal are nulled to that of the incoming subcarrier signal. In the second loop, called a B-loop, a circuit multiplies a generated signal with incoming signals to null the phase of the generated signal in a bit phase locked relationship to the incoming signal. In a third loop, called the I-loop, a phase coded PCM signal is multiplied with the incoming signals for decoding the bit information from the PCM signal. A counter means is used for timing of the generated signals and timing of sample intervals for each bit period.

  5. A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery.

    PubMed

    Morimoto, R; Satani, N; Iwakura, Y; Ono, Y; Kudo, M; Nezu, M; Omata, K; Tezuka, Y; Seiji, K; Ota, H; Kawasaki, Y; Ishidoya, S; Nakamura, Y; Arai, Y; Takase, K; Sasano, H; Ito, S; Satoh, F

    2016-06-01

    Primary aldosteronism due to unilateral aldosterone-producing adenoma (APA) is a surgically curable form of hypertension. Bilateral APA can also be surgically curable in theory but few successful cases can be found in the literature. It has been reported that even using successful adrenal venous sampling (AVS) via bilateral adrenal central veins, it is extremely difficult to differentiate bilateral APA from bilateral idiopathic hyperaldosteronism (IHA) harbouring computed tomography (CT)-detectable bilateral adrenocortical nodules. We report a case of bilateral APA diagnosed by segmental AVS (S-AVS) and blood sampling via intra-adrenal first-degree tributary veins to localize the sites of intra-adrenal hormone production. A 36-year-old man with marked long-standing hypertension was referred to us with a clinical diagnosis of bilateral APA. He had typical clinical and laboratory profiles of marked hypertension, hypokalaemia, elevated plasma aldosterone concentration (PAC) of 45.1 ng dl(-1) and aldosterone renin activity ratio of 90.2 (ng dl(-1) per ng ml(-1 )h(-1)), which was still high after 50 mg-captopril loading. CT revealed bilateral adrenocortical tumours of 10 and 12 mm in diameter on the right and left sides, respectively. S-AVS confirmed excess aldosterone secretion from a tumour segment vein and suppressed secretion from a non-tumour segment vein bilaterally, leading to the diagnosis of bilateral APA. The patient underwent simultaneous bilateral sparing adrenalectomy. Histopathological analysis of the resected adrenals together with decreased blood pressure and PAC of 5.2 ng dl(-1) confirmed the removal of bilateral APA. S-AVS was reliable to differentiate bilateral APA from IHA by direct evaluation of intra-adrenal hormone production. PMID:26538381

  6. A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery

    PubMed Central

    Morimoto, R; Satani, N; Iwakura, Y; Ono, Y; Kudo, M; Nezu, M; Omata, K; Tezuka, Y; Seiji, K; Ota, H; Kawasaki, Y; Ishidoya, S; Nakamura, Y; Arai, Y; Takase, K; Sasano, H; Ito, S; Satoh, F

    2016-01-01

    Primary aldosteronism due to unilateral aldosterone-producing adenoma (APA) is a surgically curable form of hypertension. Bilateral APA can also be surgically curable in theory but few successful cases can be found in the literature. It has been reported that even using successful adrenal venous sampling (AVS) via bilateral adrenal central veins, it is extremely difficult to differentiate bilateral APA from bilateral idiopathic hyperaldosteronism (IHA) harbouring computed tomography (CT)-detectable bilateral adrenocortical nodules. We report a case of bilateral APA diagnosed by segmental AVS (S-AVS) and blood sampling via intra-adrenal first-degree tributary veins to localize the sites of intra-adrenal hormone production. A 36-year-old man with marked long-standing hypertension was referred to us with a clinical diagnosis of bilateral APA. He had typical clinical and laboratory profiles of marked hypertension, hypokalaemia, elevated plasma aldosterone concentration (PAC) of 45.1 ng dl−1 and aldosterone renin activity ratio of 90.2 (ng dl−1 per ng ml−1 h−1), which was still high after 50 mg-captopril loading. CT revealed bilateral adrenocortical tumours of 10 and 12 mm in diameter on the right and left sides, respectively. S-AVS confirmed excess aldosterone secretion from a tumour segment vein and suppressed secretion from a non-tumour segment vein bilaterally, leading to the diagnosis of bilateral APA. The patient underwent simultaneous bilateral sparing adrenalectomy. Histopathological analysis of the resected adrenals together with decreased blood pressure and PAC of 5.2 ng dl−1 confirmed the removal of bilateral APA. S-AVS was reliable to differentiate bilateral APA from IHA by direct evaluation of intra-adrenal hormone production. PMID:26538381

  7. The bilateral advantage for famous faces: interhemispheric communication or competition?

    PubMed

    Baird, Lyndsay M; Burton, A Mike

    2008-04-01

    The bilateral advantage for the perception of famous faces was investigated using a redundant target procedure. In experiment 1 we compared simultaneous presentation of stimuli (a) bilaterally and (b) one above the other in the central field. Results showed a redundancy advantage, but only when faces were presented bilaterally. This result lends support to the notion of interhemispheric communication using cross-hemisphere representations. Experiment 2 examined the nature of such communication by comparing bilateral presentation of identical face images, with bilateral presentation of different images of the same person. When asked to make a familiar/unfamiliar face judgement, participants showed evidence for a redundancy advantage under both bilateral conditions. This suggests that the nature of the information shared in interhemispheric communication is abstract, rather than being tied to superficial stimulus properties.

  8. Collapse of Synchronization in a Memristive Network

    NASA Astrophysics Data System (ADS)

    Lü, Mi; Wang, Chun-Ni; Tang, Jun; Ma, Jun

    2015-12-01

    For an oscillating circuit or coupled circuits, damage in electric devices such as inductor, resistance, memristor even capacitor can cause breakdown or collapse of the circuits. These damage could be associated with external attack or aging in electric devices, and then the bifurcation parameters could be deformed from normal values. Resonators or signal generators are often synchronized to produce powerful signal series and this problem could be investigated by using synchronization in network. Complete synchronization could be induced by linear coupling in a two-dimensional network of identical oscillators when the coupling intensity is beyond certain threshold. The collective behavior and synchronization state are much dependent on the bifurcation parameters. Any slight fluctuation in parameter and breakdown in bifurcation parameter can cause transition of synchronization even collapse of synchronization in the network. In this paper, a two-dimensional network composed of the resonators coupled with memristors under nearest-neighbor connection is designed, and the network can reach complete synchronization by carefully selecting coupling intensity. The network keeps synchronization after certain transient period, then a bifurcation parameter in a resonator is switched from the previous value and the adjacent resonators (oscillators) are affected in random. It is found that the synchronization area could be invaded greatly in a diffusive way. The damage area size is much dependent on the selection of diffusive period of damage and deformation degree in the parameter. Indeed, the synchronization area could keep intact at largest size under intermediate deformation degree and coupling intensity. Supported by the National Natural Science of China under Grant Nos. 11265008 and 11365014

  9. Bilateral luxatio erecta with greater tuberosity fracture: a case report

    PubMed Central

    Saxena, Vikas; Pradhan, Pavan

    2013-01-01

    Bilateral shoulder dislocation with greater tuberosity fracture and luxatio erecta, both are rare by themselves, with only few reports of each. We report an unusual case of posttraumatic bilateral symmetrical shoulder dislocation involving luxatio erecta with greater tuberosity fracture in a young male. To our knowledge, this is the first case of symmetrical bilateral shoulder dislocation with greater tuberosity fracture involving luxatio erecta dislocation from Indian subcontinent. PMID:26403880

  10. Oscillatory recruitment of bilateral visual cortex during spatial attention to competing rhythmic inputs.

    PubMed

    Gray, Michael J; Frey, Hans-Peter; Wilson, Tommy J; Foxe, John J

    2015-04-01

    Selective attention uses temporal regularity of relevant inputs to bias the phase of ongoing population-level neuronal oscillations. This phase entrainment streamlines processing, allowing attended information to arrive at moments of high neural excitability. How entrainment resolves competition between spatially segregated inputs during visuospatial tasks is not yet established. Using high-density electroencephalography in humans, a bilateral entrainment response to the rhythm (1.3 or 1.5 Hz) of an attended stimulation stream was observed, concurrent with a considerably weaker contralateral entrainment to a competing rhythm. That ipsilateral visual areas strongly entrained to the attended stimulus is notable because competitive inputs to these regions were being driven at an entirely different rhythm. Strong modulations of phase locking and weak modulations of single-trial power suggest that entrainment was primarily driven by phase-alignment of ongoing oscillatory activity. In addition, interhemispheric differences in entrained phase were found to be modulated by attended hemifield, implying that the bilateral nature of the response reflected a functional flow of information between hemispheres. This modulation was strongest at the third of at least four harmonics that were strongly entrained. Ipsilateral increases in alpha-band (8-12 Hz) power were also observed during bilateral entrainment, reflecting suppression of the ignored stimulation stream. Furthermore, both entrainment and alpha lateralization significantly affected task performance. We conclude that oscillatory entrainment is a functionally relevant mechanism that synchronizes endogenous activity across the cortical hierarchy to resolve spatial competition. We further speculate that concurrent suppression of ignored input might facilitate the widespread propagation of attended information during spatial attention. PMID:25855167

  11. Epidemiology of susceptibility to breast cancer.

    PubMed

    Hulka, B S

    1996-01-01

    Numerous factors have been noted to be associated with risk of breast cancer. Indicators of endogenous hormonal alterations are among them: early age at menarche and late age at menopause, nulliparity, late age at first full term pregnancy and obesity in postmenopausal women. Other established risk factors are family history of breast cancer, histologic characteristics of benign tissue, mammographic patterns, exogenous hormones and alcohol consumption. Endogenous indicators may be a reflection of enhanced susceptibility, whereas exogenous exposures can have both independent effects on risk and the ability to interact with markers of inherited susceptibility. In case control studies of breast cancer, family history confers a risk elevation of two to three fold. The higher risk estimate occurs when first degree rather than second degree relatives are affected, or if more than one relative is affected. A relative diagnosed before age 45 increases risk for early-onset breast cancer. These findings have been obtained using either traditional analytic methods for case control data or an alternative strategy, which uses case control status as the predictor variable and models the risk to relatives in a time-dependent fashion. Risk of breast cancer is greater for the mother and sisters of cases than controls. The magnitude of risk increases with 1) decreasing age of diagnosis of the index case 2) additional family members with diagnosed breast cancer and 3) bilateral breast cancer in the index case. Although these two analytic approaches have somewhat different data requirements and may be subject to different biases, the results produced are quite consistent. Mutated p53 in female family members of patients with Li-Fraumeni syndrome was one of the first identified genetic susceptibility markers for breast cancer. Application of segregation and linkage analyses to pedigrees with multiple affected family members successfully focused the search for BRCA1. Recent cloning and

  12. Spermatozoa protein alterations in infertile men with bilateral varicocele

    PubMed Central

    Agarwal, Ashok; Sharma, Rakesh; Durairajanayagam, Damayanthi; Cui, Zhihong; Ayaz, Ahmet; Gupta, Sajal; Willard, Belinda; Gopalan, Banu; Sabanegh, Edmund

    2016-01-01

    Among infertile men, a diagnosis of unilateral varicocele is made in 90% of varicocele cases and bilateral in the remaining varicocele cases. However, there are reports of under-diagnosis of bilateral varicocele among infertile men and that its prevalence is greater than 10%. In this prospective study, we aimed to examine the differentially expressed proteins (DEP) extracted from spermatozoa cells of patients with bilateral varicocele and fertile donors. Subjects consisted of 17 men diagnosed with bilateral varicocele and 10 proven fertile men as healthy controls. Using the LTQ-orbitrap elite hybrid mass spectrometry system, proteomic analysis was done on pooled samples from 3 patients with bilateral varicocele and 5 fertile men. From these samples, 73 DEP were identified of which 58 proteins were differentially expressed, with 7 proteins unique to the bilateral varicocele group and 8 proteins to the fertile control group. Majority of the DEPs were observed to be associated with metabolic processes, stress responses, oxidoreductase activity, enzyme regulation, and immune system processes. Seven DEP were involved in sperm function such as capacitation, motility, and sperm-zona binding. Proteins TEKT3 and TCP11 were validated by Western blot analysis and may serve as potential biomarkers for bilateral varicocele. In this study, we have demonstrated for the first time the presence of DEP and identified proteins with distinct reproductive functions which are altered in infertile men with bilateral varicocele. Functional proteomic profiling provides insight into the mechanistic implications of bilateral varicocele-associated male infertility. PMID:25999357

  13. Ehlers-Danlos Syndrome Type IV with Bilateral Pneumothorax.

    PubMed

    Nakagawa, Hiroaki; Wada, Hiroshi; Hajiro, Takashi; Nagao, Taishi; Ogawa, Emiko; Hatamochi, Atsushi; Tanaka, Toshihiro; Nakano, Yasutaka

    2015-01-01

    A 17-year-old teen was hospitalized with bilateral pneumothorax. After the bilateral lungs were expanded using catheter tubes, he fully recovered and he was discharged from our hospital. He had a history of colon perforation. Ehlers-Danlos syndrome (EDS) was suspected due to the combination of colon perforation and pneumothorax, and EDS type IV was confirmed after a genetic study identified a c.1511g>a mutation in the COL3A1 gene. This is the first report of bilateral pneumothorax caused by EDS type IV. Clinicians should consider EDS type IV in the differential diagnosis for bilateral pneumothorax in conjunction with distinct previous histories and radiological findings.

  14. A Rare Presentation Of An Ectopic Breast Tissue In Axilla.

    PubMed

    Vidyasagar, Radhika; Singh, R N

    2015-10-01

    Accessory breast tissue is rare accounting to less than 1% cases seen in females. It is usually bilateral. We report a case of 24-year-old woman with a lump in the left axilla in view of its rarity and made a differential diagnosis of fibroadenoma, which following the investigations and histopathological report was confirmed as revealed fibroadenoma in the axilla. It should also be considered as a differential diagnosis for all axillary swellings. PMID:26812754

  15. Interocular symmetry analysis of bilateral eyes.

    PubMed

    Li, Yi; Bao, Fang Jun

    2014-05-01

    The purpose of this study was to evaluate the interocular symmetry of several biometric parameters between both eyes. The symmetry between the right and left eye of 397 subjects in 14 biometric parameters, spherical equivalent of refractive error (SE), Jackson crossed cylinder power of refractive error astigmatism with axes at 90° and 180° (RJ0) and at 45° and 135° (RJ45), best-corrected visual acuity (BCVA), average corneal curvature (CC), Jackson crossed cylinder power of corneal astigmatism (CJ0 and CJ45), corneal asphericity coefficient (Q), intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD), was assessed by comparative data analysis. Aside from RJ0 (p = 0.00), RJ45 (p = 0.02) and Q (p = 0.00), the overall interocular differences of other biometric parameters between fellow eyes were not significant (p > 0.05). The interocular correlation and Bland-Altman plots showed a good agreement between fellow eyes in 14 biometric parameters. Correlations between interocular differences in SE and that in RJ0 (p = 0.03), CC (p = 0.00), AL (p = 0.00) and VCD (p = 0.00) were statistically significant. There were similar strong linear relationships between refractive error astigmatism vectors and corneal astigmatism vectors in bilateral eyes. There were negative correlations of RJ45 and CJ45 between bilateral eyes. A potentially clinically important interocular symmetry in SE, BCVA, CC, CJ0, CJ45, IOP, CCT, AL, ACD, LT and VCD is found in this research, while the differences of RJ0, RJ45 and Q between left and right eyes seem a bit large. The negative interocular relationships of RJ45 and CJ45 demonstrate moderate mirror symmetry exists among fellow eyes. High interocular symmetry in bilateral eyes may be helpful in intraocular lens power calculation, intraocular pressure evaluation, post-operative visual acuity and refraction

  16. V123 BEAM SYNCHRONOUS ENCODER MODULE.

    SciTech Connect

    KERNER,T.; CONKLING,C.R.; OERTER,B.

    1999-03-29

    The V123 Synchronous Encoder Module transmits events to distributed trigger modules and embedded decoders around the RHIC rings where they are used to provide beam instrumentation triggers [1,2,3]. The RHIC beam synchronous event link hardware is mainly comprised of three VMEbus board designs, the central input modules (V201), and encoder modules (V123), and the distributed trigger modules (V124). Two beam synchronous links, one for each ring, are distributed via fiber optics and fanned out via twisted wire pair cables. The V123 synchronizes with the RF system clock derived from the beam bucket frequency and a revolution fiducial pulse. The RF system clock is used to create the beam synchronous event link carrier and events are synchronized with the rotation fiducial. A low jitter RF clock is later recovered from this carrier by phase lock loops in the trigger modules. Prioritized hardware and software triggers fill up to 15 beam event code transmission slots per revolution while tracking the ramping RF acceleration frequency and storage frequency. The revolution fiducial event is always the first event transmitted which is used to synchronize the firing of the abort kicker and to locate the first bucket for decoders distributed about the ring.

  17. System Synchronizes Recordings from Separated Video Cameras

    NASA Technical Reports Server (NTRS)

    Nail, William; Nail, William L.; Nail, Jasper M.; Le, Doung T.

    2009-01-01

    A system of electronic hardware and software for synchronizing recordings from multiple, physically separated video cameras is being developed, primarily for use in multiple-look-angle video production. The system, the time code used in the system, and the underlying method of synchronization upon which the design of the system is based are denoted generally by the term "Geo-TimeCode(TradeMark)." The system is embodied mostly in compact, lightweight, portable units (see figure) denoted video time-code units (VTUs) - one VTU for each video camera. The system is scalable in that any number of camera recordings can be synchronized. The estimated retail price per unit would be about $350 (in 2006 dollars). The need for this or another synchronization system external to video cameras arises because most video cameras do not include internal means for maintaining synchronization with other video cameras. Unlike prior video-camera-synchronization systems, this system does not depend on continuous cable or radio links between cameras (however, it does depend on occasional cable links lasting a few seconds). Also, whereas the time codes used in prior video-camera-synchronization systems typically repeat after 24 hours, the time code used in this system does not repeat for slightly more than 136 years; hence, this system is much better suited for long-term deployment of multiple cameras.

  18. Periodic and aperiodic synchronization in skilled action.

    PubMed

    Cummins, Fred

    2011-01-01

    Synchronized action is considered as a manifestation of shared skill. Most synchronized behaviors in humans and other animals are based on periodic repetition. Aperiodic synchronization of complex action is found in the experimental task of synchronous speaking, in which naive subjects read a common text in lock step. The demonstration of synchronized behavior without a periodic basis is presented as a challenge for theoretical understanding. A unified treatment of periodic and aperiodic synchronization is suggested by replacing the sequential processing model of cognitivist approaches with the more local notion of a task-specific sensorimotor coordination. On this view, skilled action is the imposition of constraints on the co-variation of movement and sensory flux such that the boundary conditions that define the skill are met. This non-cognitivist approach originates in the work of John Dewey. It allows a unification of the treatment of sensorimotor synchronization in simple rhythmic behavior and in complex skilled behavior and it suggests that skill sharing is a uniquely human trait of considerable import.

  19. Transition to complete synchronization and global intermittent synchronization in an array of time-delay systems.

    PubMed

    Suresh, R; Senthilkumar, D V; Lakshmanan, M; Kurths, J

    2012-07-01

    We report the nature of transitions from the nonsynchronous to a complete synchronization (CS) state in arrays of time-delay systems, where the systems are coupled with instantaneous diffusive coupling. We demonstrate that the transition to CS occurs distinctly for different coupling configurations. In particular, for unidirectional coupling, locally (microscopically) synchronization transition occurs in a very narrow range of coupling strength but for a global one (macroscopically) it occurs sequentially in a broad range of coupling strength preceded by an intermittent synchronization. On the other hand, in the case of mutual coupling, a very large value of coupling strength is required for local synchronization and, consequently, all the local subsystems synchronize immediately for the same value of the coupling strength and, hence, globally, synchronization also occurs in a narrow range of the coupling strength. In the transition regime, we observe a type of synchronization transition where long intervals of high-quality synchronization which are interrupted at irregular times by intermittent chaotic bursts simultaneously in all the systems and which we designate as global intermittent synchronization. We also relate our synchronization transition results to the above specific types using unstable periodic orbit theory. The above studies are carried out in a well-known piecewise linear time-delay system.

  20. Transition to complete synchronization and global intermittent synchronization in an array of time-delay systems

    NASA Astrophysics Data System (ADS)

    Suresh, R.; Senthilkumar, D. V.; Lakshmanan, M.; Kurths, J.

    2012-07-01

    We report the nature of transitions from the nonsynchronous to a complete synchronization (CS) state in arrays of time-delay systems, where the systems are coupled with instantaneous diffusive coupling. We demonstrate that the transition to CS occurs distinctly for different coupling configurations. In particular, for unidirectional coupling, locally (microscopically) synchronization transition occurs in a very narrow range of coupling strength but for a global one (macroscopically) it occurs sequentially in a broad range of coupling strength preceded by an intermittent synchronization. On the other hand, in the case of mutual coupling, a very large value of coupling strength is required for local synchronization and, consequently, all the local subsystems synchronize immediately for the same value of the coupling strength and, hence, globally, synchronization also occurs in a narrow range of the coupling strength. In the transition regime, we observe a type of synchronization transition where long intervals of high-quality synchronization which are interrupted at irregular times by intermittent chaotic bursts simultaneously in all the systems and which we designate as global intermittent synchronization. We also relate our synchronization transition results to the above specific types using unstable periodic orbit theory. The above studies are carried out in a well-known piecewise linear time-delay system.

  1. Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.

    PubMed

    van Lotten, Manon L; Schreinemakers, J Rieneke; van Noort, Arthur; Rademakers, Maarten V

    2016-09-01

    This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs. PMID:27583120

  2. Bilateral adrenal hemorrhage in polycythemia vera.

    PubMed

    Bhandari, Shruti; Agito, Katrina; Krug, Esther I

    2016-01-01

    Bilateral adrenal hemorrhage (BAH) is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency. PMID:27609733

  3. Bilateral vision loss associated with radiofrequency exposure

    PubMed Central

    Liu, Dianna; Cruz, Franz Marie; Subramanian, Prem S

    2012-01-01

    A 57-year-old otherwise healthy woman presented with painless binocular vision loss 1 week after direct application of radiofrequency energy to her orbits. She had no light perception bilaterally. Pupils were dilated and not reactive to light. Fundoscopic exam initially showed optic disc swelling in the right eye and a normal-appearing disc in the left eye. Magnetic resonance imaging of the brain and orbits showed gadolinium enhancement of both intraorbital optic nerves. She underwent a course of high-dose steroid treatment without recovery of vision. Optic discs were pale 11 weeks after injury. With exclusion of other possible causes, this represents a unique case of irreversible binocular optic nerve damage and blindness secondary to radiofrequency exposure. PMID:23271888

  4. Gorlin syndrome and bilateral ovarian fibroma

    PubMed Central

    Pirschner, Fernanda; Bastos, Pollyana Marçal; Contarato, George Luiz; Bimbato, Anna Carolina Bon Lima; Filho, Antônio Chambô

    2012-01-01

    INTRODUCTION Gorlin syndrome (GS), also known as nevoid basal cell carcinoma syndrome (NBCCS), is a rare hereditary, autosomal dominant disease that affects various systems. Its prevalence is estimated at 1/57,000 to 1/256,000 of the population. It is characterized by basal cell carcinomas, multiple odontogenic keratocysts, skeletal abnormalities and ovarian fibroma, among other disorders. PRESENTATION OF CASE To report the case of a young patient with Gorlin syndrome and bilateral ovarian fibroma. DISCUSSION A 20-year old patient with Gorlin syndrome presented with facial asymmetry, broad nasal root, dental abnormalities, micrognathism, convergent strabismus, multiple pigmented lesions on the trunk and face, pectus excavatum, kyphoscoliosis and a palpable mass in the abdomen occupying the entire pelvic region. CONCLUSION Gorlin–Goltz syndrome is a hereditary pathology that includes numerous clinical manifestations. Diagnosis is clinical and genetic confirmation is unnecessary. PMID:22771908

  5. Bilateral adrenal hemorrhage in polycythemia vera

    PubMed Central

    Agito, Katrina; Krug, Esther I.

    2016-01-01

    Bilateral adrenal hemorrhage (BAH) is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency. PMID:27609733

  6. A very rare bilateral adrenal tumor.

    PubMed

    Toniato, Antonio; Boschin, Isabella Merante; Pelizzo, Maria Rosa

    2014-04-01

    We report a case of very rare adrenal tumor. A 54-year-old patient was classified as affected by bilateral adrenal incidentaloma that surprisingly, on histology resulted solitary fibrous tumors. Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm. Only five cases of localization of SFT in adrenal gland are reported in the literature, while the frequency of retroperitoneum localization is more frequent, about 30 cases. Immunohistochemically, SFT can be positive for CD34 antigen, vimentin, CD99, and bcl-2 and usually negative for cytokeratins, chromogranin A, NSE, neurofilaments, synoptophysin, and S-100. Surgical excision remains the main treatment in fact the recurrence is locoregional and correlated with positive margins due to incomplete excision, while distant metastases are correlated with atypical or malignant features.

  7. Trismus Due to Bilateral Coronoid Hyperplasia

    PubMed Central

    Choi, Moon Gi; Kim, Dong Hyuck; Ki, Eun Jung; Cheon, Hae Myung

    2014-01-01

    Bilateral coronoid hyperplasia causes painless progressive trismus, resulting from coronoid process impingement on the posterior aspect of the zygomatic bone. The etiology of coronoid hyperplasia is unclear, with various theories proposed. An endocrine stimulus, increased temporalis activity, trauma, genetic inheritance and familial occurrence have all been proposed, but no substantive evidence exists to support any of these hypotheses. Multiplanar reformatting of axial scans and 3-dimensional reconstruction permit precise reproduction of the shape and size of the coronoid and malar structures, and relationships of all structures of the temporal and infratemporal fossae. This case shows remarkably increased mouth opening by coronoidectomy in a patient who complained of trismus due to hyperplasia of coronoid process. PMID:27489829

  8. Bilateral adrenal gland haemorrhage: an unusual cause

    PubMed Central

    Shenoy, Vasant; Malabu, Usman; Cameron, Donald; Sangla, Kunwarjit

    2014-01-01

    Summary Our patient had drainage of a large amoebic liver abscess. This got complicated by a severe degree of hypotension, which required aggressive fluid resuscitation and hydrocortisone support. Computerised tomography (CT) of the abdomen revealed bilateral adrenal gland haemorrhage (BAH) resulting in primary adrenal gland failure, which was the cause for hypotension. Patient was on long-term warfarin for provoked deep vein thrombosis of lower limb, which was discontinued before the procedure. Thrombophilia profile indicated the presence of lupus anticoagulant factor with prolonged activated partial thromboplastin time (aPTT). Patient was discharged on lifelong warfarin. This case emphasises the need for strong clinical suspicion for diagnosing BAH, rare but life-threatening condition, and its association with amoebic liver abscess and anti-phospholipid antibody syndrome (APLS). Learning points Recognition of BAH as a rare complication of sepsis.APLS can rarely cause BAH. PMID:25276353

  9. Cherubism With Bilateral Mandible and Maxilla Involvement

    PubMed Central

    Yu, Zhaoyang; Zhai, Miao; Gan, Wei; Zhang, Hong; Zhou, Yuxia; Wen, Haixia

    2015-01-01

    Abstract Cherubism is a rare, nonneoplastic, self-limiting fibro-osseous that occurs in children. Affected children usually appear normal at birth. Lesions are characterized by the replacement of bone with fibrovascular tissue containing many multinucleated giant cells. Most studies have reported cherubism to be familial and with bilateral involvement of the mandibles. The authors describe a nonfamilial case of cherubism, involving both the mandible and the maxilla, in a 4-year-old female child with slowly enlarging, painless, symmetrical swelling of both cheeks. Cherubism is a rare disease that is usually limited to the mandible, but the maxilla may be involved. Computed tomography scan and biopsy are helpful for early diagnosis. PMID:26656340

  10. Bilateral stony lung: pulmonary alveolar microlithiasis.

    PubMed

    Chandra, Subhash; Mohan, Anant; Guleria, Randeep; Das, Prasenjit; Sarkar, Chitra

    2009-01-01

    A 40-year-old male paddy field worker was referred for exertional shortness of breath and non-productive cough for 4 years. He had been treated for pulmonary tuberculosis twice. Chest radiograph showed extensive bilateral nodular opacities ("sandstorm-like") in the middle and lower lobe. Pulmonary function tests revealed a restrictive ventilatory defect. High resolution CT showed widespread nodular infiltration with "crazy paving" appearance and interrupted black pleura sign. This was confirmed as pulmonary alveolar microlithiasis (PAM) by trans-bronchial lung biopsy, which showed normal respiratory lining epithelium with dilated alveolar spaces containing many calcific bodies, some of which showed concentric calcification. The possibilities of silicosis (due to exposure to husk) and tuberculosis, both of which can mimic PAM clinically and radiologically, made this case a diagnostic challenge. PMID:21686505

  11. Bilateral stony lung: pulmonary alveolar microlithiasis

    PubMed Central

    Chandra, Subhash; Mohan, Anant; Guleria, Randeep; Das, Prasenjit; Sarkar, Chitra

    2009-01-01

    A 40-year-old male paddy field worker was referred for exertional shortness of breath and non-productive cough for 4 years. He had been treated for pulmonary tuberculosis twice. Chest radiograph showed extensive bilateral nodular opacities (“sandstorm-like”) in the middle and lower lobe. Pulmonary function tests revealed a restrictive ventilatory defect. High resolution CT showed widespread nodular infiltration with “crazy paving” appearance and interrupted black pleura sign. This was confirmed as pulmonary alveolar microlithiasis (PAM) by trans-bronchial lung biopsy, which showed normal respiratory lining epithelium with dilated alveolar spaces containing many calcific bodies, some of which showed concentric calcification. The possibilities of silicosis (due to exposure to husk) and tuberculosis, both of which can mimic PAM clinically and radiologically, made this case a diagnostic challenge. PMID:21686505

  12. Framing effect following bilateral amygdala lesion.

    PubMed

    Talmi, Deborah; Hurlemann, René; Patin, Alexandra; Dolan, Raymond J

    2010-05-01

    A paradigmatic example of an emotional bias in decision making is the framing effect, where the manner in which a choice is posed--as a potential loss or a potential gain--systematically biases an ensuing decision. Two fMRI studies have shown that the activation in the amygdala is modulated by the framing effect. Here, contrary to an expectation based on these studies, we show that two patients with Urbach-Wiethe (UW) disease, a rare condition associated with congenital, complete bilateral amygdala degeneration, exhibit an intact framing effect. However, choice preference in these patients did show a qualitatively distinct pattern compared to controls evident in an increased propensity to gamble, indicating that loss of amygdala function does exert an overall influence on risk-taking. These findings suggest either that amygdala does contribute to decision making but does not play a causal role in framing, or that UW is not a pure lesion model of amygdala function.

  13. Bilateral Trade Flows and Income Distribution Similarity.

    PubMed

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories.

  14. Bilateral Trade Flows and Income Distribution Similarity

    PubMed Central

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980–2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  15. Bilateral Trade Flows and Income Distribution Similarity.

    PubMed

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories. PMID:27137462

  16. Bilateral balanced articulation: science or dogma?

    PubMed

    Farias-Neto, Arcelino; Carreiro, Adriana da Fonte Porto

    2014-06-01

    For more than a hundred years, it has been supposed that canine guidance should be avoided in conventional complete dentures, since it would result in denture instability. Thus, bilateral balanced articulation has been held by many authors as fundamental for treatment success. However, randomized clinical trials have shown that balanced articulation is not as important as previously thought. The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant for both the dentist and dental technician. Therefore, the purpose of this study is to provide an evidence-based update on complete denture occlusion. Clinical Relevance: The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant. PMID:25073224

  17. Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation

    PubMed Central

    Schreinemakers, J. Rieneke; van Noort, Arthur; Rademakers, Maarten V.

    2016-01-01

    This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs. PMID:27583120

  18. Bilateral taurodontism in primary dentition with hypodontia

    PubMed Central

    Surendar, Marappan Natarajan; Pandey, Ramesh Kumar; Khanna, Richa

    2013-01-01

    Taurodontism is a rare dental anomaly in which there is an enlarged pulp chamber at the expense of roots with apical displacement of the pulpal floor, giving it a rectangular shape. It is caused by the failure of Hertwig's epithelial root sheath to invaginate at the proper horizontal level. Taurodontism has been reported as an intraoral feature of several syndromes like Down syndrome, Klinefelter syndrome, Smith-Magenis syndrome, Hurler syndrome, etc. Association of taurodontism with hypodontia in permanent dentition has also been reported. Taurodontism in primary dentition and its association with hypodontia is very rarely reported in the literature. The present case illustrates bilateral taurodontism of primary mandibular molars with hypodontia in maxilla. PMID:23345504

  19. [Bilateral infarction of the caudate nuclei].

    PubMed

    Mrabet, A; Mrad-Ben Hammouda, I; Abroug, Z; Smiri, W; Haddad, A

    1994-01-01

    We report the case of a 57-year-old right-handed woman, with a history of hypertension, who, in February 1990, suddenly developed behavioral and cognitive abnormalities. Prior to the onset of her illness she had been normal. On examination, neuropsychological testing (Wechsler Mental Test, Wechsler Adult Intelligence Scale Revised, Knox Cube Test) elicited attention abnormalities, decreased recent memory, apathy, reduced spontaneity and initiative and left hemiparesia. CT scan showed small low density areas in the head of both caudate nuclei and right internal capsule, indicating infarction. Two years later, the deficit had partially resolved. Apathy persisted; psychometry showed an IQ of 57. Bilateral damage to the head of the caudate nuclei disrupt cortical-subcortical connections. The caudate nucleus is an essential component of basal ganglia-thalamo-cortical circuitry and its contribution to cognitive functions and behavior appears to be important. PMID:7801044

  20. Bilateral mechanical rotational vertebral artery occlusion.

    PubMed

    Dargon, Phong T; Liang, Conrad W; Kohal, Anmol; Dogan, Aclan; Barnwell, Stanley L; Landry, Gregory J

    2013-10-01

    Rotational vertebral artery occlusion, or bow hunter's stroke, is reversible, positional symptomatic vertebrobasilar ischemia. The typical mechanism of action is obstruction of a dominant vertebral artery with contralateral head rotation in the setting of baseline ipsilateral vertebral artery stenosis or occlusion. Here we present a rare case of mechanical occlusion of bilateral patent vertebral arteries manifesting as near syncope with rightward head rotation. Diagnostic cerebral angiography showed dynamic right C5 vertebral occlusion and left C2 vertebral occlusion. The patient underwent right C4/5 transverse process decompression. Postoperative angiogram showed patent flow through the right vertebral artery in neutral position and with head turn with resultant resolution of symptoms. PMID:23465174