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Terms modified by Unilateral Selected AbstractsDisorganized, Unilateral, and Participative Organizations: New Insights from the Ethnographic LiteratureINDUSTRIAL RELATIONS, Issue 2 2001Randy HodsonArticle first published online: 17 DEC 200 Disorganized workplaces are often overlooked in contemporary models of the workplace. Contemporary accounts more typically analyze organizations in terms of tight management control or in terms of participative workplace models. This article examines 109 organizational ethnographies describing a wide range of workplaces, including many poorly run and disorganized ("anomic") workplaces. Such workplaces evidence high levels of worker resistance. In contrast, participative workplaces evidence high levels of citizenship behaviors. Unilateral or "top-down" organizations are expected to encourage accommodation behaviors, but this hypothesis is not supported. Instead, both accommodation and resistance are highest in disorganized workplaces. The continuing importance of disorganized workplaces,workplaces that provoke strong worker resistance,represents an unmet challenge to organizational theory and practice. [source] Prevalence of Unilateral and Bilateral Deafness in Border Collies and Association with PhenotypeJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2006Simon Platt Background:Congenital sensorineural deafness (CSD) occurs in Border Collies, but its prevalence and inheritance are unknown. This study estimated the prevalence of CSD in Border Collies and investigated its association with phenotypic attributes linked to the merle gene, including coat pigmentation and iris color. Hypothesis:Deafness in Border Collies is associated with pigmentation patterns linked to the merle gene. Animals:A total of 2597 Border Collies from the United Kingdom. Methods:A retrospective study of Border Collies tested, during 1994,2002, by using brainstem auditory evoked responses. Associations between deafness and phenotypic attributes were assessed by using generalized logistic regression. Results:The prevalence of CSD in puppies was estimated as 2.8%. The corresponding rates of unilateral and bilateral CSD were 2.3 and 0.5%, respectively. Adjustment for clustering of hearing status by litter reduced the overall prevalence estimate to 1.6%. There was no association between CSD and sex (P= .2). Deaf Border Collies had higher rates of merle coat pigmentation, blue iris pigment, and excess white on the head than normal hearing Border Collies (all P < .001). The odds of deafness were increased by a factor of 14 for Border Collies with deaf dams, relative to the odds for dogs with normal dams (P= .007), after adjustment for phenotypic attributes. Conclusions and Clinical Importance: Associations between CSD and pigmentation patterns linked to the merle gene were demonstrated for Border Collies. Evidence for an inherited component to CSD in Border Collies supports selective breeding from only tested and normal parents to reduce the prevalence of this disease. [source] Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunctionNEUROUROLOGY AND URODYNAMICS, Issue 8 2008Khanh Pham Abstract Aims To determine if bilateral S3 lead placement during the stage I trial period improves the "success" rate for advancing to stage II (permanent) sacral neuromodulator placement. Methods A retrospective chart review of 124 (20 male and 104 female) patients undergoing stage I sacral neuromodulation (InterStim®, Medtronic, Minneapolis, Minnesota) implantation for the treatment of refractory voiding dysfunction was performed. Patients were divided into two cohorts based on unilateral versus bilateral stage I lead placement in the S3 foramina. Both groups were then evaluated and compared with regards to overall "success", defined as progression from stage I to stage II placement. Results Fifty-five (44%) patients underwent unilateral stage I lead placement and 69 (56%) received bilateral S3 leads. Successful stage I trials were reported in 32/55 (58%) and 53/69 (76%) of unilateral and bilateral cohorts, respectively (P,=,0.03). Five wound infections were reported,2 (3.6%) following unilateral and 3 (4.3%) after bilateral stage I lead placement. No other complications were encountered. Conclusions Bilateral stage I neuromodulation trial provides a significantly higher rate of improvement in refractory voiding symptoms to allow for the progress to stage II implantation. Neurourol. Urodynam. 27:779,781, 2008, © 2008 Wiley-Liss, Inc. [source] Zygomatic complex fractures in a suburban Nigerian populationDENTAL TRAUMATOLOGY, Issue 2 2005Vincent Ugboko Abstract,,, A retrospective analysis of 128 zygomatic complex fractures was undertaken. There were 109 males (85.2%) and 19 females (14.8%), aged 3,74 years (mean ± SD, 33 ± 12.6 years). Patients in the third decade of life (38.3%) recorded the highest incidence. Road traffic accidents (74.2%) mainly from automobile (61.7%) and motorcycle (9.4%) involvement were the predominant etiology. While 38.8% of them presented within the first 24 h, males were relatively earlier than their female counterparts, although this was not statistically significant (P > 0.05). Class 3 fractures were the commonest (50%), followed by classes 2 (zygomatic arch) and 4, respectively. Most class 6 fractures (6.3%) resulted from gunshot injuries. There were 116 unilateral (left 63, right 53) and 12 bilateral fractures with the right side of the face recording more zygomatic arch fractures. In addition, statistical significance was observed between etiology, class and type of fracture (P < 0.05). One hundred and twenty-four (136 fractures) patients were available for treatment as four declined. Twelve cases did not require treatment while others were managed by either closed or open reduction under general anesthesia. Gillies' temporal approach was the commonest (57.1%) surgical technique employed. However the unstable nature of the fractures necessitated open reduction and transosseous wiring in 33 cases. The high prevalence of zygomatic complex fractures arising from vehicular accidents reflects the poor status of the road network in rural and suburban Nigerian communities. Hence government should improve on existing infrastructures, decongest the highways and enforce traffic laws amongst road users. In addition, the need to encourage massive investments in safer alternative transport systems is emphasized. [source] Lateral Wedge Resection: A Simple Technique for Repairing Involutional Lower Eyelid EntropionDERMATOLOGIC SURGERY, Issue 9 2010IGAL LEIBOVITCH MD BACKGROUND Lower lid involutional entropion is a common eyelid pathology affecting the elderly population. Most of the reported surgical techniques are mainly based on a lateral tarsal strip anchored to the orbital rim. OBJECTIVES To report the surgical outcome using a simple single-stitch lateral wedge technique to repair involutional lower entropion. METHODS This single-surgeon, retrospective, noncomparative cases series included all patients with involutional lower eyelid entropion who were operated on using the lateral wedge technique. RESULTS Fifty-eight eyelids of 52 patients (46 unilateral, 6 bilateral; 27 men, 25 women; age, mean 67±10; range 50,85) underwent surgical repair. Immediate resolution of entropion and associated ocular symptoms was achieved in 55 eyelids (94.9%). One case had postoperative ectropion that completely resolved spontaneously after 4 weeks, and one had wound dehiscence that healed completely without any intervention. Another patient had residual entropion that resolved after an additional surgical repair. No other cases of recurrence were noted during a mean follow-up period of 16 months (range 6,24 months). CONCLUSION This minimally invasive single-stitch lateral wedge technique is a simple and effective procedure for repairing involutional lower eyelid entropion and is associated with low recurrence and complication rates. Igal Leibovitch, MD, has indicated no significant interest with commercial supporters. [source] Electroconvulsive therapy is equally effective in unipolar and bipolar depressionACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010S. Bailine Bailine S, Fink M, Knapp R, Petrides G, Husain MM, Rasmussen K, Sampson S, Mueller M, McClintock SM, Tobias KG, Kellner CH. Electroconvulsive therapy is equally effective in unipolar and bipolar depression. Objective:, To determine the relative efficacy of electroconvulsive therapy (ECT) in the treatment of bipolar (BP) and unipolar (UP) depressive illness and clarify its role in BP depression. Method:, Patients referred for ECT with both UP and BP depressions. [classified by Structured Clinical Interview for DSM (SCID-I) criteria for history of mania] were included in a multi-site collaborative, double-masked, randomized controlled trial of three electrode placements , right unilateral, bifrontal or bitemporal , in a permutated block randomization scheme. Results:, Of 220 patients, 170 patients (77.3%) were classified as UP and 50 (22.7%) as BP depression in the intent-to-treat sample. The remission and response rates and numbers of ECT for both groups were equivalent. Conclusion:, Both UP and BP depressions remit with ECT. Polarity is not a factor in the response rate. In this sample ECT did not precipitate mania in depressed patients. Treatment algorithms for UP and BP depression warrant re-evaluation. [source] Surgical Approaches for Stable VitiligoDERMATOLOGIC SURGERY, Issue 10 2005Rafael Falabella MD Background. Vitiligo therapy is difficult. Depending on its clinical presentation, unilateral or bilateral vitiligo lesions respond well with different repigmentation rates, according to age, affected anatomic area, extension of lesions, time at onset, timing of depigmentation spread, and other associated factors. When stable and refractory to medical treatment, vitiligo lesions may be treated by implanting pigment cells on depigmented areas. Objective. To describe the main events of depigmentation and the fundamentals of surgical techniques for repigmenting vitiligo by implanting noncultured cellular or tissue grafts, in vitro cultured epidermis-bearing pigment cells, or melanocyte suspensions. Methods. A description of the available techniques for repigmentation of vitiligo is done, emphasizing the most important details of each procedure to obtain the best repigmentation and minimize side effects. Results. With most of these techniques, adequate repigmentation is obtained, although there are limitations when applying some methods to clinical practice. Conclusions. Restoration of pigmentation may be accomplished with all available surgical procedures in most anatomic locations, but they are of little value for acral areas. Unilateral vitiligo responds well in a high proportion of patients, and bilateral disease may also respond when stable. Appropriate patient selection is important to achieve the best results. [source] Trigeminal Trophic Syndrome,Report of Four Cases and Review of the LiteratureDERMATOLOGIC SURGERY, Issue 5 2004Parrish Sadeghi MD Background. Trigeminal trophic syndrome is a unilateral, frequently crescent-shaped neurotrophic ulceration of the face occurring after injury to the trigeminal nerve. The appearance of the ulcers resembles other disease entities such as granulomatous disease, neoplasm, vasculitis, infection, and factitial dermatitis. Objectives. The objectives of this study are to increase awareness of this disorder and to emphasize the importance of eliciting a thorough neurologic history when evaluating facial ulcerations. Methods. Four cases are reported and, using MEDLINE, the English and non-English literature from 1982 to 2002 is reviewed. Results. Including this report, there have been 60 cases of trigeminal trophic syndrome reported from 1982 to 2002. The age at presentation ranged from 14 months to 93 years. Time of onset from injury to the trigeminal ganglion or its branches and the development of the ulcers ranged from 2 weeks to 30 years. One-third of the patients had undergone trigeminal nerve ablation for the treatment of trigeminal neuralgia and another third had a history of stroke. Other causes included craniotomy, head trauma, herpes infection. Conclusion. The majority of cases of trigeminal trophic syndrome are associated with a history of stroke or trigeminal nerve ablation. Successful surgical outcome can be achieved if the underlying neurologic pathology is addressed before the reconstructive procedure. [source] Baseline cognition, behavior, and motor skills in children with new-onset, idiopathic epilepsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2010VIKRAM V BHISE Aim, Epilepsy is associated with difficulties in cognition and behavior in children. These problems have been attributed to genetics, ongoing seizures, psychosocial issues, underlying abnormality of the brain, and/or antiepileptic drugs. In a previous study, we found baseline cognitive differences between children with partial versus generalized and convulsive versus non-convulsive seizures. Measures in that study focused primarily on IQ scores. In the present study, we assessed baseline function with respect to new learning, attention, and memory, thus providing a more comprehensive profile than our previous study. Method, We examined 57 children (42 females, 15 males), aged 6 to 17 years (mean 10y 1mo, SD 2y 9mo), with new-onset, idiopathic epilepsy, using tests of cognitive function reflective of new learning, memory, and attention. Seizures were classified as generalized convulsive (n=5), generalized non-convulsive (n=18), or focal (n=34). Focal seizures were divided into unilateral versus bilateral independent foci, and presence versus absence of secondary generalization. Results, Attention was a particular area of weakness across all groups. The Vocabulary score of an intelligence screen was higher for the focal seizure groups (p=0.012), primarily because of a difference between the unilateral focal and the primary generalized groups (p<0.047). Children with generalized, non-convulsive seizures performed significantly worse than the focal group on a measure of short-term auditory memory (p=0.019). All groups performed poorly on a test of visual,motor speed. Interpretation, These findings suggest intrinsic abnormalities in children with new-onset, idiopathic epilepsy at baseline. [source] Early motor repertoire is related to level of self-mobility in children with cerebral palsy at school ageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2009JANNEKE LM BRUGGINK MD Aim, To determine the predictive value of the early motor repertoire for the level of self-mobility in children with cerebral palsy (CP) at school age. Method, Video recordings were made at 11 to 17 weeks post-term of 37 preterm infants (20 males, 17 females) who later developed CP. The early motor repertoire was assessed by obtaining a motor optimality score. At 6 to 12 years, children were classified according to the Gross Motor Function Classification System (GMFCS). Results, Of 37 children (mean gestational age 29.1wks, SD 1.9; mean birthweight 1273g, SD 324), nine had unilateral and 28 had bilateral spastic CP. Twelve children were in GMFCS level I, three level II, 10 level III, four level IV, and eight level V. The absence of the age-adequate motor repertoire, a cramped motor repertoire, an abnormal kicking pattern, and a non-flat supine posture were associated with lower levels of self-mobility (,2 for trend test, p<0.05). Predictive for a low level of self-mobility was a cramped motor repertoire/non-flat supine posture (positive predictive values [PPV] 100%, negative predictive values [NPV] 54%). Predictive for a high level of self-mobility was a non-cramped repertoire/flat supine posture (PPV 80%, NPV 74%). Interpretation, Several aspects of the motor repertoire at 11 to 17 weeks post-term predicted the degree of functional limitations in children with CP at school age. [source] Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2009ARVE OPHEIM PT MSC Aim, To compare walking function, pain, and fatigue in adults with cerebral palsy (CP) 7 years after an initial survey. Method, A multidimensional questionnaire was mailed to 226 people with unilateral (hemiplegic) or bilateral (diplegic) spastic CP who had participated in a 1999 survey. People with additional diagnoses were excluded. Special emphasis was placed on participants with deterioration in walking. The questionnaire was the same as in 1999. Results, One hundred and forty-nine participants (76 males, 73 females; mean age 40y 5mo, SD 10y 7mo, range 24,76y) with a diagnosis of unilateral (n=81) or bilateral (n=68) spastic CP responded. Fifty-two per cent of all participants reported deterioration in walking function since debut of walking, compared with 39% 7 years previously. In participants with bilateral CP, 71% reported deteriorated walking, compared with 37% of participants with unilateral CP. Participants with deteriorated walking function had greater pain frequency, pain intensity, impact of pain on daily activities, and physical fatigue and reduced balance. The number of people reporting overall mobility problems was almost double compared with 7 years previously. Interpretation, The main finding was an increased prevalence of deteriorated walking, significantly associated with bilateral spastic CP, pain, fatigue, and reduced balance. Rehabilitation programmes addressing these areas are needed. [source] Mycobacterium avium complex infection in a neck abscess: A diagnostic pitfall in fine-needle aspiration biopsy of head and neck lesionsDIAGNOSTIC CYTOPATHOLOGY, Issue 7 2009Valerie A. Fitzhugh M.D. Abstract Fine-needle aspiration biopsy (FNAB) is a useful tool in the diagnosis of mycobacterial disease, especially Mycobacterium tuberculosis. However, nontuberculous mycobacterial infection diagnosed with FNAB material is much rarer, with Mycobacterium avium complex being the most common. In this report, we present the case of a 21-year-old HIV positive man, who presented with a unilateral, tender, enlarging cervical neck mass. FNAB had revealed acute inflammation. Mycobacterium avium complex grew in culture from the material that was aspirated and was confirmed by DNA probe. Because of the paucity of articles on this subject in the cytology literature, it is important to reiterate the value of the material aspirated at the bedside and the clinic in the diagnosis of infectious disease. When faced with antibiotic-resistant cellulitis and abscesses, the FNAB material must be sent for acid fast bacteria smears and culture. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Unilateral Intracarotid Amobarbital Procedure for Language LateralizationEPILEPSIA, Issue 11 2005Jörg Wellmer Summary:,Purpose: The determination of language dominance as part of the presurgical workup of patients with pharmacoresistant epilepsies has experienced fundamental changes. With the introduction of noninvasive functional magnetic resonance imaging (fMRI), the number of patients receiving intracarotid amobarbital procedures (IAPs) for assessment of language dominance has decreased considerably. However, recent studies show that because of methodologic limitations of fMRI, IAP remains an important tool for language lateralization. The current study examines whether unilateral instead of bilateral IAP is an adequate way to apply IAP with reduced invasiveness. Methods: We retrospectively examine the predictive value of unilateral IAP for the results of bilateral IAP based on a sample of 75 patients with various types of language dominance. Target parameters are the prediction of the language-dominant hemisphere and the identification of patients with atypical language dominance. For language assessment based on unilateral IAP, we introduce the measure hemispheric language capacity (HLC). Results: Unilateral IAP performed on the side of intended surgery quantifies language capacity contralateral to the intended surgery. It detects atypical (bilateral or right) language dominance in the majority of patients. Experience with a separate series of 107 patients requiring presurgical language lateralization shows that in >80%, bilateral IAPs are redundant. Conclusions: Unilateral IAP is principally sufficient for language lateralization in the presurgical evaluation of patients with pharmacoresistant epilepsies. Necessity of bilateral IAP is restricted to few indications (e.g., callosotomy). In times of noninvasive language lateralization, we propose unilateral IAP as the method of choice for the verification of doubtful (bilateral) fMRI activation patterns. [source] Magnetic Resonance Imaging Follow-up of Progressive Hippocampal Changes in a Mouse Model of Mesial Temporal Lobe EpilepsyEPILEPSIA, Issue 6 2000Viviane Bouilleret Summary: Purpose: Hippocampal sclerosis (HS) is the most frequent lesion found in mesial temporal lobe epilepsy (mTLE). MR imaging is considered to be the most sensitive and specific method to detect HS. Despite extensive studies performed on humans and except in a recent study, the morphologic pattern of HS is usually analyzed when the disease has already fully developed, thus not allowing any insight into the mapping of the progressive morphologic changes inducing the development of mTLE. We have recently characterized a model of mTLE that reproduces the unilateral pattern of HS, induced by intrahippocampal injection of low doses of kainate (KA) in mice. Methods: In this study, we monitored the temporal evolution of the development of HS in this model of mTLE by using T2 -weighted sequence, T2 -relaxation time measurements, and T1 -weighted spin-echo technique after injection of gadolinium, from 1 h to 120 days after KA injection. Results: HS induced by intrahippocampal KA injection occurred in two phases. First, we observed a transient hyperintense T2 -weighted signal in the cortex above the injected hippocampus, most likely indicative of vasogenic edema partly due to the neurotoxic effect of KA. The concomitant increase in the T2 signal in the injected hippocampus and ipsilateral amygdala likely reflects the phase of cytotoxic edema occurring probably in relation to the excitotoxic consequences of both KA and seizure activity. Second, from 15 days on, a persistent unilateral increased T2 signal was detected in the hippocampus, which most probably reflects gliosis. Conclusions: Our findings indicate that longitudinal follow-up would permit a better understanding of the mechanisms underlying the constitution of HS in humans and eventually development of prevention strategies. [source] Magnetic resonance imaging evaluation of 264 horses with foot pain: The podotrochlear apparatus, deep digital flexor tendon and collateral ligaments of the distal interphalangeal jointEQUINE VETERINARY JOURNAL, Issue 4 2007S. DYSON Summary Reasons for performing study: To improve understanding of the interrelationships between injuries of the podotrochlear apparatus and deep digital flexor tendon (DDFT). Hypotheses: There is a difference in frequency of different types of lesions at different anatomical sites of the DDFT. Lesions of the collateral sesamoidean ligament (CSL), distal sesamoidean impar ligament (DSIL), distal interphalangeal (DIP) joint and navicular bursa are seen in association with lesions of the navicular bone. Methods: The magnetic resonance (MR) images of 264 horses with unilateral or bilateral foot pain were analysed and graded. Descriptive statistics were performed to establish the frequency of occurrence of DDFT lesion types at different anatomical levels, and lesions of the CSL, DSIL, navicular bursa, DIP joint and collateral ligaments (CLs) of the DIP joint. A Chi-square test was used to test for a difference in the proportion of navicular bone grades between limbs with and without DDFT lesions at each level, and to compare navicular bone grades for limbs with and without each of DSIL, CSL, navicular bursa or DIP joint lesions. Results: Lesions of the DDFT occurred in 82.6% of limbs, occurring most commonly at the level of the CSL (59.4%) and the navicular bone (59.0%). Core lesions predominated at the level of the proximal phalanx (90.3%), whereas at the level of the CSL and navicular bone core lesions, sagittal splits and dorsal abrasions were most common. There was a positive association between DDFT lesions and navicular bone pathology involving all aspects of the bone. Lesions of the DSIL (38.2% limbs) were more common than those of the CSL (10.5%), but the presence of either was associated with abnormalities of the navicular bone, especially involving the proximal or distal borders and the medulla. Conclusions and clinical relevance: There are close interactions between injuries of the components of the podotrochlear apparatus, the DDFT, the navicular bursa and the DIP joint. Further knowledge about the biomechanical risk factors for injury may have importance for both disease prevention and management. [source] Effect of auditory cortex lesions on the discrimination of frequency-modulated tones in ratsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 6 2006Natalia Rybalko Abstract The lateralization of functions to individual hemispheres of the mammalian brain remains, with the exception of the human brain, unresolved. The aim of this work was to investigate the ability to discriminate between falling and rising frequency-modulated (FM) stimuli in rats with unilateral or bilateral lesions of the auditory cortex (AC). Using an avoidance conditioning procedure, thirsty rats were trained to drink in the presence of a rising FM tone and to stop drinking when a falling FM tone was presented. Rats with a lesion of the AC were able to learn to discriminate between rising and falling FM tones; however, they performed significantly worse than did control rats. A greater deficit in the ability to discriminate the direction of frequency modulation was observed in rats with a right or bilateral AC lesion. The discrimination performance (DP) in these rats was significantly worse than the DP in rats with a left AC lesion. Animals with a right or bilateral AC lesion improved their DP mainly by recognizing the pitch at the beginning of the stimuli. The lesioning of the AC in trained animals caused a significant decrease in DP, down to chance levels. Retraining resulted in a significant increase in DP in rats with a left AC lesion; animals with a right lesion improved only slightly. The results demonstrate a hemispheric asymmetry of the rat AC in the recognition of FM stimuli and indicate the dominance of the right AC in the discrimination of the direction of frequency modulation. [source] Acute and long-term changes in the mesolimbic dopamine pathway after systemic or local single nicotine injectionsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2002R. Ferrari Abstract We have examined several neurochemical and behavioural parameters related to the function of the mesolimbic dopamine (DA) pathway in animals treated with nicotine following three modes of drug administration, i.e. systemic intraperitoneal injection, intra-accumbens (Acb) infusion or intraventral tegmental area (intra-VTA) microinjection. The present modes of systemic, intra-Acb and intra-VTA nicotine administration elicited comparable acute increases in dialysate DA levels from the Acb. The increase in extracellular DA levels was paralleled by a significant enhancement of locomotion in a habituated environment in the case of systemic or intra-VTA nicotine administration, whereas unilateral or bilateral intra-Acb nicotine infusion was ineffective, showing that accumbal DA increase is not sufficient to elicit locomotion in this experimental paradigm. Intra-VTA, but not systemic or intra-Acb, nicotine administration caused a long-term (at least 24-h) increase in basal dialysate DA levels from the Acb. In addition, significant increases in tyrosine hydroxylase (TH) and GluR1 (but not dopamine transporter or NR1) mRNA levels in the VTA were detected 24 h after intra-VTA nicotine administration. Systemic nicotine injection caused only an increase in TH mRNA levels while intra-Acb infusion did not modify any of the mRNAs tested. The long-term increase in basal DA levels in the Acb and TH, and GluR1 mRNA levels in the VTA upon intra-VTA nicotine microinjection indicates that even a single nicotine injection can induce plastic changes of the mesolimbic DA pathway. [source] Electrophysiological and behavioural evidence for an antagonistic modulatory role of adenosine A2A receptors in dopamine D2 receptor regulation in the rat dopamine-denervated striatumEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2000Ingrid Strömberg Abstract It has been shown that striatal adenosine A2A receptors can antagonistically interact with dopamine D2 receptors at the membrane level leading to a decrease in the affinity and efficacy of D2 receptors. Extracellular recordings and rotational behaviour were employed to obtain a correlate to these findings in an animal model of Parkinson's disease (PD). The recordings were performed in rats with unilateral 6-hydroxydopamine (6-OHDA)-induced catecholamine depletion. While recording in the dopamine-depleted striatum, local applications of the dopamine D2 agonist quinpirole reduced neuronal activity. However, when the adenosine A2A antagonist MSX-3 was applied simultaneously with quinpirole, the inhibition of neuronal firing seen after quinpirole alone was significantly potentiated (P < 0.001, n = 11). In contrast, local application of CGS 21680 attenuated the effect of quinpirole. The doses of MSX-3 and CGS 21680 used to achieve the modulation of quinpirole action had no effect per se on striatal neuronal firing. Furthermore, rotational behaviour revealed that MSX-3 dose-dependently increased the number of turns when administrated together with a threshold dose of quinpirole while no enhancement was achieved when MSX-3 was combined with SKF 38393. MSX-3 alone did not induce rotational behaviour. In conclusion, this study shows that low ineffective doses of MSX-3 enhance the effect of quinpirole on striatal firing rate, while the A2A agonist exerts the opposite action. This mechanism gives a therapeutic potential to A2A antagonists in the treatment of PD by enhancing D2 receptor function. [source] Accessory nerve function after level 2b,preserving selective neck dissectionHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2009Bilge Celik MD Abstract Background. The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b,preserving selective neck dissection. Methods. Forty-one necks of 30 patients with laryngeal cancer who underwent unilateral or bilateral level 2b,preserving neck dissections, between February 2003 and July 2005, were evaluated. Neck and shoulder movements and muscle strengths were examined and electroneuromyography (ENMG) was performed preoperatively at the postoperative 21st day and 6th month. Pathological anatomical findings at the postoperative 6th month were also evaluated. Results. All shoulder movements and muscle strengths were preserved. Neck extension, rotation movements, and flexion strengths were restricted. ENMG values were affected moderately in the early postoperative period and improved slightly in the late postoperative period. None of the patients developed shoulder syndrome or adhesive capsulitis. Conclusion. Preserving level 2b during selective neck dissection decreases trauma to the accessory nerve and improves functional results. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] CO2 laser surgery in the treatment of glottic cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2005Giovanni Motta MD Abstract Background. The aim of the study was to assess the effectiveness of CO2 laser endoscopic surgery in the treatment of glottic carcinoma limited to the true vocal cords or involving the adjacent regions. Methods. Seven hundred nineteen patients (687 men and 32 women; mean age, 60.4 years; range, 33,86 years) with glottic carcinoma (432 T1N0M0, 236 T2N0M0, 51 T3N0M0) underwent CO2 laser surgery (mean follow-up, 5 years; range, 2,17 years). Statistical comparison was carried out with Wilcoxon test, considering p < .05 the minimum significance value. Results. Overall actuarial survival, adjusted actuarial survival, and percentage of patients with no evidence of disease at 5 years were 85%, 97%, and 85%, respectively, in patients with T1a disease; 84%, 96%, and 83% in those with T1b disease; 77%, 86%, and 61% in those with T2 unilateral tumors; 77%, 88%, and 55% in those with T2 bilateral tumors; and 64%, 72%, and 60% in those with T3 disease. The statistical analysis showed the following: significant differences in the comparison of T1 versus T2 and T2 versus T3 tumors (p < .01), with the exception of no evidence of disease in the comparison of T2 versus T3 (p > .05); and no significant differences in the comparison of unilateral and bilateral tumors (p > .05). Actuarial local control, actuarial nodal control, and actuarial distant metastasis control at 5 years were 85%, 98%, and 99%, respectively, in patients with T1 disease; and 66%, 82%, and 91% in patients with T2 disease; and 66%, 83%, and 95% in patients with T3 disease. The laryngeal preservation rate was 97.3% in the T1 group, 82.5% in the T2 group, and 80.5% in T3 group. Conclusions. CO2 laser endoscopic surgery is effective in the treatment of glottic carcinoma not infiltrating the cartilaginous skeleton; the results achieved are competitive with those of open conservative operations, if we take into account the possibilities afforded by salvage surgery and the rate of laryngeal preservation achieved in the study patients. © 2004 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Suboccipital Nerve Blocks for Suppression of Chronic Migraine: Safety, Efficacy, and Predictors of OutcomeHEADACHE, Issue 6 2010Silvia Weibelt RN (Headache 2010;50:1041-1044) Background., Approximately 1 in 50 Americans is afflicted by chronic migraine (CM). Many patients with CM describe cervicogenic headache. Options for treating CM effectively are at present quite limited. Objective., To determine the safety and efficacy of occipital nerve blocks (ONBs) used to treat cervicogenic chronic migraine (CCM) and to identify variables predictive of a positive treatment response. Methods., Using a uniform dose and injection paradigm, we performed ONBs consecutively on a series of patients presenting with CCM. Patients were stratified according to specific findings found to be present or absent on physical examination. A positive treatment outcome was defined as a 50% or greater reduction in headache days per month over the 30 days following treatment relative to the 30-day pre-treatment baseline. We used a 5-point Likert scale as one of the secondary outcome variables. Results., We treated 150 consecutive patients with unilateral (37) or bilateral (113) ONBs. At the 1-month follow-up visit 78 (52%) exhibited evidence of a positive treatment response according to the primary outcome variable, and 90 (60%) reported their headache disorder to be "better" (44; 29%) or "much better" (46; 30%). A total of 8 (5%) patients reported adverse events within the ensuing 72 hours, and 3 (2%) experienced adverse events that reversed spontaneously but required emergent evaluation and management. Conclusion., For suppression of CCM, ONBs may offer an attractive alternative to orally administered prophylactic therapy. [source] SUNCT Responsive to Percutaneous Balloon Compression of the Gasserian Ganglion , 10-Year Follow-UpHEADACHE, Issue 1 2010Marcos Baabor MD (Headache 2010;50:143-145) We report the case of a woman with short-lasting unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) whose severe headache attacks ceased after percutaneous balloon compression of the Gasserian ganglion. The patient remains pain free after 10-year follow-up. This may be the first literature report of SUNCT in Chile. [source] Hemicrania Continua Responsive to Intravenous Methyl PrednisoloneHEADACHE, Issue 4 2009Sanjay Prakash DM Hemicrania continua (HC) is a strictly unilateral, continuous primary headache disorder with periodic exacerbations, usually accompanied by cranial autonomic disturbances. Exquisite and persistent effect of indomethacin is a fundamental property of HC. We report 2 patients of HC in which attacks were successfully eliminated by repeated infusion of methyl prednisolone. [source] Botulinum Toxin Type-A (BOTOX®) in the Treatment of Occipital Neuralgia: A Pilot StudyHEADACHE, Issue 10 2008Martin Taylor DO Objective., To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. Background., Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain. Methods., Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values. Results., The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated. Conclusions., Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain. [source] SUNCT Syndrome in Association With Persistent Horner Syndrome in a Chinese PatientHEADACHE, Issue 3 2004K. M. Prakash MD This is the first case report of a chinese patient with SUNCT (shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) presenting with persistent Horner's syndrome. She had episodic, brief, right periorbital pain in association with ipsilateral eye injection, lacrimation and rhinorrhea as well as persistent ipsilateral miosis and ptosis. She had partial response to a combination of indomethacin and carbamazepine therapy. [source] SUNCT Syndrome Responsive to LamotrigineHEADACHE, Issue 8 2002Jose M. Gutierrez-Garcia MD Background.,Short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection, tearing, rhinorrhea (SUNCT syndrome) is a headache form generally refractory to drug therapy. Occasional patients with SUNCT have been reported with a successful response to lamotrigine. Objective.,To report two patients with SUNCT treated with lamotrigine. Methods.,Clinical history, neurologic examination, and brain magnetic resonance imaging. Results.,Both patients with SUNCT syndrome were successfully treated with lamotrigine. In both cases, when lamotrigine was tapered off, the attacks reappeared, only to disappear when the dose was again increased. In addition, lamotrigine was well tolerated and no undesired side-effects were reported. Conclusion.,If the positive effect of lamotrigine in patients with SUNCT is confirmed in other cases, lamotrigine could become the first specific treatment for SUNCT syndrome. [source] Red Ear Syndrome and Migraine: Report of Eight CasesHEADACHE, Issue 2 2002Vincenzo Raieli MD We describe eight idiopathic cases of red ear syndrome in seven children and one adult. All were migraineurs with a history of paroxysmally painful and red ear, unilateral or alternating, in isolation or associated with migraine attacks. The reported duration of these episodes varied from 30 minutes to 1 hour. Neurologic examination, brain MRI and CT scans, and x-rays of the cervical spine were normal. The close temporal relationship between the "red ear episodes" and migraine attacks suggests an association between the two conditions. [source] Antiepileptic Drugs in the Management of Cluster Headache and Trigeminal NeuralgiaHEADACHE, Issue 2001Todd D. Rozen MD Cluster headache and trigeminal neuralgia are relatively rare but debilitating neurologic conditions. Although they are clinically and diagnostically distinct from migraine, many of the same pharmacologic agents are used in their management. For many patients, the attacks are so frequent and severe that abortive therapy is often ineffective; therefore, chronic preventive therapy is necessary for adequate pain control. Cluster headache and trigeminal neuralgia have several distinguishing clinical features. Cluster headache is predominantly a male disorder; trigeminal neuralgia is more prevalent in women. Individuals with cluster headaches often develop their first attack before age 25; most patients with trigeminal neuralgia are between age 50 and 70. Cluster headaches are strongly associated with tobacco smoking and triggered by alcohol consumption; trigeminal neuralgia can be triggered by such stimuli as shaving and toothbrushing. Although the pain in both disorders is excruciating, cluster headache pain is episodic and unilateral, typically surrounds the eye, and lasts 15 to 180 minutes; the pain of trigeminal neuralgia lasts just seconds and is usually limited to the tissues overlying the maxillary and mandibular divisions of the trigeminal nerve. Cluster headache is unique because of its associated autonomic symptoms. Although the pathophysiology of cluster headache and trigeminal neuralgia are not completely understood, both appear to have central primary processes, and these findings have prompted investigations of the effectiveness of the newer antiepileptic drugs for cluster headache prevention and for the treatment of trigeminal neuralgia. The traditional antiepileptic drugs phenytoin and carbamazepine have been used for the treatment of trigeminal neuralgia for a number of years, and while they are effective, they can sometimes cause central nervous system effects such as drowsiness, ataxia, somnolence, and diplopia. Reports of studies in small numbers of patients or individual case studies indicate that the newer antiepileptic drugs are effective in providing pain relief for trigeminal neuralgia and cluster headache sufferers, with fewer central nervous system side effects. Divalproex has been shown to provide effective pain control and to reduce cluster headache frequency by more than half in episodic and chronic cluster headache sufferers. Topiramate demonstrated efficacy in a study of 15 patients, with a mean time to induction of cluster headache remission of 1.4 weeks (range, 1 day to 3 weeks). In the treatment of trigeminal neuralgia, gabapentin has been shown to be effective in an open-label study. When added to an existing but ineffective regimen of carbamazepine or phenytoin, lamotrigine provided improved pain relief; it also may work as monotherapy. Topiramate provided a sustained analgesic effect when administered to patients with trigeminal neuralgia. The newer antiepileptic drugs show considerable promise in the management of cluster headache and trigeminal neuralgia. [source] Decision-making in community-based paediatric physiotherapy: a qualitative study of children, parents and practitionersHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2006Bridget Young BA PhD Abstract Approaches to practice based on partnership and shared decision-making with patients are now widely recommended in health and social care settings, but less attention has been given to these recommendations in children's services, and to the decision-making experiences of non-medical practitioners and their patients or clients. This study explored children's, parents' and practitioners' accounts of shared decision-making in the context of community-based physiotherapy services for children with cerebral palsy. Semi-structured interviews were conducted with 11 children with cerebral palsy living in an inner city area of northern England, and with 12 of their parents. Two focus groups were conducted with 10 physiotherapy practitioners. Data were analysed using the constant comparative method. When asked explicitly about decision-making, parents, children and practitioners reported little or no involvement, and each party saw the other as having responsibility for decisions. However, when talking in more concrete terms about their experiences, each party did report some involvement in decision-making. Practitioners' accounts focused on their responsibility for making decisions about resource allocation, and thereby, about the usefulness and intensity of interventions. Parents indicated that these practitioner-led decisions were sometimes in conflict with their aspirations for their child. Parents and children appeared to have most involvement in decisions about the acceptability and implementation of interventions. Children's involvement was more limited than parents'. While parents could legitimately curtail unacceptable interventions, children were mostly restricted to negotiating about how interventions were implemented. In these accounts the involvement of each party varied with the type of issue being decided and decision-making appeared more unilateral than shared. In advocating shared decision-making, greater understanding of its weaknesses as well as its strengths, and greater clarity about the domains that are suitable for a shared decision-making approach and the roles of different parties, would seem a helpful step. [source] Impairment and recovery on a food foraging task following unilateral vestibular deafferentation in ratsHIPPOCAMPUS, Issue 4 2006Yiwen Zheng Abstract It has been suggested that the vestibular system may contribute to the development of higher cognitive function, especially spatial learning and memory that uses idiothetic cues (e.g., dead reckoning). However, few studies have been done using behavioral tasks that could potentially separate the animals' ability for dead reckoning from piloting. The food foraging task requires the animal to continuously monitor and integrate self-movement cues and generate an accurate return path. It has been shown that bilateral vestibular-lesioned rats were impaired on this task. The present study used the same task to further examine the contribution of vestibular information to spatial navigation by comparing unilateral and bilateral lesions and by testing the animals at different time points following the lesion. The results demonstrated that animals with unilateral vestibular deafferentation were impaired in performing the task in the dark at 3 months after the lesion, and this impairment disappeared at 6 months after the lesion. This supports the notion that vestibular information contributes to dead reckoning and suggests possible recovery of function over time after the lesion. Animals with bilateral vestibular deafferentation were not able to be tested on the foraging task because they exhibited behavior distinct from the unilateral-lesioned animals, with significant hesitation in leaving their home cage for as long as 6 months after the lesion. © 2005 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||||||||