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Paralysis
Kinds of Paralysis Selected AbstractsCrisis and Organisational Paralysis: The Lingering Problem of Korean Public AdministrationJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 1 2001Jong S. Jun This essay argues that the Korean crisis is caused by the enduring problems of administrative culture, such as central control of decision-making, corruption, passive learning, moral decay, and a lack of self-governance and autonomy of administrators. The crisis has brought organisational paralysis because public administrators are not capable of responding to and coping with the crisis situation. The authors state that solutions to these problems are difficult and require strategies beyond short-term, instrumental solutions because change involves education and raising consciousness of public servants at all levels. [source] Paralysis in the left phrenic nerve after living-donor liver transplantation for biliary atresia with situs inversusLIVER TRANSPLANTATION, Issue 11 2008Yukihiro Sanada A 7-month-old boy with biliary atresia accompanied by situs inversus and absent inferior vena cava (IVC) underwent living-donor liver transplantation (LDLT). Because a constriction in the recipient hepatic vein (HV) was detected during the preparation of the HV in LDLT, a dissection in the cranial direction and a total clamp of the suprahepatic IVC was performed, and the suprahepatic IVC and the graft HV were anastomosed end-to-end. Postoperatively, atelectasis in the left upper lobe and ventilator failure accompanied by an elevation of the left hemidiaphragm were observed and mechanical ventilation was repetitively required. Paralysis in the left phrenic nerve was diagnosed by chest radiograph and ultrasonography. In our patient, conservative treatment was administrated, because weaning him from mechanical ventilation was possible a few days after intubation and the ventilator function was expected to be improved with growth. The disease course was good, and he was discharged from the hospital at 78 days after LDLT. Complications of paralysis in the phrenic nerve after cadaveric liver transplantation have been reported to be high. Although using a conventional technique during the reconstruction of the HV may injure the phrenic nerve directly, use of the piggyback technique with preservation of the IVC is rare. Even if LDLT was undertaken, a dissection of the HV or a total clamp of the suprahepatic IVC as a conventional technique can directly injure the phrenic nerve. Therefore, a dissection of the HV or a total clamp of the suprahepatic IVC at the reconstruction of the HV in LDLT should be carefully performed, and the possibility of paralysis in the phrenic nerve should be considered in patients with a relapse of respiratory symptoms and an elevation of the hemidiaphragm after LDLT. Liver Transpl 14:1659,1663, 2008. © 2008 AASLD. [source] Pain Symptom Profiles in Persons with Spinal Cord InjuryPAIN MEDICINE, Issue 7 2009Yenisel Cruz-Almeida MSPH ABSTRACT Objective., Persistent pain is a common consequence of spinal cord injury. A patient-specific assessment that combines both the identification of pain symptoms and psychosocial factors is needed for a tailored treatment approach. The aim of the study was to define pain symptom profiles and to determine their relationship with psychosocial factors in persons with spinal cord injury. Design., Face-to-face interview and examination. Setting., VA Medical Center and Miami Project to Cure Paralysis, Miami, Florida. Patients., Persons with spinal cord injury (135 men and 21 women) provided detailed descriptions of 330 neuropathic pains. Outcome Measures., The American Spinal Injury Impairment Scale, pain history and measures of pain interference, life satisfaction, locus of control, social support and depression. Results., The exploratory factor analyses and regression analyses revealed three distinct symptom profiles: 1) aching, throbbing pain, aggravated by cold weather and constipation predicted by a combination of chance locus of control and lower levels of life satisfaction; 2) stabbing, penetrating, and constant pain of high intensity predicted by a combination of pain interference, localized pain, powerful others locus of control and depressed mood; and 3) burning, electric, and stinging pain aggravated by touch and muscle spasms predicted by pain interference. Conclusions., Although these results need to be replicated in other spinal cord injury samples, our findings suggest that pain symptom profiles may be a useful way to further characterize pain in a comprehensive assessment strategy. [source] Kawasaki Disease with Facial Nerve ParalysisPEDIATRIC DERMATOLOGY, Issue 6 2003Margarita Larralde M.D., Ph.D. We describe an instance of facial nerve paralysis in a patient with KD. A 5-month-old boy developed fever, irritability, and diarrhea, treated 8 days later with cefaclor and ibuprofen. Three days later a confluent, erythematous and papular rash appeared, his lips were reddened and swollen, and his white blood count and platelet count were 20,900/mm3 and 558,000/mm3, respectively. He was admitted to the hospital with a diagnosis of KD, and an echocardiogram showed a right coronary aneurysm. The patient then developed an acute, right-sided, facial nerve peripheral paralysis that resolved over the next 6 weeks. He was treated with intravenous immune globulin (IVIG) 2 g/kg and aspirin 100 mg/kg/day with improvement of signs and symptoms. This report documents facial nerve paralysis as an uncommon complication of KD and points out that it may be a marker of increased risk of cardiovascular disease in this disorder. [source] Neurological presentations of conversion disorders in a group of Singapore childrenPEDIATRICS INTERNATIONAL, Issue 4 2008Wan-yee Teo Abstract Background: Neurological presentations of conversion disorders in children are not uncommon. Conversion disorders mimicking neurological conditions constitute a group of underdiagnosed conditions. Methods: This was a retrospective study of 13 children with neurological presentations of conversion disorders who were admitted to hospital. Patients were followed for 1,4 years. Results: Paralysis was the most common neurological symptom, patients presented with multiple, complex conversion symptoms and other neurological symptoms such as seizures and headache. The affected children underwent complete physical, neurological examination and psychological evaluation. Investigations included blood tests, cranial imaging and electroencephalography. Most common external environmental factors detected were school stress and change in family situation. Five of 13 patients had family members who were reported to have medical conditions with presentations similar to patients' neurological and psychological problem. All the patients were admitted, five patients required multiple admissions. Ten patients eventually had good outcome in terms of academic grades and social functioning. Conclusion: Diagnosis of conversion disorders mimicking neurological conditions can be challenging. There is a need to heighten awareness of this entity for early recognition and diagnosis. Awareness of this entity coupled with a high index of suspicion can facilitate accurate and earlier diagnosis. [source] Recovery from Cruciate Paralysis Due to Axial Subluxation from Metastatic Breast Carcinoma: A Case ReportTHE BREAST JOURNAL, Issue 2 2000FACS, Walter J. Faillace MD Abstract: Cruciate paralysis is an uncommon and potentially life-threatening myelopathy thought to arise from injury to the corticospinal tracts at a high cervical spinal level. The authors report on the case of a woman who developed cruciate paralysis secondary to axial subluxation of the cervical spine due to invasion by metastatic breast carcinoma. Correct bedside diagnosis, prompt spinal alignment via halo traction, and surgical spinal decompression with fusion stabilization reversed the paralysis completely. Postoperative antiestrogen medication, spinal radiation, and chemotherapy promoted local tumor control, allowing the patient longevity and good quality pain control. The prompt diagnosis and treatment of cruciate paralysis could effect a good prognosis in a seemingly terminal patient with metastatic spinal breast carcinoma by resolving life-threatening myelopathy, promoting longevity, and assisting with pain control. [source] Real-time measurement of serotonin release and motility in guinea pig ileumTHE JOURNAL OF PHYSIOLOGY, Issue 2 2006Paul P. Bertrand Enterochromaffin (EC) cells are sensors that detect chemical or mechanical stimuli and respond with release of serotonin (5-HT). 5-HT activates local motor reflexes, but whether local motor reflexes also evoke 5-HT release is unknown. The aim of the present study was to establish the relationship between the release of 5-HT and the enteric neural circuits controlling the movements of the intestine. Recordings were made from full-thickness preparations of guinea pig ileum using electrochemical techniques with carbon fibre electrodes to measure local concentrations of 5-HT. The tension in the circular muscle (CM) and longitudinal muscle (LM) was recorded with force transducers. The release of 5-HT from the EC cells was detected selectively and the timing of the events quantified. Pressure-evoked peristalsis caused detectable 5-HT release only when the recording site was invaded by a ring of CM contraction. Spontaneous and stretch-evoked reflex contraction of the CM and LM occurred simultaneously with 5-HT release. Paralysis of the smooth muscle significantly reduced the stretch-evoked release. Muscarinic agonists evoked reflexes that were associated with increases in tension in CM and LM simultaneous with 5-HT release. Tetrodotoxin abolished the coordination between the CM contraction and 5-HT release but not the direct activation of the CM and EC cells by the agonists. In conclusion, the correlation between local motor reflexes and 5-HT release observed in the present study is caused primarily by the contraction of the smooth muscle and subsequent deformation of the mucosa. The EC cell is, thus, a site of convergence for mechanical forces that contribute to the release of 5-HT during motor reflexes. [source] Bilateral Facial Nerve Paralysis associated with Otomastoiditis: A Case ReportTHE LARYNGOSCOPE, Issue S3 2010Bob B. Armin MD No abstract is available for this article. [source] Injection Versus Medialization Laryngoplasty for the Treatment of Unilateral Vocal Fold Paralysis,THE LARYNGOSCOPE, Issue 11 2007Justin E. Morgan MD Abstract Objective/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the treatment of unilateral vocal fold paralysis. Study Design: A retrospective study of patients with unilateral vocal fold paralysis who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and March 8, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and posttreatment voice parameters of videostrobolaryngoscopy, perceptual analysis, and patients' subjective voice assessment. Results: Nineteen patients were evaluated. The average time from intervention to posttreatment evaluation was 3 (range, 1,9) months. Improvements were demonstrated in all three voice parameters in both the injection and the medialization groups. No significant differences were found in the degree of improvement between the two groups. Videostrobolaryngoscopy and the perceptual analysis, both rated by the authors, correlated well with each other, but they both correlated poorly with the patients' subjective voice analysis. Conclusions: Injection and medialization laryngoplasty were comparable in their improvement of subjective and objective voice outcomes. Both treatment modalities should be included in the otolaryngologist's armamentarium for managing unilateral vocal fold paralysis. [source] Vocal Fold Paralysis After Anterior Cervical Spine Surgery: Incidence, Mechanism, and Prevention of Injury,THE LARYNGOSCOPE, Issue 9 2000Mark D. Kriskovich MD Abstract Objective Vocal fold paralysis is the most common otolaryngological complication after anterior cervical spine surgery (ACSS). However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the incidence and mechanism of vocal fold paralysis in ACSS and to determine whether controlling for endotracheal tube/laryngeal wall interactions induced by the cervical retraction system could decrease the rate of paralysis. Study Design Retrospective review and complementary cadaver dissection. Methods Data gathered on 900 consecutive patients undergoing ACSS were reviewed for complications and procedural risk factors. After the first 250 cases an intervention consisting of monitoring of endotracheal tube cuff pressure and release of pressure after retractor placement or repositioning was employed. This allowed the endotracheal tube to re-center within the larynx. In addition, anterior approaches to the cervical spine were performed on fresh, intubated cadavers and studied with videofluoroscopy following retractor placement. Results Thirty cases of vocal fold paralysis consistent with recurrent laryngeal nerve injury were identified with three patients having permanent paralysis. With this technique temporary paralysis rates decreased from 6.4% to 1.69% (P = .0002). The cadaver studies confirmed that the retractor displaced the larynx against the shaft of the endotracheal tube with impingement on the vulnerable intralaryngeal segment of the recurrent laryngeal nerve. Conclusion The study results suggest that the most common cause of vocal fold paralysis after anterior cervical spine surgery is compression of the recurrent laryngeal nerve within the endolarynx. Endotracheal tube cuff pressure monitoring and release after retractor placement may prevent injury to the recurrent laryngeal nerve during anterior cervical spine surgery. [source] Corticosteroid Treatment for Idiopathic Facial Nerve Paralysis: A Meta-analysis,THE LARYNGOSCOPE, Issue 3 2000Mitchell Jay Ramsey CPT Abstract Objective A meta-analysis was designed to evaluate facial recovery in patients with complete idiopathic facial nerve paralysis (IFNP) by comparing outcomes of those treated with corticosteroid therapy with outcomes of those treated with placebo or no treatment. Study Design Meta-analysis of prospective trials evaluating corticosteroid therapy for idiopathic facial nerve paralysis. Methods A protocol was followed outlining methods for trial selection, data extraction, and statistical analysis. A MEDLINE search of the English language literature was performed to identify clinical trials evaluating steroid treatment of IFNP. Three independent observers used an eight-point analysis to determine inclusion criteria. Data analysis was limited to individuals with clinically complete IFNP. The endpoints measured were clinically complete or incomplete facial motor recovery. Effect magnitude and significance were evaluated by calculating the rate difference and Fisher's Exact Test P value. Pooled analysis was performed with a random effects model. Results Forty-seven trials were identified. Of those, 27 were prospective and 20 retrospective. Three prospective trials met the inclusion criteria. Tests of heterogeneity indicate the trial with the smallest sample size (RD = ,0.19; 95% CI, ,0.58,0.20), to be an outlier. It was excluded from the final analysis. Analyses of data from the remaining two studies indicate corticosteroid treatment improves complete facial motor recovery for individuals with complete IFNP. Rate difference demonstrates a 17% (99% CI, 0.01,0.32) improvement in clinically complete recovery for the treatment group based on the random effects model. Conclusions Corticosteroid treatment provides a clinically and statistically significant improvement in recovery of function in complete IFNP. [source] A Patient Suffering from Hypokalemic Periodic Paralysis Is Deficient in Skeletal Muscle ATP-sensitive K+ channelsCLINICAL AND TRANSLATIONAL SCIENCE, Issue 1 2008Sofija Jovanovi Abstract Hypokalemic periodic paralysis (HOPP) is a rare disease associated with attacks of muscle weakness and hypokalemia. In the present study, immunoprecipitation/Western blotting has shown that a HOPP patient was deficient in sarcolemmal KATP channels. Real-time RT-PCR has revealed that HOPP has decreased mRNA levels of Kir6.2, a pore-forming KATP channel subunit, without affecting the expression of other KATP channel-forming proteins. Based on these findings, we conclude that HOPP could be associated with impaired expression of Kir6.2 which leads to deficiency in skeletal muscle KATP channels, which may explain the symptoms and clinical signs of this disease. [source] How two different host species influence the performance of a gregarious parasitoid: host size is not equal to host qualityJOURNAL OF ANIMAL ECOLOGY, Issue 2 2007JOHANNA HÄCKERMANN Summary 1Hyssopus pallidus Askew (Hymenoptera, Eulophidae) is a gregarious ectoparasitoid of the two tortricid moths species Cydia molesta Busck and C. pomonella L. (Lepidoptera, Tortricidae). It paralyses and parasitizes different larval instars of both species inside the apple fruit, which leads to the death of the caterpillar. 2We assessed the influence of host species characteristics and host food on the performance of the parasitoid female in terms of clutch size decisions and fitness of the F1 generation. 3A comparison of clutch size revealed that female parasitoids deposited similar numbers of eggs on the comparatively smaller C. molesta hosts as on the larger C. pomonella hosts. The number of parasitoid offspring produced per weight unit of host larva was significantly higher in C. molesta than in C. pomonella, which is contrary to the general prediction that smaller hosts yield less parasitoid offspring. However, the sex ratio was not influenced by host species that differed considerably in size. 4Despite the fact that less host resources were available per parasitoid larva feeding on C. molesta caterpillars, the mean weight of emerging female wasps was higher in the parasitoids reared on C. molesta. Furthermore, longevity of these female wasps was neither influenced by host species nor by the food their host had consumed. In addition we did not find a positive relationship between adult female weight and longevity. 5Parasitoid females proved to be able to assess accurately the nutritional quality of an encountered host and adjust clutch size accordingly. These findings indicate that host size is not equal to host quality. Thus host size is not the only parameter to explain the nutritional quality of a given host and to predict fitness gain in the subsequent generation. [source] Congenital hypomyelination neuropathy in a newborn infant: unusual cause of diaphragmatic and vocal cord paralysesJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2002JS Hahn We report a case of congenital hypomyelination neuropathy presenting at birth. The infant had generalized hypotonia and weakness. There was decreased respiratory effort along with a right phrenic nerve and left vocal cord paralyses. Tongue fasciculations were present. Deep tendon reflexes were absent in the upper extremities and hypoactive (1+) in the lower extremities. Magnetic resonance imaging of the head revealed no intracranial abnormalities, including normal cerebral myelination. Nerve conduction study showed absence of motor and sensory action potentials in the hands when the nerves in the upper limbs were stimulated. A motor response could be elicited only in the proximal leg muscles. Needle electromyography study was normal in the proximal limb muscles, but showed active denervation in the distal muscles of the arm and leg. These findings were thought to be consistent with a length-dependent sensorimotor peripheral polyneuropathy of axonal type with greater denervation of the distal muscles. A biopsy of the quadriceps muscle showed mild variability in fiber diameter, but no group typing or group atrophy. The muscle fibers showed no intrinsic abnormalities. Biopsy of the sural nerve showed scattered axons with very thin myelin sheaths. There was also a nearly complete loss of large diameter myelinated fibers. No onion bulb formations were noted. These findings were thought to be consistent with congenital hypomyelination neuropathy with a component of axonopathy. DNA analysis for identification of previously characterized mutations in the genes MPZ, PMP22, and EGR2 was negative. Several attempts at extubation failed and the infant became increasingly ventilator-dependent with increasing episodes of desaturation and hypercapnea. He also developed increasing weakness and decreased movement of all extremities. He underwent surgery at 2 months of age for placement of a gastrostomy tube and a tracheostomy. He was discharged from the hospital on a ventilator at 6 months of age. The infant was 13 months old at the time of submission of this report. Although he appears cognitively normal, he remains profoundly hypotonic and is on a home ventilator. There was no evidence of progressive weakness. Congenital hypomyelination neuropathy is a rare form of neonatal neuropathy that should be considered in the differential diagnosis of a newborn with profound hypotonia and weakness. It appears to be a heterogeneous disorder with some of the cases being caused by specific genetic mutations. [source] Hypocretin/orexin and narcolepsy: new basic and clinical insightsACTA PHYSIOLOGICA, Issue 3 2010S. Nishino Abstract Narcolepsy is a chronic sleep disorder, characterized by excessive daytime sleepiness (EDS), cataplexy, sleep paralysis and hypnagogic hallucinations. Both sporadic (95%) and familial (5%) forms of narcolepsy exist in humans. The major pathophysiology of human narcolepsy has been recently discovered based on the discovery of narcolepsy genes in animals; the genes involved in the pathology of the hypocretin/orexin ligand and its receptor. Mutations in hypocretin-related genes are rare in humans, but hypocretin ligand deficiency is found in a large majority of narcolepsy with cataplexy. Hypocretin ligand deficiency in human narcolepsy is probably due to the post-natal cell death of hypocretin neurones. Although a close association between human leucocyte antigen (HLA) and human narcolepsy with cataplexy suggests an involvement of autoimmune mechanisms, this has not yet been proved. Hypocretin deficiency is also found in symptomatic cases of narcolepsy and EDS with various neurological conditions, including immune-mediated neurological disorders, such as Guillain,Barre syndrome, MA2-positive paraneoplastic syndrome and neuromyelitis optica (NMO)-related disorder. The findings in symptomatic narcoleptic cases may have significant clinical relevance to the understanding of the mechanisms of hypocretin cell death and choice of treatment option. The discoveries in human cases lead to the establishment of the new diagnostic test of narcolepsy (i.e. low cerebrospinal fluid hypocretin-1 levels for ,narcolepsy with cataplexy' and ,narcolepsy due to medical condition'). As a large majority of human narcolepsy patients are ligand deficient, hypocretin replacement therapy may be a promising new therapeutic option, and animal experiments using gene therapy and cell transplantations are in progress. [source] Aggressive and Neglected Basal Cell CarcinomaDERMATOLOGIC SURGERY, Issue 11 2005Ali Asilian MD Background. Basal cell carcinoma (BCC) is the most common cutaneous malignancy and usually has a benign coarse. Rarely, examples of aggressive and neglected types of this tumor are seen. Objective. To present an interesting and dramatic example of how some people neglect their tumors and how devastating the sequelae can be. Methods. We report a 58-year-old man with an extensive BCC and signs of cranial nerve involvement. Results. The patient had a large, infected ulcer on his scalp. He also had skull bone destruction, osteomyelitis, mastoiditis, cranial nerve paralysis, and radiographic features of the skull base and upper cervical soft tissue involvement. Pathologic studies revealed an infiltrating form of BCC. Conclusions. If left untreated and neglected, as in this case, BCC can become inoperable and complicated. ALI ASILIAN, MD, AND BANAFSHE TAMIZIFAR, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Botulinum Toxin Type B for Dynamic Glabellar Rhytides Refractory to Botulinum Toxin Type ADERMATOLOGIC SURGERY, Issue 5 2003Tina S. Alster MD Background. Botulinum toxin type B (BTX-B; Myobloc) has recently been introduced for the treatment of dynamic rhytides. This serotype is structurally similar to botulinum toxin type A (BTX-A; Botox) and appears to produce equivalent muscular paralysis. Because of the fact that some patients may become resistant to the effects of BTX-A with its continued use or may require large doses of type A to exert adequate muscular paralysis, the use of BTX-B may prove beneficial in these cases. Objective. To determine the effect of BTX-B on glabellar rhytides refractory or showing decreased clinical effect to treatment with BTX-A. Methods. Twenty females (mean age, 43 years) with vertical glabellar rhytides showing decreased or negligible clinical effect to BTX-A were treated with intramuscular injections of BTX-B. Five standardized intramuscular sites (procerus, inferomedial corrugator muscles, superior middle corrugator muscles) received a total dose of 2,500 U. Patients were evaluated at pretreatment and 48 to 72 hours, 1 week, and 2 and 4 months after injection. Results. All glabellar rhytides improved after treatment with BTX-B injections. Peak clinical effect was noted 1 month after treatment, with 50% of peak effect evident at the 2-month follow-up. Near complete dissolution of effect was seen at 4 months after treatment. Side effects were transient and were limited to moderate injectional pain and rare bruising and frontal brow tightness. Conclusions. BTX-B is an effective treatment modality for glabellar rhytides refractory or exhibiting decreased clinical effect to BTX-A. The duration of effect using the 2,500 U dosing schedule described herein was shorter than that typically achieved after equivalent BTX-A injection. [source] Activity-based restorative therapies: Concepts and applications in spinal cord injury-related neurorehabilitationDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2009Cristina L. Sadowsky Abstract Physical rehabilitation following spinal cord injury-related paralysis has traditionally focused on teaching compensatory techniques, thus enabling the individual to achieve day-to-day function despite significant neurological deficits. But the concept of an irreparable central nervous system (CNS) is slowly being replaced with evidence related to CNS plasticity, repair, and regeneration, all related to persistently maintaining appropriate levels of neurological activity both below and above the area where the damage occurred. It is now possible to envision functional repair of the nervous system by implementing rehabilitative interventions. Making the transition from "bench to bedside" requires careful analysis of existing basic science evidence, strategic focus of clinical research, and pragmatic implementation of new therapeutic tools. Activity, defined as both function specific motor task and exercise appears to be a necessity for optimization of functional, metabolic, and neurological status in chronic paralysis. Crafting a comprehensive rehabilitative intervention focused on functional improvement through neurological gains seems logical. The terms activity-based restorative therapies, activity-based therapies, and activity-based rehabilitation have been coined in the last 10 years to describe a new fundamental approach to deficits induced by neurological paralysis. The goal of this approach is to achieve activation of the neurological levels located both above and below the injury level using rehabilitation therapies. This article reviews basic and clinical science evidence pertaining to implementation of physical activity and exercise as a therapeutic tool in the management of chronic spinal cord-related neurological paralysis. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:112,116. [source] Effect of muscle activity and botulinum toxin dilution volume on muscle paralysisDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2003Hyeon Sook Kim MD PhD The purpose of this study was to evaluate the effects of botulinum toxin A (BTX-A, Botox) dilution volume and post-injection exercise with electrical stimulation on muscle paralysis. We injected 10 units of BTX-A diluted with 0.1 ml (B1, n=8) or 0.5 ml (B5, n=8) normal saline into both gastrocnemius muscles of 16 New Zealand white rabbits; two controls received no BTX-A. After BTX-A injection, all rabbits received calf muscle stretching exercise and electrical stimulation for 2 hours on the left leg. The compound muscle action potential (CMAP) decrease was most pronounced at 1 week and progressive recovery was observed (i.e. recovery from paralysis, increase of CMAP). There was a significant decrease of CMAP amplitudes in the B5 group compared with the B1 group at week 1 and week 4 (p<0.001). Left limbs with stretching exercise and electrical stimulation showed lower CMAP amplitudes compared with control right limbs of all rabbits. To maximize the muscle paralysis effect of BTX-A, increasing dilution volume and performing post-injection stretching exercise with electrical stimulation may be a promising strategy for increasing the beneficial effect of BTX-A treatment. Future studies are needed to investigate the clinical application of this finding. [source] Friedrich Nietzsche's mental illness , general paralysis of the insane vs. frontotemporal dementiaACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2006M. Orth Objective:, For a long time it was thought that Nietzsche suffered from general paralysis of the insane (GPI). However, this diagnosis has been questioned recently, and alternative diagnoses have been proposed. Method:, We have charted Friedrich Nietzsche's final fatal illness, and viewed the differential diagnosis in the light of recent neurological understandings of dementia syndromes. Results:, It is unclear that Nietzsche ever had syphilis. He lacked progressive motor and other neurological features of a progressive syphilitic central nervous system (CNS) infection and lived at least 12 years following the onset of his CNS signs, which would be extremely rare for patients with untreated GPI. Finally, his flourish of productivity in 1888 would be quite uncharacteristic of GPI, but in keeping with reports of burgeoning creativity at some point in the progression of frontotemporal dementia (FTD). Conclusion:, We suggest that Nietzsche did not have GPI, but died from a chronic dementia, namely FTD. [source] Curiosity and cure: Translational research strategies for neural repair-mediated rehabilitationDEVELOPMENTAL NEUROBIOLOGY, Issue 9 2007Bruce H. Dobkin Abstract Clinicians who seek interventions for neural repair in patients with paralysis and other impairments may extrapolate the results of cell culture and rodent experiments into the framework of a preclinical study. These experiments, however, must be interpreted within the context of the model and the highly constrained hypothesis and manipulation being tested. Rodent models of repair for stroke and spinal cord injury offer examples of potential pitfalls in the interpretation of results from developmental gene activation, transgenic mice, endogeneous neurogenesis, cellular transplantation, axon regeneration and remyelination, dendritic proliferation, activity-dependent adaptations, skills learning, and behavioral testing. Preclinical experiments that inform the design of human trials ideally include a lesion of etiology, volume and location that reflects the human disease; examine changes induced by injury and by repair procedures both near and remote from the lesion; distinguish between reactive molecular and histologic changes versus changes critical to repair cascades; employ explicit training paradigms for the reacquisition of testable skills; correlate morphologic and physiologic measures of repair with behavioral measures of task reacquisition; reproduce key results in more than one laboratory, in different strains or species of rodent, and in a larger mammal; and generalize the results across several disease models, such as axonal regeneration in a stroke and spinal cord injury platform. Collaborations between basic and clinical scientists in the development of translational animal models of injury and repair can propel experiments for ethical bench-to-bedside therapies to augment the rehabilitation of disabled patients. © 2007 Wiley Periodicals, Inc. Develop Neurobiol, 2007 [source] Parasitoid wasp sting: A cocktail of GABA, taurine, and ,-alanine opens chloride channels for central synaptic block and transient paralysis of a cockroach hostDEVELOPMENTAL NEUROBIOLOGY, Issue 8 2006Eugene L. Moore Abstract The wasp Ampulex compressa injects venom directly into the prothoracic ganglion of its cockroach host to induce a transient paralysis of the front legs. To identify the biochemical basis for this paralysis, we separated venom components according to molecular size and tested fractions for inhibition of synaptic transmission at the cockroach cercal-giant synapse. Only fractions in the low molecular weight range (<2 kDa) caused synaptic block. Dabsylation of venom components and analysis by HPLC and MALDI-TOF-MS revealed high levels of GABA (25 mM), and its receptor agonists ,-alanine (18 mM), and taurine (9 mM) in the active fractions. Each component produces transient block of synaptic transmission at the cercal-giant synapse and block of efferent motor output from the prothoracic ganglion, which mimics effects produced by injection of whole venom. Whole venom evokes picrotoxin-sensitive chloride currents in cockroach central neurons, consistent with a GABAergic action. Together these data demonstrate that Ampulex utilizes GABAergic chloride channel activation as a strategy for central synaptic block to induce transient and focal leg paralysis in its host. © 2006 Wiley Periodicals, Inc. © 2006 Wiley Periodicals, Inc. J Neurobiol, 2006 [source] Effects of hind limb denervation on the development of appendicular ossicles in the Dwarf African Clawed Frog, Hymenochirus boettgeri (Anura: Pipidae)ACTA ZOOLOGICA, Issue 4 2009Hyoung Tae Kim Abstract Sesamoids and other appendicular ossicles are common in other classes of vertebrates but comparatively rare in amphibians. The pipid frog Hymenochirus boettgeri (Boulenger, G. A. 1899. On Hymenochirus, a new type of aglossal batrachians. , Annals of the Magazine of Natural History Series 7: 122,125) is unusual among anurans in having seven (or more) appendicular ossicles in each hind limb. Sesamoids are often associated with muscles and tendons, and their development is usually regarded as mediated by or correlated with function. This study investigated the effects of paralysis (loss of function) on development of ossicles in the hind limb of Hymenochirus. Complete denervation of the right sciatic nerve was performed at developmental stages 63 and 66, and the animals maintained for a further 6,7 or 12,13 weeks. Specimens were cleared and double stained for cartilage and bone. There were no gross morphological differences between control and sham operated groups. The lunulae were not affected by paralysis, whereas the fabella arose later and/or regressed in some specimens. The distal os sesamoides tarsalia (OST) was shorter in paralysed individuals, and both the distal OST and cartilagines plantares showed delayed maturation. Denervation of the hind limb thus affected the timing of appearance, maintenance and rate of maturation of some sesamoid bones in Hymenochirus, but had no effect on others. [source] Anti-drink driving reform in Britain, c. 1920,80ADDICTION, Issue 9 2010Bill Luckin ABSTRACT Aim The goal of this report is to provide a framework for understanding and interpreting political, scientific and cultural attitudes towards drink driving in 20th-century Britain. Exploring the inherent conservatism of successive governments, Members of Parliament (MPs) and the public towards the issue during the interwar years, the contribution seeks to explain the shift from legislative paralysis to the introduction of the breathalyser in 1967. Design Based on governmental, parliamentary and administrative records, the report follows a mainly narrative route. It places particular emphasis on connections between post-war extra-parliamentary and parliamentary movements for reform. Setting The paper follows a linear path from the 1920s to the 1970s. Britain lies at the heart of the story but comparisons are made with nations,particularly the Scandinavian states,which took radical steps to prosecute drinking and dangerous drivers at an early date. Findings The report underlines the vital post-war role played by Graham Page, leading parliamentary spokesman for the Pedestrians' Association; the centrality of the Drew Report (1959) into an ,activity resembling driving'; the pioneering Conservative efforts of Ernest Marples; and Barbara Castle's consolidating rather than radically innovative activities between 1964 and 1967. Conclusion Both before and after the Second World War politicians from both major parties gave ground repeatedly to major motoring organizations. With the ever-escalating growth of mass motorization in the 1950s, both Conservative and Labour governments agonized over gridlock and ,murder on the roads'. Barbara Castle finally took decisive action against drink drivers, but the ground had been prepared by Graham Page and Ernest Marples. [source] Females of the European beewolf preserve their honeybee prey against competing fungiECOLOGICAL ENTOMOLOGY, Issue 2 2001Erhard Strohm Summary 1. Females of the European beewolf Philanthus triangulum (Hymenoptera, Sphecidae) provision brood cells with paralysed honeybees as larval food. Because brood cells are located in warm, humid locations there is a high risk of microbial decomposition of the provisions. Low incidence of fungus infestation (Aspergillus sp.) in nests in the field suggested the presence of an anti-fungal adaptation. 2. To test whether the paralysis caused the protection from fungus infestation, the timing of fungus growth on bees that were freeze-killed, paralysed but not provisioned, and provisioned regularly by beewolf females was determined. Fungus growth was first detected on freeze-killed bees, followed by paralysed but not provisioned bees. By contrast, fungus growth on provisioned bees was delayed greatly or even absent. Thus, paralysis alone is much less efficient in delaying fungus growth than is regular provisioning. 3. Observations of beewolves in their nests revealed that females lick the body surface of their prey very thoroughly during the period of excavation of the brood cell. 4. To separate the effect of a possible anti-fungal property of the brood cell and the licking of the bees, a second experiment was conducted. Timing of fungus growth on paralysed bees did not differ between artificial and original brood cells. By contrast, fungus growth on bees that had been provisioned by a female but were transferred to artificial brood cells was delayed significantly. Thus, the treatment of the bees by the female wasp but not the brood cell caused the delay in fungus growth. 5. Beewolf females most probably apply anti-fungal chemicals to the cuticle of their prey. This is the first demonstration of the mechanism involved in the preservation of provisions in a hunting wasp. Some kind of preservation of prey as a component of parental care is probably widespread among hunting wasps and might have been a prerequisite for the evolution of mass provisioning. [source] Thyrotoxic, hypokalaemic periodic paralysisEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2005Melissa J Gillett Abstract Thyrotoxic, hypokalaemic periodic paralysis is an uncommon, potentially life-threatening endocrine emergency. Because of the acute onset of neurological symptoms patients often initially present to hospital ED. To reduce patient morbidity and costs of unnecessary investigations, early recognition and appropriate treatment is required. The case of a young man of Singaporean origin is presented to highlight current treatment, management and pathophysiology of this condition. [source] Effects of a saxitoxin-producer strain of Cylindrospermopsis raciborskii (cyanobacteria) on the swimming movements of cladoceransENVIRONMENTAL TOXICOLOGY, Issue 2 2008Aloysio da S. Ferrão Filho Abstract This study evaluated the effects of a saxitoxin-producer strain (T3) of the cyanobacteria species Cylindrospermopsis raciborskii on the swimming movements of three cladoceran species (Daphnia gessneri, D. pulex, and Moina micrura). Acute toxicity bioassays were designed to access the effects of T3 strain, of a nonsaxitoxin producer strain (NPLP-1) of the same species and of a raw water sample from Funil reservoir (Rio de Janeiro, Brazil), that contained this and other cyanobacteria. In the acute bioassays, animals were exposed to C. raciborskii filaments or Funil water for 24,48 h and then transferred to food suspensions without cyanobacterial filaments for a further 48 h. During the exposure time to T3 strain filaments there was a decrease in the number of swimming individuals, with animals showing progressive immobilization. The same effect was observed with Funil water sample. Animals stayed alive on the bottom of the test tube and recovered swimming movements when transferred to food suspensions without toxic cells. This effect was not observed with the strain NPLP-1. The cladoceran D. pulex showed to be extremely sensitive to T3 strain and to Funil water containing C. raciborskii filaments, showing complete paralysis after 24-h exposure to T3 cell densities of 103 and 104 cells mL,1, and after 24-h exposure to only 10% of raw water. However, D. gessneri was not sensitive to both T3 and to Funil water, whereas M. micrura was intermediate in sensitivity. This is the first report on the effects of cyanobacterial saxitoxins on movements of freshwater cladocerans, showing also difference in sensitivity among closely related Daphnia species. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2008. [source] A case of a periarticular abscess and suppurative arthritis of the atlanto-occipital jointEQUINE VETERINARY EDUCATION, Issue 7 2009G. van Galen Summary This Case Report describes a periarticular abscess and a suppurative arthritis of the atlanto-occipital joint in an adult horse. The horse showed a painful swelling localised on the atlanto-occipital region and ataxia in all 4 limbs. During hospitalisation, the horse developed recumbency, dysphagia, facial paralysis and seizures. Ultrasonography of the atlanto-occipital region enabled a tentative diagnosis to be made, which was later confirmed at autopsy. Culture of the abscess revealed a Staphylococcus aureus. However, the horse had a history of recurrent fever, hypertrophy and abscessation of the submandibular lymph nodes, neck pain and dyspnoea for 2 months, which was suggestive of strangles. [source] Hyperkalaemic periodic paralysis: Mother nature versus human natureEQUINE VETERINARY EDUCATION, Issue 8 2008S. J. Spier First page of article [source] Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses.EQUINE VETERINARY JOURNAL, Issue 4 2003Part 1: Maintenance of surgical arytenoid abduction, complications of surgery Summary Reasons for performing study: Laryngoplasty (LP) is currently the most common surgical treatment for equine laryngeal paralysis, however, there have been no reports quantifying the degree of retention of arytenoid abduction following L P. ADitionally, the complications of LP have been poorly documented. Objectives: To record the degree of arytenoid abduction retention following LP and to accurately document all complications of surgery. Methods: A study (1986,1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP (using 2 stainless steel wires) and combined ventriculocordectomy was undertaken; 198 owners completed questionnaires, a median of 19 months following surgery. The degree of arytenoid abduction achieved was endoscopically, semi-quantitatively evaluated using a 5-grade system, at 1 day, 7 days, and 6 weeks after surgery. Results: On the day following LP, 62% of horses had good (median grade 2) arytenoid abduction, 10% had excessive (grade 1), and 5% had minimal (grade 4) abduction (overall - median grade 2). Due to progressive loss of abduction, moderate (median grade 3, range 1,5) abduction was present overall at 1 and 6 weeks after LP. Further surgery was required to re-tighten prostheses in 10% of cases with excessive loss of abduction, or to loosen prostheses in 7% of horses which had continuing high levels of LP abduction and significant post operative dysphagia. LP wound problems (mainly seromas and suture abscesses) were reported to last <2 weeks in 9% of cases, <4 weeks in 4% and >4 weeks in 4%. The (partially sutured) laryngotomy wounds discharged post operatively for <2 weeks in 22% of cases, <4 weeks in 7% and for >4 weeks in 2%. Coughing occurred at some stage post operatively in 43% of cases and its presence correlated significantly with the degree of surgical arytenoid abduction. This coughing occurred during eating in 24% of cases and was not associated with eating (or dysphagia) in the other 19% of cases. Chronic (>6 months duration) coughing occurred in 14% of cases, but appeared to be due to intercurrent pulmonary disease in half of these horses. Conclusions: Suturing the cricotracheal membrane allows most laryngotomy wounds to heal quickly. Laryngoplasty wound problems were of little long-term consequence when stainless steel wire prostheses were used. Potential relevance: A significant loss of LP abduction occurs in most horses in the 6 weeks following surgery and efforts should be made to find ways to prevent such loss. However, excessive LP abduction is associated with post operative dysphagia and coughing. [source] | ||||||||||||||||||||||||||||||||||||||||