Pediatric Anesthesia, EarlyView.
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Δευτέρα 24 Σεπτεμβρίου 2018
Interventional procedures in children and adolescents with chronic non‐cancer pain as part of a multidisciplinary pain treatment program
Half a century of anesthesia for children: An interview with Dr. Nishan G. ‘Nick’ Goudsouzian
Pediatric Anesthesia, EarlyView.
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Ade2 Functions in the Drosophila Fat Body To Promote Sleep
Metabolic state is a potent modulator of sleep and circadian behavior and animals acutely modulate their sleep in accordance with internal energy stores and food availability. Across phyla, hormones secreted from adipose tissue act in the brain to control neural physiology and behavior to modulate sleep and metabolic state. Growing evidence suggests the fat body is a critical regulator of complex behaviors, but little is known about the genes that function within the fat body to regulate sleep. To identify molecular factors functioning in non-neuronal tissues to regulate sleep, we performed an RNAi screen selectively knocking down genes in the fat body. We found that knockdown of Phosphoribosylformylglycinamidine synthase/Pfas (Ade2), a highly conserved gene involved the biosynthesis of purines, sleep regulation and energy stores. Flies heterozygous for multiple Ade2 mutations are also short sleepers and this effect is partially rescued by restoring Ade2 to the Drosophila fat body. Targeted knockdown of Ade2 in the fat body does not alter arousal threshold or the homeostatic response to sleep deprivation, suggesting a specific role in modulating baseline sleep duration. Together, these findings suggest Ade2 functions within the fat body to promote both sleep and energy storage, providing a functional link between these processes.
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THE IMPLEMENTATION OF PATIENT REPORTED OUTCOME MEASURES IN APPROPRIATENESS CRITERIA OF SURGERY FOR DEGENERATIVE LUMBAR SCOLIOSIS
The current management of de novo degenerative lumbar scoliosis (DLS) is characterized by a substantial variety of treatment options reflecting the absence of a clear, evidence-based, widespread stepwise approach [1]. Nonoperative treatment includes physical conditioning and exercise, pharmacological agents for pain control, use of orthotics, and pain interventions like epidural and facet injections [1-3]. Operative treatment can include instrumented stabilization and correction with posterior or anterior fusion, neurological decompression, or a combination of these [1 3].
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Laryngeal Adductor Reflex And Future Projections for Brainstem Monitoring. Reply to “A method for intraoperative recording of the laryngeal adductor reflex during lower brainstem surgery in children”
In their Letter to the Editor, Costa et al. (2018) report on using the laryngeal adductor reflex (LAR), along with standard, methodologies, to monitor vagus nerve pathways in three pediatric patients during the removal of large 4th ventricle tumors. Preservation of LAR correlated with the absence of X cranial nerve neurological deficits.
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A method for intraoperative recording of the laryngeal adductor reflex during lower brainstem surgery in children
The recently published study Sinclair et al. (2017) presented a nice method for the intraoperative recording of the laryngeal adductor reflex (LAR) during thyroid and cervical spine surgeries.
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Automated EEG source imaging: a retrospective, blinded clinical validation study
Approximately 1/3 of patients with epilepsy are drug-resistant (Kwan et al. 2000). In this patient group, epilepsy surgery of the presumed epileptogenic focus is currently the treatment option with highest efficacy (Dwivedi et al. 2017; Engel et al. 2012; Wiebe et al. 2001). However, accurate localization of the epileptic focus is often challenging. Since there is no single-modality that reliably can localize the area that needs to be resected in order to render the patient seizure-free (EZ, epileptogenic zone), the presurgical evaluation is based on a multimodal approach (Rosenow and Lüders 2001).
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Electrooculogram and submandibular montage to distinguish different eye, eyelid, and tongue movements in electroencephalographic studies
Different types of ictal eye and eyelid movements have been described in the literature. In some generalized epilepsies, such as Jeavons Syndrome, eyelid myoclonia is a cardinal symptom (Jeavons, 1977). In focal epilepsies, eye and head version have an important lateralizing value regarding the epileptogenic zone (Rasmussen and Penfield, 1948; Wyllie et al., 1986). Eyelid flutter, forced rapid blinking, oculoclonic seizures, or epileptic nystagmus have all been described as having localizing value pointing to a posterior quadrant epileptogenic zone (Bancaud et al., 1965; Foerster and Penfield, 1930; Gastaut, 1960; Gastaut and Roger, 1954; Salanova et al., 1992; Williamson et al., 1992).
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New insights into the pathophysiology of fasciculations in amyotrophic lateral sclerosis: an ultrasound study
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the upper (UMN) and lower motor neurons (LMN). Fasciculations are involuntary twitches due to spontaneous contraction of muscle fascicles, originating from motor unit depolarizations as recorded by electromyography (EMG) (de Carvalho et al., 2017). Widespread fasciculations are characteristic of ALS and, therefore, have been incorporated to the diagnostic criteria (de Carvalho et al. 2008).
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Identifying mild-moderate Parkinson’s disease using whole-brain functional connectivity
Parkinson's disease (PD) is the second most common progressive neurodegenerative disease and is associated predominantly with motor symptoms, such as bradykinesia, in combination with rigidity and resting tremors. Moreover, PD is related to numerous non-motor symptoms, such as mood disorders and cognitive changes (Chaudhuri et al., 2009), some of which precede the motor dysfunction by more than a decade. The current diagnosis of PD is largely based on self-reported symptoms and clinical assessments (Jankovic, 2008) and has a high rate of misdiagnosis (Hughes et al., 1992).
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Indications for Neuromuscular Ultrasound: Expert Opinion and Review of the Literature
For much of the last fifty years, there has been remarkable uniformity in electrodiagnostic practice. Aside from the rare patient who might need referral to a specialized center for a single fiber EMG study, patients have been able to receive consistent diagnostic evaluations with comparable results regardless of the size of the laboratory or its geographic location. However, now a number of laboratories provide advanced ultrasound imaging in addition to standard electrophysiological assessment of nerve and muscle, a trend that appears to be accelerating, and this is creating an unprecedented gap between ultrasound enhanced and standard clinical neurophysiology practice.
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Passive Functional Mapping of Receptive Language Areas Using Electrocorticographic Signals
Resective brain surgery for the treatment of tumors or intractable epilepsy often requires localizing "eloquent" cortical regions involved in production and comprehension of language to minimize post-surgical deficits. Among the techniques to identify these eloquent regions, electrical cortical stimulation (ECS) has become the gold standard, perhaps because of its relatively low cost and procedural simplicity (see Borchers et al., 2012 for review).
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Which heart rate variability index is an independent predictor of mortality in cirrhosis
Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure.
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BILIARY STONE DISEASE IN PATIENTS RECEIVING SOMATOSTATIN ANALOGS FOR NEUROENDOCRINE NEOPLASMS. A RETROSPECTIVE OBSERVATIONAL STUDY
Somatostatin analogs are the backbone of neuroendocrine neoplasms treatment. Biliary stone disease is a potentially severe adverse event of somatostatin analogs: an increased incidence has been reported in somatostatin analogs-treated acromegalic patients, but studies on patients with neuroendocrine neoplasms are lacking.
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Which heart rate variability index is an independent predictor of mortality in cirrhosis
Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure.
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BILIARY STONE DISEASE IN PATIENTS RECEIVING SOMATOSTATIN ANALOGS FOR NEUROENDOCRINE NEOPLASMS. A RETROSPECTIVE OBSERVATIONAL STUDY
Somatostatin analogs are the backbone of neuroendocrine neoplasms treatment. Biliary stone disease is a potentially severe adverse event of somatostatin analogs: an increased incidence has been reported in somatostatin analogs-treated acromegalic patients, but studies on patients with neuroendocrine neoplasms are lacking.
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3 ways telemedicine can increase the reach of your EMS agency
Improve access to care and triage less urgent calls for more efficient use of healthcare resources
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Genomic prediction ability for beef fatty acid profile in Nelore cattle using different pseudo-phenotypes
Abstract
The aim of the present study was to compare the predictive ability of SNP-BLUP model using different pseudo-phenotypes such as phenotype adjusted for fixed effects, estimated breeding value, and genomic estimated breeding value, using simulated and real data for beef FA profile of Nelore cattle finished in feedlot. A pedigree with phenotypes and genotypes of 10,000 animals were simulated, considering 50% of multiple sires in the pedigree. Regarding to phenotypes, two traits were simulated, one with high heritability (0.58), another with low heritability (0.13). Ten replicates were performed for each trait and results were averaged among replicates. A historical population was created from generation zero to 2020, with a constant size of 2000 animals (from generation zero to 1000) to produce different levels of linkage disequilibrium (LD). Therefore, there was a gradual reduction in the number of animals (from 2000 to 600), producing a "bottleneck effect" and consequently, genetic drift and LD starting in the generation 1001 to 2020. A total of 335,000 markers (with MAF greater or equal to 0.02) and 1000 QTL were randomly selected from the last generation of the historical population to generate genotypic data for the test population. The phenotypes were computed as the sum of the QTL effects and an error term sampled from a normal distribution with zero mean and variance equal to 0.88. For simulated data, 4000 animals of the generations 7, 8, and 9 (with genotype and phenotype) were used as training population, and 1000 animals of the last generation (10) were used as validation population. A total of 937 Nelore bulls with phenotype for fatty acid profiles (Sum of saturated, monounsaturated, omega 3, omega 6, ratio of polyunsaturated and saturated and polyunsaturated fatty acid profile) were genotyped using the Illumina BovineHD BeadChip (Illumina, San Diego, CA) with 777,962 SNP. To compare the accuracy and bias of direct genomic value (DGV) for different pseudo-phenotypes, the correlation between true breeding value (TBV) or DGV with pseudo-phenotypes and linear regression coefficient of the pseudo-phenotypes on TBV for simulated data or DGV for real data, respectively. For simulated data, the correlations between DGV and TBV for high heritability traits were higher than obtained with low heritability traits. For simulated and real data, the prediction ability was higher for GEBV than for Yc and EBV. For simulated data, the regression coefficient estimates (b(Yc,DGV)), were on average lower than 1 for high and low heritability traits, being inflated. The results were more biased for Yc and EBV than for GEBV. For real data, the GEBV displayed less biased results compared to Yc and EBV for SFA, MUFA, n-3, n-6, and PUFA/SFA. Despite the less biased results for PUFA using the EBV as pseudo-phenotype, the b(Yi,DGV estimates obtained for the different pseudo-phenotypes (Yc, EBV and GEBV) were very close. Genomic information can assist in improving beef fatty acid profile in Zebu cattle, since the use of genomic information yielded genomic values for fatty acid profile with accuracies ranging from low to moderate. Considering both simulated and real data, the ssGBLUP model is an appropriate alternative to obtain more reliable and less biased GEBVs as pseudo-phenotype in situations of missing pedigree, due to high proportion of multiple sires, being more adequate than EBV and Yc to predict direct genomic value for beef fatty acid profile.
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Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis
Abstract
The impact of different Helicobacter pylori (H. pylori) status (H. pylori negative, H. pylori eradication and H. pylori persistence) on the development of metachronous gastric lesions after endoscopic resection of early gastric cancer is not well defined. Thus, a systematic review and meta-analysis was performed to investigate this relationship. Two authors independently searched the electronic databases (Pubmed, Embase, the Cochrane Library and Web of Science) through March 2018, without language restriction. Pooled risk ratio for metachronous gastric lesions with regard to H. pylori status was calculated using fixed- or random-effects models, and heterogeneity and publication bias were also measured. 20 eligible studies were finally identified in systematic review, and 17 out of 20 studies were further included in meta-analysis. H. pylori eradication was associated with overall 50% lower odds of metachronous events (RR = 0.50; 95 % CI 0.41–0.61). Pooled risk ratios for metachronous gastric neoplasm were 0.85 (95 % CI 0.43–1.68) between H. pylori-eradicated and -negative patients, and 0.63 (95 % CI 0.35–1.12) between H. pylori-negative and -persistent patients, respectively. In conclusion, based on the best available evidence, eradication of H. pylori can provide protection against secondary gastric neoplasm, and this quantitative benefit seemed greater than among asymptomatic individuals. Metachronous risk seems comparable between H. pylori-eradicated and -negative population, or between H. pylori-negative and -persistent patients.
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Independent processing of increments and decrements in odorant concentration by ON and OFF olfactory receptor neurons
Abstract
A salient feature of the insect olfactory system is its ability to detect and interpret simultaneously the identity and concentration of an odorant signal along with the temporal stimulus cues that are essential for accurate odorant tracking. The olfactory system of the cockroach utilizes two parallel pathways for encoding of odorant identity and the moment-to-moment succession of odorant concentrations as well as the rate at which concentration changes. This separation originates at the peripheral level of the ORNs (olfactory receptor neurons) which are localized in basiconic and trichoid sensilla. The graded activity of ORNs in the basiconic sensilla provides the variable for the combinatorial representation of odorant identity. The antagonistically responding ON and OFF ORNs in the trichoid sensilla transmit information about concentration increments and decrements with excitatory signals. Each ON and OFF ORN adjusts its gain for odorant concentration and its rate of change to the temporal dynamics of the odorant signal: as the rate of change diminishes, both ORNs improve their sensitivity for the rate of change at the expense of the sensitivity for the instantaneous concentration. This suggests that the ON and OFF ORNs are optimized to detect minute fluctuations or even creeping changes in odorant concentration.
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Identifying mild-moderate Parkinson’s disease using whole-brain functional connectivity
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): Yan Tang, Bailin Liu, Yuan Yang, Chang-min Wang, Li Meng, Bei-sha Tang, Ji-feng Guo
Abstract
Objective
Our study aims to extract significant disorder-associated patterns from whole brain functional connectivity to distinguish mild-moderate Parkinson's disease (PD) patients from controls.
Methods
Resting-state fMRI data were measured from thirty-six PD individuals and thirty-five healthy controls. Multivariate pattern analysis was applied to investigate whole-brain functional connectivity patterns in individuals with 'mild-moderate' PD. Additionally, the relationship between the asymmetry of functional connectivity and the side of the initial symptoms was also analyzed.
Results
In a leave-one-out cross-validation, we got the generalization rate of 80.28% for distinguishing PD patients from controls. The most discriminative functional connectivity was found in cortical networks that included the default mode, sensorimotor and attention networks. Compared to patients with the left side initially affected, an increased abnormal functional connectivity was found in patients in whom the right side was initially affected.
Conclusions
Our results indicated that discriminative functional connectivity is likely associated with disturbances of cortical networks involved in sensorimotor control and attention. The spatiotemporal patterns of motor asymmetry may be related to the lateralized dysfunction on the early stages of PD.
Significance
This study identifies discriminative functional connectivity that is associated with disturbances of cortical networks. Our results demonstrated new evidence regarding the functional brain changes related to the unilateral motor symptoms of early PD.
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A method for intraoperative recording of the laryngeal adductor reflex during lower brainstem surgery in children
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): Paolo Costa, Pier Paolo Gaglini, Paolo Tavormina, Federica Ricci, Paola Peretta
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Automated EEG source imaging: a retrospective, blinded clinical validation study
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): Amir G. Baroumand, Pieter van Mierlo, Gregor Strobbe, Lars H. Pinborg, Martin Fabricius, Guido Rubboli, Anne-Mette Leffers, Peter Uldall, Bo Jespersen, Jannick Brennum, Otto Mølby Henriksen, Sándor Beniczky
Abstract
Objective
To evaluate the accuracy of automated EEG source imaging (ESI) in localizing epileptogenic zone.
Methods
Long-term EEG, recorded with the standard 25-electrode array of the IFCN, from 41 consecutive patients with focal epilepsy who underwent resective surgery, were analyzed blinded to the surgical outcome. The automated analysis comprised spike-detection, clustering and source imaging at the half-rising time and at the peak of each spike-cluster, using individual head-models with six tissue-layers and a distributed source model (sLORETA). The fully automated approach presented ESI of the cluster with the highest number of spikes, at the half-rising time. In addition, a physician involved in the presurgical evaluation of the patients, evaluated the automated ESI results (up to four clusters per patient) in clinical context and selected the dominant cluster and the analysis time-point (semi-automated approach). The reference standard was location of the resected area and outcome one year after operation.
Results
Accuracy was 61% (95% CI: 45-76%) for the fully automated approach and 78% (95% CI: 62-89%) for the semi-automated approach.
Conclusion
Automated ESI has an accuracy similar to previously reported neuroimaging methods.
Significance
Automated ESI will contribute to increased utilization of source imaging in the presurgical evaluation of patients with epilepsy.
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New insights into the pathophysiology of fasciculations in amyotrophic lateral sclerosis: an ultrasound study
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): J.F. Vázquez-Costa, M. Campins-Romeu, J.J. Martínez-Payá, J.I. Tembl, M.E. del Baño-Aledo, J. Ríos-Díaz, V. Fornés-Ferrer, M.J. Chumillas, T Sevilla
Abstract
Objective
To describe the fasciculation pattern in ALS and to analyse its clinical and pathophysiological significance.
Methods
Ultrasound of 19 muscles was performed in 44 patients with a recent diagnosis (<90 days) of ALS. The number of fasciculations was recorded in each muscle and the muscle thickness and strength were additionally measured in limb muscles. A subgroup of patients were electromyographically assessed.
Results
US was performed in 835 muscles and EMG was available in 263 muscles. US detected fasciculations more frequently than EMG. Fasciculations were widespread, especially in upper limbs onset patients and in the cervical region. Fasciculations' number inversely associated with ALSFR-R and body mass index (BMI) and directly with BMI loss and upper motor neuron (UMN) impairment. Our statistical model suggest that fasciculations increase with the initial lower motor neuron (LMN) degeneration, reach their peak when the muscle became mildly to moderately weak, decreasing afterwards with increasing muscle weakness and atrophy.
Conclusions
Our study suggests that both UMN and LMN degeneration trigger fasciculations causing BMI loss. The degree of LMN impairment could account for differences in fasciculations' rates within and between muscles.
Significance
In ALS, fasciculations could explain the link between hyperexcitability and BMI loss.
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Electrooculogram and submandibular montage to distinguish different eye, eyelid, and tongue movements in electroencephalographic studies
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): Cristina Rosado Coelho, Guadalupe Fernandez-Baca Vaca, Hans O. Lüders
Abstract
Objective
We propose an electrooculogram and submandibular montage that helps to discriminate eye/eyelid/tongue movements and to differentiate them from epileptiform activity or slowing on electroencephalography (EEG).
Methods
We analyzed different eye/eyelid and tongue movements in 6 and 4 patients, respectively. Six peri–orbitally and one submandibular electrodes were placed. We referred these electrodes to an indifferent reference (Cz/Pz) and we recorded eye/eyelid and tongue movements simultaneously with the 10-20 system EEG. Additionally, we analyzed 2 seizures with the electrooculogram montage.
Results
The electrooculogram deflections always showed an opposite phase direction when eye/eyelid movements occurred. Conversely, epileptiform activity produced deflections in the same phase direction in all electrooculogram electrodes. The electrooculogram montage was able to distinguish eye ictal semiology. Vertical tongue movements showed opposite phase deflections between the submandibular and the inferior ocular electrodes. Horizontal tongue movements revealed opposite phase reversal deflections between both inferior ocular electrodes.
Conclusions
The proposed montage accurately defines different eye/eyelid and tongue movements from brainwave activity. Additionally, it is useful to differentiate eye/eyelid movements from epileptiform activity and to characterize ictal ocular semiology, which can help localize or lateralize the epileptogenic zone.
Significance
We propose this new montage to provide added value to prolonged video-EEG studies.
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Laryngeal Adductor Reflex And Future Projections for Brainstem Monitoring. Reply to “A method for intraoperative recording of the laryngeal adductor reflex during lower brainstem surgery in children”
Publication date: Available online 24 September 2018
Source: Clinical Neurophysiology
Author(s): Sedat Ulkatan, Maria J. Tellez, Catherine Sinclair
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Tomosynthesis for colonic localization of patency capsules
Publication date: Available online 24 September 2018
Source: Arab Journal of Gastroenterology
Author(s): Teppei Omori, Ayumi Ito, Shinichi Nakamura, Katsutoshi Tokushige
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Athlete’s Heart: Diagnostic Challenges and Future Perspectives
Abstract
Distinguishing between adaptive and maladaptive cardiovascular response to exercise is crucial to prevent the unnecessary termination of an athlete's career and to minimize the risk of sudden death. This is a challenging task essentially due to the substantial phenotypic overlap between electrical and structural changes seen in the physiological athletic heart remodeling and pathological changes seen in inherited or acquired cardiomyopathies. Stress testing is an ideal tool to discriminate normal from abnormal cardiovascular response by unmasking subtle pathologic responses otherwise undetectable at rest. Treadmill or bicycle electrocardiography, transthoracic echocardiography, and cardiopulmonary exercise testing are common clinical investigations used in sports cardiology, specifically among participants presenting with resting electrocardiographic abnormalities, frequent premature ventricular beats, or non-sustained ventricular arrhythmias. In this setting, as well as in cases of left ventricular hypertrophy or asymptomatic left ventricular dysfunction, stress imaging and myocardial tissue characterization by cardiovascular magnetic resonance show promise. In this review, we aimed to reappraise current diagnostic schemes, screening strategies and novel approaches that may be used to distinguish adaptive remodeling patterns to physical exercise from early phenotypes of inherited or acquired pathological conditions commanding prompt intervention.
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Heterozygous WNT1 variant causing a variable bone phenotype
American Journal of Medical Genetics Part A, EarlyView.
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Management of nasopharyngeal teratomas associated with cleft palate.
Management of nasopharyngeal teratomas associated with cleft palate.
Int J Oral Maxillofac Surg. 2018 Sep 19;:
Authors: Diakité C, Bénateau H, Dakpé S, Guerreschi P, Galinier P, Veyssière A
Abstract
Nasopharyngeal teratomas are rare tumours, responsible for a high birth mortality rate from acute respiratory distress. Palatine localization can lead to an embryopathogenic mechanical obstacle responsible for a cleft palate. The aim of this study was to update current knowledge concerning the management of this rare pathological association. We conducted a multicentre, retrospective study by case analysis. The inclusion criteria were patients of any age under care for a nasopharyngeal teratoma associated with a velopalatine cleft. The diagnosis of the teratoma was confirmed by histological analysis. Seven cases were included in the study: three cases from the University Hospital of Lille, one from the University Hospital of Caen, one from of the University Hospital of Toulouse, and two from of the University Hospital of Amiens. Approximately 30% of patients experienced acute respiratory distress at birth, necessitating oro- or nasotracheal intubation. The surgical excision was performed in the first 5 months of life for all patients and in a single operative time for 70%. There was no recurrence. Therapeutic management of nasopharyngeal teratomas associated with cleft palate at birth is multidisciplinary and is based on surgical excision. In the absence of other associated pathologies, the prognosis is favourable.
PMID: 30243829 [PubMed - as supplied by publisher]
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The effect of the volume of supra-inguinal injected solution on the spread of the injectate under the fascia iliaca: a preliminary study
Abstract
The fascia iliaca compartment is the compartment confined by the fascia iliaca (FI) and a muscular layer formed by the iliac- and psoas muscle. This compartment creates a virtual tunnel that contains the femoral nerve (FN), the obturator nerve (ON), and the lateral femoral cutaneous nerve (LFCN) of the lumbar plexus. In this pilot study, we aimed to determine the suggested volume needed to reach the three target nerves of the lumbar plexus (FN, ON, and LFCN) with a single-injection ultrasound-guided supra-inguinal fascia iliaca compartment (S-FICB). A computer tomography (CT scan)-guided step-up/step-down sequence was used to determine the suggested injection volume to target all three nerves. Subsequently, an anatomist blinded for the injected volume and CT findings, dissected the cadavers, and evaluated the spread of dye underneath the fascia iliaca. In total, seven pelvic areas of four cadavers were evaluated on CT scan and dissected. Distribution of dye underneath the FI in relation to the FN, ON, and the LFCN was recorded in all dissected cadavers. Combining CT and dissection findings, the suggested volume to reach the FN, ON, and LFCN with an S-FICB was 40 mL.
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Cascade and no‐repetition rules are comparable controls for the auditory frequency mismatch negativity in oddball tasks
Psychophysiology, EarlyView.
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Contralateral delay activity tracks the storage of visually presented letters and words
Psychophysiology, EarlyView.
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Visuospatial sequence learning on the serial reaction time task modulates the P1 event‐related potential
Psychophysiology, EarlyView.
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The anger incentive delay task: A novel method for studying anger in neuroscience research
Psychophysiology, EarlyView.
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Effects of photoperiod, temperature and aging on adult diapause termination and post-diapause development in female Asian comma butterflies, Polygonia c-aureum Linnaeus (Lepidoptera: Nymphalidae)
Abstract
Polygonia c-aureum females exhibit photoperiodically induced imaginal diapause, characterized by cessation of ovarian development. Females grown at a short daylength (SD) entered imaginal diapause, whereas those grown at a long daylength (LD) produced eggs rapidly after adult emergence at 21 °C. The termination of diapause was influenced by daylength: diapause ended faster at LD than SD. Complete termination of diapause took 30 days in unchilled females reared under LD at 21 °C. On the other hand, prompt, synchronized and strong diapause termination occurred at post-chilling periods. Photoperiods at post-chilling periods affected ovarian development, when the length of pre-chilling periods or the length of chilling periods was shorter, suggesting that these treatments were not enough to complete diapause development. Ovarian development proceeded earlier in chilled and subsequent warmed females than unchilled females. Wing damage was remarkable at post-chilling periods when females were reared under an adequate length of pre-chilling and chilling periods, especially comparing with females under pre-overwintering conditions without chilling, indicating that post-diapause reproductive development was weak in unchilled females. Thus, exposure to low temperatures is necessary for a strong diapause termination in this butterfly.
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Anesthesiologists should bring in their expertise during the early postoperative period to improve surgical outcome
No abstract available
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Ambulatory anesthesia: what's new in 2018
No abstract available
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Proton-pump inhibitor-induced fundic gland polyps with hematemesis
Abstract
Fundic gland polyps (FGPs) are generally considered benign. Proton-pump inhibitors (PPIs) are used worldwide as first-line therapy for gastroesophageal reflux disease and nonsteroidal anti-inflammatory drug-induced ulcer treatment. Long-term use of PPIs increases the risk of FGP development. We report an extremely rare case of PPI-induced FGPs with hematemesis. A 37-year-old woman taking daily rabeprazole presented to the hospital with a complaint of hematemesis and tarry stools. Esophagogastroduodenoscopy (EGD) revealed > 20 pedunculated polyps in the gastric body and fundus. Histological examination showed multiple fragments of fundic gland mucosa with dilated glands. Based on these findings and the clinical history, FGPs were diagnosed. Rabeprazole use was discontinued. Repeat EGD performed 9 months later showed a significant decrease in the number and size of the polyps. FGPs are small polyps typically located in the gastric corpus and fundus. They are commonly reported in patients in their 60s and predominantly in females. We conclude that PPI use is a risk factor for the development of FGPs and hematemesis.
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