Prolonged allocentric navigation deficits indicate hippocampal damage in TGA

ObjectiveTo investigate long-term recovery of allocentric and egocentric spatial orientation as a sensitive marker for hippocampal and extrahippocampal network function in transient global amnesia (TGA).MethodsA group of 18 patients with TGA performed an established real-space navigation paradigm, requiring allo- and egocentric spatial orientation abilities, 3 days (postacute stage) and 3 months (follow-up) after symptom onset. Visual exploration behavior and navigation strategy were documented by a gaze-controlled, head-fixed camera. Allo- and egocentric spatial orientation performance was compared to that of 12 age-matched healthy controls. Navigation-induced brain activations were measured using [18F]-fluorodeoxyglucose-PET in a subgroup of 8 patients in the postacute stage and compared to those of the controls.ResultsIn the postacute stage, the patients navigated worse and had higher error rates than controls in allocentric (p = 0.002), but not in egocentric, route planning (p = 0.30), despite complete recovery of verbal (p = 0.58) and figural memory (p = 0.11). Until follow-up, allocentric navigation deficits improved, but higher error rates and reduced use of shortcuts persisted (p < 0.0001). Patients still exhibited relatively more fixations of unique landmarks during follow-up (p = 0.05). PET measurements during the postacute stage showed increased navigation-induced brain activations in the right hippocampus, bilateral retrosplenial, parietal, and mesiofrontal cortices, and cerebellar dentate nucleus in patients compared to controls (p < 0.005).ConclusionsPatients with TGA show selective and prolonged deficits of allocentric spatial orientation. Activations in right hippocampal and extrahippocampal hubs of the cerebral navigation network functionally substitute for the deficit in creating and updating the internal cognitive map in TGA.

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Real-space navigation testing differentiates between amyloid-positive and -negative aMCI

Neurology ◽

10.1212/wnl.0000000000008758 ◽

2020 ◽

Vol 94 (8) ◽

pp. e861-e873 ◽

Cited By ~ 5

Author(s):

Florian Schöberl ◽

Cauchy Pradhan ◽

Stephanie Irving ◽

Katharina Buerger ◽

Guoming Xiong ◽

...

Keyword(s):

Route Planning ◽

Word List ◽

Real Space ◽

Visual Exploration ◽

Amyloid Pet ◽

Space Navigation ◽

Exploration Behavior ◽

Spatial Environment ◽

List Learning ◽

The Right

ObjectiveTo distinguish between patients with amyloid-positive (A+) and -negative (A−) amnestic mild cognitive impairment (aMCI) by simultaneously investigating navigation performance, visual exploration behavior, and brain activations during a real-space navigation paradigm.MethodsTwenty-one patients with aMCI were grouped into A+ (n = 11) and A− cases by amyloid-PET imaging and amyloid CSF levels and compared to 15 healthy controls. Neuropsychological deficits were quantified by use of the Consortium to Establish a Registry for Alzheimer's Disease–plus cognitive battery. All participants performed a navigation task in which they had to find items in a realistic spatial environment and had to apply egocentric and allocentric route planning strategies. 18F-fluorodeoxyglucose was injected at the start to detect navigation-induced brain activations. Subjects wore a gaze-controlled, head-fixed camera that recorded their visual exploration behavior.ResultsA+ patients performed worse during egocentric and allocentric navigation compared to A− patients and controls (p < 0.001). Both aMCI subgroups used fewer shortcuts, moved more slowly, and stayed longer at crossings. Word-list learning, figural learning, and Trail-Making tests did not differ in the A+ and A− subgroups. A+ patients showed a reduced activation of the right hippocampus, retrosplenial, and parietal cortex during navigation compared to A− patients (p < 0.005).ConclusionsA+ patients with aMCI perform worse than A− patients with aMCI in egocentric and allocentric route planning because of a more widespread impairment of their cerebral navigation network. Navigation testing in real space is a promising approach to identify patients with aMCI with underlying Alzheimer pathology.

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Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

The Heart Surgery Forum ◽

10.1532/hsf98.2014315 ◽

2014 ◽

Vol 17 (3) ◽

pp. 146

Author(s):

Osman Tansel Darcin ◽

Mehmet Kalender ◽

Ayse Gul Kunt ◽

Okay Guven Karaca ◽

Ata Niyazi Ecevit ◽

...

Keyword(s):

Endovascular Repair ◽

Therapeutic Option ◽

Complete Recovery ◽

Aortic Aneurysms ◽

Thoracoabdominal Aorta ◽

Mortality And Morbidity ◽

Early Results ◽

The Mean ◽

Procedural Success

Background: Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.Methods: From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.Results: All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.Conclusion: Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.

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A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia

Blood ◽

10.1182/blood.v80.9.2203.2203 ◽

1992 ◽

Vol 80 (9) ◽

pp. 2203-2209 ◽

Cited By ~ 83

Author(s):

MS Tallman ◽

D Hakimian ◽

D Variakojis ◽

D Koslow ◽

GA Sisney ◽

...

Keyword(s):

Complete Remission ◽

Interferon Alpha ◽

Hairy Cell Leukemia ◽

Complete Recovery ◽

Community Acquired Pneumonia ◽

Hairy Cell ◽

Cell Leukemia ◽

Single Cycle ◽

Severe Pancytopenia

Abstract Twenty-six patients with hairy cell leukemia (HCL) were treated with 2- chlorodeoxyadenosine (2-CdA), a purine analogue resistant to adenosine deaminase, at 0.1 mg/kg/d for 7 days by continuous intravenous infusion. Fifteen patients were previously untreated, while 11 patients had received prior treatment with splenectomy alone (three patients), interferon alpha alone (four), splenectomy, then interferon alpha (two), or splenectomy, interferon alpha, then 2-deoxycoformycin (2-DCF) (two). Sixteen (80%) of 20 patients evaluable at 3 months achieved complete remission (CR), and four (20%) achieved partial remission (PR) following a single cycle of therapy. All four patients in PR had complete recovery of their peripheral blood counts (except one patient whose platelet count remained 84,000/microL), but had residual HCL in the bone marrow (three patients) or residual splenomegaly (one). Patients with bulky adenopathy, massive splenomegaly, and severe pancytopenia responded as well as those with only modest marrow involvement. The three patients with residual marrow disease received a second cycle of 2-CdA, and two have attained CR. Therefore, 18 of 20 (90%) achieved CR with either one or two cycles of therapy. No patient achieving CR has relapsed at a median follow-up of 12 (+/- 2.1) months. Toxicities included myelosuppression and culture-negative fever. A community-acquired pneumonia was the only infectious complication. Since a single cycle of 2-CdA induces sustained CR in the vast majority of patients with minimal toxicity, this agent is emerging as the treatment of choice for all patients with HCL.

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Recovery from Transient Global Amnesia Following Restoration of Hippocampal and Fronto–Cingulate Perfusion

Behavioural Neurology ◽

10.1155/2010/768153 ◽

2010 ◽

Vol 22 (3-4) ◽

pp. 131-139 ◽

Cited By ~ 2

Author(s):

Paolo Caffarra ◽

Letizia Concari ◽

Simona Gardini ◽

Sabrina Spaggiari ◽

Francesca Dieci ◽

...

Keyword(s):

Acute Phase ◽

Neuropsychological Testing ◽

Transient Global Amnesia ◽

Normal Limits ◽

Global Amnesia ◽

One Year ◽

The Right ◽

Rcbf Spect ◽

Subject Comparison

A patient who suffered a transient global amnesia (TGA) attack underwent regional cerebral blood flow (rCBF) SPECT imaging and neuropsychological testing in the acute phase, after one month and after one year. Neuropsychological testing in the acute phase showed a pattern of anterograde and retrograde amnesia, whereas memory was within age normal limits at follow up. SPECT data were analysed with a within subject comparison and also compared with those of a group of healthy controls. Within subject comparison between the one month follow up and the acute phase detected increases in rCBF in the hippocampus bilaterally; further rCBF increases in the right hippocampus were detected after one year. Compared to controls, significant hypoperfusion was found in the right precentral, cingulate and medial frontal gyri in the acute phase; after one month significant hypoperfusion was detected in the right precentral and cingulate gyri and the left postcentral gyrus; after one year no significant hypoperfusion appeared. The restoration of memory was paralleled by rCBF increases in the hippocampus and fronto-limbic-parietal cortex; after one year neither significant rCBF differences nor cognitive deficits were detectable. In conclusion, these data indicate that TGA had no long lasting cognitive and neural alterations in this patient.

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Renal Outcomes of Childhood IgA Nephropathy and Henoch Schönlein Purpura Nephritis

Siriraj Medical Journal ◽

10.33192/smj.2021.88 ◽

2021 ◽

Vol 73 (10) ◽

pp. 687-694

Author(s):

Thanaporn Chaiyapak ◽

Anirut Pattaragarn ◽

Suroj Supavekin ◽

Nuntawan Piyaphanee ◽

Kraisoon Lomjansook ◽

...

Keyword(s):

Iga Nephropathy ◽

Complete Recovery ◽

Clinicopathological Characteristics ◽

Henoch Schonlein Purpura ◽

Renal Outcomes ◽

Nephritic Syndrome ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura ◽

Purpura Nephritis

Background: Henoch-Schönlein purpura nephritis (HSPN) is considered the systemic form of IgA nephropathy (IgAN). However, differing clinicopathological features and renal outcomes of children with IgAN and HSPN have been reported in some studies. Methods: This study retrospectively reviewed children with IgAN and HSPN younger than 18 years, between January 2004 and December 2015. The clinicopathological characteristics at diagnosis and the renal outcomes after at least 1 year of follow-up were compared between the two groups. Results: A total of 54 children, comprising 21 with IgAN and 33 with HSPN, were recruited. The children with HSPN were younger than the children with IgAN. Gross hematuria and nephritic syndrome at the initial presentation were more common in children with IgAN. Regarding the pathological findings, IgAN had greater chronicity than HSPN. After a median follow-up period from first presentation to renal outcomes measurement of 4.0 years (1.3-12.2) in children with IgAN and 4.2 years (1.1-11.4) in children with HSPN, the renal outcomes were better in the latter group. The incidence of chronic kidney disease (CKD) was 28.6% in children with IgAN and 6.1% in children with HSPN (p = 0.02). Complete recovery was observed more frequently in children with HSPN than in children with IgAN (57.1% in IgAN vs. 87.9% in HSPN, p = 0.01). Conclusions: Childhood IgAN has greater chronicity and worse renal outcomes than childhood HSPN, with a lower rate of complete recovery and a higher frequency of CKD. We recommend long-term follow-up for CKD in children with IgAN.

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Osteosynthesis with bone plaque in a black female howler monkey (Alouatta caraya)

Clínica Veterinária ◽

10.46958/rcv.2018.xxiii.n.134.p.74-85 ◽

2018 ◽

Vol XXIII (134) ◽

pp. 74-85

Author(s):

Christiano Pavan Mateus ◽

Cláudio Roberto da Silva ◽

Weliton dos Anjos Aragão

Keyword(s):

Complete Recovery ◽

Correct Selection ◽

Howler Monkey ◽

Alouatta Caraya ◽

Radiographic Images ◽

Early Ambulation ◽

Black Howler Monkey ◽

Black Howler ◽

Both Bones

The surgical treatment for the correction of fractures in wild animals requires the correct selection of the osteosynthesis method to be used, in such a way as to achieve the reduction and stabilization of the fracture focus, and an adequate evolution during the postoperative period. The purpose of this report was to describe and monitor bone healing in a tibiofibular oblique proximal diaphyseal fracture with a 2.7 mm bone plate implant in a female black howler monkey of the Alouatta caraya species. In the follow-up of the patient’s evolution, the radiographic images showed evidence of consolidation of both bones and stable fixation of the plate, providing early ambulation and complete recovery of limb function.

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Long-term Outcome of LGI-1 Encephalitis in Chinese: a 2-year follow-up

10.21203/rs.2.10604/v1 ◽

2019 ◽

Author(s):

Wendeng Xu ◽

Feifei He ◽

Jian Wu ◽

Jing Ye

Keyword(s):

Acute Phase ◽

Phase 1 ◽

Complete Recovery ◽

Memory Deficit ◽

Neurological Dysfunction ◽

Residual Symptom ◽

Term Outcome ◽

Long Term Outcome

Abstract Background Antibodies directed to leucien-rich glioma-inactivated 1 (LGI-1) encephalitis is a rare autoimmune encephalitis,characterized by limbic encephalitis syndrome and faciobrachial dystonic seizures (FBDS) . Most of cases are sensitive to immunotherapy in acute phase. Our aim was to give a detailed description of the long-term outcome of the LGI-1 encephalitis in Chinese . Methods We enrolled 36 patients with LGI-1 antibodies in serum/CSF from September 2013 to December 2016 and of which 28 patients were performed a 2-year follow-up. Clinical data of all patients was recorded and clinical outcome was assessed at 2-year follow-up. Follow-up MRI was scanned in partial patients. Results 11(39.3%)patients(mRS =0)had complete recovery,7(25.0%)patients(mRS =1)had mild neurological dysfunction, 10(7.2%)patients had severe neurological dysfunction(mRS≥2)and 8 patients (28.6%) had relapses.The numbers of patients with residual psychiatric change and memory deficit was 5 (17.8%)and 15(53.6%) respectively. No patients had a residual seizures and FBDS. Follow-up MRI were available in 10 patients. Among 5 patients with normal MRI in acute phase, 1 patients showed bilateral hippocampus atrophy on follow-up MRI and among 5 patients with abnormal MRI in acute phase, 4 patients showed lesion partial remission, 1 patients showed lesion dissolve on follow-up MRI. Conclusion Our study showed that only one third of patients with IGI-1 encephalitis got complete recovery at 2-year follow-up and relapses are common. The major residual symptom is memory deficit.

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Smutgrass (Sporobolus Indicus) Control in Bermudagrass (Cynodon dactylon) Turf with Triazine-MSMA Applications

Weed Technology ◽

10.1017/s0890037x00028773 ◽

1994 ◽

Vol 8 (4) ◽

pp. 836-839 ◽

Cited By ~ 2

Author(s):

Roy K. Nishimoto ◽

Charles L. Murdoch

Keyword(s):

Cynodon Dactylon ◽

Complete Recovery ◽

Common Bermudagrass ◽

Better Than

Two or three applications of MSMA applied alone were ineffective in controlling smutgrass in common bermudagrass turf. Where atrazine at 2.2 kg ai/ha or simazine at 2.2 kg/ha was followed by two or three MSMA applications at 2.2 or 4.5 kg/ha, smutgrass control was increased. Metribuzin followed by two or three applications of MSMA was only slightly better than MSMA applied alone. Up to 35% injury to bermudagrass was observed 2 wk after the initial MSMA or the MSMA-triazine treatment, but complete recovery was evident 2 to 4 wk later, even with one or two follow-up MSMA applications at weekly intervals. Bermudagrass injury from the application of triazines followed with MSMA did not differ from MSMA applied alone in two of three experiments. In one experiment, atrazine or metribuzin followed with MSMA applications caused 10 to 25% more bermudagrass injury than MSMA applied alone.

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An analysis of the causes of transient paraplegia during percutaneous vertebral augmentation under local anesthesia: A case series of 12 patients

Journal of Orthopaedic Surgery ◽

10.1177/2309499019861879 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901986187

Author(s):

Guan Shi ◽

Fei Feng ◽

Chen Hao ◽

Jia Pu ◽

Bao Li ◽

...

Keyword(s):

Spinal Cord ◽

Local Anesthesia ◽

Vertebral Body ◽

Case Series ◽

Operation Time ◽

Complete Recovery ◽

Vertebral Compression Fractures ◽

Vertebral Augmentation ◽

Anesthetic Drugs

Background: Percutaneous vertebral augmentation (PVA) under local anesthesia has been widely used to treat osteoporotic vertebral compression fractures and vertebral body tumors. However, the occurrence of spinal cord or nerve root dysfunction may result in poor prognosis for patients. The aim of this study was to analyze the causes of transient paraplegia in 12 patients undergoing PVA. Methods: The medical records of 12 patients with transient paraplegia during PVA in our hospital were analyzed. Data, including operation, vertebral, anesthetic dose, operation time, recovery time, and follow-up, were extracted. Results: Among the 12 patients, ranging in age from 62 years to 83 years, with a mean age of 74 years, 8 were females and 4 were males. The average anesthetic dose injected per vertebral body was 6.38 ml. Patients required an average of 218.75 min to recover sensation and movement completely. However, the amount of anesthetic injected into each vertebral body was not related to the time required for complete recovery. Follow-up showed that all patients had regained normal bilateral sensation and motor function. Postoperative visual analog scale and Oswestry Disability Index values of the 12 patients were significantly improved compared with preoperative values. Conclusion: The complication of transient paraplegia was caused by local anesthetic drugs infiltrating into the spinal canal and inhibiting nerve conduction in the spinal cord.

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Infantile Cortical Hyperostosis: Report of a Case with Observations on Clinical Manifestations, Radiology, and Pathology with a Late Follow-Up of Eight Years

Case Reports in Pediatrics ◽

10.1155/2016/2073854 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Pedro Carlos M. Sarmento Pinheiro ◽

Ierecê Lins Aymore ◽

Armando Rocha Amoedo ◽

Paulo Miguel Hemais

Keyword(s):

Clinical Manifestations ◽

Complete Recovery ◽

Infantile Cortical Hyperostosis ◽

Puncture Biopsy ◽

Elevated Sedimentation Rate ◽

Cortical Hyperostosis ◽

Neonatal Patient ◽

Histopathological Studies ◽

Radiology And Pathology

Purpose. The purpose of our study was to investigate clinical manifestations, roentgen images, histopathological studies, and evolution of the disease in patient displaying infantile cortical hyperostosis.Methods. Roentgenograms were made to evaluate a neonatal patient presenting multiple soft-tissue swellings. The initial radiographs insinuated that the disease had been present for some timein utero. Bone puncture biopsy of the tibia for histopathological observation and diagnosis conclusions was performed.Results. The disease was demonstrated radiographically by massive cortical diaphyseal thickening and also extensive periosteal new bone formation surrounding several bones. Results in blood count were as follows: discrete anemia, moderate leukocytosis, and elevated sedimentation rate. Histological pattern of tissue removed from tibia showed lamellar cortical bones and hyperplasia. Biopsy studies disclosed no evidence of neoplasia as well as of bacterial infection.Comments. Clinical manifestations in a neonatal patient displaying infantile cortical hyperostosis have gradually decreased. Radiograph findings have demonstrated complete recovery of bones manifested by the disease. The pathologic findings are in accordance with previous microscopic examination summarized by the literature. Total patient cure, without sequels, could be demonstrated.

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