Stimulus-induced, sleep-bound, focal seizures: a case report.

STUDY OBJECTIVES: In nocturnal frontal lobe epilepsy (NFLE), seizures occur almost exclusively during NREM sleep. Why precisely these seizures are sleep-bound remains unknown. Studies of patients with nonlesional familial forms of NFLE have suggested the arousal system may play a major role in their pathogenesis. We report the case of a patient with pharmaco-resistant, probably cryptogenic form of non-familial NFLE and strictly sleep-bound seizures that could be elicited by alerting stimuli and were associated with ictal bilateral thalamic and right orbital-insular hyperperfusion on SPECT imaging. DESIGN: Case report. SETTING: University Hospital Zurich. PATIENTS OR PARTICIPANTS: One patient with pharmaco-resistant epilepsy. CONCLUSION: This case shows that the arousal system plays a fundamental role also in cryptogenic non-familial forms of NFLE.

Asphalt Cement Containing AC-13, HR-522, Construction Report, 1985

Stopping and turning maneuvers on high traffic volume asphalt cement concrete surfaced roads and streets often causes distortion of the pavement. Distortion may show up as excessive rutting in the wheel path, shoving of the pavement and/or rippling of the surface. Often times repeated corrective work such as cold milling or heater planing is required in these areas to maintain the pavement surface in a reasonable condition. In recent years polymer additives have been developed for asphalt cement concrete paving mixes that show promise in improving the inplace stability of the pavements. AC-13 (Styrelf 13) available from Bitucote Products Company, St. Louis, Missouri is an asphalt cement that has been modified by an additive to exhibit characteristics of very high stability in asphalt mixes.

Radarsat backscattering from an agricultural scene

Orbital remote sensing in the microwave electromagnetic region has been presented as an important tool for agriculture monitoring. The satellite systems in operation have almost all-weather capability and high spatial resolution, which are features appropriated for agriculture. However, for full exploration of these data, an understanding of the relationships between the characteristics of each system and agricultural targets is necessary. This paper describes the behavior of backscattering coefficient (sigma°) derived from calibrated data of Radarsat images from an agricultural area. It is shown that in a dispersion diagram of sigma° there are three main regions in which most of the fields can be classified. The first one is characterized by low backscattering values, with pastures and bare soils; the second one has intermediate backscattering coefficients and comprises well grown crops mainly; and a third one, with high backscattering coefficients, in which there are fields with strong structures causing a kind of double bounce effect. The results of this research indicate that the use of Radarsat images is optimized when a multitemporal analysis is done making the best use of the agricultural calendar and of the dynamics of different cultures.

Characterization and discrimination of soils by their reflected electromagnetic energy

The objective of this work was to verify if reflected energy of soils can characterize and discriminate them. A spectroradiometer (Spectral reflectance between: 400-2,500 nm) was utilized in laboratory. The soils evaluated are located in Bauru region, SP, Brazil, and are classified as Typic Argiudoll (TR), Typic Eutrorthox (LR), Typic Argiudoll (PE), Typic Haplortox (LE), Typic Paleudalf (PV) and Typic Quartzipsamment (AQ). They were characterized by their spectral reflectance as for descriptive conventional methods (Brazilian and International) according to the types of spectral curves. A method for the spectral descriptive evaluation of soils was established. It was possible to characterize and discriminate the soils by their spectral reflectance, with exception for LR and TR. The spectral differences were better identified by the general shape of spectral curves, by the intensity of band absorption and angle tendencies. These characteristics were mainly influenced by organic matter, iron, granulometry and mineralogy constituents. A reduction of iron and clay contents, which influenced higher reflectance intensity and shape variations, occurred on the soils LR/TR, PE, LE, PV and AQ, on that sequence. Soils of the same group with different clay textures could be discriminated. The conventional descriptive evaluation of spectral curves was less efficient on discriminating soils. Simulated orbital data discriminated soils mainly by bands 5 and 7.

The temporoparietal fascia flap: a versatile tool in head and neck reconstruction.

PURPOSE OF REVIEW: The article reviews recent significant advances and current applications of the temporoparietal fascia flap (TPFF) in head and neck surgery. RECENT FINDINGS: The recent literature describes a wide span of new applications of the TPFF in many areas. Significant developments and refinements in the reconstruction of orbitomaxillary composite defects and orbital exenteration cavities are reported. The TPFF combined with alloplastic framework is gaining in importance in external ear reconstruction. Innovative prefabricated skin or soft-tissue grafts based on the TPFF are used to restore facial contour or in the reconstruction of complex facial defects. The free TPFF finds a role in laryngotracheal reconstruction as a vascular carrier to support cartilage grafts. SUMMARY: Owing to its reliability and unequalled structural properties, the TPFF still plays a central role in facial reconstruction. Future investigation will likely incorporate the free TPFF as a vascular carrier of bioengineered tissues, such as cartilage and mucosa, for various head and neck indications.

Toxicidade de antibióticos no cultivo in vitro da batata em meios semi-sólido e líquido

O objetivo deste trabalho foi avaliar os efeitos fitotóxicos de antibióticos no crescimento e na taxa de multiplicação in vitro da batata. Brotações da cultivar Baronesa foram cultivadas em meio de multiplicação de consistência semi-sólida e líquida. O meio de multiplicação foi formado pelos sais e vitaminas de MS ao qual adicionou-se um dos seguintes antibióticos: ampicilina, cloranfenicol, estreptomicina e tetraciclina, previamente selecionados em razão da ação bactericida sobre contaminantes da cultura, nas concentrações de 0, 32, 64, 128, 256, 512 e 1.024 mg L-1. Por 21 dias os materiais foram mantidos em sala de crescimento a 25±2°C, 16 horas de luz e fluxo de radiação de 35 µmol m-2 s-1. Nos tratamentos em que se utilizou meio de cultura líquido, os frascos foram mantidos sob constante agitação em mesa agitadora do tipo orbital. A ampicilina foi o único antibiótico que não afetou a sobrevivência e o desenvolvimento dos explantes de batata em meio de multiplicação, podendo ser indicada para trabalhos de descontaminação in vitro dessa espécie. O aumento das concentrações de cloranfenicol, estreptomicina e tetraciclina no meio de cultura apresentou efeitos fitotóxicos severos sobre o crescimento e taxa de multiplicação do material vegetal.

Optic perineuritis: clinical and radiographic features.

BACKGROUND: Optic perineuritis is an uncommon variety of orbital inflammatory disease that is distinct from demyelinating optic neuritis. OBJECTIVE: To describe the clinical and radiographic features of idiopathic optic perineuritis, with particular emphasis on those features that help to distinguish this condition from optic neuritis. METHODS: We reviewed the medical records of 14 patients with optic perineuritis who were seen in 2 neuro-ophthalmology clinics. RESULTS: Patients ranged in age from 24 to 60 years; 5 were older than 50 years. All patients had visual loss, eye pain, or both. The visual acuity was 20/20 or better in 8 of the 15 eyes. The results of visual field testing were normal in 2 eyes, and a paracentral scotoma or an arcuate defect was seen in 7. Magnetic resonance imaging scans demonstrated circumferential enhancement around the optic nerve, sometimes with intraorbital extension. Response to corticosteroids was dramatic; however, 4 patients had a relapse with lowering of the dose. CONCLUSIONS: In contrast to those with optic neuritis, patients with optic perineuritis are often older at onset and are more likely to show sparing of central vision. Magnetic resonance imaging scans demonstrate enhancement around, rather than within, the optic nerve. Response to corticosteroids is more dramatic than in patients with optic neuritis, and patients are more likely to experience recurrence after stopping treatment.

SWIVIT - Swiss video-intubation trial evaluating video-laryngoscopes in a simulated difficult airway scenario: study protocol for a multicenter prospective randomized controlled trial in Switzerland.

BACKGROUND: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation. METHODS/DESIGN: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq?, A. P. Advance?, King Vision?) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC?, GlideScope?, McGrath?) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt. DISCUSSION: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway. TRIAL REGISTRATION: NCT01692535.

Asphalt Cement Containing AC-13, HR-522, Final Report, 1988

Stopping and turning maneuvers on high traffic volume asphalt cement concrete surfaced roads and streets often cause distortion of the pavement. Distortion may show up as excessive rutting in the wheel path, shoving of the pavement and/or rippling of the surface. Often times repeated corrective work such as cold milling or heater planing is required in these areas to maintain the pavement surface in a reasonable condition. In recent years polymer additives have been developed for asphalt cement concrete paving mixes that show promise in improving the inplace stability of the pavements. AC-13 (Styrelf 13) available from Bitucote Products Company, St. Louis, Missouri is an asphalt cement that has been modified by an additive to exhibit characteristics of very high stability in asphalt mixes.

Low Profile Marker for Wet/Night Visibility, HR-1005, 1977

Conventional highway lane markings are ineffective at night, particularly when the pavement is wet. There is a recognized need for a system that is effective at night under wet conditions and where there is no reduction in current daytime standards. To be effective at all times the system must maintain wet-night retroreflective properties while resisting deterioration caused by snowplows, studded tires, sand and salt applications, and lane changing maneuvers by traffic. This project tested a system of low-profile lane markers developed by Battelle Columbus Laboratory under contract with the Implementation Division of the Federal Highway Administration.

Diagnostic pitfalls: posterior ischemic optic neuropathy mimicking optic neuritis.

In young people, the most frequent cause of isolated monocular visual loss due to an optic neuropathy is optic neuritis. We present the case of a 27 year old woman who presented monocular visual loss, excruciating orbital pain and unusual temporal headache. The initial diagnosis of optic neuritis revealed later to be a posterior ischemic optic neuropathy (PION). In this case, PION was the first unique presentation of a non-traumatic carotid dissection, and it was followed 24h later by an ischemic stroke. Sudden monocular visual loss associated with a new-onset headache are clinical symptoms that should immediately prompt to a carotid dissection.

Childhood epilepsy with neuropsychological regression and continuous spike waves during sleep: epilepsy surgery in a young adult.

We describe the case of a man with a history of complex partial seizures and severe language, cognitive and behavioural regression during early childhood (3.5 years), who underwent epilepsy surgery at the age of 25 years. His early epilepsy had clinical and electroencephalogram features of the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia (Landau-Kleffner syndrome), which we considered initially to be of idiopathic origin. Seizures recurred at 19 years and presurgical investigations at 25 years showed a lateral frontal epileptic focus with spread to Broca's area and the frontal orbital regions. Histopathology revealed a focal cortical dysplasia, not visible on magnetic resonance imaging. The prolonged but reversible early regression and the residual neuropsychological disorders during adulthood were probably the result of an active left frontal epilepsy, which interfered with language and behaviour during development. Our findings raise the question of the role of focal cortical dysplasia as an aetiology in the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia.

Contribuições do solo e dossel em modelo de estimativa de biomassa aérea no Bioma Pampa

O objetivo deste trabalho foi avaliar o desempenho preditivo do submodelo espectral do modelo JONG, com a inserção de variáveis espectrais que considerassem a densidade de biomassa do dossel e as contribuições dos diferentes solos subjacentes. Índices calculados pela diferença e razão simples - entre as bandas 4 e 3, 4 e 5, 4 e 7, do sensor orbital ETM+/Landsat 7 - foram sugeridos para representar a contribuição espectral dos solos subjacentes e a influência das diferenças estruturais dos dosséis. A parametrização da componente espectral foi implementada por regressão linear múltipla e, em seguida, foi comparada aos dados de biomassa obtidos em campo. As variáveis espectrais que melhor expressaram as variações da disponibilidade inicial de forragem foram a fração solo (modelo linear de mistura espectral) e a razão entre as bandas 4 e 7. A componente espectral do modelo JONG, com a nova parametrização, apresenta sensibilidade para eliminar as influências do solo e dossel na disponibilidade inicial de biomassa e facilita a interpretação dos resultados, em razão da relação entre as variáveis espectrais selecionadas.

Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma.

Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group. More common signs should also be considered suspicious until proved otherwise, such as strabismus, the second most frequent sign of retinoblastoma. Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Other causal pathologies, including persistent hyperplastic primary vitreous (PHPV), Coats' disease, ocular toxocariasis or retinopathy of prematurity, may also manifest the same warning signs and require specialized differential diagnosis. Members of the immediate family circle are most likely to notice the first signs, the general practitioner, pediatrician or general ophthalmologist the first to be consulted. On their attitude will depend the final outcome of this vision and life-threatening disease. Early diagnosis is vital.

Comment explorer une exophtalmie? [How to investigate a patient with exophthalmos?]

Exophthalmos is the main symptom revealing orbital masses. This sign needs to be imaged mainly by MRI and/or CT. As Graves disease is the main etiology of exophthalmos, CT scan should be performed as the initial imaging modality. Indications for US and Doppler are mostly limited to the study of ocular masses, and eventually may help the characterization of extra-ocular lesions. In all cases, imaging is useful to characterize: the precise location of the lesion which can be the intra-conal space (including muscles), the extra-conal space (associated or not to an extra-orbital lesion), or the eyeball; the features of the lesion (density, signal, enhancement.). These findings are used to generate a differential diagnosis. Imaging is also useful to precise the extension of the mass, and in some cases to select the appropriate surgical approach, and for follow-up.