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PubMed1988

Radiation therapy for retinoblastoma: comparison of results with lens-sparing versus lateral beam techniques.

From 1979 through 1986, 170 children were seen at our institution diagnosed with retinoblastoma. Sixty-six of the children with involvement of 121 eyes, were referred for definitive external beam radiation to one or both eyes. During the study period, two distinct radiation techniques were used. From 1980 through mid-1984, a lens-sparing technique included an anterior electron beam with a contact lens mounted lead shield, combined with a lateral field, was used. Since mid-1984, a modified lateral beam technique has been used, mixing lateral electrons and superior and inferior lateral oblique split beam wedged photons. Doses prescribed were similar for both techniques, ranging from 3,850 to 5,000 cGy in 4 to 5 weeks. The lens-sparing and the modified lateral techniques are compared for local control. For eyes with Group I through III disease, the lens-sparing technique resulted in local control in 33% of the eyes treated, where the modified lateral technique controlled 83% of the eyes treated (p = .006). Mean time to relapse was identical in both groups, that is 24 and 26 months respectively. Most relapses were successfully treated with further local therapy, including laser or cryosurgery, or 60Co plaques. Five eyes required enucleation following initial treatment with the lens-sparing technique, but none thus far with the lateral beam technique. For eyes with Group IV and V disease, no significant differences were found between the two techniques in terms of local control or eventual need for enucleation. With a mean follow-up time of 33 months for the entire group, the 4-year survival is 93%. Two of the 4 deaths are due to second primary tumor, and all 4 have occurred in the lens-sparing group. Because follow-up time is more limited in the lateral beam group, this is not statistically significant and direct survival comparisons are premature.

Eye Neoplasms↗
PubMed1994

Opioid receptor-dependent long-term potentiation at the lateral perforant path-CA3 synapse in rat hippocampus.

The involvement of opioid receptors in the induction of long-term potentiation (LTP) was investigated in the lateral and medial perforant path projections to area CA3 of the hippocampus in anesthetized rats. The opioid receptor antagonist naloxone (10 nmol), applied to the hippocampal CA3 region 10 min prior to tetanization, blocked the induction lateral perforant path-CA3 LTP induced by high-frequency stimulation. By contrast, LTP induction in medial perforant path-CA3 was not attenuated by a 10 nmol quantity of naloxone. (+)-Naloxone (10 nmol), the inactive stereoisomer of naloxone, was without effect on the induction of lateral perforant path-CA3 LTP. Naloxone applied 1 h following LTP induction did not reverse established lateral perforant path-CA3 LTP, indicating that opioid receptors are involved in the induction but not the maintenance of LTP in this pathway. LTP of medial perforant path responses developed immediately, while LTP of lateral perforant path responses was slow to develop. The latter pattern is similar to the time course of the development of LTP observed at the mossy fiber-CA3 synapse and suggests that lateral and medial perforant path synapses may use distinct mechanisms of both induction and expression of LTP. These data extend previous findings demonstrating opioid receptor-dependent mechanisms of LTP induction at both the mossy fiber-CA3 synapse and the lateral perforant path-dentate gyrus synapse. We suggest that lateral perforant path and mossy fiber synapses may utilize similar, opioid receptor-dependent, mechanisms of LTP induction and expression.

Animals↗
PubMed1993

Characterization of the outer hair cell's lateral wall membranes.

We examined the properties of outer hair cell (OHC) lateral wall membranes by application of 2 fluorescent membrane probes. The markers, C6-NBD-Ceramide and DiOC6, have been used in other cell types to label Golgi apparatus and endoplasmic reticulum, respectively. In living isolated OHCs NBD-Ceramide demonstrated uninterrupted fluorescence along the OHC lateral wall, while DiOC6 labeling proved punctate and notably less uniform in this region. In aldehyde-fixed isolated OHCs both probes exhibited distinct, continuous lateral wall fluorescence. Fixed preparations of the organ of Corti labeled with each probe demonstrated diffuse fluorescence throughout the inner hair cell cytoplasm unlike the uniform, circumferential lateral wall fluorescence seen in OHCs. OHCs exposed to salicylate following NBD-Ceramide labeling displayed patchy, less distinct labeling along the OHC lateral wall. The thickness of lateral wall fluorescence in salicylate exposed cells was 49% greater than control OHCs. We interpreted the salicylate induced change in lateral wall labeling as a fluorescent representation of previously described ultrastructural dilatation and vesiculation of the subsurface cisternae. The distribution of these 2 fluorescent probes along OHC lateral wall membranes suggests that the OHC's subsurface cisternae are neither Golgi nor ER, but share characteristics of both.

4-Chloro-7-nitrobenzofurazan↗
PubMed1992

Preoperative computed tomography scanning and arthroscopy in predicting outcome after lateral retinacular release.

We initiated a study to look at preoperative, flexed-knee, midpatellar computed tomography (CT) scans and intraoperative arthroscopic findings of lateral patellar articular degeneration in predicting the results after lateral retinacular release for failed nonoperative treatment of anterior knee pain. Twenty patients with 30 painful knees underwent preoperative flexed-knee, midpatellar CT scans that were retrospectively classified by the method of Fulkerson into normal alignment, lateral subluxation, lateral patellar tilt, and combined tilt and subluxation. Arthroscopy was performed before open lateral release. The lateral facet of the patella was graded as either minimal changes (Outerbridge I or II) or advanced (Outerbridge III or IV) changes. Patients were followed for a minimum of 2 years and graded on a standard patellofemoral rating scale. Only 22 of 30 knees that were thought to be clinically malaligned, actually were malaligned by CT scan; eight CT scans were interpreted as normal. The results were further stratified into group A (CT-documented tilt, minimal facet changes), group B (CT-documented tilt, advanced facet changes), and group C (normal CT). Ninety-two percent of group A were rated good or excellent. Twenty-two percent of Group B rated good/excellent, 33% fair, 44% poor. Only 13% of group C rated good (one patient). Based on the results of the study, we recommend lateral release for anterior knee patients with CT-proven patellar tilt who have not responded to conservative treatment and have minimal facet changes with minimal or no subluxation. Lateral retinacular release should not be offered as a treatment to the patient with a normally aligned patella because poor results will most likely result.

Adolescent↗
PubMed1995

Dual energy X-ray absorptiometry of the spine--decubitus lateral versus anteroposterior projection in osteoporotic women: comparison to single energy X-ray absorptiometry of the forearm.

We investigated the discriminatory ability of dual energy X-ray absorptiometry (DXA) of the lumbar spine in the anteroposterior vs. decubitus lateral projection in 53 elderly women with at least one vertebral fracture and 63 age-matched women without fracture. Twenty-three premenopausal healthy women served as a reference group. Spine measurements were compared to forearm measurements by single energy X-ray absorptiometry (SXA). Bone mineral density (BMD) of the women with fractures was 16% lower in the AP projection and 17% lower in the decubitus lateral projection compared to age-matched women without fractures. t-Scores (deviation from normal premenopausal values in SDs) were -2.1 to -2.3 in the women without fractures, and -3.9 (AP projection), -3.1 (lateral projection) and -3.8 (forearm) in the women with vertebral fractures. t-Scores as well as z-scores for bone mineral content of the vertebral body and the vertebral posterior elements (both measured with the lateral projection) were similar. ROC analysis showed no significant difference between the AP and the lateral projection of the spine. When subjects with vertebral endplate sclerosis (about 25% in each group, with considerably elevated spinal BMD) were excluded, it did not significantly change the diagnostic abilities for fractures. We found no diagnostic advantage of the lateral projection as compared to the AP projection or forearm measurement. Future studies will reveal whether absorptiometry in the lateral projection can be improved by supine lateral scanning.

Absorptiometry, Photon↗
PubMed2004

Lateral automobile impacts and the risk of traumatic brain injury.

STUDY OBJECTIVES: We determine the relative risk and severity of traumatic brain injury among occupants of lateral impacts compared with occupants of nonlateral impacts. METHODS: This was a secondary analysis of the National Highway Traffic Safety Administration's National Automotive Sampling System, Crashworthiness Data Systems for 2000. Analysis was restricted to occupants of vehicles in which at least 1 person experienced an injury with Abbreviated Injury Scale score greater than 2. Traumatic brain injury was defined as an injury to the head or skull with an Abbreviated Injury Scale score greater than 2. Outcomes were analyzed using the chi2 test and multivariate logistic regression, with adjustment of variance to account for weighted probability sampling. RESULTS: Of the 1,115 occupants available for analysis, impact direction was lateral for 230 (18.42%) occupants and nonlateral for 885 (81.58%) occupants. One hundred eighty-seven (16.07%) occupants experienced a traumatic brain injury, 14.63% after lateral and 16.39% after nonlateral impact. The unadjusted relative risk of traumatic brain injury after lateral impact was 0.89 (95% confidence interval [CI] 0.51 to 1.56). After adjusting for several important crash-related variables, the relative risk of traumatic brain injury was 2.60 (95% CI 1.1 to 6.0). Traumatic brain injuries were more severe after lateral impact according to Abbreviated Injury Scale and Glasgow Coma Scale scores. The proportion of fatal or critical crash-related traumatic brain injuries attributable to lateral impact was 23.5%. CONCLUSION: Lateral impact is an important independent risk factor for the development of traumatic brain injury after a serious motor vehicle crash. Traumatic brain injuries incurred after lateral impact are more severe than those resulting from nonlateral impact. Vehicle modifications that increase head protection could reduce crash-related severe traumatic brain injuries by up to 61% and prevent up to 2,230 fatal or critical traumatic brain injuries each year in the United States.

Abbreviated Injury Scale↗
PubMed2006

Sex differences in cerebral laterality of language and visuospatial processing.

Sex differences on language and visuospatial tasks are of great interest, with differences in hemispheric laterality hypothesized to exist between males and females. Some functional imaging studies examining sex differences have shown that males are more left lateralized on language tasks and females are more right lateralized on visuospatial tasks; however, findings are inconsistent. Here we used functional magnetic resonance imaging to study thirty participants, matched on task performance, during phonological and visuospatial tasks. For each task, region-of-interest analyses were used to test differences in cerebral laterality. Results indicate that lateralization differences exist, with males more left lateralized during the phonological task and showing greater bilateral activity during the visuospatial task, whereas females showed greater bilateral activity during the phonological task and were more right lateralized during the visuospatial task. Our data provide clear evidence for differences in laterality between males and females when processing language versus visuospatial information.

Adult↗
PubMed2005

Age-dependent differences in lateral balance recovery through protective stepping.

BACKGROUND: Aging appears to present particular problems for lateral balance stability related to falls. Protective stepping is a common strategy for maintaining balance that may be impaired with aging due to changes in neuromusculoskeletal factors. This study assessed the response patterns, kinematics, and single support hip abduction torque during lateral protective stepping for balance recovery in healthy young and elderly adults. METHODS: Ten healthy elderly and 10 younger adults received stepper-motor driven waist-pulls of bipedal stance applied pseudorandomly to either side. Stepping response strategies were quantified with force platforms and motion analysis. FINDINGS: The young responded primarily using a single lateral sidestep with the limb that was initially loaded passively by the waist-pull, while older subjects favored crossover stepping using multiple steps with more inter-limb collisions. When the elderly did use loaded side steps, the steps were longer, slower, and higher and included greater and prolonged lateral trunk motion than in the young. Overall, older subjects produced greater and less rapid stabilizing hip abduction torque during the single support phase. INTERPRETATION: Age-associated differences in lateral balance control through stepping included using a riskier recovery strategy with increased collisions between the limbs, multiple steps, altered first step characteristics and lateral trunk motion during direct sidestepping, and a generally greater support hip torque. The difficulties with lateral balance control in aging may reflect factors such as impaired hip abduction torque-time capacity and lateral trunk mobility/control. Our findings contribute additional knowledge pertaining to the problem of balance dysfunction and falls among the elderly.

Accidental Falls↗
PubMedDate not supplied

Activation of brachioradialis muscles transferred to restore lateral pinch in tetraplegia.

PURPOSE: Surgical transfers of muscles are used to restore lateral pinch in tetraplegia; however, outcomes are variable. The purpose of this study was to compare activation of the brachioradialis (Br) after transfer to the flexor pollicis longus during maximum effort in its primary function (elbow flexion) with maximum effort in its postoperative function (lateral pinch) and to record Br activation during functional tasks. METHODS: Fine-wire electrodes recorded activation of the Br in 11 arms with tetraplegia. Subjects produced maximum lateral pinch force with and without elbow stabilization and were classified according to elbow strength. The elbow was stabilized by supporting the arm and limiting elbow motion. A force sensor mounted on a custom grip recorded the pinch force. Electromyographic (EMG) signals recorded during lateral pinch were expressed as a percentage of the maximum voluntary contraction recorded during maximum-effort elbow flexion. RESULTS: The EMG activation was significantly lower during lateral pinch compared with resisted elbow flexion. The mean EMG during lateral pinch in the self-supported elbow condition was 34% of the maximum voluntary contraction; with the elbow stabilized the EMG increased to 55% of the maximum voluntary contraction. Postoperative pinch-force magnitude was 14 N with self-support and 20 N with the elbow stabilized. Subjects with weak elbow extension strength produced significantly lower pinch forces compared with subjects with strong elbow extension but had similar ability to activate the Br. The Br activation was higher when the pinch tasks were performed successfully. CONCLUSIONS: These findings suggest a reduced ability to activate the transferred muscle fully in lateral pinch function after surgery, even with the addition of elbow support. The Br activation is linked to successful performance of lateral pinch tasks. The subjects' inability to activate the transferred muscle fully may be affected by postoperative muscle re-education and contribute to postoperative weakness.

Adult↗
PubMed2005

Medial and lateral osteoarthritis of the knee is related to variations of hip and pelvic anatomy.

OBJECTIVE: We evaluated if increased risk of combined hip and lateral knee osteoarthritis (OA) could be attributed to anatomical reasons in the hip region resulting in increased abductor moment over the knee. METHODS: We measured pelvic width, femoral offset, femoral neck length and angle in 29 women with lateral knee OA (13 unilateral, 16 bilateral) and 27 women with bilateral medial OA. Twenty-one of these patients with normal hips (lateral/medial OA of the knee=12/9) and 35 with associated hip OA (lateral/medial OA of the knee=17/18) were evaluated separately. Radiographic examinations in 14 women planned for hip prosthesis because of failures after hip fracture acted as controls. RESULTS: Patients with lateral OA of the knee had wider pelvis than controls (13.7 mm increased distance between the medial borders of the acetabulum, P=0.001). Patients with medial OA had 11.4mm longer distance from the centre of the femoral head to the centre of the proximal part of the femoral shaft (P=0.005), corresponding to a higher offset. The pelvic and hip anatomy also differed between patients with medial and lateral OA of the knee. In the groups without hip OA, presence of lateral knee OA was associated with a wider pelvis (P=0.009), shorter femoral neck (P=0.02) and Head-Shaft distance (P=0.04). In the groups with OA of the hip associated lateral OA of the knee also implied increased Neck Shaft angle (coxa valga, P=0.008), but there was no difference in pelvic width (P=0.15). We found a shorter lever arm over the hip in lateral knee OA compared to medial knee OA (P=0.02), but not when compared to controls. CONCLUSION: Our findings suggest that occurrence of medial or lateral OA has a biomechanical background originating from pelvis and hip anatomy.

Female↗
PubMedDate not supplied

Detection of abdominal aortic calcification with lateral spine imaging using DXA.

Radiographic abdominal aortic calcification (AAC) is associated with incident cardiovascular disease and mortality independent of other risk factors. Lateral spine imaging using dual-energy X-ray absorptiometry (DXA) is now available to detect prevalent vertebral fracture (called vertebral fracture assessment), but its potential utility to detect radiographic AAC has not been investigated. Fifty-seven of 205 women age 65 or older who had participated in a prior study of the detection of prevalent vertebral fracture with lateral DXA had technically adequate radiographs and lateral DXA images to assess AAC. Two readers scored both the radiographic and lateral DXA images for AAC using a previously validated 24-point scale, blinded to both of each other's readings and also to their own readings on the other technology. The agreement between radiograph and lateral DXA AAC scores was very good (intra-class correlation coefficient [ICC] of 0.81 (95% confidence interval [CI]: 0.66-0.90) for reader 1 and 0.82 (95% CI: 0.69-0.90) for reader 2). The ICC between the two reader's AAC scores on radiographs was 0.92 (95% CI: 0.88-0.95) and on lateral DXA images was 0.89 (95% CI: 0.80-0.94). Lateral spine imaging with DXA shows very good agreement with standard radiography in the detection of AAC. Lateral imaging of the spine with DXA intended to detect vertebral fracture is a promising technology for the simultaneous assessment of a risk factor for cardiovascular disease incidence and death.

Absorptiometry, Photon↗
PubMedDate not supplied

The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging.

The lateral ulnar collateral ligament is an important element of the elbow's lateral capsuloligamentous complex, and loss of integrity contributes to posterolateral rotatory instability. However, the normal appearance on magnetic resonance imaging is poorly defined. The purpose of this study was to assess the appearance of the lateral ulnar collateral ligament of asymptomatic elbows on magnetic resonance imaging. We performed magnetic resonance imaging on 20 asymptomatic elbows. The lateral ulnar collateral ligament was identified as a hypointense structure originating from the lateral epicondyle and inserting on the proximal ulna in 10 cases (50%) and was ambiguous in the other 10 elbows. The identified lateral ulnar collateral ligament images included areas of high signal intensity, which was confusing because it suggested ligamentous disruption within the ligament. These results indicate that magnetic resonance imaging is not reliable for diagnosing lateral ulnar collateral ligament injuries at the present time. Further progress in magnetic resonance imaging will be clinically useful for diagnosing abnormalities of the lateral ulnar collateral ligament.

Adult↗
PubMed2005

NMDA receptor antagonists block heterosynaptic long-term depression (LTD) but not long-term potentiation (LTP) in the CA3 region following lateral perforant path stimulation.

High-frequency stimulation of lateral perforant path is accompanied by a heterosynaptic long-term depression (LTD) of medial perforant path synaptic responses in both the dentate gyrus and the CA3 region of the hippocampus. We reported previously that LTP induction at lateral perforant path-CA3 synapses is unaffected by NMDA antagonists. However, it is not known if heterosynaptic LTD that is observed in the CA3 region following lateral perforant path stimulation also is independent from NMDA receptors. We address this question in anesthetized adult rats using systemic administration of the competitive NMDA receptor antagonist CPP. Induction of lateral perforant path-CA3 LTP produced a sustained heterosynaptic depression of medial perforant path-CA3 responses. Systemic administration of CPP (10 mg/kg) was ineffective in blocking the induction of LTP at lateral perforant path-CA3 responses. However, heterosynaptic LTD of medial perforant path-CA3 responses was blocked completely by CPP. These data indicate that NMDA receptors are not required for the induction of lateral perforant path-CA3 LTP, but are involved in the induction of heterosynaptic LTD that accompanies lateral perforant path activity. The requirement for NMDA receptors for heterosynaptic LTD suggests one functional role of NMDA receptors at termination fields of the lateral perforant path.

Adaptation, Physiological↗
PubMed2005

GABA(A) receptor activation in the lateral parabrachial nucleus induces water and hypertonic NaCl intake.

Inhibitory serotonergic and cholecystokinergic mechanisms in the lateral parabrachial nucleus and central GABAergic mechanisms are involved in the regulation of water and NaCl intake. In the present study we investigated if the GABA(A) receptors in the lateral parabrachial nucleus are involved in the control of water, NaCl and food intake in rats. Male Holtzman rats with stainless steel cannulas implanted bilaterally into the lateral parabrachial nucleus were used. Bilateral injections of muscimol (0.2 nmol/0.2 microl) into the lateral parabrachial nucleus strongly increased 0.3 M NaCl (20.3+/-7.2 vs. saline: 2.6+/-0.9 ml/180 min) without changing water intake induced by the treatment with the diuretic furosemide combined with low dose of the angiotensin converting enzyme inhibitor captopril s.c. In euhydrated and satiated rats, bilateral lateral parabrachial nucleus injections of muscimol (0.2 and 0.5 nmol/0.2 microl) induced 0.3 M NaCl intake (12.1+/-6.5 and 32.5+/-7.3 ml/180 min, respectively, vs. saline: 0.4+/-0.2 ml/180 min) and water intake (5.2+/-2.0 and 7.6+/-2.8 ml/180 min, respectively, vs. saline: 0.8+/-0.4 ml/180 min), but no food intake (2+/-0.4 g/240 min vs. saline: 1+/-0.3 g/240 min). Bilateral lateral parabrachial nucleus injections of the GABA(A) antagonist bicuculline (1.6 nmol/0.2 microl) abolished the effects of muscimol (0.5 nmol/0.2 microl) on 0.3 M NaCl and water intake. Muscimol (0.5 nmol/0.2 microl) into the lateral parabrachial nucleus also induced a slight ingestion of water (4.2+/-1.6 ml/240 min vs. saline: 1.1+/-0.3 ml/240 min) when only water was available, a long lasting (for at least 2 h) increase on mean arterial pressure (14+/-4 mm Hg, vs. saline: -1+/-1 mm Hg) and only a tendency to increase urinary volume and Na+ and K+ renal excretion. Therefore the activation of GABA(A) receptors in the lateral parabrachial nucleus induces strong NaCl intake, a small ingestion of water and pressor responses, without changes on food intake.

Analysis of Variance↗
PubMed2006

Myosin light chain kinase regulates synaptic plasticity and fear learning in the lateral amygdala.

Learning and memory depend on signaling molecules that affect synaptic efficacy. The cytoskeleton has been implicated in regulating synaptic transmission but its role in learning and memory is poorly understood. Fear learning depends on plasticity in the lateral nucleus of the amygdala. We therefore examined whether the cytoskeletal-regulatory protein, myosin light chain kinase, might contribute to fear learning in the rat lateral amygdala. Microinjection of ML-7, a specific inhibitor of myosin light chain kinase, into the lateral nucleus of the amygdala before fear conditioning, but not immediately afterward, enhanced both short-term memory and long-term memory, suggesting that myosin light chain kinase is involved specifically in memory acquisition rather than in posttraining consolidation of memory. Myosin light chain kinase inhibitor had no effect on memory retrieval. Furthermore, ML-7 had no effect on behavior when the training stimuli were presented in a non-associative manner. Anatomical studies showed that myosin light chain kinase is present in cells throughout lateral nucleus of the amygdala and is localized to dendritic shafts and spines that are postsynaptic to the projections from the auditory thalamus to lateral nucleus of the amygdala, a pathway specifically implicated in fear learning. Inhibition of myosin light chain kinase enhanced long-term potentiation, a physiological model of learning, in the auditory thalamic pathway to the lateral nucleus of the amygdala. When ML-7 was applied without associative tetanic stimulation it had no effect on synaptic responses in lateral nucleus of the amygdala. Thus, myosin light chain kinase activity in lateral nucleus of the amygdala appears to normally suppress synaptic plasticity in the circuits underlying fear learning, suggesting that myosin light chain kinase may help prevent the acquisition of irrelevant fears. Impairment of this mechanism could contribute to pathological fear learning.

Amygdala↗
PubMed2006

A spatially structured network of inhibitory and excitatory connections directs impulse traffic within the lateral amygdala.

The lateral nucleus of the amygdala is the entry point of most sensory inputs into the amygdala. However, the way information is processed and distributed within the lateral nucleus still eludes us. To gain some insight into this issue, we have examined the spatial organization of excitatory and inhibitory connections in the lateral nucleus. To this end, we performed whole-cell recordings of principal lateral amygdala neurons and studied their responses to local pressure applications of glutamate in coronal and horizontal slices of the guinea-pig amygdala. In coronal sections, glutamate puffs performed at a distance from the recorded cells usually evoked inhibitory responses, except when the recorded neuron was adjacent to the external capsule, in which case excitatory responses could be evoked from ejection sites along the external capsule. In contrast, glutamate puffs evoked a mixture of excitatory and inhibitory responses in horizontal slices. Excitatory responses were generally evoked from stimulation sites located lateral to the recorded cell whereas inhibitory responses were commonly elicited from medial stimulation sites, irrespective of their rostrocaudal position. These findings confirm and extend previous tract-tracing studies where it was found that intrinsic connections within the lateral amygdala prevalently run in the dorsoventral and lateromedial directions. However, our results also reveal a hitherto unsuspected level of spatial heterogeneity in the intrinsic circuit of the lateral amygdala. The prevalence of excitatory responses in horizontal slices coupled to the ubiquity of inhibitory responses in coronal slices suggest that the lateral amygdala network is designed to allow associative interactions within the rostrocaudal plane while preventing runaway excitation locally.

Amygdala↗
PubMed2005

Lateralized cognitive dysfunction and psychotic symptoms in schizophrenia.

Our understanding of hemispheric asymmetries in schizophrenia can be attributed to extensive neuropsychological and neuroimaging research on this topic; however, it has yet to be determined whether lateralized cognitive dysfunction represents a single core trait in schizophrenia or whether the lateralized impairments are domain specific. To test whether lateralized deficits are core features in schizophrenia we examined performance across a wide range of lateralized cognitive domains including attention, fluency, recognition memory, perception, and arousal. We also examined the relationship between lateralized impairments and psychotic and affective symptoms to determine whether abnormal hemispheric asymmetries were possibly state-related. The sample consisted of 43 subjects with schizophrenia and 66 normal healthy comparison subjects without psychiatric illness. Schizophrenia subjects exhibited abnormal right hemisphere performance on a test of recognition memory and abnormal left hemisphere performance on a measure of arousal. These findings suggest that lateralized cognitive disturbances in schizophrenia do not represent a single core lateralized deficit. Regarding the symptom analyses, severity of positive symptoms was related to right hemisphere cognitive impairment (including fluency and recognition memory), whereas severity of negative symptoms was related to left hemisphere cognitive impairment (including fluency). Overall, our findings suggest that lateralized dysfunction can occur in both hemispheres in schizophrenia, and that the positive psychotic symptoms may relate more to right hemisphere impairment, whereas negative psychotic symptoms may related more to left hemisphere impairment.

Adult↗
PubMed2004

The use of a lateral stabilizer increases the incidence of wound trouble following the Nuss procedure.

BACKGROUND: A lateral stabilizer has been used to prevent bar displacement during the Nuss procedure for pectus excavatum repair in pediatric patients. We experienced wound troubles in patients who had a stabilizer placed within them. The aim of this study was to examine the effect of a lateral stabilizer and other clinical factors on wound troubles after the Nuss procedure. METHODS: 53 patients with pectus excavatum underwent repair by the Nuss procedure. Preoperative clinical data, operative data, and postoperative complications were examined in all patients. RESULTS: A lateral stabilizer was placed in 29 of the 53 patients. Short-term results were excellent in 42 patients (79.2%). Postoperative complications involved pneumothorax requiring drainage in two patients, atelectasis in one patient, pleural effusion in three patients, deterioration of scoliosis in one patient, erythema in one patient, persistent pain in two patients, bar displacement in four patients, and local wound complications (Seroma with dermatitis due to pressure damage) in five patients. All seromas with dermatitis due to pressure damage were initially aseptic around lateral stabilizers and became infected in four patients after resection of the seroma or spontaneous perforation. Removal of both the pectus bar and lateral stabilizer was performed in two of those four patients and the lateral stabilizer was removed in the other two patients to prevent catastrophic infection such as empyema or mediastinitis. The use of a lateral stabilizer increases the incidence of wound trouble (p = 0.041). CONCLUSIONS: Although the Nuss procedure has evolved into an effective method for pectus excavatum repair, the use of a lateral stabilizer increases the incidence of wound difficulties.

Adolescent↗