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Quantitative assessment of mirror movements after stroke.

BACKGROUND AND PURPOSE: Mirror movements (MM) are involuntary synchronous movements of one limb during voluntary unilateral movements of the opposite limb. We measured MM in stroke and control subjects and evaluated whether MM after stroke are related to motor function. METHODS: Twenty-three patients and 16 control subjects were studied. A computerized dynamometer was used during two squeezing tasks to measure intended movements from the active hand as well as MM from the opposite hand. Motor deficits were measured with the arm motor component of the Fugl-Meyer scale. RESULTS: During paretic hand squeezing, MM in the unaffected hand were detected in 70% (repetitive squeeze) to 78% (sustained squeeze) of stroke patients. For both tasks, this was significantly (P < 0.05) greater than the incidence of MM in the paretic hand or in either hand of control subjects (17% to 44%), except when compared with the incidence of MM in the dominant hand of control subjects (56%; P = 0.17). The incidence of MM in the paretic hand was not significantly different from that seen in either hand of control subjects. Patients with MM in the unaffected hand had significantly greater motor deficit than patients without MM. Patients with MM in the paretic hand had significantly better motor function than patients without MM. CONCLUSIONS: Simultaneously recording motor performances of both hands provides precise information to characterize MM. MM in the unaffected hand and in the paretic hand are associated with different degrees of motor deficit after stroke. Evaluation of MM may be useful for studying mechanisms of stroke recovery.

Adult↗

"Mirror image" antagonists of thrombin-induced platelet activation based on thrombin receptor structure.

Platelet activation by thrombin plays a critical role in hemostasis and thrombosis. Based on structure-activity studies of a cloned platelet thrombin receptor, we designed two "mirror image" antagonists of thrombin and thrombin receptor function. First, "uncleavable" peptides mimicking the receptor domain postulated to interact with thrombin were found to be potent thrombin inhibitors. Second, proteolytically inactive mutant thrombins designed to bind but not cleave the thrombin receptor were found to be specific antagonists of receptor activation by thrombin. The effectiveness of these designed antagonists in blocking thrombin-induced platelet activation suggests a model for thrombin-receptor interaction and possible strategies for the development of novel antithrombotic agents.

Amino Acid Sequence↗

A monozygotic mirror-image twin pair with discordant psychiatric illnesses: a neuropsychiatric and neurodevelopmental evaluation.

One piece of genetic evidence for the biological distinctness of schizophrenia and bipolar illness is the rarity of monozygotic twin pairs in which one twin suffers from schizophrenia and the other from bipolar disorder. The authors describe a pair of monozygotic mirror-image twins with discordant diagnoses, schizophrenia in one twin and bipolar or schizoaffective disorder in the other.

Adult↗

The cost-effectiveness of clozapine: a controlled, population-based, mirror-image study.

A retrospective cohort study, with a mirror-image design, was used to measure inpatient service utilization in 63 consecutive patients started on clozapine from a geographical catchment area compared to a control group matched for previous inpatient service use. An intent-to-treat analysis, including those patients (n = 28) who discontinued clozapine during the study period, showed a significant reduction in number of admissions and total time spent in hospital in the 2 years following clozapine initiation compared to the previous 2 years and to the follow-up period in the control group. This translated into a reduction of 7,300 pounds in hospitalization costs per patient started on clozapine, over the 2-year period. In those patients who continued clozapine treatment for the whole of the 2-year period, there was a two-thirds reduction in number of admissions and total time spent in hospital compared to no change in the clozapine discontinuers. These findings suggest that clozapine is a clinically and cost-effective intervention for severe schizophrenia in routine clinical settings.

Adult↗

Use of a mirror to assist breast pumping.

This case describes a woman who was unable to position the shields of a breast pump properly onto her breasts. Several thoracic surgeries as well as a spinal fusion contributed to her physical limitations. Using a mirror to watch herself place the breast shields enabled her to pump effectively.

Adult↗

Praxis as a mirroring process: teaching psychiatric nursing grounded in Newman's health as expanding consciousness.

The purpose of this column is to describe the application of Newman's theory of health as expanding consciousness in nursing education. The authors examine the value of mirroring presence, self-reflection, appreciation of meaning and pattern, and creative approaches to student learning in their care of clients with chronic mental illness. Praxis as the basis for caring in the human health experience is discussed in this newly developed teaching-learning model.

Humans↗

The media and the public opinion on genetics and biotechnology: mirrors, windows, or walls?

Arguments regarding the relationship between media discourse and public opinion have raged for decades, if not centuries. COmparing media coverage of biotechnology between 1992 and 2001 in two national newspapers with national survey data collected in early 2003, an argument is made that a general one-dimensional media effect is not occurring within the US public regarding media discourse. Given the multivalent characteristics of the media and the interpretive filters used by audiences - including ignoring information - even strong slants by the presumed opinion-leading press (the New York Times and the Washington Post) do not predict public opinion on a nascent issue such as biotechnology. While some observations show these mirrors to be ephemeral.

Biotechnology↗

Activity of oxytocinergic neurons in the paraventricular nucleus mirrors the periodicity of the endogenous stimulatory rhythm regulating prolactin secretion.

PRL secretion is regulated by an endogenous stimulatory rhythm of PRL-releasing factors within the hypothalamus. The endogenous rhythm has a bimodal periodicity with a nocturnal component which peaks at approximately 0300 h and a diurnal component that peaks at approximately 1700 h. Several PRL-releasing factors are known to be involved in this rhythm. Among these are oxytocin (OT), vasoactive intestinal peptide, and serotonin. We have proposed that OT is the neurohormone that stimulates PRL release from the lactotroph. In this study, we examined the activity of OTergic neurons in the paraventricular nucleus using the expression of the protooncogene c-fos (Fos) as a marker of neuronal activity. Ovariectomized rats were killed at either 0300, 1200, or 1700 h and brains quickly fixed by perfusion with 2.5% acrolein in 4% paraformaldehyde. Brains were blocked and processed for OT/Fos immunohistochemistry. Rats killed at 0300 and 1700 h had significantly greater proportion of Fos expressing OTergic neurons than control rats (1200 h). Percent of Fos-positive OTergic neurons were 2- and 1.5-fold greater at 0300 and 1700 h than 1200 h, respectively. The majority of these neurons were located in the medial parvocellular paraventricular nucleus and periventricular area. In another experiment, groups of OVX rats were killed every 2 h over a 24-h period and OT extracted from their anterior and posterior pituitaries. OT was present in the anterior pituitary in a bimodal rhythm. OT concentrations were greatest at approximately 0400 h and slowly declined to baseline by 1000 h. Another peak of OT was present in the anterior pituitary at approximately 2000 h and quickly declined to baseline by 2400 h. This rhythm of OT was not reflected in either the posterior pituitary or trunk blood. These data suggest that activity of a specific population of OTergic neurons of the paraventricular nucleus is rhythmic. The periodicity of these neurons mirrors that of the endogenous stimulatory rhythm. Furthermore, the anatomical location of these neurons suggests that they may project to the median eminence. Indeed, this heightened activity is reflected in a bimodal rhythm of OT in the anterior pituitary. Taken together, the data presented here provide compelling support for the role of OT as the neurohormone in the mechanism of the endogenous stimulatory rhythm.

Animals↗

Mirror-like spread of chronic pain.

The spread of chronic pain from its initial site of presentation is common, but the mechanisms of the spread are unknown. Here the authors present neurophysiologic evidence of altered interhemispheric conduction in a patient with a mirror-like spread of complex regional pain syndrome symptoms.

Adult↗

Abnormalities in visual spatial attention in men with mirror movements associated with isolated hypogonadotropic hypogonadism.

We studied spatial attentional performance on a visually cued reaction time task in men with isolated hypogonadotropic hypogonadism. A subset of these patients, who displayed mirror movements, have spatial attentional abnormalities. They were slow to respond to targets in the right visual field and especially slow when those targets followed incorrect or diffuse cues. This slowing was present for at least 500 msec after cue onset. They responded equally to targets in the left visual field independent of the spatial cues. The patient population as a whole was significantly faster than controls across all experimental conditions, although the speed of their attentional movement was normal. These data suggest that patients with isolated hypogonadotropic hypogonadism perform reaction time tasks quickly, that faster reaction times do not reflect superior attentional performance, and that a subset of these patients has a spatial attentional abnormality.

Adult↗

Human cortical plasticity: functional recovery with mirror movements.

Cortical plasticity of the human brain permits functional recovery after brain injury even in the absence of neuronal recovery. We report the combined evaluation, including electrophysiology and functional magnetic resonance imaging, of the pattern of cortical and cerebellar reorganization, in a patient with mirror movements as a sequel of perinatal unilateral brain injury. Recovery resulted in motor control by the healthy hemisphere using direct ipsilateral corticospinal projections and the contralateral cerebellum.

Adolescent↗

Disruption of residual reading capacity in a pure alexic patient after a mirror-image right-hemispheric lesion.

A 74-year-old woman became a letter-by-letter reader after the occurrence of a left occipito-temporal hematoma. Seven months later, she suffered a second, mirror-image hematoma in the right hemisphere. After this second lesion, her residual reading capacity deteriorated dramatically in terms of both accuracy and reading latencies for words and isolated letters. Our findings support the hypothesis that the right hemisphere contributes to the residual reading capacities of pure alexic patients.

Aged↗

frizzled regulates mirror-symmetric pattern formation in the Drosophila eye.

Coordinated morphogenesis of ommatidia during Drosophila eye development establishes a mirror-image symmetric pattern across the entire eye bisected by an anteroposterior equator. We have investigated the mechanisms by which this pattern formation occurs and our results suggest that morphogenesis is coordinated by a graded signal transmitted bidirectionally from the presumptive equator to the dorsal and ventral poles. This signal is mediated by frizzled, which encodes a cell surface transmembrane protein. Mosaic analysis indicates that frizzled acts non-autonomously in an equatorial to polar direction. It also indicates that relative levels of frizzled in photoreceptor cells R3 and R4 of each ommatidium affect their positional fate choices such that the cell with greater frizzled activity becomes an R3 cell and the cell with less frizzled activity becomes an R4 cell. Moreover, this bias affects the choice an ommatidium makes as to which direction to rotate. Equator-outwards progression of elav expression and expression of the nemo gene in the morphogenetic furrow are regulated by frizzled, which itself is dynamically expressed about the morphogenetic furrow. We propose that frizzled mediates a bidirectional signal emanating from the equator.

Animals↗

Low-intensity optical bistability in an active Fabry-Perot mirror induced by input-phase-insensitive parametric downconversion.

A Fabry-Perot resonator filled with second-order nonlinear optical material is investigated. Attention is devoted to making the resonator act as a nonlinear mirror for ultralow-intensity light signals that can be switched by a control beam at the second-harmonic frequency. The interaction process is an input-phase-independent parametric downconversion. The theoretical problem is solved through implementation of a dummy variable method optimized for a parametric process. Efficient amplification and bistability of low-intensity signals have been found.

Journal Article↗

Compensation of birefringence in active elements with a novel Faraday mirror operating at high average power.

A decrease in the depolarization ratio by more than one order of magnitude by use of a recently proposed Faraday mirror (FM) in comparison with the traditional FM has been demonstrated experimentally. At a high average laser power, the possibility of an increase in the accuracy of compensation of depolarization in the active element by means of a lambda/4 plate with both the traditional and the novel FM is shown.

Journal Article↗

Confocal total-internal-reflection fluorescence microscopy with a high-aperture parabolic mirror lens.

We present a theoretical study of a new total-internal-reflection fluorescence microscope for the detection of fluorescence at a water-glass interface. The system is designed for confocal imaging and spectroscopy of nanoparticles and single molecules. Focusing and fluorescence collection through standard glass coverslips is accomplished by a parabolic mirror lens. The large aperture of the element is used to excite fluorescence within the evanescent field of a diffraction-limited focus and to collect focal emission with high efficiency. Tight focusing and supercritical excitation reduce the detection volume for fluorescent analyte molecules well below that of an attoliter (10(-18) L), which can be advantageous for monitoring surface binding of single molecules without interference from fluorescence of the unbound bulk. Calculations of the electric fields in the focus region and simulated confocal imaging demonstrate the performance of the system.

Journal Article↗

Iterative method for the design of a dual-phase-conjugation-mirror resonator with multiple apertures.

Apertures have been used to select the low-order transverse modes in resonators. The additional diffraction losses result in a change in the transverse-mode structure, and the presence of apertures inside a resonator generally distorts the mode shape. The optimization of a multiple-aperture resonator demands an approach that differs from the conventional method in which the mode theory is used. We demonstrate an iterative design method to find optimal phase profiles for the reflector surfaces to build a resonator with multiple apertures to produce a lowest-order mode with much smaller diffraction loss and to satisfy the phase-conjugation conditions at the mirrors. The results are compared with conventional stable resonators, and we show that substantial improvement in round-trip loss and beam quality can also be obtained.

Journal Article↗

Testing and applicability of the UPC-ZEBRA interferometer as a phasing system in segmented-mirror telescopes.

In segmented-mirror telescopes, wave-front discontinuities caused by segment misalignment are a major problem because they severely degrade optical performance. While angular misalignments are usually measured with deflectometric wave-front sensors (e.g., Shack-Hartmann sensors), a number of techniques have been proposed for the measurement of vertical discontinuities (pistons). In earlier papers we presented an instrument called UPC-ZEBRA that uses a novel interferometric technique to measure piston error during the daytime with an uncertainty of 5 nm within a 30-microm range. Here we present the most representative results obtained during the testing stage and a detailed analysis of error sources. The main modifications to be introduced for the instrument's use as a phasing calibration system are also outlined.

Journal Article↗