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ipsilateral motor evoked potentials in a patient with unihemispheric cortical atrophy due to Rasmussen encephalitis

Neural Regeneration Research 2019年第6期14卷 1025-1028页

作者： Raffaele Nardone Patrick B.Langthaler Andrea Orioli Viviana Versace Giuditta Ilaria Scarano Francesco Brigo Leopold Saltuari Luca Carnicelli Eugen Trinka Luca Sebastianelli Department of Neurology Franz Tappeiner HospitalMeranoItaly Department of Neurology Hochzirl HospitalZirlAustria Centre for Cognitive Neurosciences Salzburg SalzburgAustria University for Medical Informatics and Health Technology UMITHall in TirolAustria Department of Neurology Christian Doppler KlinikParacelsus Medical UniversitySalzburgAustria Spinal Cord Injury and Tissue Regeneration Center SalzburgAustria Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie SalzburgAustria Department of Mathematics Paris Lodron University of SalzburgAustria Department of Neurorehabilitation Hospital of VipitenoVipitenoItaly Research Unit for Neurorehabilitation South Tyrol BolzanoItaly Department of Psychology Franz Tappeiner HospitalMeranoItaly Department of Neuroscience Biomedicine and Movement ScienceUniversity of VeronaVeronaItaly

The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male patient with acquired unilateral hemispheric atrophy due to Rasmussen encephalitis. In particular,the ipsilateral corticospinal pathways were explored using focal transcranial magnetic stimulation. In the first dorsal interosseous and wrist extensors muscles, the median amplitudes of the ipsilateral motor evoked potentials induced by transcranial magnetic stimulation in the patient were higher than those of 10 age-matched healthy control subjects. In the biceps brachii muscle, the median amplitudes of the ipsilateral motor evoked potentials were the second largest in the patient compared to the controls. This study demonstrated a reinforcement of ipsilateral motor projections from the unaffected motor cortex to the hemiparetic hand in a subject with acquired unihemispheric cortical damage.

关键词： transcranial magnetic stimulation motor cortex ipsilateral motor evoked potentials ipsilateral motor pathways Rasmussen encephalitis cortical atrophy hemispheric damage

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ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?

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Chinese Journal of Traumatology 2019年第1期22卷 59-62页

作者： Nur Azuatul Akma Kamaludin Nur Azree Ferdaus Kamudin Shalimar Abdullah Jamari Sapuan Department of Orthopaedics & Traumatology Universiti Kebangsaan Malaysia Cheras Kuala Lumpur Malaysia Faculty of Medicine Universiti Sultan Zainal Abidin Kuala Terengganu Terengganu Malaysia

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an an atomical lock ing plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.

关键词： Simultaneous ipsilateral fractures Radius fractures Irreducible elbow dislocation Radial head Radial head arthroplasty

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Hemichorea due to ipsilateral thalamic infarction: A case report

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World Journal of Clinical Cases 2021年第19期9卷 5287-5293页

作者： Zhao-Sheng Li Jia-Jia Fang Xiao-Hui Xiang Guo-Hua Zhao Department of Neurology The Fourth Affiliated HospitalZhejiang University School of MedicineYiwu 322000Zhejiang ProvinceChina

BACKGROUND Hemichorea usually results from vascular lesions of the basal ganglia.Most often,the lesion is contralateral to the affected limb but rarely,it may be ipsilateral.The pathophysiology of ipsilateral hemichorea is still poorly understood.We review the literature on hemichorea due to ipsilateral cerebral infarction and explore possible mechanisms for its occurrence.CASE SUMMARY A 72-year-old woman presented with complaints of involuntary movements of the muscles of the left side of the face and mild weakness of the right limbs.Her symptoms had started suddenly 1 d earlier.After admission to the hospital,the involuntary movements spread to involve the left limbs also.Magnetic resonance imaging revealed a left thalamic infarction.The patient’s hemichorea subsided after treatment with haloperidol(2 mg per time,3 times/d)for 3 d;the hemiparesis resolved with rehabilitation physiotherapy.She is presently symptom free and on treatment for prevention of secondary stroke.We review the literature on the occurrence of ipsilateral hemichorea following thalamic infarction and discuss the possible pathomechanisms of this unusual presentation.CONCLUSION ipsilateral hemichorea following a thalamic stroke is rare but it can be explained by structure of the extrapyramidal system.The thalamus is a relay station that exerts a bilateral control of motor function.

关键词： ipsilateral Hemichorea Thalamic infarction Hemiparesis Stroke Case report

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Performance and Implementations of Vibrotactile Brain-Computer Interface with ipsilateral and Bilateral Stimuli

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Journal of Donghua University(English Edition) 2018年第6期35卷 439-445页

作者：孙红艳金晶张宇王蓓王行愚 Key Laboratory of Advanced Control and Optmization for Chemical Processes East China University of Science and Technology

The tactile P300 brain-computer interface( BCI) is related to the somatosensory perception and response of the human brain,and is different from visual or audio BCIs. Recently,several studies focused on the tactile stimuli delivered to different parts of the human body. Most of these stimuli were symmetrically bilateral.Only a fewstudies explored the influence of tactile stimuli laterality.In the current study,we extensively tested the performance of a vibrotactile BCI system using ipsilateral stimuli and bilateral stimuli.Two vibrotactile P300-based paradigms were tested. The target stimuli were located on the left and right forearms for the left forearm and right forearm( LFRF) paradigm,and on the left forearm and calf for the left forearm and left calf( LFLC)paradigm. Ten healthy subjects participated in this study. Our experiments and analysis showed that the bilateral paradigm( LFRF) elicited larger P300 amplitude and achieved significantly higher classification accuracy than the ipsilateral paradigm( LFLC). However, both paradigms achieved classification accuracies higher than 70% after the completion of several trials on average,which was usually regarded as the minimum accuracy level required for BCI system to be deemed useful.

关键词： brain-computer interface (BCI) tactile P300 ipsilateral stimuli bilateral stimuli paradigm left forearm right forearm left calf

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Paired associated magnetic stimulation promotes neural repair in the rat middle cerebral artery occlusion model of stroke

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Neural Regeneration Research 2020年第11期15卷 2047-2056页

作者： Bei-Yao Gao Cheng-Cheng Sun Guo-Hua Xia Shao-Ting Zhou Ye Zhang Ye-Ran Mao Pei-Le Liu Ya Zheng Dan Zhao Xu-Tong Li Janie Xu Dong-Sheng Xu Yu-Long Bai Department of Rehabilitation Medicine Huashan HospitalFudan UniversityShanghaiChina Rehabilitation Section Department of Spine SurgeryTongji HospitalMedical School of Tongji UniversityShanghaiChina Department of Psychiatry and Behavioral Sciences University of CaliforniaDavisCAUSA Department of Neurology Minhang Hospital Affiliated to Fudan UniversityShanghaiChina Brownell Talbot School OmahaNEUSA

Paired associative stimulation has been used in stroke patients as an innovative recovery treatment.However,the mechanisms underlying the therapeutic effectiveness of paired associative stimulation on neurological function remain unclear.In this study,rats were randomly divided into middle cerebral occlusion model(MCAO)and paired associated magnetic stimulation(PAMS)groups.The MCAO rat model was produced by middle cerebral artery embolization.The PAMS group received PAMS on days 3 to 20 post MCAO.The MCAO group received sham stimulation,three times every week.Within 18 days after ischemia,rats were subjected to behavioral experiments—the foot-fault test,the balance beam walking test,and the ladder walking test.Balance ability was improved on days 15 and 17,and the footfault rate was less in their affected limb on day 15 in the PAMS group compared with the MCAO group.Western blot assay showed that the expression levels of brain derived neurotrophic factor,glutamate receptor 2/3,postsynaptic density protein 95 and synapsin-1 were significantly increased in the PAMS group compared with the MCAO group in the ipsilateral sensorimotor cortex on day 21.Resting-state functional magnetic resonance imaging revealed that regional brain activities in the sensorimotor cortex were increased in the ipsilateral hemisphere,but decreased in the contralateral hemisphere on day 20.By finite element simulation,the electric field distribution showed a higher intensity,of approximately 0.4 A/m^2,in the ischemic cortex compared with the contralateral cortex in the template.Together,our findings show that PAMS upregulates neuroplasticity-related proteins,increases regional brain activity,and promotes functional recovery in the affected sensorimotor cortex in the rat MCAO model.The experiments were approved by the Institutional Animal Care and Use Committee of Fudan University,China(approval No.201802173 S)on March 3,2018.

关键词： brain-derived neurotrophic factor finite element simulation glutamate receptor ipsilateral hemisphere paired associative stimulation PSD95 resting-state functional MRI stroke synapsin I transcranial magnetic stimulation

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A meta-analysis of the prognosis in patients with breast cancer with ipsilateral supraclavicular lymph node metastasis versus patients with stage Ⅲb/c or Ⅳ breast cancer

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Chronic Diseases and Translational Medicine 2015年第4期1卷 -页

作者： Xu-Hong Liu Lei Zhang Bo Chen Department of Breast Surgery the First Hospital of China Medical University Shenyang Liaoning 110001 China

OBJECTIVE:To systematically evaluate the prognosis in patients with breast cancer with ipsilateral supraclavicular lymph node metastasis (SLNM) versus patients with stage IIIb/c or IV breast cancer, so as to provide evidence for clinical practice and research.;METHODS:Computer retrieval from PubMed, Cochrane Libratory, CNKI (China National Knowledge Infrastructure), CBM and Wanfang Database with the assistance of other retrieval tools. All the studies evaluating the prognosis in patients with breast cancer with ipsilateral supraclavicular lymph node metastasis versus patients with stage IIIb/c or IV breast cancer were collected. Quality assessment was performed for the included data based on the quality assessment criteria appropriate for this study. Meta-analysis was performed using RevMan 5.3 software.;RESULTS:A total of four references (1277 patients) were included. Assessment of influences on prognosis: As compared to the stage IIIb/c group, the 5-year survival rate was slightly lower in the SLNM group (relative risk () 0.79; 95% confidence interval () 0.59-1.06; = 1.55, = 0.12), but there was no statistical significance; in contrast, the 5-year survival rate was significantly increased in the SLNM group as compared to the stage IV group ( = 2.70; 95%: 1.36-5.37; = 2.84, = 0.005). As compared to the stage IIIb/c group, the 5-year disease-free survival rate was lower in the SLNM group ( = 0.65; 95%: 0.40-1.05; = 1.75, = 0.08); however, there was no statistical significance.;CONCLUSIONS:In patients with advanced breast cancer receiving combined therapy, the prognosis in patients with breast cancer with ipsilateral SLNM was significantly better than in those with stage IV breast cancer, and slightly worse than those with stage IIIb/c breast cancer. However, with the scarcity and poor quality of these observational studies, the long-term prognosis remains to be further verified in large-sample, high-quality studies.

关键词： Breast cancer ipsilateral Meta-analysis Supraclavicular lymph node metastasis

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Comparison of breast reconstruction using ipsilateral and contralateral pedicle transverse rectus abdominis musculocutaneous flaps

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Plastic and Aesthetic Research 2017年第9期4卷 155-160页

作者： Ramesh Omranipour Sima Mashayekhi Mahtab Vasigh Sadaf Alipour Habibollah Mahmoodzadeh Cancer Institute Tehran University of Medical SciencesImam Khomeini HospitalTehran 13145-158Iran.

Aim: Breast reconstruction has several beneficial effects on psychosocial well-being and quality of life. The ultimate goal has always been to create the most natural breast mound. Thus in many centers, the unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains the most common technique for breast reconstruction. Our objective was to retrospectively compare the outcomes of ipsilateral and contralateral pedicle TRAM flaps. Methods: The total of 110 patients underwent unilateral breast reconstruction with pedicle TRAM flap at Cancer Institute of Tehran University of Medical Science from January 1996 to June 2011. Premorbid risk factors, postoperative outcomes and demographic data were assessed. The analysis of the recordings was done by SPSS 20. Results: Out of 110 patients who were included in the study, 87 had ipsilateral and 23 contralateral pedicle TRAM flaps. The incidence of flap complications that did not require surgical intervention was 19.7% in ipsilateral and 30.4% in contralateral pedicle TRAM flap. The incidence of flap loss requiring revision was significantly higher in contralateral group (P = 0.001). Major complications were noted in 11.5% of the ipsilateral pedicle TRAM patients and 26.1% of the contralateral group (P ipsilateral pedicle TRAM patients and in 34.8% of the contralateral group (P ipsilateral pedicle TRAM patients (39.1% vs. 19.5%, P = 0.001). The type of pedicled TRAM flap (ipsilateral vs. contralateral), had significant effect on complications (odds ratio = 0.007, P = 0.002) while other variables had no significant effect on the incidence of complications. Conclusion: This study indicates that the overall outcome and mid-term morbidity-free survivals of ipsilateral pedicle TRAM flap breast re

关键词： Breast reconstruction transvers rectus abdominis musculocutaneous flap unilateral pedicle TRAM flap ipsilateral pedicle TRAM flap

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Transient ipsilateral Lower Limb Paresis after Interscalene Brachial Plexus Block

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Case Reports in Clinical Medicine 2014年第3期3卷 157-160页

作者： O. H. Idehen F. E. Amadasun Department of Anaesthesia University of Benin Teaching Hospital Benin City Nigeria

We describe a partial motor block of ipsilateral lower limb after interscalene block with the injection of 40 ml of 0.5% bupivacaine and 2% lignocaine with adrenaline. Immediately after the block, patient reported a right motor hemi syndrome which was transient. We concluded that the neurological symptom was caused by the technique of interscalene brachial plexus block may be as a result of excessive lateral deviation of the neck with a compromised collateral circulation.

关键词： Interscalene Block Transient ipsilateral Lower Limb Paresis

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Role of Radiotherapy-Induced Malignancies in Patients with Both Breast and Lung Cancer Diagnoses

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Advances in Breast Cancer Research 2018年第3期7卷 231-242页

作者： Eric Khang Nguyen Garth Andrew Nicholas Xinni Song Department of Radiation Oncology Juravinski Cancer Centre Hamilton Canada Department of Internal Medicine Division of Medical Oncology The Ottawa Hospital Regional Cancer Centre Ottawa Canada

Background:Breast and lung cancer are two of the most commonly diagnosed cancers in North America. While patients are living longer with advances in treatment and supportive care, some patients are being diagnosed with a second malignancy. The primary objective in this study was to assess the correlation between the development of an ipsilateral lung cancer or breast cancer, and prior radiation therapy. In addition, we sought to report the survival outcomes of patients in these clinical scenarios. Methods: We conducted a single institution (the Ottawa Hospital Cancer Centre) retrospective review of patients with the diagnoses of both breast and lung cancer treated between 1995 and 2013. Patients were included if they received radiation for a breast primary, and subsequently developed an ipsilateral lung primary, or vice-versa. Data included patient demographics, lifestyle factors, tumor location and subtype, cancer stages, treatment modalities, and survival outcomes. Results: Of 252 patients included in the study, 217 patients developed a breast primary first, with 35 patients developing a lung primary first. Median disease-free survival from the second primary diagnosis was 36 months in breast primary first patients, and 59 months in the lung primary first cohort. There was no significant correlation between the laterality of radiation treatment and side of second primary based on Fisher’s exact test. Conclusions: Our data reveal no association between side of radiation treatment and subsequent cancer development. The benefits of radiotherapy outweigh the risk of radiation-induced primaries. Longer term studies with matched patient cohorts are required to further assess treatment and lifestyle factors that may contribute towards the development of second malignancies.

关键词： Breast Lung Cancer Radiotherapy-Induced ipsilateral

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Homolateral Combined Fracture of Monteggia and Galeazzi. Case Report and Review of the Literature

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Open Journal of Orthopedics 2019年第3期9卷 61-65页

作者： Marius Monka Kevin Bouhelo-Pam Ohoya Etsaka Terence Olivier Albert Ngatsé-Oko Armand Moyikoua Department of Trauma-Orthopedics CHU-Brazzaville Teaching Hospital Brazzaville Congo

Introduction: Homolateral combined fractures of Monteggia and Galeazzi are very rare. Their treatment is exclusively surgical and should be proposed early in order to restore the anatomy of the antebrachial skeleton, pronosupination, and the flexion-extension of the elbow and wrist. Observation: We reported the case of a 45-year-old woman who presented a homolateral fracture of Monteggia and Galeazzi following a road accident. This combination of fractures posed a problem of diagnosis and management. Surgical follow-up presented functional issues. Conclusion: The association of Monteggia and Galeazzi fracture is very rare and poorly reported in the literature. This observation reminds us of the importance of performing a complete clinical and paraclinical assessment before any therapeutic decision.

关键词： ipsilateral Fracture Monteggia Galeazzi

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