Defining Meyer's loop-temporal lobe resections, visual field deficits and diffusion tensor tractography

Anterior temporal lobe resection is often complicated by superior quadrantic visual field deficits (VFDs). In some cases this can be severe enough to prohibit driving, even if a patient is free of seizures. These deficits are caused by damage to Meyer's loop of the optic radiation, which shows considerable heterogeneity in its anterior extent. This structure cannot be distinguished using clinical magnetic resonance imaging sequences. Diffusion tensor tractography is an advanced magnetic resonance imaging technique that enables the parcellation of white matter. Using seed voxels antero-lateral to the lateral geniculate nucleus, we applied this technique to 20 control subjects, and 21 postoperative patients. All patients had visual fields assessed with Goldmann perimetry at least three months after surgery. We measured the distance from the tip of Meyer's loop to the temporal pole and horn in all subjects. In addition, we measured the size of temporal lobe resection using postoperative T1-weighted images, and quantified VFDs. Nine patients suffered VFDs ranging from 22% to 87% of the contralateral superior quadrant. In patients, the range of distance from the tip of Meyer's loop to the temporal pole was 24–43 mm (mean 34 mm), and the range of distance from the tip of Meyer's loop to the temporal horn was –15 to +9 mm (mean 0 mm). In controls the range of distance from the tip of Meyer's loop to the temporal pole was 24–47 mm (mean 35 mm), and the range of distance from the tip of Meyer's loop to the temporal horn was –11 to +9 mm (mean 0 mm). Both quantitative and qualitative results were in accord with recent dissections of cadaveric brains, and analysis of postoperative VFDs and resection volumes. By applying a linear regression analysis we showed that both distance from the tip of Meyer's loop to the temporal pole and the size of resection were significant predictors of the postoperative VFDs. We conclude that there is considerable variation in the anterior extent of Meyer's loop. In view of this, diffusion tensor tractography of the optic radiation is a potentially useful method to assess an individual patient's risk of postoperative VFDs following anterior temporal lobe resection

Two Large HI Shells in the Outer Galaxy near l=279 degrees

As part of a survey of HI 21-cm emission in the Southern Milky Way, we have detected two large shells in the interstellar neutral hydrogen near l=279 deg. The center velocities are +36 and +59 km/s, which puts the shells at kinematic distances of 7 and 10 kpc. The larger shell is about 610 pc in diameter and very empty, with density contrast of at least 15 between the middle and the shell walls. It has expansion velocity of about 20 km/s and swept up mass of several million solar masses. The energy indicated by the expansion may be as high as 2.4 X 10^53 ergs. We estimate its age to be 15 to 20 million years. The smaller shell has diameter of about 400 pc, expansion velocity about 10 km/s and swept up mass of about 10^6 solar masses. Morphologically both regions appear to be shells, with high density regions mostly surrounding the voids, although the first appears to have channels of low density which connect with the halo above and below the HI layer. They lie on the edge of the Carina arm, which suggests that they may be expanding horizontally into the interarm region as well as vertically out of the disk. If this interpretation is correct, this is the first detection of an HI chimney which has blown out of both sides of the disk.Comment: 21 pages, 14 jpeg figures, accepted for publication in A

A determination of the Spectra of Galactic components observed by WMAP

WMAP data when combined with ancillary data on free-free, synchrotron and dust allow an improved understanding of the spectrum of emission from each of these components. Here we examine the sky variation at intermediate latitudes using a cross-correlation technique. In particular, we compare the observed emission in 15 selected sky regions to three ``standard'' templates. The free-free emission of the diffuse ionised gas is fitted by a well-known spectrum at K and Ka band, but the derived emissivity corresponds to a mean electron temperature of ~4000-5000K. This is inconsistent with estimates from galactic HII regions. The origin of the discrepancy is unclear. The anomalous emission associated with dust is clearly detected in most of the 15 fields studied; it correlates well with the Finkbeiner et al. model 8 predictions (FDS8) at 94 GHz, with an effective spectral index between 20 and 60GHz of -2.85. Furthermore, the emissivity varies by a factor of ~2 from cloud to cloud. A modestly improved fit to the anomalous dust at K-band is provided by modulating the template by an estimate of the dust colour temperature, specifically FDS8*T^n. We find a preferred value n~1.6. The synchrotron emission steepens between GHz frequencies and the WMAP bands. There are indications of spectral index variations across the sky but the current data are not precise enough to accurately quantify this from region to region. Our analysis of the WMAP data indicates strongly that the dust-correlated emission at the low WMAP frequencies has a spectrum which is compatible with spinning dust; we find no evidence for a synchrotron component correlated with dust (abridged).Comment: 18 pages, 6 figures, revised version uses cross-correlation method rather than T-T method. Paper re-organised and sent back to refere

The Relation Between the Surface Brightness and the Diameter for Galactic Supernova Remnants

In this work, we have constructed a relation between the surface brightness ($\Sigma$) and diameter (D) of Galactic C- and S-type supernova remnants (SNRs). In order to calibrate the $\Sigma$-D dependence, we have carefully examined some intrinsic (e.g. explosion energy) and extrinsic (e.g. density of the ambient medium) properties of the remnants and, taking into account also the distance values given in the literature, we have adopted distances for some of the SNRs which have relatively more reliable distance values. These calibrator SNRs are all C- and S-type SNRs, i.e. F-type SNRs (and S-type SNR Cas A which has an exceptionally high surface brightness) are excluded. The Sigma-D relation has 2 slopes with a turning point at D=36.5 pc: $\Sigma$(at 1 GHz)=8.4$^{+19.5}_{-6.3}$$\times10^{-12}$ D$^{{-5.99}^{+0.38}_{-0.33}}$ Wm$^{-2}$Hz$^{-1}$ster$^{-1}$ (for $\Sigma$$\le3.7\times10^{-21}$ Wm$^{-2}$Hz$^{-1}$ster$^{-1}$ and D$\ge$36.5 pc) and $\Sigma$(at 1 GHz)=2.7$^{+2.1}_{-1.4}$$\times$ 10$^{-17}$ D$^{{-2.47}^{+0.20}_{-0.16}}$ Wm$^{-2}$Hz$^{-1}$ster$^{-1}$ (for $\Sigma$$>3.7\times10^{-21}$ Wm$^{-2}$Hz$^{-1}$ster$^{-1}$ and D$<$36.5 pc). We discussed the theoretical basis for the $\Sigma$-D dependence and particularly the reasons for the change in slope of the relation were stated. Added to this, we have shown the dependence between the radio luminosity and the diameter which seems to have a slope close to zero up to about D=36.5 pc. We have also adopted distance and diameter values for all of the observed Galactic SNRs by examining all the available distance values presented in the literature together with the distances found from our $\Sigma$-D relation.Comment: 45 pages, 2 figures, accepted for publication in Astronomical and Astrophysical Transaction

Feedback from winds and supernovae in massive stellar clusters - II. X-ray emission

The X-ray emission from a simulated massive stellar cluster is investigated. The emission is calculated from a 3D hydrodynamical model which incorporates the mechanical feedback from the stellar winds of three O stars embedded in a giant molecular cloud (GMC) clump containing 3240M of molecular material within a 4 pc radius. A simple prescription for the evolution of the stars is used, with the first supernova (SN) explosion at t = 4.4Myr. We find that the presence of the GMC clump causes short-lived attenuation effects on the X-ray emission of the cluster. However, once most of the material has been ablated away by the winds, the remaining dense clumps do not have a noticeable effect on the attenuation compared with the assumed interstellar medium (ISM) column. We determine the evolution of the cluster X-ray luminosity, LX, and spectra, and generate synthetic images. The intrinsic X-ray luminosity drops from nearly 1034 erg s-1 while the winds are 'bottled up', to a nearconstant value of 1.7 × 1032 erg s-1 between t = 1 and 4Myr. LX reduces slightly during each star's red supergiant stage due to the depressurization of the hot gas. However, LX increases to 1034 erg s-1 during each star's Wolf-Rayet stage. The X-ray luminosity is enhanced by two to three orders of magnitude to ̃1037 erg s-1 for at least 4600 yr after each SN explosion, at which time the blastwave leaves the grid and theX-ray luminosity drops. The X-ray luminosity of our simulation is generally considerably fainter than predicted from spherically symmetric bubble models, due to the leakage of hot gas material through gaps in the outer shell. This process reduces the pressure within our simulation and thus the X-ray emission. However, the X-ray luminosities and temperatures which we obtain are comparable to similarly powerful massive young clusters

Imaging memory in temporal lobe epilepsy: predicting the effects of temporal lobe resection

Functional magnetic resonance imaging can demonstrate the functional anatomy of cognitive processes. In patients with refractory temporal lobe epilepsy, evaluation of preoperative verbal and visual memory function is important as anterior temporal lobe resections may result in material specific memory impairment, typically verbal memory decline following left and visual memory decline after right anterior temporal lobe resection. This study aimed to investigate reorganization of memory functions in temporal lobe epilepsy and to determine whether preoperative memory functional magnetic resonance imaging may predict memory changes following anterior temporal lobe resection. We studied 72 patients with unilateral medial temporal lobe epilepsy (41 left) and 20 healthy controls. A functional magnetic resonance imaging memory encoding paradigm for pictures, words and faces was used testing verbal and visual memory in a single scanning session on a 3T magnetic resonance imaging scanner. Fifty-four patients subsequently underwent left (29) or right (25) anterior temporal lobe resection. Verbal and design learning were assessed before and 4 months after surgery. Event-related functional magnetic resonance imaging analysis revealed that in left temporal lobe epilepsy, greater left hippocampal activation for word encoding correlated with better verbal memory. In right temporal lobe epilepsy, greater right hippocampal activation for face encoding correlated with better visual memory. In left temporal lobe epilepsy, greater left than right anterior hippocampal activation on word encoding correlated with greater verbal memory decline after left anterior temporal lobe resection, while greater left than right posterior hippocampal activation correlated with better postoperative verbal memory outcome. In right temporal lobe epilepsy, greater right than left anterior hippocampal functional magnetic resonance imaging activation on face encoding predicted greater visual memory decline after right anterior temporal lobe resection, while greater right than left posterior hippocampal activation correlated with better visual memory outcome. Stepwise linear regression identified asymmetry of activation for encoding words and faces in the ipsilateral anterior medial temporal lobe as strongest predictors for postoperative verbal and visual memory decline. Activation asymmetry, language lateralization and performance on preoperative neuropsychological tests predicted clinically significant verbal memory decline in all patients who underwent left anterior temporal lobe resection, but were less able to predict visual memory decline after right anterior temporal lobe resection. Preoperative memory functional magnetic resonance imaging was the strongest predictor of verbal and visual memory decline following anterior temporal lobe resection. Preoperatively, verbal and visual memory function utilized the damaged, ipsilateral hippocampus and also the contralateral hippocampus. Memory function in the ipsilateral posterior hippocampus may contribute to better preservation of memory after surgery

'MRI-negative PET-positive' temporal lobe epilepsy (TLE) and mesial TLE differ with quantitative MRI and PET: a case control study

Background: \u27MRI negative PET positive temporal lobe epilepsy\u27 represents a substantial minority of temporal lobe epilepsy (TLE). Clinicopathological and qualitative imaging differences from mesial temporal lobe epilepsy are reported. We aimed to compare TLE with hippocampal sclerosis (HS+ve) and non lesional TLE without HS (HS-ve) on MRI, with respect to quantitative FDG-PET and MRI measures.Methods: 30 consecutive HS-ve patients with well-lateralised EEG were compared with 30 age- and sex-matched HS+ve patients with well-lateralised EEG. Cerebral, cortical lobar and hippocampal volumetric and co-registered FDG-PET metabolic analyses were performed.Results: There was no difference in whole brain, cerebral or cerebral cortical volumes. Both groups showed marginally smaller cerebral volumes ipsilateral to epileptogenic side (HS-ve 0.99, p = 0.02, HS+ve 0.98, p &lt; 0.001). In HS+ve, the ratio of epileptogenic cerebrum to whole brain volume was less (p = 0.02); the ratio of epileptogenic cerebral cortex to whole brain in the HS+ve group approached significance (p = 0.06). Relative volume deficits were seen in HS+ve in insular and temporal lobes. Both groups showed marked ipsilateral hypometabolism (p &lt; 0.001), most marked in temporal cortex. Mean hypointensity was more marked in epileptogenic-to-contralateral hippocampus in HS+ve (ratio: 0.86 vs 0.95, p &lt; 0.001). The mean FDG-PET ratio of ipsilateral to contralateral cerebral cortex however was low in both groups (ratio: HS-ve 0.97, p &lt; 0.0001; HS+ve 0.98, p = 0.003), and more marked in HS-ve across all lobes except insula.Conclusion: Overall, HS+ve patients showed more hippocampal, but also marginally more ipsilateral cerebral and cerebrocortical atrophy, greater ipsilateral hippocampal hypometabolism but similar ipsilateral cerebral cortical hypometabolism, confirming structural and functional differences between these groups.<br /

First detection of optical light from SNR G279.0+1.1

This is the initial paper in a series presenting the first optical detections and subsequent follow-up spectroscopy of known Southern Galactic supernova remnants (SNRs) previously discovered in the radio. These new detections come from the AAO/UKST HAlpha survey of the Southern Galactic plane which has opened up fresh opportunities to study Galactic remnants. Here we present the first optical imaging and follow-up spectra of Galactic SNR G279.0+1.1 where a series of 14 small-scale fragmented groups of HAlpha filaments have been discovered in a ~2.3 deg. area centred on G279.0+1.1. Individually they are somewhat inconspicuous but collectively they are completely enclosed within the overall radio contours of this known SNR. Three of these filamentary groupings are particularly prominent and optical spectra have been obtained across two of them. Their morphological structure and spectral characteristics are typical of optically detected SNR filaments. Very strong [S II] emission relative to H has been detected with [S II]/HAlpha 0.7 and 1.1, confirming strong, shock heated emission. This is sufficient to classify these filaments in the likely SNR domain and therefore indicating a direct connection with the radio remnant. Other typical SNR emission lines such as [O II] at 3727A, HBeta, [O III] at 4959 and 5007A, HAlpha and [N II] at 6548 and 6584A were also detected, lending strong support to an SNR origin of these optical filaments. The value and insights that these optical data can provide for known remnants are discussed along with their relevance to the Galactic nitrogen abundance. A serendipitous discovery of an adjacent H II region is also briefly described.Comment: 11 Pages. Accepted for publication in MNRA

Validity evidence and reliability of a simulated patient feedback instrument

Contains fulltext : 110154.pdf (publisher's version ) (Open Access)BACKGROUND: In the training of healthcare professionals, one of the advantages of communication training with simulated patients (SPs) is the SP's ability to provide direct feedback to students after a simulated clinical encounter. The quality of SP feedback must be monitored, especially because it is well known that feedback can have a profound effect on student performance. Due to the current lack of valid and reliable instruments to assess the quality of SP feedback, our study examined the validity and reliability of one potential instrument, the 'modified Quality of Simulated Patient Feedback Form' (mQSF). METHODS: Content validity of the mQSF was assessed by inviting experts in the area of simulated clinical encounters to rate the importance of the mQSF items. Moreover, generalizability theory was used to examine the reliability of the mQSF. Our data came from videotapes of clinical encounters between six simulated patients and six students and the ensuing feedback from the SPs to the students. Ten faculty members judged the SP feedback according to the items on the mQSF. Three weeks later, this procedure was repeated with the same faculty members and recordings. RESULTS: All but two items of the mQSF received importance ratings of > 2.5 on a four-point rating scale. A generalizability coefficient of 0.77 was established with two judges observing one encounter. CONCLUSIONS: The findings for content validity and reliability with two judges suggest that the mQSF is a valid and reliable instrument to assess the quality of feedback provided by simulated patients

New VLA observations of the SNR Puppis A: the radio properties and the correlatoin withe the X-ray emission

In this paper we report on a new study of the SNR Puppis A based on VLA observations at 1425 MHz; the improvement represents a factor of two in angular resolution and almost ten times in sensitivity compared to the best previous image of Puppis A. This new image is used to compare with re-processed 327 MHz data and ROSAT and Chandra images to investigate morphological and spectral characteristics.Comment: 14 pages, 9 figures, accepted for publication in A &