Early Globus Pallidus Internus Stimulation in Pediatric Patients With Generalized Primary Dystonia: Long-Term Efficacy and Safety

Primary generalized dystonia presents mainly at a young age and commonly is severely disabling. The authors report the long-term follow-up (mean, 73 months; range, 50-101 months) of 5 pediatric patients (mean age at surgery 13 years; range, 8-16 years) undergoing globus pallidus internus deep brain stimulation. Mean improvement in the Burke-Fahn-Marsden movement score was 67.4% (range, 47.0%-87.5%), 75.4% (range, 61.5%-91.7%), and 83.5% (range, 72.0%-93.3%) at 3 months, 12 months, and long-term follow-up (>36 months), respectively. Hardware problems (electrode dislocation/breakage of extension cable, and imminent perforation of extension cable) were observed in 2 patients (operative revision without sequelae). Except for mild dysarthria in 2 patients, no other therapy-related morbidity was observed. The authors found globus pallidus internus stimulation to offer a very effective and safe therapy in pediatric patients with primary dystonia. Early neurosurgical intervention seems to be crucial to prevent irreversible impairment of motor function

The Metallicity Dependence of the Fourier Components of RR Lyrae Light Curves is the Oosterhoff/Arp/Preston Period Ratio Effect in Disguise

The correlation of particular Fourier components of the light curves of RR Lyrae variables with metallicity, discovered by Simon and later by Kovacs and his coworkers, is shown to have the same explanation as the period ratios (period shifts in log P) between RRab Lyrae variables that have the same colors, amplitudes, and light-curve shapes but different metallicities. A purpose of this paper is to demonstrate that the model which predicts the period-metallicity relations is the mediating parameters of colors, amplitudes, and light-curve shapes also explains the Simon/Kovacs et al. correlation between period, Phi_31, and metallicity. The proof is made by demonstrating that the combination of the first and third phase terms in a Fourier decomposition of RRab light curves, called Phi_31 by Simon and Lee, varies monotonically across the RR Lyrae instability strip in the same way that amplitude, color, and rise time vary with period within the strip. The premise of the model is that if horizontal branches at the RR Lyrae strip are stacked in luminosity according to the metallicity, then there necessarily must be a log period shift between RR Lyraes with different metallicities at the same Phi_31 values. However, there are exceptions to the model. (...)Comment: 17 pages, 8 figures, 1 table. Accepted for publication in The A

Period-colour and amplitude-colour relations in classical Cepheid variables IV: The multi-phase relations

The superb phase resolution and quality of the OGLE data on LMC and SMC Cepheids, together with existing data on Galactic Cepheids, are combined to study the period-colour (PC) and amplitude-colour (AC) relations as a function of pulsation phase. Our results confirm earlier work that the LMC PC relation (at mean light) is more consistent with two lines of differing slopes, separated at a period of 10 days. However, our multi-phase PC relations reveal much new structure which can potentially increase our understanding of Cepheid variables. These multi-phase PC relations provide insight into why the Galactic PC relation is linear but the LMC PC relation is non-linear. This is because the LMC PC relation is shallower for short (log P < 1) and steeper for long (log P > 1) period Cepheids than the corresponding Galactic PC relation. Both of the short and long period Cepheids in all three galaxies exhibit the steepest and shallowest slopes at phases around 0.75-0.85, respectively. A consequence is that the PC relation at phase ~0.8 is highly non-linear. Further, the Galactic and LMC Cepheids with log P > 1 display a flat slope in the PC plane at phases close to the maximum light. When the LMC period-luminosity (PL) relation is studied as a function of phase, we confirm that it changes with the PC relation. The LMC PL relation in V- and I-band near the phase of 0.8 provides compelling evidence that this relation is also consistent with two lines of differing slopes joined at a period close to 10 days.Comment: 12 pages, 1 table and 13 figures, MNRAS accepte

Intracranial hypotension following traumatic brain injury: a diagnostic and therapeutic challenge.

BACKGROUND: Intracranial hypotension (IH) is a recognised cause of coma, however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury (TBI). CASE REPORT: We report a case of a 67-year-old patient who became comatose following evacuation of bilateral acute subdural haematomas with concurrent respiratory failure. Imaging and intraparenchymal intracranial pressure (ICP) monitoring confirmed secondary IH. She was managed with an epidural blood patch, and a 72 hours period in the trendelenberg position guided by ICP monitoring and clinical assessment. She subsequently made an excellent neurological recovery from an initial Glasgow coma scale (GCS) of 3 to a GCS of 15. CONCLUSION: A diagnosis of secondary IH can easily be missed in patients who have suffered a primary brain injury. In patients with a poor neurological recovery, clinicians should rule out secondary IH as a potential cause as immediate treatment can lead to a profound clinical improvement

Period-color and amplitude-color relations in classical Cepheid variables III: The Large Magellanic Cloud Cepheid models

Period-colour (PC) and amplitude-colour (AC) relations are studied for the Large Magellanic Cloud (LMC) Cepheids under the theoretical framework of the hydrogen ionization front (HIF) - photosphere interaction. LMC models are constructed with pulsation codes that include turbulent convection, and the properties of these models are studied at maximum, mean and minimum light. As with Galactic models, at maximum light the photosphere is located next to the HIF for the LMC models. However very different behavior is found at minimum light. The long period (P>10days) LMC models imply that the photosphere is disengaged from the HIF at minimum light, similar to the Galactic models, but there are some indications that the photosphere is located near the HIF for the short period (P<10 days) LMC models. We also use the updated LMC data to derive empirical PC and AC relations at these phases. Our numerical models are broadly consistent with our theory and the observed data, though we discuss some caveats in the paper. We apply the idea of the HIF-photosphere interaction to explain recent suggestions that the LMC period-luminosity (PL) and PC relations are non-linear with a break at a period close to 10 days. Our empirical PC and PL relations are also found to be non-linear with the F-test. Our explanation relies on the properties of the Saha ionization equation, the HIF-photosphere interaction and the way this interaction changes with the phase of pulsation and metallicity to produce the observed changes in the Cepheid PC and PL relations.Comment: 19 pages, 6 tables and 18 figures, MNRAS accepte

The Cepheid Period-Luminosity Relation at Mid-Infrared Wavelengths: II. Second-Epoch LMC Data

We present revised and improved mid-infrared Period-Luminosity (PL) relations for Large Magellanic Cloud (LMC) Cepheids based on double-epoch data of 70 Cepheids observed by Spitzer at 3.6, 4.5, 5.8 and 8.0um. The observed scatter at all wavelengths is found to decrease from +/-0.17 mag to +/-0.14 mag, which is fully consistent with the prediction that the total scatter is made up of roughly equal contributions from random sampling of the light curve and nearly-uniform samplings of stars across the instability strip. It is calculated that the Cepheids in this sample have a full amplitude of about 0.4 mag and that their fully-sampled, time-averaged magnitudes should eventually reveal mid-infrared PL relations that each have intrinsic scatter at most at the +/-0.12 mag level, and as low as +/-0.08 mag after correcting for the tilt of the LMC.Comment: 7 pages, 6 figures, 1 data tabl

On the use of Principal Component Analysis in analysing Cepheid light curves

We show how Principal Component Analysis can be used to analyse the structure of Cepheid light curves. This method is more efficient than Fourier analysis at bringing out changes in light curve shape as a function of period. Using this technique, we study the shape of fundamental and first overtone mode Cepheid light curves in the Galaxy, LMC and SMC over a wide period range. For fundamentals, we find evidence for structural changes at $\log P \approx 1.55, 2.1$. It is suggested that the feature at $\log P \approx 2.1$ is associated with a resonance in the Cepheid normal mode spectrum. For overtones, we recover the Z shape in the $R_{21}$ period plane and reproduce the metallicity dependence of this Z shape.Comment: Accepted for publication in MNRA

The Period Changes of the Cepheid RT Aurigae

Observations of the light curve for the 3.7-day Cepheid RT Aur both before and since 1980 indicate that the variable is undergoing an overall period increase, amounting to +0.082 +-0.012 s/yr, rather than a period decrease, as implied by all observations prior to 1980. Superposed on the star's O-C variations is a sinusoidal trend that cannot be attributed to random fluctuations in pulsation period. Rather, it appears to arise from light travel time effects in a binary system. The derived orbital period for the system is P = 26,429 +-89 days (72.36 +-0.24 years). The inferred orbital parameters from the O-C residuals differ from those indicated by existing radial velocity data. The latter imply the most reasonable results, namely a1 sin i = 9.09 (+-1.81) x 10^8 km and a minimum secondary mass of M2 = 1.15 +-0.25 Msun. Continued monitoring of the brightness and radial velocity changes in the Cepheid are necessary to confirm the long-term trend and to provide data for a proper spectroscopic solution to the orbit.Comment: Accepted for publication in PASP (November 2007

Period-color and amplitude-color relations in classical Cepheid variables

In this paper we analyze the behavior of Galactic, LMC and SMC Cepheids in terms of period-color (PC) and amplitude-color (AC) diagrams at the phases of maximum, mean and minimum light. We find very different behavior between Galactic and Magellanic Cloud Cepheids. Motivated by the recent report of a break in LMC PC relations at 10 days (Tammann et al. 2002), we use the F-statistical test to examine the PC relations at mean light in these three galaxies. The results of the F-test support the existence of the a break in the LMC PC(mean) relation, but not in the Galactic or SMC PC(mean) relations. Furthermore, the LMC Cepheids also show a break at minimum light, which is not seen in the Galactic and SMC Cepheids. We further discuss the effect on the period-luminosity relations in the LMC due to the break in the PC(mean) relation.Comment: 10 pages, 5 figures and 5 tables. MNRAS accepte