Intraoperative electrocorticography and successful focus resection in a case of Sturge-Weber syndrome

This paper reports a surgically treated case of Sturge-Weber syndrome (SWS) in which the epileptic foci and haemangiomatosis were successfully resected under monitoring of intraoperative electrocorticography. The patient was a 19-month-old female infant who was referred to our hospital because of frequent hemi-tonic-clonic convulsions that were resistant to anticonvulsant therapy. Serial MRI showed progressive atrophy in the left fronto-parieto-temporal lobe, and gyral enhancement by gadolinium corresponded to venous haemangiomatosis of SWS. Three-dimensional reconstruction of the MR images was performed using the Viewing Wand System. Conventional EEG taken before the operation showed slow activity in the left frontal lobe. Intraoperative ECoG revealed spike focus at the posterior temporal cortex to the margin of the haemangiomatosis. Lesionectomy with lobar corticectomy of the total frontal and parietal lobe and part of the temporal lobe was performed. The epileptogenic focus detected by ECoG in the posterior temporal lobe was also resected. In post-excisional ECoG, epileptogenic activities had disappeared. The patient had hemiparesis and hemihypesthesia just after the surgery, but gradually recovered from the paresis and almost has normal motor function except for right-hand clumsiness up to 1 year after surgery. The present study demonstrated that lobar corticectomy of the haemangiomatosis-affected cortex with resection of the neighbouring epileptogenic focus is a good surgical alternative even if a haemangiomatosis of the SWS affected multilobar corti of the hemisphere

Comparison of scapular upward rotation during arm elevation in the scapular plane in healthy volunteers and patients with rotator cuff tears pre- and post-surgery.

[Background] Function loss caused by rotator cuff tears alters the scapular orientation, however, few prior studies have reported on scapular movements after rotator cuff repair. The purpose was to determine the scapular orientations before and after rotator cuff repair. [Methods] We recruited 14 healthy controls, 10 small and six massive rotator cuff tear in patients. The scapular upward rotation during arm elevation was analyzed using fluoroscopic imaging. [Findings] Before surgery, both rotator cuff groups demonstrated greater scapular upward rotation compared to healthy controls. Two months postoperation, the analyses showed significant differences between the patients with small rotator cuff tears and healthy controls at arm elevations of 90°, and between patients with both rotator cuff tear groups and healthy controls at arm elevations of 120°. At five months post-operation, significant differences still existed between the healthy controls and both rotator cuff groups. In regard to the temporal effects in the patients with small rotator cuff tears, the scapular upward rotation decreased significantly over time (2–5 months postoperation) at arm elevations of 120°. We did not identify a main effect owing to time in the patients with massive rotator cuff tears. [Interpretation] In patients with small rotator cuff tears, scapular upward rotation was reduced over the period of 2–5 months postoperation, however, the patients with massive rotator cuff tears showed greater scapular upward rotation throughout the experimental period. The results suggested that the execution of the rehabilitation program should consider that the tear size could affect scapular motion

Ferromagnetic amorphous oxides in the EuO-TiO[2] system studied by the Faraday effect in the visible region and the x-ray magnetic circular dichroism at the Eu M[4,5] and L[2,3] edges

Amorphous Eu[2]TiO[4] and EuTiO[3] have been studied by a combination of the Faraday effect in the visible region and polarization-dependent x-ray absorption spectroscopy at the Eu M[4, 5] and L[2, 3]edges to examine the role of Eu 4f-5d exchange interactions on the ferromagnetic behavior. The bulk-sensitive x-ray absorption spectra (XAS) for Eu L[2, 3] edges show that most of the europium ions are present as the divalent state in the amorphous Eu[2]TiO[4] and EuTiO[3]. The Eu M[4, 5] edge x-ray magnetic circular dichroism (XMCD) signals, measured for the amorphous Eu[2]TiO[4], dramatically increase upon cooling through the Curie temperature (16 K) determined by a superconducting quantum interference device (SQUID) magnetometer. Sum-rule analysis of the XMCD at Eu M4, 5edges measured at 10 K yields a 4f spin magnetic moment of 6.6μB per Eu[2+] ion. These results confirm that the ferromagnetic properties exclusively arise from 4f spins of Eu[2+]. In addition, for both the amorphous Eu[2]TiO[4] and EuTiO[3], the temperature and magnetic-field dependence of Eu L[2, 3]edge XMCD signals can be scaled with the corresponding magnetization measured by SQUID, indicating that the 5d magnetic polarization of Eu[2+] is involved in the process to cause the ferromagnetic interaction between Eu[2+] ions. We further discuss the origin of ferromagnetism in the amorphous system on the basis of the energy diagram of Eu 4f and 5d levels deduced from the Faraday effect in the visible region. From the wavelength dependence of Faraday rotation angles of the amorphous EuO-TiO[2] system in comparison with those of the divalent Eu chalcogenides as reported previously, it is found that the magnitude of crystal-field splitting of Eu 5d levels in the former is on the same order as that in the latter, which explains an enhanced ferromagnetic exchange interaction between Eu 4f and 5d states