Head shape measurement standards and cranial orthoses in the treatment of infants with deformational plagiocephaly : a systematic review

The review aims to determine how head shape is measured and describes the use of orthoses in the management of deformational plagiocephaly. A systematic review was conducted and papers published in English up to and including 2006 were sourced from nine databases. Initial screening of papers retrieved was conducted and consensus for inclusion reached according to specified criiteria. Twenty papers were included; three literature reviews and 17 original papers. Of the original papers, eight concerned the method of head shape measurement. Measurements are important in determining clinical classification and treatment modality of deformational plagiocephaly. All studies were appraised and assigned a level of evidence according to the Scottish Intercollegiate Guidelines Network. Methodological quality was inadequate. Publications involving the use of cranial orthoses used convenience samples, were not blinded, and used different measurement techniques. No control groups were included and participants were not randomised. Evidence suggests that conservative treatments might reduce skull deformity although the quality is poor. Clinical studies investigating the use of cranial orthoses reported beneficial effects. Further research of appropriate design is required to identify the efficacy of cranial orthoses in the treatment of deformational plagiocephaly based on a standardised measurement technique to facilitate classification of deformational plagiocephaly

Stochastic analysis of exit fluid temperature records from the active TAG hydrothermal mound (Mid-Atlantic Ridge, 26°N) : 1. Modes of variability and implications for subsurface flow

Author Posting. © American Geophysical Union, 2007. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 112 (2007): B07101, doi:10.1029/2006JB004435.Yearlong time series records of exit fluid temperature from the active TAG hydrothermal mound (Mid-Atlantic Ridge, 26°N) reveal a complex space-time pattern of flow variability within the mineral deposit. Exit fluid temperatures were measured every 8–10 min from 17 sites distributed across the upper terrace of the mound from June 2003 to June 2004. High-temperature records were obtained using Deep Sea Power and Light SeaLogger® probes deployed in fractures discharging ∼360°C black smoker fluids, and low-temperature records were obtained using VEMCO Ltd. Minilog probes deployed in cracks discharging ∼20°C diffuse flow fluids. The temperature records are considerably more variable than those acquired from vent fields on the fast spreading East Pacific Rise and exhibit a complex mix of both episodic and periodic variability. The diffuse flow records alternate between periods of discharge and periods of what I infer to be recharge when fluid temperatures are equal to background water column levels (∼2.7°C) as ambient seawater is drawn into the seafloor. The space-time patterns of these episodic variations suggest that they represent reorganizations of the secondary circulation system driving diffuse discharge on the upper terrace of the mound on timescales from a few hours to a few days, most likely in response to permeability perturbations. Harmonic temperature oscillations were observed over a range of periods, with the principal lunar semidiurnal tidal period (M2) being most dominant. During certain times, exit fluid temperatures at diffuse sites pulse at diurnal and semidiurnal tidal periods when they are hovering near background water column levels, which I interpret as flow reversals associated with the vertical displacement of a fluid boundary layer at the seafloor interface when the local net flux is near zero. The pulsing behavior is predicted by poroelastic models of tidal loading but is not consistent with effects from tidal currents, which demonstrates that poroelastic effects from tidal loading modulate shallow subsurface flow at the active TAG mound.This work was supported by the National Science Foundation (OCE-0137329)

Variations of atmospheric methane supply from the Sea of Okhotsk unduced by the seasonal in cover

Measurements of dissolved methane in the surface waters of the western Sea of Okhotsk are evaluated in terms of methane exchange rates and are used to assess the magnitude of seasonal variations of methane fluxes from the ocean to the atmosphere in this area. Methane concentrations northeast of Sakhalin were observed to range from 385 nmol L−1 under the ice cover in winter to 6 nmol L−1 in the icefree midsummer season. The magnitude of supersaturations indicates that this part of the Okhotsk Sea is a significant source for atmospheric methane. From the seasonal variation of the supersaturations in the surface waters it is evident that the air-sea exchange is interrupted during the winter and methane from sedimentary sources accumulates under the ice cover. According to our measurements an initial early summer methane pulse into the atmosphere of the order of 560 mol km−2 d−1 can be expected when the supersaturated surface waters are exposed by the retreating ice. The methane flux in July is approximately 150 mol km−2 d−1 which is of the order of the average annual flux in the survey area. The magnitude of the seasonal CH4 flux variation northeast of Sakhalin corresponds to an amount of 7.3 × 105 g km−2 whereby 74% or 5.4 × 105 g km−2 are supplied to the atmosphere between April and July. For the whole Sea of Okhotsk the annual methane flux is roughly 0.13 × 1012 g (terragrams), based on the assumption that 15% of the entire area emit methane. Variations of long-term data of atmospheric methane which are recorded at the same latitude adjacent to areas with seasonal ice cover show a regional methane pulse between April and July. The large-scale level of atmospheric methane in the northern hemisphere undergoes an amplitudinal variation of about 25 parts per billion by volume (ppbv) which translates into approximately 36 Tg. Thus the estimated 0.6 Tg of ice-induced methane dynamics in northern latitudes can hardly explain this seasonal signal. However, the effects of seasonal ice cover on pulsed release of methane appear strong enough to contribute, in concert with other seasonal sources, to characteristic short-term wobbles in the atmospheric methane budget which are observed between 50°N and 60°N

Human pallidothalamic and cerebellothalamic tracts: anatomical basis for functional stereotactic neurosurgery

Anatomical knowledge of the structures to be targeted and of the circuitry involved is crucial in stereotactic functional neurosurgery. The present study was undertaken in the context of surgical treatment of motor disorders such as essential tremor (ET) and Parkinson’s disease (PD) to precisely determine the course and three-dimensional stereotactic localisation of the cerebellothalamic and pallidothalamic tracts in the human brain. The course of the fibre tracts to the thalamus was traced in the subthalamic region using multiple staining procedures and their entrance into the thalamus determined according to our atlas of the human thalamus and basal ganglia [Morel (2007) Stereotactic atlas of the human thalamus and basal ganglia. Informa Healthcare Inc., New York]. Stereotactic three-dimensional coordinates were determined by sectioning thalamic and basal ganglia blocks parallel to stereotactic planes and, in two cases, by correlation with magnetic resonance images (MRI) from the same brains prior to sectioning. The major contributions of this study are to provide: (1) evidence that the bulks of the cerebellothalamic and pallidothalamic tracts are clearly separated up to their thalamic entrance, (2) stereotactic maps of the two tracts in the subthalamic region, (3) the possibility to discriminate between different subthalamic fibre tracts on the basis of immunohistochemical stainings, (4) correlations of histologically identified fibre tracts with high-resolution MRI, and (5) evaluation of the interindividual variability of the fibre systems in the subthalamic region. This study should provide an important basis for accurate stereotactic neurosurgical targeting of the subthalamic region in motor disorders such as PD and ET

Subthalamic nucleus deep brain stimulation in elderly patients – analysis of outcome and complications

BACKGROUND: There is an ongoing discussion about age limits for deep brain stimulation (DBS). Current indications for DBS are tremor-dominant disorders, Parkinson's disease, and dystonia. Electrode implantation for DBS with analgesia and sedation makes surgery more comfortable, especially for elderly patients. However, the value of DBS in terms of benefit-risk ratio in this patient population is still uncertain. METHODS: Bilateral electrode implantation into the subthalamic nucleus (STN) was performed in a total of 73 patients suffering from Parkinson's disease. Patients were analyzed retrospectively. For this study they were divided into two age groups: group I (age <65 years, n = 37) and group II (age ≥ 65 years, n = 36). Examinations were performed preoperatively and at 6-month follow-up intervals for 24 months postoperatively. Age, UPDRS motor score (part III) on/off, Hoehn & Yahr score, Activity of Daily Living (ADL), L-dopa medication, and complications were determined. RESULTS: Significant differences were found in overall performance determined as ADL scores (group I: 48/71 points, group II: 41/62 points [preoperatively/6-month postoperatively]) and in the rate of complications (group I: 4 transient psychosis, 4 infections in a total of 8 patients, group II: 2 deaths [unrelated to surgery], 1 intracerebral hemorrhage, 7 transient psychosis, 3 infections, 2 pneumonia in a total of 13 patients), (p < 0.05). Interestingly, changes in UPDRS scores, Hoehn & Yahr scores, and L-dopa medication were not statistically different between the two groups. CONCLUSION: DBS of the STN is clinically as effective in elderly patients as it is in younger ones. However, a more careful selection and follow-up of the elderly patients are required because elderly patients have a higher risk of surgery-related complications and a higher morbidity rate