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1.
Stereotact Funct Neurosurg ; 95(5): 330-340, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28982108

RESUMO

AIMS: To address the feasibility and importance of intraoperative neurophysiological monitoring (IONM) in dorsal root entry zone (DREZ) lesioning for brachial plexus avulsion pain. METHODS: Muscle motor evoked potential (mMEP) and somatosensory evoked potential (SSEP) were applied during DREZ lesioning for brachial plexus avulsion pain. RESULTS: IONM of mMEPs and SSEPs was feasible for monitoring of the spinal cord during DREZ lesioning. With the exception of 3 unrecordable mMEPs in ipsilateral arms, mMEPs were preserved and referenced to look for changes according to lesioning in 6 upper extremities (66.6%) and 8 lower extremities. All 3 patients with >50% reduction in baseline mMEP amplitude after lesioning in either the ipsilateral upper or lower extremities showed postoperative ataxia and weakness of the lower extremities (100%). Only 2 out of 9 patients (22.2%) with brachial plexus avulsion pain had discernible baseline SSEPs in the ipsilateral upper extremities. One of 2 patients with discernible SSEPs in the upper extremities showed significant SSEP events during the DREZ lesioning and experienced postoperative ataxia and weakness in the legs despite the absence of a SSEP event in the lower extremities. CONCLUSION: Significant events on IONM were common during DREZ lesioning for brachial plexus avulsion pain and were closely related to the occurrence of postoperative neurological deficits.


Assuntos
Plexo Braquial/fisiopatologia , Potencial Evocado Motor/fisiologia , Potenciais Somatossensoriais Evocados/fisiologia , Monitorização Neurofisiológica Intraoperatória/métodos , Dor/fisiopatologia , Radiculopatia/fisiopatologia , Adulto , Idoso , Plexo Braquial/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/diagnóstico , Dor/cirurgia , Radiculopatia/diagnóstico , Radiculopatia/cirurgia , Estudos Retrospectivos , Raízes Nervosas Espinhais/fisiopatologia , Raízes Nervosas Espinhais/cirurgia
2.
Stereotact Funct Neurosurg ; 94(3): 187-97, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27434073

RESUMO

OBJECTIVES: To investigate the clinical outcome of patients treated with chronic deep brain stimulation (DBS) of the centromedian nucleus (CM) for refractory epilepsy and to determine the location of active contacts. METHODS: The outcome of CM stimulation was evaluated as percent seizure reduction compared to the baseline 3 months. To establish the location of active contacts, 27 leads were studied in 14 patients with refractory epilepsy. An analysis was conducted to reveal whether any coordinates of the center of the active contacts predicted percent seizure reduction. RESULTS: With an average follow-up of 18.2 ± 5.6 months, the mean percent seizure reduction (n = 14) was 68 ± 22.4% (25-100%). Eleven of the 14 patients (78.6%) achieved >50% improvement in seizure frequency. Specifically, all 4 patients (100%) with generalized epilepsy (Lennox-Gastaut syndrome) and 7 of 10 patients (70%) with multilobar epilepsy showed >50% reduction in seizure frequency. The mean coordinates of the center of the active contact were located in the superior part of the anterior ventrolateral CM. The calculated coordinates of laterality from midline (x), anterior-posterior (y) and height (z) from the posterior commissure did not correlate with seizure outcome measured by percent seizure reduction. However, the locations of active contacts used during chronic CM stimulation in multilobar epilepsy were identified more dorsal to those used in generalized epilepsy. CONCLUSIONS: Chronic CM stimulation is a safe and effective means in the treatment of refractory epilepsy.


Assuntos
Estimulação Encefálica Profunda , Epilepsia Resistente a Medicamentos/terapia , Núcleos Intralaminares do Tálamo/cirurgia , Adolescente , Adulto , Doença Crônica , Eletrodos Implantados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
3.
Stereotact Funct Neurosurg ; 93(4): 240-4, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25998571

RESUMO

BACKGROUND: Dorsal root entry zone (DREZ) lesioning has been reported to be effective for phantom limb pain caused by brachial plexus avulsion pain. Most reports on DREZ lesioning for brachial plexus avulsion pain have focused on the results of pain relief without a detailed description of phantom sensations following DREZ lesioning. MATERIALS AND METHODS: Two patients (1 with amputation and the other nonamputated) with chronic intractable phantom limb pain caused by brachial plexus avulsion underwent DREZ lesioning on the avulsed segments of the cervical spinal cords. Changes of the phantom limb were observed. RESULTS: Immediately following DREZ lesioning, the phantom limb pain disappeared in the amputee, the phantom arm was shortened and the phantom hand disappeared. The other patient with the nonamputated arm reported an immediate 50% reduction in the size of the phantom hand, and pain relief was up to 70% of the preoperative phantom limb pain. There was no further change in the phantom arm and hand during the follow-up of 1.5-2 years. CONCLUSIONS: The phantom arms and hands showed a prompt shortening and reduction in size, rather than a disappearance, following successful DREZ lesioning in patients with chronic phantom limb pain caused by brachial plexus avulsion.


Assuntos
Neuropatias do Plexo Braquial/complicações , Plexo Braquial/lesões , Membro Fantasma/cirurgia , Complicações Pós-Operatórias/cirurgia , Radiculopatia/cirurgia , Rizotomia/métodos , Raízes Nervosas Espinhais/lesões , Acidentes de Trabalho , Acidentes de Trânsito , Idoso , Amputação Cirúrgica , Braço/inervação , Braço/cirurgia , Plexo Braquial/fisiopatologia , Neuropatias do Plexo Braquial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Membro Fantasma/etiologia , Membro Fantasma/fisiopatologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Radiculopatia/fisiopatologia , Raízes Nervosas Espinhais/cirurgia
4.
Stereotact Funct Neurosurg ; 93(4): 271-81, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26183282

RESUMO

BACKGROUND AND OBJECTIVE: We investigated the efficacy of combined somatosensory evoked potentials (SSEP) and electromyography monitoring during paddle lead placement through cervicothoracic laminectomy under general anesthesia in a retrospective review of data from 25 patients. METHODS: Muscle motor evoked potentials (MEP) recordings and SSEP monitoring were used for surveillance of the spinal cord. Collision testing of SSEP and threshold amplitudes of compound muscle action potentials (CMAP) in the bilateral upper and lower extremities evoked by electrode contacts of the paddle lead were checked to determine the laterality of the lead in the mediolateral direction. RESULTS: A significant decrease in amplitudes of muscle MEP in spite of stable SSEP occurred in 2 patients: 1 patient with a retrograde C1-C2 insertion and another patient with an anterograde C4/C5 insertion. Repositioning of leads based on significantly asymmetrical collision testing of SSEP and thresholds of CMAP in bilateral extremities was needed in 6 and 8 patients, respectively. In 22 patients, paresthesia coverage of the painful area was consistently located in the painful side, either unilaterally or bilaterally. There was no episode of revision for suboptimal lead placement. CONCLUSIONS: Intraoperative neurophysiological guidance using SSEP and muscle MEP was useful for the safe and accurate placement of paddle leads for cervicothoracic SCS.


Assuntos
Eletrodos Implantados , Eletromiografia , Potencial Evocado Motor , Potenciais Somatossensoriais Evocados , Laminectomia , Monitorização Intraoperatória/métodos , Estimulação da Medula Espinal/instrumentação , Potenciais de Ação , Idoso , Braço/inervação , Vértebras Cervicais , Síndrome Pós-Laminectomia/terapia , Feminino , Humanos , Perna (Membro)/inervação , Masculino , Pessoa de Meia-Idade , Neuralgia/terapia , Parestesia/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Vértebras Torácicas
5.
Stereotact Funct Neurosurg ; 93(3): 212-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25895656

RESUMO

BACKGROUND/OBJECTIVES: Although motor cortex stimulation (MCS) has been used for more than 20 years in the treatment of chronic neuropathic pain, there is still a debate about the efficacy of MCS. METHODS: To investigate the long-term results and the factors associated with the long-term success of chronic MCS, 21 patients who underwent MCS trial were classified as having central poststroke pain, central pain after spinal cord injury (SCI) and peripheral neuropathic pain, and we investigated the clinical factors associated with long-term success and degree of pain relief. RESULTS: Of the 21 patients, 16 (76.2%) had a successful trial and underwent chronic MCS. In the long-term follow-up (53 ± 39 months), only the diagnosis (central poststroke pain and peripheral neuropathic pain) was associated with long-term success defined as >30% pain relief compared with baseline (p < 0.05, χ(2) test). The difference in pain relief was not significant in patients having SCI pain (p > 0.05, 1-way ANOVA). The other variables did not show any significant influence in the long-term success and degree of pain relief (p > 0.05, 1-way ANOVA). CONCLUSIONS: MCS was more effective in the treatment of chronic neuropathic pain of central poststroke pain and peripheral neuropathic pain types than in the treatment of SCI pain in the long-term follow-up.


Assuntos
Estimulação Encefálica Profunda/tendências , Córtex Motor/fisiologia , Neuralgia/terapia , Manejo da Dor/tendências , Dor Intratável/terapia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Medição da Dor/tendências , Dor Intratável/diagnóstico , Resultado do Tratamento
6.
World Neurosurg ; 168: 398-410, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36527219

RESUMO

OBJECTIVE: The purpose of this study was to suggest appropriate indications and contraindications for full endoscopic surgery and to predict the prognosis for the incidence of complications by reviewing the literature on full endoscopic lumbar decompression for various spinal stenoses and systematically analyzing the contraindications and complications of endoscopic surgery. METHODS: We searched the PubMed/MEDLINE database to identify articles on full endoscopic decompression for lumbar spinal stenosis. The levels of evidence in all studies were classified according to the method adopted by the North American Spine Society (NASS) 2005. Full endoscopic lumbar decompression was divided into interlaminar and transforaminal decompressions. We selected articles that contained preoperative contraindications and complications during and after surgery. We analyzed the evidence level and classified the prescribed contraindications and complications according to the literature. RESULTS: We identified 362 articles, of which 57 met our criteria, with evidence ranging from levels I to V. After reviewing the literature on full endoscopic lumbar decompression, pure back pain without neurogenic symptoms and instability/deformities requiring stabilization were found to be contraindications. Also, in transforaminal decompression, central stenosis or complex foraminal stenoses were contraindications. Dysesthesia (most common), untreated pain, dural tear, disc herniation, infection, incomplete decompression, and other complications have been reported as complications of transforaminal decompression. On the other hand, dural tear (most common), epidural hematoma, transient dysesthesia, untreated pain, motor weakness, and other complications have been reported in interlaminar decompression. CONCLUSIONS: Full endoscopic lumbar surgery, including transforaminal and interlaminar decompression, is a safe and effective surgical option for treating lumbar spinal stenosis; however, it is important to select the transforaminal or interlaminar approach according to the indication.


Assuntos
Estenose Espinal , Humanos , Estenose Espinal/cirurgia , Descompressão Cirúrgica/efeitos adversos , Descompressão Cirúrgica/métodos , Vértebras Lombares/cirurgia , Parestesia/cirurgia , Endoscopia/efeitos adversos , Endoscopia/métodos , Dor nas Costas/cirurgia , Contraindicações , Resultado do Tratamento
7.
J Yeungnam Med Sci ; 39(3): 250-255, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34340280

RESUMO

In 2010, the World Health Organization classified mucin-producing bile duct tumors of the liver into two distinct entities; mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct. We present the case of a patient with MCN-L having a uniquely pedunculated shape. A 32-year-old woman was referred to our institution with a diagnosis of biliary cystic neoplasm. She had undergone left salpingo-oophorectomy for ovarian cancer 15 years ago. Imaging studies showed an 8 cm-sized well defined, multiloculated cystic lesion suggesting a mucinous cystic neoplasm. The cystic mass was pedunculated at the liver capsule and pathologically diagnosed as MCN-L. The mass was resected with partial hepatectomy. The patient recovered uneventfully. She was discharged 7 days postoperatively. The patient has been doing well for 6 months after the operation. The patient will be followed up annually because of the favorable postresection prognosis of MCN-L.

8.
NPJ Digit Med ; 5(1): 107, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35908091

RESUMO

While many deep-learning-based computer-aided detection systems (CAD) have been developed and commercialized for abnormality detection in chest radiographs (CXR), their ability to localize a target abnormality is rarely reported. Localization accuracy is important in terms of model interpretability, which is crucial in clinical settings. Moreover, diagnostic performances are likely to vary depending on thresholds which define an accurate localization. In a multi-center, stand-alone clinical trial using temporal and external validation datasets of 1,050 CXRs, we evaluated localization accuracy, localization-adjusted discrimination, and calibration of a commercially available deep-learning-based CAD for detecting consolidation and pneumothorax. The CAD achieved image-level AUROC (95% CI) of 0.960 (0.945, 0.975), sensitivity of 0.933 (0.899, 0.959), specificity of 0.948 (0.930, 0.963), dice of 0.691 (0.664, 0.718), moderate calibration for consolidation, and image-level AUROC of 0.978 (0.965, 0.991), sensitivity of 0.956 (0.923, 0.978), specificity of 0.996 (0.989, 0.999), dice of 0.798 (0.770, 0.826), moderate calibration for pneumothorax. Diagnostic performances varied substantially when localization accuracy was accounted for but remained high at the minimum threshold of clinical relevance. In a separate trial for diagnostic impact using 461 CXRs, the causal effect of the CAD assistance on clinicians' diagnostic performances was estimated. After adjusting for age, sex, dataset, and abnormality type, the CAD improved clinicians' diagnostic performances on average (OR [95% CI] = 1.73 [1.30, 2.32]; p < 0.001), although the effects varied substantially by clinical backgrounds. The CAD was found to have high stand-alone diagnostic performances and may beneficially impact clinicians' diagnostic performances when used in clinical settings.

9.
Opt Lett ; 36(8): 1380-2, 2011 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-21499363

RESUMO

We demonstrate the fabrication by direct laser writing and the operation of a directional coupler containing Bragg gratings in each waveguide. We achieve high-precision control over the longitudinal shift between the gratings, which feature first-order Bragg resonance at telecommunication wavelengths. We observe fundamental differences between light transmission characteristics in couplers with unshifted and shifted gratings in agreement with theoretical predictions.

10.
Opt Lett ; 36(7): 1170-2, 2011 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-21479019

RESUMO

We experimentally study the fields close to an interface between two photonic crystal waveguides that have different dispersion properties. After the transition from a waveguide in which the group velocity of light is v(g) ~ c/10 to a waveguide in which it is v(g) ~ c/100, we observe a gradual increase in the field intensity and the lateral spreading of the mode. We attribute this evolution to the existence of a weakly evanescent mode that exponentially decays away from the interface. We compare this to the situation where the transition between the waveguides only leads to a minor change in group velocity and show that, in that case, the evolution is absent. Furthermore, we apply novel numerical mode extraction techniques to confirm experimental results.

11.
Opt Express ; 18(25): 25693-701, 2010 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-21164915

RESUMO

We investigate the modes of double heterostructure cavities where the underlying photonic crystal waveguide has been dispersion engineered to have two band-edges inside the Brillouin zone. By deriving and using a perturbative method, we show that these structures possess two modes. For unapodized cavities, the relative detuning of the two modes can be controlled by changing the cavity length, and for particular lengths, a resonant-like effect makes the modes degenerate. For apodized cavities no such resonances exist and the modes are always non-degenerate.


Assuntos
Refratometria/instrumentação , Ressonância de Plasmônio de Superfície/instrumentação , Simulação por Computador , Desenho Assistido por Computador , Cristalização , Desenho de Equipamento , Análise de Falha de Equipamento , Luz , Modelos Teóricos , Fótons , Espalhamento de Radiação
12.
Opt Express ; 17(5): 3716-21, 2009 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-19259212

RESUMO

We formulate and demonstrate experimentally the high-resolution spectral method based on Bloch-wave symmetry properties for extracting mode dispersion in periodic waveguides from measurements of near-field profiles. We characterize both the propagating and evanescent modes, and also determine the amplitudes of forward and backward waves in different waveguide configurations, with the estimated accuracy of several percent or less. Whereas the commonly employed spatial Fourier-transform (SFT) analysis provides the wavenumber resolution which is limited by the inverse length of the waveguide, we achieve precise dispersion extraction even for compact photonic structures.

13.
Opt Lett ; 34(24): 3776-8, 2009 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-20016610

RESUMO

We demonstrate that the spatial profiles of both propagating and evanescent Bloch modes in a periodic structure can be extracted from a single measurement of an electric field at the specified optical wavelength. We develop a systematic extraction procedure by extending the concepts of high-resolution spectral methods previously developed for temporal data series to take into account the symmetry properties of Bloch modes simultaneously at all spatial locations. We illustrate the application of our method to a photonic crystal waveguide interface and confirm its robustness in the presence of noise.

14.
Opt Express ; 16(2): 1104-14, 2008 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-18542184

RESUMO

We suggest a novel and general approach to the design of photonic-crystal directional couplers operating in the slow-light regime. We predict, based on a general symmetry analysis, that robust tunneling of slow-light pulses is possible between antisymmetrically coupled photonic crystal waveguides. We demonstrate, through Bloch mode frequency-domain and finite-difference time-domain (FDTD) simulations that, for all pulses with strongly reduced group velocities at the photonic band-gap edge, complete switching occurs at a fixed coupling length of just a few unit cells of the photonic crystal.


Assuntos
Desenho Assistido por Computador , Cristalização/métodos , Tecnologia de Fibra Óptica/instrumentação , Modelos Teóricos , Transdutores , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Luz , Fótons , Espalhamento de Radiação
15.
Asian J Neurosurg ; 13(2): 403-406, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29682044

RESUMO

Twiddler's syndrome is an uncommon hardware complication involving the lead and pulse generators in cardiac pacemakers and defibrillators, deep brain stimulators, and vagal nerve stimulators. However, until very recently, it had not been reported in spinal cord stimulation (SCS). Considering the incidence of hardware complications of spinal cord stimulation, there may be an underreporting of Twiddler's syndrome due to lack of awareness. Two cases of Twiddler's syndrome as a hardware complication of SCS were identified between 2005 and 2015. One patient with hardware failure due to Twiddler's syndrome refused to have a revision surgery. The other patient who had a lead migration associated with coiling of the lead and twisting of pulse generator needed a revision surgery. Twiddler's syndrome in patients treated with SCS is an uncommon but important adverse event. Awareness of characteristic presentation and radiologic finding is essential in the identification of Twiddler's syndrome in SCS.

16.
Asian J Neurosurg ; 13(2): 407-410, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29682045

RESUMO

Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is an effective treatment for refractory epilepsy. Due to the unique location of ANT in the thalamus facing the lateral and third ventricles, transventricular DBS lead placement is an essential part of ANT DBS. However, there is no report regarding hardware problems including impedance variability in transventricular ANT DBS due to limited experience. A 45-year-old male patient with previously effective, bilateral ANT DBS presented with increasing seizure frequency and a shortened battery longevity within 2 years. Magnetic resonance imaging showed that the left-sided DBS lead was in the third ventricle leaning on the medial wall of ANT. Electrode revision was performed. Upon disconnecting the proximal lead from the extension connection, cerebrospinal fluid egress through fine gaps between the metallic electrode contacts, and electrode spacing was observed. This case raises a concern about the transventricular approach for ANT lead placement because the currently available DBS electrode lead is not waterproofed. A careful, longitudinal follow-up of DBS impedance for ANT DBS is warranted.

17.
Asian J Neurosurg ; 13(2): 442-445, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29682056

RESUMO

A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord. Considering potential risks associated with removal of the lesion, intradural C1-3 dorsal root rhizotomy with dentate ligament resection was performed. The paroxysmal lancinating pain of ON was significantly alleviated, and the remodeling of the extent of allodynic pain was noted after C1-3 dorsal root rhizotomy. These changes gradually occurred during the second postoperative month, and this effect was maintained for 24 months postoperatively. Significant reduction in chronic allodynic pain of secondary ON caused by cervicomedullary CM involving central sensitization in the trigeminocervical complex was observed with reduction of irritating, afferent input with C1-C3 dorsal root rhizotomy.

18.
World Neurosurg ; 97: 292-303, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27744081

RESUMO

OBJECTIVE: To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome. METHODS: In 21 patients who underwent paddle lead SCS at T9 (3-column, n = 9; 5-column, n =12) for failed back surgery syndrome, a 12-month follow-up numerical rating scale, percent pain relief, and computed tomography assessment of contact angle and percent reduction of T9 canal area were investigated. RESULTS: There was no difference in paresthesia coverage of the painful area, trial success rate, clinical outcomes, and percent pain relief between the 2 groups (P >0.05). The contact angle in the 5-column group was generally more than that of the 3-column group (P = 0.067). Overall reduction of 35.51% ± 4.76% in the T9 canal was observed and there was no difference between the 2 groups (P >0.05) and no correlation between the contact angle and percent T9 spinal canal reduction (r = -0.247, P > 0.05). CONCLUSIONS: Although clinical efficacy of SCS using three-column and five-column paddle lead was not significant different from each other, significant inclination of paddle lead in posterior epidural space with significant reduction in T9 canal area were observed in both groups. The degree of inclination in the 5-column group was more than that in the 3-column lead group. Close approximation of paddle lead contacts to dorsal spinal cord with reduced dorsal cerebrospinal fluid space and intraoperative neurophysiologic guidance might have contributed to the high rate of trial success and long-term pain control.


Assuntos
Eletrodos Implantados , Síndrome Pós-Laminectomia/diagnóstico por imagem , Síndrome Pós-Laminectomia/terapia , Estimulação da Medula Espinal/métodos , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Seguimentos , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Medição da Dor/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
19.
Opt Express ; 14(23): 11265-70, 2006 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-19529541

RESUMO

We study propagation of polychromatic light near the edge of a nonlinear waveguide array. We describe simultaneous spatial and spectral beam reshaping associated with power and wavelength-dependent tunneling between the waveguides. We present experimental verifications of the effects predicted theoretically including the first observation of supercontinuum nonlinear surface modes.

20.
J Cerebrovasc Endovasc Neurosurg ; 18(1): 32-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27114964

RESUMO

Behçet's disease is an inflammatory disorder involving multiple organs. Its cause is still unknown, but vasculitis is the major pathologic characteristic. The common vascular lesions associated with Behçet's disease are aneurysm formation, arterial or venous occlusive diseases, and varices. Arterial aneurysms mostly occur in large arteries. Intracranial aneurysms hardly occur with Behçet's disease. We would like to present a 41-year-old female patient with Behçet's disease who showed symptoms of severe headache due to subarachnoid hemorrhage. Brain computed tomography revealed multiple aneurysms. We also present a literature review of intracranial arterial aneurysms associated with Behçet's disease.

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