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Jorien M van de Pas,Margaretha CE van der Woude,Henricus J Belgers,Karel WE Hulsewé,Erik R de Loos 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.2
Background: Double-lumen tubes (DLT) and endobronchial blockers (EB) are used for one-lung ventilation in thoracic surgery. More complications are seen when using DLT when compared to EB, while major complications are rarely seen. Case: This case report describes a perforation of the right mainstem bronchus by an EZ-Blocker EB in a patient undergoing a minimally invasive esophagectomy after neoadjuvant chemoradiation. Conclusions: We advise to insert an EZ-BlockerTM EB with caution and only under direct bronchoscopic visualization, especially in previous irradiated patients.
Modality-Dependent Impact of Hallucinations on Low-Frequency Fluctuations in Schizophrenia
Hare, S. M.,Ford, J. M.,Ahmadi, A.,Damaraju, E.,Belger, A.,Bustillo, J.,Lee, H. J.,Mathalon, D. H.,Mueller, B. A.,Preda, A. Oxford University Press 2017 Schizophrenia bulletin Vol.43 No.2
<P>Prior resting-state functional magnetic resonance imaging (fMRI) analyses have identified patterns of functional connectivity associated with hallucinations in schizophrenia (Sz). In this study, we performed an analysis of the mean amplitude of low-frequency fluctuations (ALFF) to compare resting state spontaneous low-frequency fluctuations in patients with Sz who report experiencing hallucinations impacting different sensory modalities. By exploring dynamics across 2 low-frequency passbands (slow-4 and slow-5), we assessed the impact of hallucination modality and frequency range on spatial ALFF variation. Drawing from a sample of Sz and healthy controls studied as part of the Functional Imaging Biomedical Informatics Research Network (FBIRN), we replicated prior findings showing that patients with Sz have decreased ALFF in the posterior brain in comparison to controls. Remarkably, we found that patients that endorsed visual hallucinations did not show this pattern of reduced ALFF in the back of the brain. These patients also had elevated ALFF in the left hippocampus in comparison to patients that endorsed auditory (but not visual) hallucinations. Moreover, left hippocampal ALFF across all the cases was related to reported hallucination severity in both the auditory and visual domains, and not overall positive symptoms. This supports the hypothesis that dynamic changes in the ALFF in the hippocampus underlie severity of hallucinations that impact different sensory modalities.</P>
Disrupted network cross talk, hippocampal dysfunction and hallucinations in schizophrenia
Hare, Stephanie M.,Law, Alicia S.,Ford, Judith M.,Mathalon, Daniel H.,Ahmadi, Aral,Damaraju, Eswar,Bustillo, Juan,Belger, Aysenil,Lee, Hyo Jong,Mueller, Bryon A.,Lim, Kelvin O.,Brown, Gregory G.,Preda Elsevier 2018 Schizophrenia Research Vol.199 No.-
<P><B>Abstract</B></P> <P>Hallucinations characterize schizophrenia, with approximately 59% of patients reporting auditory hallucinations and 27% reporting visual hallucinations. Prior neuroimaging studies suggest that hallucinations are linked to disrupted communication across distributed (sensory, salience-monitoring and subcortical) networks. Yet, our understanding of the neurophysiological mechanisms that underlie auditory and visual hallucinations in schizophrenia remains limited.</P> <P>This study integrates two resting-state functional magnetic resonance imaging (fMRI) analysis methods – amplitudes of low-frequency fluctuations (ALFF) and functional network connectivity (FNC) – to explore the hypotheses that (1) abnormal FNC between salience and sensory (visual/auditory) networks underlies hallucinations in schizophrenia, and (2) disrupted hippocampal oscillations (as measured by hippocampal ALFF) beget changes in FNC linked to hallucinations. Our first hypothesis was supported by the finding that schizophrenia patients reporting hallucinations have higher FNC between the salience network and an associative auditory network relative to healthy controls. Hippocampal ALFF was negatively associated with FNC between primary auditory cortex and the salience network in healthy subjects, but was positively associated with FNC between these networks in patients reporting hallucinations. These findings provide <I>indirect</I> support favoring our second hypothesis. We suggest future studies integrate fMRI with electroencephalogram (EEG) and/or magnetoencephalogram (MEG) methods to <I>directly probe</I> the temporal relation between altered hippocampal <I>oscillations</I> and changes in cross-network functional communication.</P>