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Roubelakis A, Modi A, Holman M, Casali G, Khan AZ. Uniportal video-assisted thoracic surgery: the lesser invasive thoracic surgery. Asian Cardiovasc Thorac Ann 2014; 22:72-6. [PMID: 24585647 DOI: 10.1177/0218492313479356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We evaluated whether single-port video-assisted thoracic surgery is feasible without compromising outcomes, and whether the technique could be reproduced by a trainee. METHODS In a 6-month period, 37 operations were performed by single-port video-assisted thoracic surgery. Of the 37 patients, 27 (73%) were male and the mean age was 45.1 ± 21 years. Twenty-three (62%) were operated on by consultants and 14 (38%) by trainees. The procedures included 19 (51.3%) operations for treatment of pneumothoraces, 8 (21.6%) metastasectomies, 7 (18.9%) lung biopsies, 2 (5.4%) empyema débridements, and 1 (2.7%) pleuropericardial window. RESULTS Mean operative time was 51.8 ± 14.7 min. Patient-controlled analgesia infusion was used for 1.3 ± 1 days. Three (8.1%) patients needed an operative reintervention, but there was no intensive treatment unit admission or hospital mortality. Mean postoperative hospital stay was 3.3 ± 2.7 days. On follow-up, all patients had a tissue diagnosis and all lung nodules were R0 resections. Patients operated on by consultants and trainees had similar preoperative profiles and postoperative outcomes, except that those operated on by trainees used patient-controlled analgesia significantly longer (1.8 ± 1.48 vs. 1 ± 0.48 days; p = 0.03). CONCLUSION Single-port video-assisted thoracic surgery can be performed and reproduced well without compromising outcomes. It is considered aesthetically better and may reduce analgesic requirements, but it might not reduce hospital stay.
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Khan AZ, Khandelwal S. V-065ROBOTIC RESECTION OF SECOND RIB TUMOUR. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ismail M, Iqbal Z, Khan MI, Javaid A, Arsalan H, Farhadullah H, Khan F, Khan AZ, Nasir F, Khan JA. Frequency, Levels and Predictors of Potential Drug-Drug Interactions in a Pediatrics Ward of a Teaching Hospital in Pakistan. TROP J PHARM RES 2013. [DOI: 10.4314/tjpr.v12i3.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Portman ME, Esteves LS, Le XQ, Khan AZ. Improving integration for integrated coastal zone management: an eight country study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 439:194-201. [PMID: 23063925 DOI: 10.1016/j.scitotenv.2012.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 09/01/2012] [Accepted: 09/10/2012] [Indexed: 06/01/2023]
Abstract
Integrated coastal zone management (ICZM) is a widely accepted approach for sustainable management of the coastal environment. ICZM emphasizes integration across sectors, levels of government, uses, stakeholders, and spatial and temporal scales. While improving integration is central to progress in ICZM, the role of and the achievement of integration remain understudied. To further study these two points, our research analyzes the performance of specific mechanisms used to support ICZM in eight countries (Belgium, India, Israel, Italy, Portugal, Sweden, UK, and Vietnam). The assessment is based on a qualitative comparative analysis conducted through the use of two surveys. It focuses on five ICZM mechanisms (environmental impact assessment; planning hierarchy; setback lines; marine spatial planning, and regulatory commission) and their role in improving integration. Our findings indicate that certain mechanisms enhance specific types of integration more effectively than others. Environmental impact assessment enhances science-policy integration and can be useful to integrate knowledge across sectors. Planning hierarchy and regulatory commissions are effective mechanisms to integrate policies across government levels, with the latter also promoting public-government integration. Setback lines can be applied to enhance integration across landscape units. Marine spatial planning is a multi-faceted mechanism with the potential to promote all types of integration. Policy-makers should adopt the mechanisms that are suited to the type of integration needed. Results of this study also contribute to evidence-based coastal management by identifying the most common impediments related to the mechanisms of integration in the eight studied countries.
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Vitfell-Pedersen J, Yap TA, Moreno V, Baird RD, Khan AZ, Barton DPJ, Kaye SB. The role of surgery in patients with advanced gynaecological cancers participating in phase I clinical trials. EUR J GYNAECOL ONCOL 2012; 33:211-213. [PMID: 22611966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE While gynaecological cancer patients who participate in Phase I clinical trials are not routinely considered for elective surgery because of a short life expectancy, this should not be overlooked in carefully selected responding patients. METHODS/RESULTS We describe two cases of patients with different gynaecological cancers, who received treatment within separate phase I trials, and who then proceeded to surgical resection of their cancers, resulting in complete remission. CONCLUSION Surgery, when feasible, should be taken into consideration as a potential management option, even when patients are receiving treatment within a phase I trial.
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Khan AZ, Aarons L. Design and Analysis of the Aminopyrine Breath Test. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1985.tb14220.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mattam K, Khan AZ, Casali G. OP-060 ROLE OF TELEMEDICINE IN TREATMENT OF ACUTE CARDIAC EMERGENCIES IN RURAL SETTING. Int J Cardiol 2010. [DOI: 10.1016/s0167-5273(10)70062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Khan AZ, Ching R, Morris-Stiff G, England R, Sherridan MB, Smith AM. Pleuropancreatic fistulae: specialist center management. J Gastrointest Surg 2009; 13:354-8. [PMID: 18972169 DOI: 10.1007/s11605-008-0699-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 09/08/2008] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS Internal pancreatic fistulae are uncommon sequelae of severe acute pancreatitis. Due to their low prevalence, experience in the management of this condition remains sparse outside specialist centers and management remains controversial. We report our experience with pleuropancreatic fistulae (PPF). PATIENTS Six patients (three males, median age 34 years [range, 32-74 years]) with PPF were managed in our unit over a 24-month period from April 2006 to April 2008. The etiology of pancreatitis was alcohol (four), gallstones (one), and unknown cause (one). All patients had documented pleural effusions with amylase content >1,000 iu/dl. RESULTS All patients underwent computerized tomography (CT) and magnetic resonance imaging (MRI) cross-sectional scanning to identify the site of ductal disruption. CT alone was able to identify the disruption in four cases and a combination of CT and MRI localized the ductal disruption in all patients. Five of six patients required ERCP and placement of a pancreatic duct (PD) stent. No patient required pancreatic surgery and all patients remain well at a median follow up of 39 weeks. CONCLUSION Pleuropancreatic fistulae can present a challenging diagnostic dilemma. A multi-disciplinary approach addressing nutritional support and endotherapy allows successful non-operative resolution within specialist units.
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Khan AZ, Wong VK, Malik HZ, Stiff GM, Prasad KR, Lodge JPA, Toogood GJ. The impact of caudate lobe involvement after hepatic resection for colorectal metastases. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2008; 35:510-4. [PMID: 18644694 DOI: 10.1016/j.ejso.2008.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 05/05/2008] [Accepted: 06/09/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hepatic resections involving the caudate lobe are technically challenging with results from some centers indicating inferior outcomes. We assessed outcomes following hepatic resection for colorectal metastases involving the caudate lobe in a tertiary care center. METHODS Operative and oncological data from a prospectively maintained database were analyzed on 687 patients undergoing hepatic resection for colorectal metastases between 1993 and 2006. Patients were analyzed as those with caudate lobe metastases (CLM) and compared with those without caudate lobe involvement (NCLM). RESULTS Fifty-two of 687 patients had metastases involving the caudate lobe (8%). Patients with caudate lobe involvement were more likely to require an extended hepatic resection (75% vs 27%, P=0.001), perioperative blood transfusion (29% vs 14%, P=0.002), have a positive resection margin (57% vs 32%, P=0.001) and stay longer in hospital (12 vs 8 days, P=0.001). There was no difference in the complication rates (37% vs 29%) or 30-day mortality between the two groups (2% vs 1%). The median disease free (20 months vs 21 months), and cancer specific survival (42 months vs 59 months) were also similar in the CLM and NCLM groups. CONCLUSIONS Although caudate lobe involvement adds to the technical complexity of hepatic resection, these patients can be offered long term survival, similar to other patients with hepatic metastases from colorectal cancer.
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Abstract
Drugs are an uncommon but well-recognised cause of acute pancreatitis and new agents of drug-induced pancreatitis continue to be reported. We describe only the 10th reported case of lisinopril-induced pancreatitis in a young female patient.
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Gogalniceanu P, Crewdson K, Khan AZ, Botha AJ. Transhiatal chest drainage after oesophagectomy. Ann R Coll Surg Engl 2008; 89:535-6. [PMID: 18170937 DOI: 10.1308/rcsann.2007.89.5.535] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Khan AZ, Pitsinis V, Mudan SS. Complete pathological response following down-staging chemoradiation in locally advanced pancreatic cancer: Challenging the boundaries. World J Gastroenterol 2007; 13:6433-5. [PMID: 18081235 PMCID: PMC4205465 DOI: 10.3748/wjg.v13.i47.6433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer is an aggressive malignancy, relatively resistant to chemotherapy and radiotherapy, which usually presents late. Disease specific mortality approaches unity despite advances in adjuvant therapy. We present the first reported case of complete pathological response following neoadjuvant therapy in a locally advanced pancreatic adenocarcinoma.
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Andreani SM, Dang HH, Grondona P, Khan AZ, Edwards DP. Rectovaginal fistula in Crohn's disease. Dis Colon Rectum 2007; 50:2215-22. [PMID: 17846837 DOI: 10.1007/s10350-007-9057-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 03/26/2007] [Accepted: 05/01/2007] [Indexed: 12/14/2022]
Abstract
PURPOSE Crohn's disease is characterized by transmural bowel inflammation and a tendency to form fistulas with adjacent structures. Several different fistulas have been described: enterocutaneous, enteroenteric, enterovesical, enterovaginal, and perineal. Rectovaginal fistulas are difficult to treat despite multimodal therapy. This study was designed to review the current strategic options to best manage this condition. METHODS We reviewed the English-language literature from 1966 to 2006, using PUBMED, targeting Crohn's disease involving vagina using key words "rectovaginal fistula and CD," "anovaginal fistula and CD," "anovaginal fistula," and "rectovaginal fistula." We excluded the involvement of the vagina from a pouch after a proctectomy. A total of 776 articles were found; 206 articles were identified and judged as being relevant on the basis of title-related articles and links were reviewed. Fifty-three articles were selected after reading the abstract or full manuscript. RESULTS The management of rectovaginal fistula, representing 9 percent of all fistulas, remains a challenge in the setting of Crohn's disease. Medical treatments are not favorable with low rates of long-term symptomatic control and unacceptable high rates of recurrence. Several novel and new surgical techniques have been described, and rectal advancement flap, in selected patients, seems to have the most successful results. CONCLUSIONS The management of rectovaginal fistula of Crohn's origin should involve both gastroenterologists and coloproctologists, with the best surgical results being achieved in patients receiving optimum medical therapy. More focused studies targeting these patients with the use of combined medical and surgical therapy are necessary.
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Khan AZ, Bann SD, Pitsinis V, McCall J, Mudan SS. Refining the technique of hepatic parenchymal transection: combined saline-linked radiofrequency precoagulation and ultrasonic aspiration. HEPATO-GASTROENTEROLOGY 2007; 54:1167-9. [PMID: 17629063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND/AIMS With recognition of its benefits, there has been a trend towards minimizing blood loss during hepatic parenchymal transection but no one technique has been shown to be superior to another. We analyzed our experience with using a novel combined technique of saline-linked radiofrequency precoagulation and ultrasonic aspiration for hepatic parenchymal transection. METHODOLOGY This combined technique was used in 12 patients for parenchymal transection for metastatic hepatic disease and data was collected prospectively. Total blood loss, bile leaks, parenchymal transection time, hepatic pedicle clamp requirement and 30-day mortality were used as outcome measures. RESULTS Four minor and 8 major hepatic resections were performed in twelve patients of who two underwent a synchronous resection of the rectum. The median blood loss was 525 mL (IQR 312.5-1150) in these patients who had a median postoperative stay of 7 days (IQR 7-14). The median parenchymal transection time was 120 minutes (IQR 100-153.75). No patient required portal triad clamping at anytime and there was no mortality. CONCLUSIONS Combined technique of saline-link radiofrequency ablation and ultrasonic aspiration appears to be comparable to other techniques and should be considered as an alternative.
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Forshaw MJ, Khan AZ, Davies AR, Strauss DC, Pearce A, Mason RC. Postoperative ventilation in the recovery area. Ann R Coll Surg Engl 2007; 89:449; author reply 449-50. [PMID: 17535629 PMCID: PMC1963571 DOI: 10.1308/003588407x179161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Escofet X, Khan AZ, Mazarani W, Woods WGA. Lessons to be learned: a case study approach. Lateral aberrant thyroid tissue: is it always malignant? ACTA ACUST UNITED AC 2007; 127:45-6. [PMID: 17319317 DOI: 10.1177/1466424007073207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Traditionally 'lateral aberrant thyroid' tissue present in cervical lymph nodes in the face of a clinically normal thyroid gland is held to be a metastasis from an occult primary thyroid carcinoma. A patient in whom follicular thyroid tissue was found in a lymph node lateral to the carotid sheath in the presence of a thyroid gland which was histologically free of cancer is herewith presented.
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Abstract
Outcomes are improving
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Pitsinis V, Khan AZ, Cranshaw I, Allum WH. Single center experience of laparoscopic vs. open resection for gastrointestinal stromal tumors of the stomach. HEPATO-GASTROENTEROLOGY 2007; 54:606-8. [PMID: 17523332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND/AIMS With better understanding of disease biology and technological advances, an increasing number of gastric gastrointestinal stromal tumors (GISTs) are being resected laparoscopically. We assessed our management of gastric GISTs in our institution. METHODOLOGY Prospectively collected data from 13 patients who underwent surgery for gastric gastrointestinal stromal tumors over an 18-month period were analyzed with respect to operative and oncological outcomes. Seven patients underwent open resection and 6 patients had laparoscopic resection. RESULTS The tumors were evenly distributed in both groups in whom the median age was 68 years in the open group vs. 70 years in the laparoscopic group. The median operating time was 132 min in the open group and 110 min in the laparoscopic group and patients who had a laparoscopic resection had a shorter hospital stay (4 days versus 11 days). Patients in the open group had a larger tumor the patients in the laparoscopic group (11.5 x 6 x 4 cm vs. 5 x 4 x 3 cm). No patient had evidence of recurrence at median follow-up of 9 months. CONCLUSIONS Patients with small gastric GISTs can be safely resected with a laparoscopic approach, offering a quicker operation and shorter hospital stay. A laparoscopic approach does not alter risk of early local or distant recurrence.
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Abstract
Spontaneous oesophageal perforation, or Boerhaave's syndrome, represents barogenic oesophageal injury. Patients don't always present with classical features and treatment may be delayed. Various approaches and strategies have been described but, despite advances in surgery and critical care, the condition continues to carry a high morbidity and mortality. Primary repair may be undertaken in patients who present within 24 hours of perforation and remains the gold standard. Increasingly, this strategy is being adopted for patients who present later with similar mortality rates. Diversion with exclusion and resectional procedures may be undertaken when repair is not possible.
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Moxey PW, Khan AZ, Karanjia ND. A case of small-bowel perforation caused by a migrated duodenal stent. Endoscopy 2007; 39 Suppl 1:E54. [PMID: 17323276 DOI: 10.1055/s-2006-944903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Khan AZ, Karanjia ND. The impact of staging laparoscopy prior to hepatic resection for colorectal metastases. Eur J Surg Oncol 2007; 33:1010-3. [PMID: 17267165 DOI: 10.1016/j.ejso.2006.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Accepted: 12/05/2006] [Indexed: 12/19/2022] Open
Abstract
AIMS To evaluate the role of routine laparoscopy as a staging modality prior to laparotomy and hepatic resection for metastatic colorectal cancer. METHODS Prospectively collected data were analysed from a database. In the first half of the series patients underwent selective laparoscopy before proceeding to laparotomy and in the second part of the series laparoscopy was used routinely. Patients undergoing laparotomy directly were analysed in Group 1 and those having laparoscopy before laparotomy in Group 2. The ability of laparoscopy to pick up unresectable and extrahepatic disease, resectability rate and open and close laparotomy rate were recorded. RESULTS Of the 284 patients, 74 were in Group 1 (no laparoscopy) and 210 in Group 2 (laparoscopy as standard). The resectability rate was 81% in Group 1 and 87% in Group 2. The open and close laparotomy rate was 19% and 8%, respectively (p=0.025). In Group 2 alone, laparoscopy identified 39% of unresectable disease and prevented an open and close procedure. CONCLUSIONS Routine use of staging laparoscopy increases the resectability rate and reduces the inoperability rate in these patients.
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Ren L, Khan AZ, Blohm G, Henriques DYP, Sergio LE, Crawford JD. Proprioceptive guidance of saccades in eye-hand coordination. J Neurophysiol 2006; 96:1464-77. [PMID: 16707717 DOI: 10.1152/jn.01012.2005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The saccade generator updates memorized target representations for saccades during eye and head movements. Here, we tested if proprioceptive feedback from the arm can also update handheld object locations for saccades, and what intrinsic coordinate system(s) is used in this transformation. We measured radial saccades beginning from a central light-emitting diode to 16 target locations arranged peripherally in eight directions and two eccentricities on a horizontal plane in front of subjects. Target locations were either indicated 1) by a visual flash, 2) by the subject actively moving the handheld central target to a peripheral location, 3) by the experimenter passively moving the subject's hand, or 4) through a combination of the above proprioceptive and visual stimuli. Saccade direction was relatively accurate, but subjects showed task-dependent systematic overshoots and variable errors in radial amplitude. Visually guided saccades showed the smallest overshoot, followed by saccades guided by both vision and proprioception, whereas proprioceptively guided saccades showed the largest overshoot. In most tasks, the overall distribution of saccade endpoints was shifted and expanded in a gaze- or head-centered cardinal coordinate system. However, the active proprioception task produced a tilted pattern of errors, apparently weighted toward a limb-centered coordinate system. This suggests the saccade generator receives an efference copy of the arm movement command but fails to compensate for the arm's inertia-related directional anisotropy. Thus the saccade system is able to transform hand-centered somatosensory signals into oculomotor coordinates and combine somatosensory signals with visual inputs, but it seems to have a poorly calibrated internal model of limb properties.
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Khan AZ, Pisella L, Vighetto A, Cotton F, Luauté J, Boisson D, Salemme R, Crawford JD, Rossetti Y. Optic ataxia errors depend on remapped, not viewed, target location. Nat Neurosci 2005; 8:418-20. [PMID: 15768034 DOI: 10.1038/nn1425] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2004] [Accepted: 02/25/2005] [Indexed: 11/09/2022]
Abstract
Optic ataxia is a disorder associated with posterior parietal lobe lesions, in which visually guided reaching errors typically occur for peripheral targets. It has been assumed that these errors are related to a faulty sensorimotor transformation of inputs from the 'ataxic visual field'. However, we show here that the errors observed in the contralesional field in optic ataxia depend on a dynamic gaze-centered internal representation of reach space.
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Khan AZ, Escofet X, Roberts KM, Salman AR. Spontaneous splenic rupture--a rare complication of amyloidosis. SWISS SURGERY = SCHWEIZER CHIRURGIE = CHIRURGIE SUISSE = CHIRURGIA SVIZZERA 2003; 9:92-4. [PMID: 12723290 DOI: 10.1024/1023-9332.9.2.92] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We present a case of spontaneous rupture of the spleen, an uncommon complication of systemic amyloidosis. Amyloid deposition leading to capsular distension and increased vascular fragility is thought to predispose the spleen to rupture spontaneously.
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Abstract
Eye-hand coordination is complicated by the fact that the eyes are constantly in motion relative to the head. This poses problems in interpreting the spatial information gathered from the retinas and using this to guide hand motion. In particular, eye-centered visual information must somehow be spatially updated across eye movements to be useful for future actions, and these representations must then be transformed into commands appropriate for arm motion. In this review, we present evidence that early visuomotor representations for arm movement are remapped relative to the gaze direction during each saccade. We find that this mechanism holds for targets in both far and near visual space. We then show how the brain incorporates the three-dimensional, rotary geometry of the eyes when interpreting retinal images and transforming these into commands for arm movement. Next, we explore the possibility that hand-eye alignment is optimized for the eye with the best field of view. Finally, we describe how head orientation influences the linkage between oculocentric visual frames and bodycentric motor frames. These findings are framed in terms of our 'conversion-on-demand' model, in which only those representations selected for action are put through the complex visuomotor transformations required for interaction with objects in personal space, thus providing a virtual on-line map of visuomotor space.
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