Unilateral Presentation Research Articles

A szakértői elfogultság a büntetőügyekben II. rész

Aim: In the two-part study, the article from Science about Itiel Dror's work is summarized, and then in this second part, his studies related to forensic pathology are studied in detail, with commentaries. All of the results are compared to other scientific papers. Methodology: After summarizing the second half of the Science article, the study performs a synthesis of numerous commentaries and other international papers. The authors' points of view are summarised at the end of the study. Findings: The cognitive bias of forensic experts can have a serious impact on the jurisdiction, yet detailed research on the topic had only started after the infamous mistaken identifications around the turn of the millennium. Itiel Dror's role in this is pioneering and undoubted, although this paper clarifies some of his statements, and discusses them in agreement with other authors. We also consider the unilateral presentation of bias to be dangerous. Bias cannot be eliminated or excluded, but with certain techniques, the forensic practitioner can try to reduce the danger. Value: The study provides a comprehensive picture of the problem of expert bias through the work of Itiel Dror, and also offers useful solutions to mitigate it.

Divergent Presentation of GRIN2B Neurodevelopmental Disorder in Monozygotic Twins: Case Report with Unique Imaging Phenotypes.

We describe a set of monozygotic twins with Glutamate Ionotropic Receptor N-methyl-D-aspartate Type Subunit 2B-related neurodevelopmental disorder (GRIN2B-ND) who exhibited distinct clinical and imaging characteristics due to a de novo heterozygous pathogenic variant in the GRIN2B gene (c.2453T > C, p.Met818Thr). Twin A displayed extensive symmetric malformation of cortical development (MCD) resembling polymicrogyria, accompanied by shallow sulci, dilated lateral ventricles, and dysplastic appearances of the basal ganglia, corpus callosum, and hippocampi. In twin B, malformative features, such as reduced brain volume, MCD, shallow sulci, and dilated lateral ventricle, were confined to the left hemisphere. In combination with previously published data, our report highlights variable phenotypes associated with the p.(Met818Thr) pathogenic variant, specifically with a potential for asymmetric or even unilateral presentation. We discuss the potential interplay between genetic and environmental factors underlying this phenomenon within the context of monozygotic twins. In addition, we also highlight the importance of recognizing potential genetic underpinnings in the assessment of apparently unilateral brain malformations.

Oculodermal melanocytosis in Asian Indian patients: Prevalence, clinical presentation, and association with choroidal melanoma.

To study the prevalence, clinical presentation, treatment, and follow-up of ocular (dermal) melanocytosis (ODM) and its association with choroidal melanoma (CM) in Asian Indian patients. This was a retrospective case series of patients with ODM conducted in a quaternary eye care center. Of the total 1.48 million patients during the study period, we identified 213 patients with ODM with a prevalence rate of 0.014%. Median age at presentation was 13 years (range 0-76 years). Unilateral presentation of ODM was noted in 87% cases. ODM involved the sclera in 100% cases, the iris in 23%, the choroid in 20%, the eyelid in 29%, and V1 and V2 dermatomes in 53% cases. Nineteen patients (9%) were found to have CM, with 1.3 times increased risk of CM compared to the Caucasian population. The most common tumor location was in the inferior quadrant (n = 8, 44%). The mean tumor thickness was 8.3 ± 2.8 mm with a mean basal diameter of 14.0 ± 4.3 mm. Primary treatment of CM included plaque brachytherapy (n = 6), enucleation (n = 9), and few patients refused for treatment (n = 3). During a mean follow-up period of 21 months, one patient died because of lung metastasis. Although rare, choroidal melanoma does occur in the presence of ODM with an increased risk in Asian Indians compared to the Caucasian population. Patients with ODM should be examined periodically for early detection of CM.

Review of atypical optic neuritis.

Optic neuritis (ON), an inflammatory optic neuropathy, is among the most common causes of visual loss. In its initial clinical appearance, ON may have unilateral or bilateral presentation, and anterior (papillitis) or retrobulbar localization. Traditionally, cases are divided into typical and atypical ON. In the Western hemisphere, most typical cases of optic nerve inflammation are associated with multiple sclerosis (MS). However, ON may also be associated with a series of disorders of known or initially undetected origin. Atypical ON has a somewhat different clinical picture from typical ON, and encompasses neuromyelitis optica spectrum disease (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), idiopathic recurrent neuroretinitis (NR), chronic relapsing inflammatory ON (CRION), ON within systemic autoimmune diseases, paraneoplastic and neuritis during or after infectious diseases or vaccination. The causes should be meticulously worked up, to address the therapeutic and prognostic challenges posed by these conditions. Here, we provide a brief overview of atypical ON, as encountered in our clinical practice, and additionally discuss the possible occurrence of optic neuropathies other than inflammatory and other ocular diseases within these disorders.

Ocular findings in dogs and cats following chemical injury by the Bronze Orange Bug (Musgraveia sulciventris).

To describe the ocular findings in dogs and cats after chemical injury by the Bronze Orange Bug (Musgraveia sulciventris), which is endemic to eastern Australia in Queensland and New South Wales. Medical records were reviewed for the keywords "stink bug" between February 2013 and January 2023. Signalment, clinical signs, month at presentation, and affected eye(s) were recorded. Cases were divided into confirmed and suspected cases. Twenty-four confirmed and nine suspected cases were identified, consisting of 26 dogs and seven cats. There were 19 females (57.6%) and 14 males (42.4%). Median age at presentation was 1.9 (range 0.16-12.5) years, with a median weight of 6.1 (range 1.3-25) kilograms. All cases presented between August and May, with the majority (75.7%) presenting in summer. This correlates with the breeding life cycle of the Bronze Orange Bug. Unilateral presentation was more common (97%; n = 32) than bilateral (3%; n = 1) with an increased incidence of left eyes (60.6%; n = 20) compared to right eyes (36.4%; n = 12). Presenting signs included acute onset blepharospasm (100%), superficial corneal ulceration (90.9%), conjunctival hyperemia (87.8%), chemosis (60.6%), periocular swelling (51.5%), conjunctival ulceration (39.4%), third eyelid protrusion (39.4%), miosis (36.4%), corneal edema (36.4%), and aqueous flare (24.2%). The median time to resolution of clinical signs was 13 days. The Bronze Orange Bug's defensive secretion causes acute onset ocular irritation consistent with acidic chemical burns in dogs and cats. Bronze Orange Bug exposure should be considered as a differential diagnosis in endemic areas, particularly during the summer months.

Hemispheric asymmetry for global-local processing: Effects of stimulus category and ageing.

Hemispheric asymmetry has been reported for global-local processing in young and older adults, with global processing specialised in the right hemisphere (RH-global specialisation) and local processing specialised in the left hemisphere (LH-local specialisation). Questions persist regarding the extent to which hemispheric asymmetry is influenced by stimulus category (verbal stimuli processed in the left hemisphere; visuospatial stimuli processed in the right hemisphere). Some evidence suggests stimulus category does not influence hemispheric asymmetry (stimulus-independent account) while other evidence suggests it does (stimulus-dependent account). In older adults, there is evidence of a local-processing advantage, believed to result from slower and less accurate performance in right-hemisphere compared to left-hemisphere functioning-the right-hemisphere ageing hypothesis. We examined hemispheric asymmetry for global-local processing in young and older participants with three hierarchical figures (letters, verbalisable objects, and nonverbalisable shapes), in a within-subjects design using a divided-attention paradigm and unilateral presentation. Our findings for letters and verbalisable objects support the stimulus-independent account-young and older participants demonstrated RH-global specialisation and LH-local specialisation regardless of stimulus category. In older participants, we also found a local-processing advantage for all three stimulus categories-an advantage best explained as faster and more accurate performance in local processing regardless of the visual field of stimulus presentation. Overall, we found hemispheric asymmetry for global-local processing in both young and older adults, and differences in global processing between young and older adults. Future investigation is suggested for the hemispheric asymmetry found in global-local processing of nonverbalisable shapes, and the mechanisms underlying age-related changes in global processing.

Clinical Presentation and Treatment Outcomes of Adult-Onset Coats Disease.

Purpose: To study the clinical profile, treatment, and outcomes of patients 35 years or older diagnosed with Coats disease. Methods: A cross-sectional observational hospital-based study was performed. Results: The study included 74 eyes diagnosed with adult-onset Coats disease. The mean age at presentation was 50 years (range, 35-75). Most patients were men (72.5%) and had a unilateral presentation (92.8%). The most common stage at presentation was 2A (extrafoveal exudation) (39.2%) followed by 2B (foveal exudation (33.7%). Optical coherence tomography was performed in 40 eyes; 32 eyes (80.0%) had intraretinal fluid (IRF), 31 eyes (77.5%) had hard exudates, and 22 eyes (55.0%) had a disorganized retinal inner layer. Fluorescein angiography was performed in 35 eyes and showed an irregular foveal avascular zone in 28 eyes (80.0%). Multiple leaking microaneurysms were seen in 32 eyes (91.4%), with extensive vascular abnormalities involving the macula (86%) and extramacular zones (91%). Treatment modalities comprised laser photoablation (43.4%), cryotherapy with or without laser application (5.7%), and intravitreal injections (49%), alone or in combination. At a mean follow-up of 28 months (range, 3-293), 23 eyes (39.6%) had anatomic resolution of subretinal fluid and/or IRF. No statistical improvement was found in the mean best-corrected visual acuity (VA) between preoperatively and postoperatively (P > .05). Conclusions: Patients with adult-onset Coats disease have a unilateral presentation with a less severe stage than patients with childhood-onset disease. Despite the good anatomic responses after treatment, the final VA remained unchanged.

Unilateral Hearing Loss and Auditory Asymmetry in Mitochondrial Disease: A Scoping Review.

Background/Objectives: Mitochondrial transfer RNA mutations are one of the most important causes of hereditary hearing loss in humans. In most cases, its presentation is bilateral and symmetrical; however, there are numerous cases of single-sided presentation or asymmetrical onset described in the literature that may represent a diagnostic challenge. The aim of this review is to present the evidence of auditory asymmetry in mitochondrial diseases, highlighting the possible presence of cases with atypical presentation. Methods: A review of the English literature to date on hearing loss and mitochondrial diseases was performed using PubMed, Scopus, and Google Scholar databases. The literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for scoping review. Results: A total of 10 full-text articles were included in this review, comprising 25 patients with single-sided or asymmetrical hearing loss associated with mitochondrial disease. Conclusions: Sensorineural hearing loss due to mitochondrial disease can represent a complex diagnostic challenge in cases of asymmetric or unilateral presentation. It is critical to recognize this clinical variant and to diagnose it in daily clinical practice.

Salzmann Nodular Degeneration in Ocular and Systemic Diseases.

This review aimed to evidence the predisposing conditions for Salzmann nodular degeneration (SND), where particular attention was paid to its association with ocular and systemic diseases. SND is a rare disease characterized by bluish-white nodules located in the mid-periphery of the cornea, which are otherwise completely clear. SND has been found in association with different systemic and ocular diseases, and it may have unilateral or bilateral presentation. Initial forms are only diagnosed occasionally as they are asymptomatic, whereas, in advanced disease, the visual acuity might be seriously impaired. Although SND is well described, its exact etiopathology is currently still unknown and is frequently misdiagnosed. It is associated with ocular surface inflammatory conditions and previous corneal surgery, and it has been described in different systemic diseases. Diagnosis is clinically based with slit lamp examinations, and instrumental assessments with corneal topography permit one to observe the alterations of the corneal profile, whereas anterior segment-optical coherence tomography (AS-OCT) is used to investigate the stromal depth of the nodules. Therapy might be conservative with the objective of improving the ocular surface homeostasis and surgical outcomes, where the aim is to restore the corneal regularity and visual acuity. Ophthalmologists should pay particular attention when detecting nodules in patients with ocular and non-ocular inflammatory diseases to guarantee the patient a timely diagnosis and a better therapeutic outcome. Additionally, collaboration between specialists who deal with treating patients suffering from disorders potentially associated with SND is recommended.

The Linburg-Comstock Anomaly: A Study on Prevalence and Effect on Various Strength Metrics.

The Linburg-Comstock (LC) anomaly is a common tendinous connection between the flexor pollicis longus and flexor digitorum profundus (FDP), most frequently to the FDP of the index finger. The purpose of this study was to obtain epidemiologic data on the LC anomaly in a healthy, ethnically diverse population and to study the effect of the LC anomaly on grip strength, tip pinch strength, key pinch strength, and chuck pinch strength. We examined 500 healthy subjects (292 females and 208 males) bilaterally for the presence of the LC anomaly. Each subject had their grip strength, tip pinch strength, key pinch strength, and chuck pinch strength measured bilaterally using a dynamometer for grip strength and a pinch meter for all pinch strength measurements. The LC anomaly was present in 213 of the 500 subjects (43%). One hundred one subjects (47%) had a unilateral presentation, and 112 (53%) subjects had a bilateral presentation. The LC anomaly was associated with a weaker tip pinch strength. When examining the LC anomaly among different ethnic groups, the highest prevalence was found in the Hispanic (57%) population followed by Caucasian (50%), Asian (41%), and African American (31%) populations. The LC anomaly has different prevalence according to ethnicity, with a higher prevalence in the Hispanic and Caucasian populations and a lower overall prevalence in the African American populations. The LC anomaly can also result in weaker tip pinch strength.

Bilateral idiopathic oculomotor neuropathy in a cat

AbstractIdiopathic oculomotor neuropathy is a well‐recognised syndrome in people, and it has also been described in dogs. In dogs, the disease appears to have a good prognosis; however, only reports of a unilateral presentation exist. Evidence of oculomotor dysfunction in cats has been previously associated with intracranial neoplasia, with a poor prognosis. This case report describes the clinical and imaging findings and outcome of a 12‐year‐old, male, neutered, domestic shorthair cat with bilateral mydriasis, unresponsive to light, as the sole clinical sign. Thorough diagnostic investigations led to a diagnosis of bilateral idiopathic oculomotor neuropathy. No treatment was prescribed, and there was no change in the clinical signs with 9‐month follow‐up. To the authors’ knowledge, this is the first report of bilateral idiopathic oculomotor neuropathy in a cat, which, based on this case, suggests a good prognosis with minimal adverse impact on the patient.

MR Imaging Findings in Anti-Leucine-Rich Glioma Inactivated Protein 1 Encephalitis: A Systematic Review and Meta-analysis.

Antibodies against leucine-rich glioma inactivated protein 1 (LGI1) constitute a common form of autoimmune encephalitis. On MR imaging, it may show T2 FLAIR hyperintensities of the medial temporal lobe (T2 FLAIR-MTL), involve the basal ganglia, or be unremarkable. We performed a systematic review and meta-analysis to obtain prevalence estimates of abnormal findings on MR imaging in anti-LGI1 encephalitis. A human brain map of the LGI1 microarray gene expression was derived from the Allen Human Brain Atlas. PubMed and Web of Science were searched with the terms "LGI1" and "encephalitis" from inception to April 7, 2022. Thirty-one research publications, encompassing case series and retrospective cohort and case-control studies, with >10 patients with anti-LGI1 encephalitis and MR imaging data were included. Pooled prevalence estimates were calculated using Freeman-Tukey double-arcsine transformation. Meta-analysis used DerSimonian and Laird random effects models. Of 1318 patients in 30 studies, T2 FLAIR-MTL hyperintensities were present in 54% (95% CI, 0.48-0.60; I2 = 76%). Of 394 patients in 13 studies, 27% showed bilateral (95% CI, 0.19-0.36; I2 = 71%) and 24% unilateral T2 FLAIR-MTL abnormalities (95% CI, 0.17-0.32; I2 = 61%). Of 612 patients in 15 studies, basal ganglia abnormalities were present in 10% (95% CI, 0.06-0.15; I2 = 67%). LGI1 expression was highest in the amygdala, hippocampus, and caudate nucleus. Only part of the spectrum of MR imaging abnormalities in anti-LGI1 encephalitis could be included in a meta-analysis. MR imaging findings were not the main outcomes in most studies, limiting available information. I2 values ranged from 62% to 76%, representing moderate-to-large heterogeneity. T2 FLAIR-MTL hyperintensities were present in around one-half of patients with anti-LGI1. The prevalence of unilateral and bilateral presentations was similar, suggesting unilaterality should raise the suspicion of this disease in the appropriate clinical context. Around 10% of patients showed basal ganglia abnormalities, indicating that special attention should be given to this region. LGI1 regional expression coincided with the most frequently reported abnormal findings on MR imaging. Regional specificity might be partially determined by expression levels of the target protein.

Aetiological Profile, Clinical Features and Risk Factors for Otomycosis in Dar Es Salaam, Tanzania: A Cross-Sectional Study.

Otomycosis is a commonly encountered otological disorder in otorhinolaryngology practice. It has several predisposing factors such as habitual use of cotton buds, water in the ear, hot humid atmospheric condition or high temperature. Diagnosis of otomycosis frequently relies on the patient's history, otoscopic examination and ascertained clinical features and therefore posing diagnostic and therapeutic challenges. Data on otomycosis in Tanzania are scarce. A hospital based descriptive cross-sectional study was conducted at a private hospital from January to June 2022 in Dar es Salaam, Tanzania. All the clinically diagnosed cases were enrolled in the study with typical symptoms and characteristic fungal debris in the external auditory canal. Data was collected using semi-structured questionnaires and analyzed using Statistical Package for Social Sciences version 23. A total of 250 patients were recruited in this study. Majority were females, 153(81.2%) while males were 97(38.8%). Otomycosis was found to be predominantly unilateral in 203 (81.2%) patients. The commonest presenting complaint was ear itching (94.0%) followed by earache (78.6%), hearing loss (75.6%), ear fullness (74.4%), ear discharge (61.2%) and ringing sensation (14.0%). Based on the type of fungal debris on Otoendoscopy, whitish debris was more predominant in 191 (76.4%) patients followed by yellowish debris, 37 (14.8%), blackish debris, 15 (6.0%) and mixed (whitish-black) debris in 7 (2.8%) patients. The commonest risk factor was earbud use (40.8%) and the least one was comorbid conditions (4.4%). Females were more affected by otomycosis. The commonest otological complaint was ear itching while the least one was ringing sensation. Unilateral presentation of otomycosis predominated and the left ear was more affected. The commonest type of fungal debris was whitish debris and the least one was the mixed type (whitish-black). The commonest risk factor for otomycosis was earbud use and the least was comorbid conditions.

Role of Magnetic Resonance Imaging in the Evaluation of Trigeminal Neuralgia Using Steady-State Imaging.

Trigeminal neuralgia (TN) poses diagnostic challenges due to its complex origins, often associated with neurovascular compression. Advanced imaging techniques, particularly magnetic resonance imaging (MRI) with thefast imaging employing steady-state acquisition (FIESTA) sequence, offer crucial insights into TN pathophysiology. This prospective cross-sectional observational study aimed to elucidate MRI's utility in diagnosing TN and correlating imaging findings with clinical manifestations and treatment outcomes. A cohort of 41 patients clinically suspected of TN underwent MRI evaluation at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, utilizing various sequences including FIESTA. Analysis revealed a higher incidence among females, predominant unilateral presentation, and a higher prevalence of abnormal MRI findings, with neurovascular compression as the leading etiology. Correlation analysis demonstrated significant associations between facial pain localized to the trigeminal nerve distribution, triggering factors, and abnormal MRI findings. Gender distribution did not significantly influence MRI findings. Treatment outcomes favored microvascular surgery over conservative management in cases of neurovascular compression. This study underscores MRI's pivotal role, particularly FIESTA, in TN evaluation, guiding personalized treatment strategies and emphasizing the importance of integrated clinical and imaging approaches. Further research is warranted to validate these findings and explore additional imaging modalities for a deeper understanding of TN pathogenesis.

The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma.

Background: This study compares the outcomes of managing retinoblastoma between patients with unilateral and bilateral presentations. Methods: The study, conducted at the King Hussein Cancer Center in Amman, Jordan, retrospectively analyzed cases of retinoblastoma treated between March 2003 and December 2019. Evaluation criteria included clinical features, disease stage, treatment methods, and overall management outcomes. Results: The study comprised 697 eyes from 478 patients with retinoblastoma, with 52% being males. Bilateral disease was observed in 70% of patients, and a family history of retinoblastoma was more prevalent in cases with bilateral disease (20%) compared to those with unilateral disease (4%). Unilateral cases had a median age at diagnosis of 28 months, whereas bilateral cases were diagnosed at a median age of 6 months. Extra-ocular retinoblastoma was detected in 1% of eyes. According to the International Intraocular Retinoblastoma Classification (IIRC), 88% of unilateral cases presented with advanced disease (IIRC group D/E), compared to 46% in bilateral cases. Primary enucleation was performed in 29% of unilateral cases and 16% of bilateral cases (p-value 0.0007). Eye salvage rates were 31% in unilateral cases and 68% in bilateral cases (p-value < 0.0001). At 120 months of follow-up, 5% of patients died from secondary neoplasms or metastases, 81% were alive, and 14% were lost to follow-up. There was no significant difference in metastasis, secondary neoplasms, or mortality between patients with unilateral and bilateral retinoblastoma. Conclusions: This study highlights the nuanced differences in clinical characteristics and outcomes between unilateral and bilateral retinoblastoma, emphasizing the necessity of customized management and early detection strategies. It demonstrates that while bilateral retinoblastoma benefits from earlier detection and has a higher rate of eye salvage, there is no significant difference in metastasis or mortality rates when compared to unilateral cases. The critical roles of primary enucleation in advanced cases, along with effective communication and patient education, are also underscored to improve treatment adherence. Overall, these findings point to the importance of tailored approaches in optimizing outcomes for the diverse patient population affected by retinoblastoma.

Blepharochalasis and Lichen Planus Pigmentosus: A Very Rare Association

AbstractBlepharochalasis syndrome is a condition of the eyelids consisting of episodic inflammation and chronic skin changes. It is usually bilateral and tends to manifest in the upper eyelids. But, there are cases of unilateral presentation also which exclusively affects the lower eyelids. There are multiple theories regarding the etiology of blepharochalasis. Blepharochalasis is believed to be a manifestation of angioneurotic edema. Hormonal changes may play an important role in the disease process. Immunohistochemical analysis of excised eyelid skin has demonstrated the presence of IgA in several studies. These findings suggest that there may be a concomitant inflammatory process accompanying the extravasations’ of fluid and localized edema occurring at the capillary level. Blepharochalasis might also present as part of systemic disease. The disease, lichen planus pigmentosus, is a variant of lichen planus and has also been noted the presence of IgA and IgG along with complement C3 in the epidermal cells in several studies.

Cone-beam computed tomographic evaluation to estimate the prevalence of palatogingival groove in the maxillary anterior teeth and its radiographic characteristics: An institutional retrospective study.

The purpose of the study was to radiographically evaluate the prevalence of palatogingival groove (PG) in the East Indian population in the maxillary anterior teeth in different genders, its unilateral/bilateral presentation, classified based on its radiographic characteristics, to determine the prevalence of different types, which could help in future treatment planning. The design of the study was a retrospective study. Analysis of 429 maxillary anterior teeth (144 central incisors, 145 lateral incisors, and 139 canines) in 72 cone-beam computed tomography scans was done (31 males and 41 females, mean age 27.3 ± 7.63). Demographic details of patients and characteristics of PG, i.e. location, extension, depth, and type, were recorded. The presence of alveolar bone loss and periapical pathology was noted. An overall prevalence of PG was found to be 2.33% (n = 10), with PG being detected in 2 (1.388%) central incisors, 8 (5.51%) lateral incisors, and 0 (0%) canines. Eight of the patients had a unilateral presence, while one patient reported with bilateral presence, implying a significantly higher predilection of unilateral occurrence (P = 0.02). The prevalence was found to be higher in females (n = 8). The teeth were categorized as either having Type I (6 teeth), Type II (3 teeth), or Type III (1 teeth). Three of the 10 PGs were present in the mesial, six in the mid-palatal, and one in the distal portion of the palatal surface. The prevalence of PG in the maxillary incisors in this cohort is 2.33%. The maxillary lateral incisors are the most affected teeth. Unilateral presentation is more common.

Impairment of unconscious emotional processing after unilateral medial temporal structure resection

The role of the amygdala in unconscious emotional processing remains a topic of debate. Past lesion studies have indicated that amygdala damage leads to impaired electrodermal activity in response to subliminally presented emotional stimuli. However, electrodermal activity can reflect both emotional and nonemotional processes. To provide behavioral evidence highlighting the critical role of the amygdala in unconscious emotional processing, we examined patients (n = 16) who had undergone unilateral resection of medial temporal lobe structures, including the amygdala. We utilized the subliminal affective priming paradigm in conjunction with unilateral visual presentation. Fearful or happy dynamic facial expressions were presented in unilateral visual fields for 30 ms, serving as negative or positive primes. Subsequently, neutral target faces were displayed, and participants were tasked with rating the valence of these targets. Positive primes, compared to negative ones, enhanced valence ratings of the target to a greater extent when they stimulated the intact hemisphere (i.e., were presented in the contralateral visual field of the intact hemisphere) than when they stimulated the resected hemisphere (i.e., were presented in the contralateral visual field of the resected hemisphere). These results suggest that the amygdala is causally involved in unconscious emotional processing.

Neutrophilic dermatosis of dorsal hands: A unilateral presentation

A rare localized version of Sweet syndrome known as neutrophilic dermatosis of dorsal hands is characterized by bluish or hemorrhagic papules, bullae, and nodules on the dorsal hands. Cases have been associated with myeloproliferative disorders, malignancy, inflammatory bowel disease, and rheumatoid arthritis. We are reporting a case of a 39-year-old male presented with sudden onset hyperpigmented raised lesions studded with fluid-filled vesicles on the left dorsal hands. Histology confirmed the clinical diagnosis of neutrophilic dermatosis of dorsal hands. Unilateral presentation of neutrophilic dermatosis of dorsal hands is rarely encountered in day-to-day practice. Hence, we are reporting this case.

Interhemispheric reactivity of the subthalamic nucleus sustains progressive dopamine neuron loss in asymmetrical parkinsonism

Parkinson's disease (PD) is characterized by the progressive and asymmetrical degeneration of the nigrostriatal dopamine neurons and the unilateral presentation of the motor symptoms at onset, contralateral to the most impaired hemisphere. We previously developed a rat PD model that mimics these typical features, based on unilateral injection of a substrate inhibitor of excitatory amino acid transporters, L-trans-pyrrolidine-2,4-dicarboxylate (PDC), in the substantia nigra (SN). Here, we used this progressive model in a multilevel study (behavioral testing, in vivo 1H-magnetic resonance spectroscopy, slice electrophysiology, immunocytochemistry and in situ hybridization) to characterize the functional changes occurring in the cortico-basal ganglia-cortical network in an evolving asymmetrical neurodegeneration context and their possible contribution to the cell death progression. We focused on the corticostriatal input and the subthalamic nucleus (STN), two glutamate components with major implications in PD pathophysiology. In the striatum, glutamate and glutamine levels increased from presymptomatic stages in the PDC-injected hemisphere only, which also showed enhanced glutamatergic transmission and loss of plasticity at corticostriatal synapses assessed at symptomatic stage. Surprisingly, the contralateral STN showed earlier and stronger reactivity than the ipsilateral side (increased intraneuronal cytochrome oxidase subunit I mRNA levels; enhanced glutamate and glutamine concentrations). Moreover, its lesion at early presymptomatic stage halted the ongoing neurodegeneration in the PDC-injected SN and prevented the expression of motor asymmetry. These findings reveal the existence of endogenous interhemispheric processes linking the primary injured SN and the contralateral STN that could sustain progressive dopamine neuron loss, opening new perspectives for disease-modifying treatment of PD.