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Emi Itoshima - One of the best experts on this subject based on the ideXlab platform.
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Phenotype–phenotype and genotype–phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy
Journal of Human Genetics, 2012Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle ( r =−0.43 with P =0.0084, r =−0.34 with P =0.038, and r =−0.43 with P =0.009, respectively, n =37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms ( P =0.017, n =35, Mann–Whitney U -test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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Phenotype-phenotype and genotype-phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy.
Journal of Human Genetics, 2011Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle (r=−0.43 with P=0.0084, r=−0.34 with P=0.038, and r=−0.43 with P=0.009, respectively, n=37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms (P=0.017, n=35, Mann–Whitney U-test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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paretic side normal side ratios of cross sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy
American Journal of Ophthalmology, 2010Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
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Paretic side/normal side ratios of cross-sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy.
American journal of ophthalmology, 2009Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
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Clinical features, ARIX and PHOX2B nucleotide changes in three families with congenital Superior Oblique Muscle palsy
Acta Medica Okayama, 2008Co-Authors: Sayuri Imai, Emi Itoshima, Toshihiko Matsuo, Hiroshi OhtsukiAbstract:We analyzed nucleotide changes in 3 genes, ARIX, PHOX2B, and KIF21A, in 6 patients of 3 families with congenital Superior Oblique Muscle palsy. Three exons of ARIX, 3 exons of PHOX2B, and exons 8, 20, and 21 of KIF21A were amplified by polymerase chain reaction from genomic DNA isolated from the peripheral blood. The DNA fragments were directly sequenced in both directions. In 2 different families, a heterozygous nucleotide change, ARIX 153G>A, in the 5’-untranslated region was found in common between a father and daughter with Muscle palsy and between a mother and daughter with Muscle palsy (Family No. 1 and No. 3). In the other family (Family No. 2), a heterozygous 15-nucleotide deletion, PHOX2B 1124del15, resulting in loss of 5 alanine residues in the alanine repeat of the protein, was found in the daughter with Muscle palsy and her father with normal traits, but was not found in the mother with Muscle palsy. No KIF21A nucleotide change was found in any patients. The ARIX 153G>A polymorphism might be a genetic risk factor for the development of congenital Superior Oblique Muscle palsy.
Toshihiko Matsuo - One of the best experts on this subject based on the ideXlab platform.
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Clinical factors underlying a single surgery or repetitive surgeries to treat Superior Oblique Muscle palsy
SpringerPlus, 2015Co-Authors: Kana Aoba, Toshihiko Matsuo, Ichiro Hamasaki, Kayoko HasebeAbstract:The purpose of this study is to know clinical factors underlying either a single surgery or repetitive surgeries, required to treat Superior Oblique Muscle palsy. Retrospective review was made on 246 consecutive patients with idiopathic (n = 212) or acquired (n = 34) Superior Oblique Muscle palsy who underwent surgeries in 8 years at one institution. Idiopathic palsy included congenital and decompensated palsies while acquired palsy included traumatic and ischemic palsies. Clinical factors, compared between groups with a single surgery (n = 203) and two or more surgeries (n = 43), were surgical methods, sex, age at surgery, horizontal, vertical, and cyclotorsional deviations, and stereopsis at near fixation. Inferior Oblique Muscle recession on paretic side was chosen in about 60% of the single-surgery and repetitive-surgery group as an initial surgery, followed by inferior rectus Muscle recession on non-paretic side. The age at surgery was significantly older, vertical and cyclotorsional deviations were significantly larger in the repetitive-surgery group, compared with the single-surgery group (P = 0.01, P < 0.001, P = 0.02, Mann–Whitney U-test, respectively). The 95% confidence interval of vertical deviations was 15–17 prism diopters in the single-surgery group and 23–28 prism diopters in the repetitive surgery group. Significant differences in vertical deviations were replicated also in subgroups of patients with either idiopathic or acquired palsy. In conclusions, the 95% confidence interval of vertical deviations, determined by alternate prism and cover test, would be used as a common benchmark for predicting either a single surgery or repetitive surgeries, required to treat idiopathic and acquired Superior Oblique Muscle palsy, in the process of obtaining the informed consent.
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Phenotype–phenotype and genotype–phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy
Journal of Human Genetics, 2012Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle ( r =−0.43 with P =0.0084, r =−0.34 with P =0.038, and r =−0.43 with P =0.009, respectively, n =37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms ( P =0.017, n =35, Mann–Whitney U -test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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Phenotype-phenotype and genotype-phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy.
Journal of Human Genetics, 2011Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle (r=−0.43 with P=0.0084, r=−0.34 with P=0.038, and r=−0.43 with P=0.009, respectively, n=37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms (P=0.017, n=35, Mann–Whitney U-test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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paretic side normal side ratios of cross sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy
American Journal of Ophthalmology, 2010Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
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Paretic side/normal side ratios of cross-sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy.
American journal of ophthalmology, 2009Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
Hiroshi Ohtsuki - One of the best experts on this subject based on the ideXlab platform.
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Phenotype–phenotype and genotype–phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy
Journal of Human Genetics, 2012Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle ( r =−0.43 with P =0.0084, r =−0.34 with P =0.038, and r =−0.43 with P =0.009, respectively, n =37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms ( P =0.017, n =35, Mann–Whitney U -test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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Phenotype-phenotype and genotype-phenotype correlations in patients with idiopathic Superior Oblique Muscle palsy.
Journal of Human Genetics, 2011Co-Authors: Sayuri Imai Ohkubo, Emi Itoshima, Toshihiko Matsuo, Kayoko Hasebe, Yoshie Hirai Shira, Hiroshi OhtsukiAbstract:Idiopathic Superior Oblique Muscle palsy presents, as quantitative phenotypes, vertical deviation and cyclodeviation in eye alignment on clinical testing, and Superior Oblique Muscle hypoplasia on imaging. We determined ARIX and PHOX2B polymorphisms as genotypes, and analyzed phenotype–phenotype and genotype–phenotype correlations in 37 patients with idiopathic Superior Oblique Muscle palsy. Vertical deviations were measured at upright position of the head and head tilt for 30° to either side, and angles of objective excyclodeviations were determined by image analysis on fundus photographs. Cross-sectional areas of the Superior Oblique Muscle near the eye globe-optic nerve junction were measured by image analysis on coronal sections of magnetic resonance imaging to calculate the paretic-side/normal-side ratios. Among the phenotypes, the increase in vertical deviations elicited by head tilt to the paretic side, the decrease in vertical deviations elicited by head tilt to the normal side and the difference of angles of objective excyclodeviations between the paretic side and normal side were significantly correlated inversely with the paretic-side/normal-side ratios of the cross-sectional areas of the Muscle (r=−0.43 with P=0.0084, r=−0.34 with P=0.038, and r=−0.43 with P=0.009, respectively, n=37, Pearson's correlation test). Fifteen patients with ARIX and/or PHOX2B polymorphisms had significantly greater paretic-side/normal-side ratios of the Muscle compared with 20 patients without the polymorphisms (P=0.017, n=35, Mann–Whitney U-test). The patients with ARIX and/or PHOX2B polymorphisms had less hypoplastic Superior Oblique Muscles.
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Clinical features, ARIX and PHOX2B nucleotide changes in three families with congenital Superior Oblique Muscle palsy
Acta Medica Okayama, 2008Co-Authors: Sayuri Imai, Emi Itoshima, Toshihiko Matsuo, Hiroshi OhtsukiAbstract:We analyzed nucleotide changes in 3 genes, ARIX, PHOX2B, and KIF21A, in 6 patients of 3 families with congenital Superior Oblique Muscle palsy. Three exons of ARIX, 3 exons of PHOX2B, and exons 8, 20, and 21 of KIF21A were amplified by polymerase chain reaction from genomic DNA isolated from the peripheral blood. The DNA fragments were directly sequenced in both directions. In 2 different families, a heterozygous nucleotide change, ARIX 153G>A, in the 5’-untranslated region was found in common between a father and daughter with Muscle palsy and between a mother and daughter with Muscle palsy (Family No. 1 and No. 3). In the other family (Family No. 2), a heterozygous 15-nucleotide deletion, PHOX2B 1124del15, resulting in loss of 5 alanine residues in the alanine repeat of the protein, was found in the daughter with Muscle palsy and her father with normal traits, but was not found in the mother with Muscle palsy. No KIF21A nucleotide change was found in any patients. The ARIX 153G>A polymorphism might be a genetic risk factor for the development of congenital Superior Oblique Muscle palsy.
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Static Otolith-ocular Reflex Reflects Superior Oblique Muscle Disorder
American journal of ophthalmology, 2006Co-Authors: Ichiro Hamasaki, Satoshi Hasebe, Hiroshi OhtsukiAbstract:Purpose To elucidate the action of static otolith-ocular reflex (sOOR) in patients with Superior Oblique palsy (SOP). Design Observational case series study. Methods Compensatory ocular countertorsion produced by sOOR was analyzed in 12 patients with unilateral SOP and 11 normal subjects using a head-mounted measuring system. Results When the head was tilted laterally to the ipsilateral side, the mean ratio (%) of compensatory countertorsion of the paretic eye in SOP patients to the head-tilt angle was significantly decreased compared with that in normal subjects (7 ± 6% for patients and 17 ± 4% for normal subjects, P P Conclusions sOOR reflects the anatomic disorder of the Superior Oblique Muscle in SOP.
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ARIX and PHOX2B polymorphisms in patients with congenital Superior Oblique Muscle palsy
Acta medica Okayama, 2005Co-Authors: Y. Jiang, Toshihiko Matsuo, Hiroshi Ohtsuki, Hirotake Fujiwara, Satoshi Hasebe, Tatsuji YasudaAbstract:To identify ARIX gene and PHOX2B gene polymorphisms in patients with congenital Superior Oblique Muscle palsy, 3 exons of the ARIX gene and PHOX2B gene were sequenced by genomic DNA amplification with polymerase chain reaction (PCR) and direct sequencing in 31 patients with congenital Superior Oblique Muscle palsy and in 54 normal individuals. A family with a father and one daughter each having congenital Superior Oblique Muscle palsy was also included in this study. Eleven patients with congenital Superior Oblique Muscle palsy had heterozygous nucleotide changes in the ARIX gene, including 4 patients reported on previously. One patient with atrophy of the Superior Oblique Muscle had a new change of T-4G in the promoter region of the ARIX gene. The other 6 patients had a heterozygous nucleotide change of G153A in the 5'-untranslated region (UTR) of the exon 1 of the ARIX gene. These nucleotide changes of the ARIX gene, taken together, had a significant association with congenital Superior Oblique Muscle palsy(P = 0.0022). One patient and 5 patients had heterozygous nucleotide changes of A1106 C and A1121 C in exon 3 of the PHOX2B gene, respectively, while these changes were absent in the normal individuals. Two patients had both the G153A change in the 5'-UTR of exon 1 of the ARIX gene and the A1121 C change in exon 3 of the PHOX2B gene. In conclusion, the polymorphisms of the ARIX gene and PHOX2B gene may be genetic risk factors for the development of congenital Superior Oblique Muscle palsy.
Eriko Uchiyama - One of the best experts on this subject based on the ideXlab platform.
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paretic side normal side ratios of cross sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy
American Journal of Ophthalmology, 2010Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
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Paretic side/normal side ratios of cross-sectional areas of the Superior Oblique Muscle vary largely in idiopathic Superior Oblique palsy.
American journal of ophthalmology, 2009Co-Authors: Eriko Uchiyama, Sayuri Imai, Toshihiko Matsuo, Emi ItoshimaAbstract:Purpose To search for a new definition of Muscle hypoplasia in congenital or idiopathic Superior Oblique Muscle palsy. Design Retrospective case-control study. Methods Cross-sectional areas of the Superior Oblique and 4 rectus Muscles near the eye globe–optic nerve junction were measured by an image analysis software on magnetic resonance images of 50 patients with congenital or idiopathic Superior Oblique Muscle palsy and 45 patients with other disease conditions serving as a control. The paretic side/contralateral normal side ratios of the cross-sectional areas and the left side/right side ratios were calculated for the Superior Oblique Muscle palsy patients and the control patients, respectively. Results The 95% confidence intervals in paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle were 0.55 to 0.80 in the right-side Superior Oblique Muscle palsy, and 0.48 to 0.75 in the left-side palsy, while the 95% confidence interval in the left side/right side ratios was 0.99 to 1.00 in the control. The 95% confidence intervals in the left side/right side ratios of the 4 rectus Muscles were 1.00, both in the Superior Oblique Muscle palsy and in the control. Conclusions The Muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the Superior Oblique Muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls.
Juan A Pareja - One of the best experts on this subject based on the ideXlab platform.
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referred pain from the trochlear region in tension type headache a myofascial trigger point from the Superior Oblique Muscle
Headache, 2005Co-Authors: Cesar Fernandez De Las Penas, Maria Luz Cuadrado, Robert D Gerwin, Juan A ParejaAbstract:Background.—Tension-type headache (TTH) is a prototypical headache in which myofascial trigger points (MTrPs) can play an important role. To our knowledge, MTrPs in the Muscle tissues of the trochlear region, ie, the Superior Oblique Muscle (SOM), have not been previously mentioned, and a referred pain pattern from this region has never been reported. Objective.—To describe the referred pain from the trochlear area based on the examination of MTrPs in the SOM in patients with episodic and chronic TTH (CTTH). Design.—A blinded, controlled study. Methods.—The trochlear region was examined in 15 patients with CTTH, 15 patients with episodic TTH (ETTH), and 15 control subjects. Referred pain elicited by different maneuvers performed during manual palpation, ie, maintained pressure, active Muscle contraction, and stretching of the Muscle, was assessed with a visual analogue scale. Patients with ETTH were examined on days when they were headache-free, whereas CTTH patients were examined on days in which headache intensity was less than 4 points on a 10-cm horizontal visual analogue scale. Results.—Eighty-six percent of patients with CTTH and 60% with ETTH had referred pain that originated from MTrPs in the SOM, while only 27% of the controls reported referred pain. This pain was perceived as a deep ache located at the retro-orbital region, sometimes extending to the supra-orbital region or the homo-lateral forehead. Pain intensity was greater in CTTH patients than in ETTH patients or control subjects (P < .001). Conclusions.—MTrPs in the SOM may evoke a typical referred pain pattern in patients with TTH. The presence of a myofascial disorder in the trochlear region might contribute to the pathogenesis of TTH.
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referred pain from the trochlear region in tension type headache a myofascial trigger point from the Superior Oblique Muscle
Headache, 2005Co-Authors: Cesar Fernandez De Las Penas, Maria Luz Cuadrado, Robert D Gerwin, Juan A ParejaAbstract:BACKGROUND: Tension-type headache (TTH) is a prototypical headache in which myofascial trigger points (MTrPs) can play an important role. To our knowledge, MTrPs in the Muscle tissues of the trochlear region, ie, the Superior Oblique Muscle (SOM), have not been previously mentioned, and a referred pain pattern from this region has never been reported. OBJECTIVE: To describe the referred pain from the trochlear area based on the examination of MTrPs in the SOM in patients with episodic and chronic TTH (CTTH). DESIGN: A blinded, controlled study. METHODS: The trochlear region was examined in 15 patients with CTTH, 15 patients with episodic TTH (ETTH), and 15 control subjects. Referred pain elicited by different maneuvers performed during manual palpation, ie, maintained pressure, active Muscle contraction, and stretching of the Muscle, was assessed with a visual analogue scale. Patients with ETTH were examined on days when they were headache-free, whereas CTTH patients were examined on days in which headache intensity was less than 4 points on a 10-cm horizontal visual analogue scale. RESULTS: Eighty-six percent of patients with CTTH and 60% with ETTH had referred pain that originated from MTrPs in the SOM, while only 27% of the controls reported referred pain. This pain was perceived as a deep ache located at the retro-orbital region, sometimes extending to the supra-orbital region or the homo-lateral forehead. Pain intensity was greater in CTTH patients than in ETTH patients or control subjects (P < .001). CONCLUSIONS: MTrPs in the SOM may evoke a typical referred pain pattern in patients with TTH. The presence of a myofascial disorder in the trochlear region might contribute to the pathogenesis of TTH.
