Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis

IntroductionCaloric testing is the most frequently used test to assess peripheral vestibular function since the beginning of the 20th century. However, the video head impulse test, vHIT, has gained prominence in the field of neurotology, as it is a faster examination, easier to perform and less uncomfortable for the patient.ObjectiveTo compare, through systematic review and meta-analysis, the proportion of altered cases between vHIT tests and caloric testing in patients with chronic dizziness, in addition to assessing the sensitivity and specificity of vHIT, with caloric testing as the gold standard.MethodsThe literature search was carried out in the PubMed, Scopus, BVS-Bireme, Web of Science, Embase, Cochrane and ProQuest indexed databases, with no restrictions regarding the publication period. All articles that contained the results of the two tests were included in the evaluation of patients with dizziness. Two researchers independently conducted data selection and extraction from the studies, strictly following the inclusion and exclusion criteria defined in the research protocol. In case of disagreement during the selection, a discussion was carried out with a third evaluator.ResultsEleven of the 1293 initial articles met the eligibility criteria and were analyzed. 2670 patients were evaluated, of which 1112 (41.6%) were males and 1558 (58.4%) females, with a mean age of 51.6 years. The proportion of altered results in the vHIT was 21% (95%CI 9% –33%), and 55% in the caloric testing (95%CI 43% –67%).ConclusionThe vHIT does not substitute for caloric testing. The tests are complementary in assessing the patient with dizziness, as they describe the tonotopy of the ampullary crest at different frequency ranges of stimulation. In chronic cases, the vHIT has a low sensitivity and high diagnostic specificity in comparison to caloric testing.     

Evidence for motility and pinocytosis in ramified microglia in tissue culture

Ramified microglial cells were investigated in primary cultures of dissociated cerebral cortical tissue from rats. The identification of these cells was confirmed through immunohistochemical staining with 7 monoclonal antibodies selective for microglia. While there was significant variation in staining intensity with different antibodies, all stained the identified ramified cells; the antibodies OX-42 and ED1 yielded the most intense immunoreactivity. Based on distinctive morphological features, the microglia could be identified in living cultures where they were monitored using time-lapse video recording. This technique revealed extremely dynamic features of cellular plasticity and motility. Ramified microglia exhibited constant and rapid alterations in the size and shape of their cell body with an associated extension and retraction of processes; concomitantly, the cells moved about in a circumscribed area. These features of plasticity and motility were unique to this cell type, and correlated with OX-42 immunostaining. The microglia also possessed a differentially high level of pinocytotic activity; this too was correlated with OX-42 staining. From the nature of their morphological plasticity and motility, high pinocytosis, and cellular distribution, it is hypothesized that the ramified microglia specifically function as a system of fluid cleansing in normal brain tissue.     

40例电视胸腔镜手术体会

目的 探讨电视胸腔镜(VATS)手术的优点、适应证和手术技巧。方法 回顾总结VATS手术40例。病种有原发性自发性气胸20例，多发性肺大疱3例，Ⅰ期肺癌3例等。手术方式有肺大疱切除23例，肺叶切除术3例(辅助小切口)，肺楔形切除4例，纵隔肿瘤切除术3例，结核瘤切除1例，活检3例，胸膜粘连术3例，射频消融1例，纤维板剥脱术1例。结果 本组病例手术时间平均65分钟，失血量少于100ml，中转开胸2例，术后胸液总量平均150ml。胸管置留时间1～7天，平均住院时间7．8天，无气胸、良性肿瘤和结核复发，恶性胸水明显减少或消失，无持续漏气、二次开胸止血和手术死亡等并发症。结论 VATS手术适应证范围较广，微创出血少，美观，恢复快，只要掌握了手术技巧，操作便捷，并发症少，疗效满意。     

Image processing in swallowing and speech research

An image processing system for application to studies of the temporal and spatial parameters of movement during swallowing and speech is described. Image sequences from videotape are digitized for computerized manipulation and analysis in an attempt to improve on conventional visual inspection. The system is “interactive” or “event-driven”: after executing a function, the computer waits for guidance from the user who controls the program through keyboard and mouse input, selecting options from menus and responding to prompts. The analyst alters image clarity by the application of filters and heightens contrast through video enhancement. A technique called “remapping” reduces head motion and provides uniform spatial scaling. Animated sequences of images are used, as opposed to frame-by-frame analysis, to preserve temporal context and increase efficiency of measurement. Low cost off-the-shelf personal computer hardware is used along with original software tailored to the application.     

内窥镜除皱术的临床应用

自１９９４年４月采用内窥镜已行额、面部除皱术２２例，取得了较好的临床效果。介绍了应用内窥镜除皱术的操作方法、适应证选择的经验体会。认为在选择好适应证的前提下，是一种简洁的除皱方法。     

电视腹腔镜录像系统在腹部外科临床教学中的应用

随着腹腔镜外科的发展,多数腹部外科手术均能在腹腔镜下完成.通过先进的腹腔镜录像系统,可获得大量腹内脏器病变的录像资料.充分利用腹腔镜录像资料进行外科临床教学,可为学生提供真实、形象、生动、全面的疾病相关图像信息,不但可提高学生的学习兴趣,还能让学生更容易理解、掌握所学的知识.     

视频脑电图诊断儿童癫痫128例

目的 分析视频脑电图（Video-EEG)在小儿癫痫诊断，分类中的应用价值及癫痫发作期的EEG特点。临床诊断的癫痫患儿128（男94，女34）例，1mo-14岁，平均年龄5．4岁，应用伟思VEEG1161B型视频脑电图仪，对患儿进行至少4－6h包括清醒与睡眠期的临床和EEG监测。监测中对各种状态及事件进行标记，结束后将EEG信号与临床录象资料同步回放并逐秒分析。结果 128例癫痫患儿中有54例（42．2％）进一步确定了癫痫综合征的诊断，其中儿童良性癫痫伴中央－颞区棘波25例，儿童失神癫痫3例，少年肌阵挛癫痫1例，额叶癫痫5例，West综合征13例，Lennox-Gastaut综合征7例，有49例（38．3％）可明确其发作类型，其中强直或（和）阵挛发作10例，部分性发作33例，肌阵挛发作5例，失张力发作1例，另外有25例（19．5）尚无法分类。结论 视频脑电图 是诊断癫痫及明确癫分类的可靠检查方法。     

NSE与视频脑电图在儿童热性惊厥的相关性研究

Objective: To evaluate the diagnostic value of serum neuron specific enolase and Video EEG inFebrile Convulsion of childen. Method:Serum NSE was detected by RIA on the first day and the seventh day afterseizure in 40 children with simple febrile convulsion and 18 with complex febrile convulsion. Video EEG was per-formed at 1st, 7th and 30th day in all the patients. Results: There were significant differences between NSE levels at24th hour and on 7th day after convulsion (P<0.01). NSE concentrations in patients with SFC and CFC were also     

Intrahippocampal Injection of Endothelin-1: A New Model of Ischemia-induced Seizures in Immature Rats

Summary:  The goal of this study was to develop a new model of ischemia-induced seizures in immature rats using injection of vasoconstrictor Endothelin-1 (ET-1) into the brain. ET-1 (10, 20, or 40 pmol) was infused into the left dorsal hippocampus of freely moving Wistar rats 12 (P12) and 25 (P25) days old. Animals were then video/EEG-monitored for 100 min and monitoring was repeated 22 h later. Parameters of electrographic seizures (frequency and mean duration) as well as pattern of their behavioral correlates were evaluated. The pattern of behavioral seizures was used to develop model-specific scoring system. Cresyl violet and Fluoro Jade-B-staining were used to evaluate brain damage. Extension of the lesion was correlated with seizure severity. After ET-1-injection, seizures occurred in 83–100% animals of all age-and-dose groups and persisted for 24 h except P12 rats with 10 pmol. There were no differences in average seizure duration (18–40 s) or seizure frequency (3–7 seizures/100 min) among individual dose-groups. Between the 1st and 2nd observation period, total seizure duration decreased in 71% of P12 and 47% of P25 rats. Electrographic seizure activity was most frequently accompanied by clonus, incidence of more severe convulsions (barrel rolling or generalized clonic seizures) increased with dose of ET-1. Morphologic examination did not reveal any dose-related difference in damage severity, hippocampal damage was however more extensive in P12 compared to P25 animals. Seizure severity correlated positively with severity of the damage in both age groups. Our study presents focal injection of ET-1 into the brain as a new and practical model of ischemia-induced seizures in immature rats.