How many forms of perseveration? Evidence from cancellation tasks in right hemisphere patients

Neglect patients' performance during cancellation tasks is characterized by left sided omissions and, in many cases, by the production of inappropriate material of various kinds in the ipsilesional space, e.g. additional marks over already cancelled targets, marks drawn away from targets, scribbles, irrelevant drawings. It is unclear whether these behaviours, which have collectively been called perseverative, are functionally and anatomically connected and whether they correlate with the severity of neglect. Here we report a retrospective study on 33 right brain damaged patients with neglect after right hemisphere lesions in whom we measured the intensity of perseveration of the three following kinds: (1) ‘additional marks' (AM) perseveration where patients cancelled a target with two or more well separated marks; (2) ‘scribble’ perseveration, where patients, instead of cancelling the target with a single pen stroke as required by the task, performed multiple pen strokes without breaking the pen-to-paper contact, with the final product being a scribble; (3) ‘flying marks’ (FM) perseveration where patients produced cancellation marks well away from the targets. We found that AM and FM perseveration correlated with neglect severity, while ‘scribble’ perseveration did not. The lesion-symptom mapping showed three separate anatomical areas in the right hemisphere: ‘scribble’ perseveration was associated with lesions of the orbitofrontal cortex and caudate nucleus; AM perseveration was associated with damage to the rolandic operculum, superior temporal gyrus and inferior frontal gyrus; FM perseveration was associated with damage to the dorsal premotor cortex and the temporal pole. Neglect severity followed damage to a region which grossly corresponds to the sum of the regions associated with AM and FM perseveration respectively. This complex behavioural and anatomical pattern is interpreted in terms of a three-factor model, in which AM perseveration is caused by a deficit of disengagement of attention from the right side (also causing omissions), FM perseveration is caused by directional hypokinesia (also causing left-side omissions), and ‘scribble’ perseveration is the consequence of a failure to inhibit an initiated motor act, which is completely separate (both anatomically and functionally) from the disorder inducing omissions.     

Friedrich Trendelenburg: Historical background and significant medical contributions

Friedrich Trendelenburg's name is widely known today because it is associated with the Trendelenburg position. However, Trendelenburg made many other valuable contributions to the field of medicine, including a test, a gait, and a sign. A historical review of his life helps to elucidate the factors that contributed to his innovative approaches and techniques. Both Trendelenburg's mentors in his early years and the influences upon him throughout his professional career contributed to his development as a pioneer of surgery, anesthesia, and clinical diagnostics. Clin. Anat. 27:815–820, 2014. © 2014 Wiley Periodicals, Inc.     

The difference between registered natural head position and estimated natural head position in three dimensions

This study determined the intra-rater and inter-rater reliability of re-orientating three-dimensional (3D) facial images into the estimated natural head position. Three-dimensional facial images of 15 pre-surgical class III orthognathic patients were obtained and automatically re-orientated into natural head position (RNHP) using a 3D stereophotogrammetry system and in-house software. Six clinicians were asked to estimate the NHP of these patients (ENHP); they re-estimated five randomly selected 3D images after a 2-week interval. The differences in yaw, roll, pitch, and chin position between RNHP and ENHP were measured. For intra-rater reliability, the intra-class correlation coefficient (ICC) values ranged from 0.55 to 0.77, representing moderate reliability for roll, yaw, pitch, and chin position, while for inter-rater reliability, the ICC values ranged from 0.38 to 0.58, indicating poor to moderate reliability. The median difference between ENHP and RNHP was small for roll and yaw, but larger for pitch. There was a tendency for the clinicians to estimate NHP with the chin tipped more posteriorly (6.3 ± 5.2 mm) compared to RNHP, reducing the severity of the skeletal deformity in the anterior–posterior direction.     

采用穿刺侧肢体外展120°体位对气切患者PICC置管的研究

目的探讨穿刺侧肢体外展120°体位对气管切开患者PICC置管的影响。方法将120例需行PICC穿刺的气管切开患者，随机分为试验组和对照组，各60例。对照组采用传统穿刺体位。试验组采用穿刺侧肢体外展120°体位。比较两组置管成功率、置管时间、患者舒适度、置管后并发症的差异。结果试验组置管成功率100％，平均置管时间28min，置管后并发症发生率3．3％。对照组置管成功率88．3％，平均置管时间40min，置管后并发症发生率26．4％，两组比较有显著性差异（P〈0．05）。术后舒适度评分，试验组为2．5分，对照组为2．8分，两组比较无显著性差异（P〉0．05）。结论对于气管切开患者行PICC置管，穿刺侧肢体外展120°较传统穿刺体位更加安全高效，减少了患者痛苦及因反复盲目调节导管而导致的感染发生，也简化了护士的操作流程，更重要的是增加了气管切开患者PICC置管的成功率，保证患者得到及时有效的治疗。     

Cerebrospinal fluid pressure as a function of body position in dogs

Abstract

Cerebrospinal fluid (CSF) pressure has been measured as a function of body position in dogs under pentobarbital anaesthesia. CSF pressure was higher than superior sagittal sinus pressure by an almost constant 6 cm of water; regardless of positioni, if 30 min were allowed for the system to reach equilibrium. The sinus pressure was found to depend on simple hydrostatic theory when the sinus was at or below the level of the heart. When the sinus was above the heart, the collapsing nature of the jugular veins prevented the sinus pressure from dropping as low as a simple hydrostatic theory would predict. [Neurol Res 1994; 16: 439-442]     

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??The position of lips directly affects facial beauty. In orthodontic treatment process??clinicians always choose incisor retraction to adjust lip protrusion?? reshaping the soft tissue beauty. However??with the retraction of incisors??the change of lip soft tissue is not in a simple same-size ratio. To ideally rebuild lip shape??the exact prediction of retraction extent of incisor is a widely-concerned problem. This study investigated the response of lip position to incisor position??aiming to provide a reference for further clinical treatment.     

护理干预对提高玻璃体腔硅油填充术患者体位依从性的探讨

目的 探讨护理干预对提高玻璃体腔内硅油填充术患者体位依从性的效果影响.方法 按手术时间先后顺序将60例复杂性视网膜脱离患者分为两组,对照组按眼科疾病常规护理,进行特殊体位指导；干预组在此基础上由专人实施术前特殊体位的示范和指导,术后在认知、行为、体位方面进行护理干预.观察两组患者在采取特殊体位过程中的不适症状及体位的依从时间.结果 实验组患者较对照组特殊体位持续时间长,出现的并发症与局部不适症状少而轻.结论 护理干预可提高玻璃体腔内硅油填充术患者特殊体位的依从性,保证术后的有效体位,减轻因体位引起的不适症状,减少并发症的发生,提高手术的成功率.     

天茄子不同提取部位止血作用研究

目的研究天茄子不同提取部位的止血药理作用。方法依次以环己烷（T1）、水（T2）和乙醇（T3）为溶剂进行提取并对乙醇提取物依次用石油醚（T4）、乙酸乙酯（T5）、正丁醇（T6）进行萃取得到相应的部位以及水部位（T7）,采用毛细玻管法、玻片法、剪尾法和测定血浆复钙时间检测其止血作用。结果 T3、T6、T7可缩短小鼠玻片法凝血时间,T3、T5、T6、T7可显著缩短小鼠毛细管法凝血时间,T3、T4、T5、T6、T7可显著缩短小鼠断尾法出血时间,T3、T6、T7可显著缩短小鼠血浆复钙时间。结论天茄子95%醇总提物、乙酸乙酯部位、正丁醇部位、水部位凝血效果显著,其中95%醇总提物、正丁醇部位、水部位凝血效果极其显著。     

基于2D电阻抗成像的位置误差和相对数量指数的后处理方法

本文提出了一种基于2D电阻抗成像的位置误差和相对数量指数的后处理方法,用于多种电导率分布的确定、组织成分的识别以及位置信息的确定。此外,还介绍了一种基于现有两种重建算法的混合正则化算法,并将三种重建算法重建的结果进行了比较。结果证明,这种后处理方法可以提高2D电阻抗成像的位置精度和空间分辨率,使得电阻抗成像适用于临床检查和过程监测。