Spinal accessory nerve palsy due to neurovascular compression. Report of a case diagnosed by magnetic resonance imaging and magnetic resonance angiography

The case of a young patient with left accessory nerve paralysis is reported. He had slight tilting of the head to the right side, developed over a period of about 6 months. On neurological examination hypotrophy of the left sternocleidomastoid and trapezius muscles was observed. MRI and MR-angiography imaged the presence of a neurovascular compression between the medulla oblungata, at the level of the nerve entry zone, and a vessel loop of an elongated left vertebral artery. In spite of the absence of a surgical demonstration it is our opinion that the neurovascular conflict is the cause of the accessory nerve palsy.     

Graduated compression stockings in the prevention of deep vein thrombosis in patients with acute myocardial infarction

Venous volume (venous capacity) of the calf is low in patientswith acute myocardial infarction, who also have a high riskof deep vein thrombosis (DVT). The effect of graduated compressionstockings on the venous volume and on the incidence of DVT wastherefore studied in 80 patients aged 70 years and above withacute myocardial infarction. Graduated compression stockingswere randomly fitted to one leg, the other serving as a control,after which the venous volume was measured by strain gauge plethysmography.The incidence of DVT was measured by the ¹²⁵I fibrinogen uptaketest. Venous volume was significantly higher in legs treatedwith graduated compression stockings compared to control legs.DVT developed in eight control legs but not in any leg treatedwith graduated compression stockings (P = 0.003). DVT was alsosignificantly more frequent in women compared to men and themajority of DVT developed in legs with very low venous volumevalues.     

MRI in aqueduct compression and obstructive hydrocephalus due to an ectatic basilar artery

We describe a patient with an ectatic basilar artery in whom MRI showed marked indentation of the floor of the third ventricle and backward displacement of the midbrain, probably causing aqueduct stenosis. It appeared likely that the associated hydrocephalus was due not only to any water-hammer effect, but also to occlusion of the aqueduct.     

Tetralogy of Fallot with Absent Pulmonary Valve and Bronchial Compression: Treatment with Endobronchial Stents

Absent pulmonary valve syndrome (APVS) is a rare congenital cardiac lesion. The lesion includes ventricular septal defect, overriding aorta, and absence of the pulmonary valve, with resultant pulmonary incompetence. It has been suggested that the pulmonary incompetence induces intrauterine dilatation of the pulmonary artery, which leads to tracheobronchial compression. One of the presenting features in infants with APVS is severe airway obstruction, which may be difficult to manage. We report an infant who benefited from bilateral endobronchial endoscopic stent placement.     

Vascular compression of the airway: Indications for and results of surgical management

Vascular compression of the airway is a significant cause of respiratory compromise in children. While the indications for surgical repair are sometimes life threatening, they can also be subtle. This retrospective study examines 45 surgical cases of tracheobronchial compromise secondary to vascular compression at a large children's hospital between July 1983 and February 1996. A total of 34 were diagnosed with innominate artery compression, ten with a double aortic arch and one with an anomalous right subclavian artery. The 45 patients, 25 male and 20 female, ranged in age from 12 days to 11 years at surgery (average 13 months). A total of 21 (47%) presented with proven or suspected episodes of cyanosis or apnea. All 45 patients had evidence of vascular compression during microlaryngoscopy and bronchoscopy. The diagnosis was confirmed by magnetic resonance imaging (MRI) in 23/45 (51%), barium swallow in 22/45 (49%) and aortogram in 3/45 (7%). There was one death. One patient had a tracheotomy before surgery and continues to require it after surgery. Complete resolution of symptoms was achieved in 39/45 (87%) with five requiring more than one operation before their symptoms resolved completely. A total of four patients experienced a recurrence of symptoms within a variable length of time after surgery. Surgical indications and treatment alternatives will be discussed.     

Median nerve compression in Proteus syndrome

Proteus syndrome is a multi–organ disorder, a prime feature of which is localized gigantism, usually clinically obvious. Symptoms secondary to hypertrophy of nerves has not been previously recognized as a part of the syndrome. Accepted: 16 May 1997     

Reversed palmaris longus muscle on MRI: report of four cases

Muscle anomalies around the wrist, in particular the palmaris longus muscle, may cause effort-related median nerve compression. A search of the medical records at our university hospital between 1994 and 1999 revealed four patients with an effort-related median nerve compression due to a reversed palmaris longus muscle. Magnetic resonance imaging was used in the patient work-up and showed an anomalous muscle in each case that had been missed initially. All four patients were free of pain after simple excision of the anomalous muscle. Awareness of muscle anomalies at the wrist on MR imaging is essential in evaluating patients with nerve compressions at the wrist. The purpose of this article is to heighten this awareness in radiologists. Received: 23 June 1999; Revised: 30 September 1999; Accepted: 24 December 1999     

经皮电针对背根节慢性压迫模型大鼠相应腰髓节段GFAP和5-HT阳性神经元的影响和与疼痛的关系

目的研究经皮电针对背根节慢性压迫模型(CCD)大鼠相应腰髓节段神经胶质原纤维酸性蛋白(GFAP)和血清素(5-HT)的影响和与疼痛的关系。方法选用雄性Wistar大鼠42只,随机分为3组:A正常对照组(6只),B背根节慢性压迫模型组(18只),C经皮电针治疗背根节慢性压迫模型组(18只),其中从B、C组各挑选基础痛域基本相似的6只大鼠,隔日进行痛域的测定,并于2周同A组随机选出的2只大鼠共同进行免疫组织化学染色。其余28只分别于术后2 d,1周进行免疫组织化学染色。选取大鼠相应L4-L6脊髓阶段组织,进行GFAP和5-HT的特异性染色。结果①痛域变化:造模第2天开始出现痛敏,且痛域与术后时间呈负相关,C组经TENS治疗6 d后,痛域比B组有显著性的增加;②免疫组织化学染色结果:2 d时,B、C组GFAP和5-HT阳性神经元较A组显著性的增加;1和2周时,B组较A、C组GFAP和5-HT阳性神经元数均显著性的增加,C组较A组相比均无显著性的差异。结论GFAP和5-HT阳性神经元的活化率的减少可能是经皮神经电刺激(TENS)降低CCD模型疼痛的可能机制之一,且GFAP和5-HT阳性神经元之间可能存在相互激活作用。     

医学影像存储与传输系统存储模式的探讨

目的 探讨医学影像存储与传输系统中的存储介质、结构，提高图像存储容量及调用速度。方法PACS采用三级（在线、近线、离线）存储结构；利用硬盘、多服务器磁盘阵列、磁带库等作为存储介质，支持影像数据的短期存储管理和长期存储管理；采用冗余存储技术和镜像存储方式；提供定时自动备份和数字迁移功能。结果成功地实现了医学图像在网络中的存储、备份及调用。结论PACS中的三级存储模式大大提高了图像的存储容量及调用速度，提高了工作效率。     

基于USB技术的Holter系统的研究与设计

本文介绍了Holter系统的开发研究,着重介绍了其中的关键技术：低功耗的硬件设计、实时高效的算法、大容量存储设备和高速可靠的回放接口等.