Carpal tunnel syndrome secondary to an accessory flexor digitorum superficialis muscle belly: case report and review of the literature

Anomalous muscles usually do not cause symptoms but are of academic interest mainly discovered during cadaveric dissection. An aberrant muscle belly arising from the index finger flexor digitorum superficialis tendon causing carpal tunnel syndrome is rare. The management of such an anatomical variant is dependent on whether the median nerve compression is associated with a palpable mass. A brief case highlighting important management principles along with a complete literature review is reported.     

副神经阻滞在麻醉与疼痛临床上的应用

副神经阻滞在国内尚未见临床应用的报道，作者近年将其应用于腋窝带状疱疹后神经痛的治疗取得了良好效果。副神经阻滞也可用于临床麻醉和斜颈治疗，用局麻药进行阻滞时不仅并发症少，操作也比较容易，是颇有临床价值的技术，尤其对胸锁乳突肌或斜方肌过度紧张时星状神经节阻滞疗法配用此法时可提高疗效。本文评述其相关解剖、操作方法、适应证与副作用。     

Accessory mitral valve associated with aortic regurgitation in an elderly patient: report of a case

We encountered a 75-year-old man who complained of exertional dyspnea. An echocardiographic examination showed aortic regurgitation and a tumor in the left ventricular outflow tract. Under complete extracorporeal circulation, we surgically made an incision of the ascending aorta with a slight thickening of the aortic valve and an enlarged annulus. After excising the aortic valve, an examination of the subvalvular region revealed mitral valve-like tissue extending from the annular region of the right coronary cusp to the ventricular septum, while the chordae tendinae was attached to the septum. This issue was excised, and the aortic valve was replaced with a 27-mm SJM valve. The postoperative course was uneventful, and the patient was discharged in good condition on postoperative day 30. An accessory mitral valve is extremely rare. Since this indication for surgical treatment is associated with congenital heart disease or a left ventricular outflow tract obstruction, most patients are young. Our patient had no associated cardiac anomalies and no pressure gradient attributable to a left ventricular outflow tract obstruction. This accessory mitral valve was discovered during aortic valve replacement surgery. To our knowledge, our patient is the oldest reported with an accessory mitral valve to have undergone a surgical resection.     

2000～2003年滨州市一次性使用卫生用品卫生状况分析

[目的]了解一次性使用卫生用品卫生状况。[方法]2000～2003年按照《消毒管理办法》和《一次性使用卫生用品卫生标准》,对滨州市生产、销售的一次性使用卫生用品及生产厂家的生产环境卫生质量进行调查。[结果]合计调查796份一次性使用卫生用品,合格率为81.66%,卫生巾、卫生纸、一次性口罩、一次性尿巾、避孕工具合格率分别为88.55%、62.65%、91.67%、87.88%、95.24%。[结论]建议加强对一次性使用卫生用品生产、销售领域的监督管理,不断提高产品卫生质量。     

Female odors lead to rapid activation of mitogen-activated protein kinase (MAPK) in neurons of the vomeronasal system

Pheromonal mediation of reproductive function proceeds along a neuroanatomical pathway that connects the vomeronasal organ (VNO) at the periphery with downstream target-sites in the amygdala and hypothalamus. The MAPK pathway is a prominent cascade linking receptor activation to induction of effectors such as c-Fos. We addressed the question: Does a specific pheromone stimulus lead to activation (phosphorylation, P) of MAPK in the VN system of the male mouse? Phosphorylation of MAPK in the VN system was evaluated 15-30 min and 1.5-2 h after exposure to female odors, using immunocytochemical techniques. A rapid and transient cytoplasmic expression of PMAPK was noted in the VNO with a unique distribution of the expressing neurons in columns extending over the entire basal to apical axis. A rapid and sustained expression was noted in most amygdaloid and hypothalamic VN target-sites and also in a few amygdaloid and hypothalamic sites outside the traditional VN system. The extent of expression and the subcellular compartmentalization (nucleus, cytoplasm, processes) of PMAPK were region-dependent. Of the VN target-sites, the accessory olfactory bulb (AOB) stood out in the lack of expression of PMAPK, in the high expression of the MAPK enzyme itself and in the massive of expression of c-Fos. This expression profile implicates another pathway(s) in mediating VNO signaling to the AOB. Our results are the first to demonstrate the use of PMAPK to trace functional pathways. Based on the wide cellular and intracellular expression of phosphorylated MAPK in the VN system, we propose that the MAPK pathway plays an important role in mediating female pheromone signaling in the male mouse.     

An unusual auricular malformation accompanied by accessory tragus: macrotragus

Definition of malformations of the tragus is important for terminology and treatment. Most common entities are the skin tag, accessory tragus, preauricular sinus, and cyst, whereas macrotragus is an uncommon and unaddressed deformity that should be distinguished from these. In this report, three cases with diagnosis of the macrotragus are presented. The tragus was uniformly large and displaced anteriorly, and external auditory meatus was not obliterated in all cases. For correction, excision of the excess tragal cartilage and skin was performed. In all cases, bilaterally symmetric tragus was achieved. There were no complications in the early postoperative period and there was no enlargement after 6 months of observation. Macrotragus and accessory tragus are different entities that should be distinguished for accurate diagnosis. They have similar histopathological but distinct anatomical characteristics. Although both are treated by a simple excision, in the case of macrotragus, special effort should be taken to leave enough cartilage to restore normal tragal contours. Presented at the 5th Congress of the Balkan Association for Plastic, Reconstructive Aesthetic Surgery, Kuşadası, Turkey, May 22–26, 2007.     

Effect of Accessory Cells on Stimulation of Murine T-Cell Leukemia with Antibodies to the CD3/T Cell Antigen Receptor Complex

Stimulation of EL4 and RL  

     

膈神经副神经肌电图检查对提高臂丛神经根性损伤诊断符合率的机制和意义

目的阐明膈神经、副神经肌电图检查对提高臂丛神经根性损伤诊断符合率的机制和意义。方法对１００例术中证实为全臂丛或上中干根性损伤的术前肌电图资料（包括膈神经、副神经和臂丛神经）进行分析，总结Ｃ５神经根性损伤中节前、后的发生率，术前诊断符合率及膈神经、副神经的功能。结果１００例臂丛神经根性损伤中，Ｃ５神经根性损伤的诊断符合率为８７％，比过去提高３１．９％；节后损伤的诊断符合率为８１．９％，提高３０．８％。膈神经、副神经完全损伤者Ｃ５神经根均为节前损伤。膈神经完全损伤１３例，不全损伤７例中５例（７１．４％）为节前损伤；副神经完全损伤５例，不全损伤１４例中８例（５７．１％）为节前损伤。结论对膈神经、副神经进行肌电图检测，可提高Ｃ５神经根性损伤的术前诊断符合率；并可判断膈神经、副神经的功能是否适合作神经移位术的动力神经     

Successful management of concomitant omphalocele, accessory hepatic lobe, and biliary atresia in a 44-day-old boy

We report the second case in literature of a boy with the association of large omphalocele, accessory hepatic lobe, and biliary atresia, and the first successful treatment. The patient was submitted to a surgical treatment at 44 days of life, including Kasai procedure, correction of the remnant abdominal wall defect, and removal of a hepatic accessory lobe. The boy evolved with normalization of hepatic function tests. After 15 years of follow-up, the patient is completely healthy, weights 45 kg, and is 1.64 m tall.     

Relation of single unit properties to the oculomotor function of the nucleus of the basal optic root (accessory optic system) in chickens

Summary Single unit recordings in the nucleus of the basal optic root (nBOR) of the accessory optic system in chickens suggest that it has a role in vertical stabilizing eye movements. Cells have unusually large receptive fields and never respond to small stationary stimuli. They respond best to large richly patterned stimuli moving slowly (2–4 °/s) in vertical directions. Cells responsive to upward movement tend to be located in the dorsal portion of nBOR, which projects to motor areas producing upward eye movement, whereas cells responsive to downward movement tend to be located in the ventral portion of nBOR, which projects to motor areas producing downward eye movement; this suggests that these synapses onto oculomotor neurons are excitatory.In many nBOR units, the preferred and null directions are not opposite to each other. These directional asymmetries seem to be correlated with other properties of the units in a manner that supports the idea that the accessory optic system is arranged according to a vestibular coordinate system. This finding complements the abundant anatomical and physiological evidence linking the accessory optic system to the vestibular system.This work was supported by a research grant from the National Eye Institute, EY02937