Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.     

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??Objective??To measure and compare the discrepancy of Collum angle of incisors among different types of Angle malocclusion using CBCT??and to provide guidance for the prevention of alveolar bone fenestration and dehiscence in anterior region. Methods??The cases of malocclusion were chosen in the Xi'an Jiao Tong University Hospital of Stomatology from 2014 to 2016??and four types of malocclusion were obtained class ??30 cases????class ??1 ??29 cases????class ??2??27 cases????class ??30 cases????according to the clinical occlusion. Sagittal sections of right upper and lower incisors were obtained by three-dimensional CBCT images using Invivo 5 software?? and Auto CAD 2007 software was used to measure the angle formed by the long axis of crown and root??Collum angle????and then analyzing the differences among groups were analyzed by single factor variance and compared by Scheffe method. Results??There were significant differences in the size of Collum angle among different types of malocclusion??P??0.05??. The Collum angle of upper incisor in class ??2 was ??7.02 ± 1.83??°??which was significantly larger than that of other groups. The Collum angle of lower incisor in Class ??1 was??-2.25 ± 4.76??°??which meaned that the crown could be lip side compared to the root??and there was significant difference compared with the other groups. The Collum angle of the lower incisor in class ?? was??8.15 ± 2.50??°??which was also significantly larger than other groups. Conclusion??There are significant differences in the Collum angle of the upper and lower incisors among different types of malocclusion. The crown of upper incisor in Class ?? 2 and lower incisor in Class ?? can be lingual side to the root??and the crown of lower incisor in Class II1 can be lip side compared to the root??which should be taken into consideration when the incisor is pulled backward or inclined to lip to avoid the root cutting through bone cortex.     

目测法评估床头抬高角度测量误差的分析

目的针对目前医院病床基本无配备床头抬高角度测量工具的现状,调查护士目测法评估床头抬高角度的测量误差,探讨使用精确测量工具的必要性。方法随机选择我院各护理单元主管护师、护师和护士各2名,共96名。采用目测法评估床头抬高15°、30°、45°三种角度,与角度尺精确测量法比较床头抬高角度的差异。结果目测评估床头抬高15°、30°、45°所产生的实际角度分别为（10.56±3.67）°、（19.54±6.58）°、（38.18±9.69）°,测量误差发生率96.2%,其中实际测量角度小于目标角度,占93.8%,实际测量角度大于目标角度,占2.4%,与角度尺测量方法比较,差异有统计学意义（P〈0.01）。结论目测法评估会影响有特殊卧位要求患者的治疗效果,并发症发生几率增加,应使用精确的测量工具。     

Scaphoid fracture geometrics: an assessment of location and orientation

The location and angle of scaphoid fractures are important attributes which guide management. We used a 3 dimensional scaphoid model, generated from CT scans, to map scaphoid fracture planes. The point at which the fracture plane crossed the central axis of the scaphoid was noted. The angle of the fracture planes with regard to the central axis was also noted. This allowed calculation of the location of the fracture and the angle of the 379 fractures. The mean point of intersection for fractures with the scaphoid axis was 50% along the scaphoid. Sixty percent of all fractures were found around the central 20% of the scaphoid. The mean angle between the scaphoid axis and the fracture plane was 63 degrees). On comparing angle with location, as fractures move away from the scaphoid waist, they become less perpendicular to the scaphoid axis (p?p?p?p?=?.018). There was no link between fracture plane angles and age, sex and union status. Most fractures occur at the centre of the scaphoid. There is a link between the location and angle of scaphoid fractures. It also identifies older patients and males are more likely to have more proximal scaphoid fractures.     

Oseltamivir (Tamiflu)-induced bilateral acute angle closure glaucoma and transient myopia

A 27-year-old woman developed bilateral acute angle closure glaucoma (AACG) and transient myopia after taking oseltamivir for four days. On the fourth day, she received systemic and topical intraocular pressure (IOP)-lowering agents, and IOP decreased in both eyes. However, her visual acuity was unchanged. A myopic shift of -5.25 D OD and -5.0 D OS was estimated to have occurred in the acute phase. A-scan ultrasonography and Pentacam showed markedly shallow anterior chambers and increased lens thickness. Ultrasound biomicroscopy revealed an annular ciliochoroidal effusion with forward displacement of the lens-iris diaphragm. Ciliochoroidal effusion and transient myopia were resolved after discontinuation of oseltamivir.     

Musculotendinous architecture of pathological supraspinatus: A pilot in vivo ultrasonography study

Architectural changes associated with tendon tears of the supraspinatus muscle (SP) have not been thoroughly investigated in vivo with the muscle in relaxed and contracted states. The purpose of this study was to quantify the geometric properties within the distinct regions of SP in subjects with full‐thickness tendon tears using an ultrasound protocol previously developed in our laboratory, and to compare findings with age/gender matched normal controls. Twelve SP from eight participants (6 male/2 female), mean age 57 ± 6.0 years, were investigated. Muscle geometric properties of the anterior region (middle and deep parts) and posterior region (deep part) were measured using image analysis software. Along with whole muscle thickness, fiber bundle length (FBL) and pennation angle (PA) were computed for architecturally distinct regions and/or parts. Pathologic SP was categorized according to the extent of the tear in the tendon (with or without retraction). In the anterior region, mean FBL of the pathologic SP was similar with normal controls; however, mean PA was significantly smaller in pathologic SP with retraction compared with normal controls, in the contracted state (P < 0.05). Mean FBL in the posterior region in both relaxed and contracted states was significantly shorter in the pathologic SP with retraction compared with normal controls (P < 0.05). Findings suggest FBL changes associated with tendon pathology vary between the distinct regions, and PA changes are related to whether there is retraction of the tendon. The ultrasound protocol may provide important information on architectural changes that may assist in decision making and surgical planning. Clin. Anat., 2013. © 2012 Wiley Periodicals, Inc.     

Spatially matched in vivo and ex vivo MR metabolic profiles of prostate cancer – investigation of a correlation with Gleason score

MR metabolic profiling of the prostate is promising as an additional diagnostic approach to separate indolent from aggressive prostate cancer. The objective of this study was to assess the relationship between the Gleason score and the metabolic biomarker (choline + creatine + spermine)/citrate (CCS/C) measured by ex vivo high‐resolution magic angle spinning MRS (HR‐MAS MRS) and in vivo MRSI, and to evaluate the correlation between in vivo‐ and ex vivo‐measured metabolite ratios from spatially matched prostate regions. Patients (n = 13) underwent in vivo MRSI prior to radical prostatectomy. A prostate tissue slice was snap‐frozen shortly after surgery and the locations of tissue samples (n = 40) collected for ex vivo HR‐MAS were matched to in vivo MRSI voxels (n = 40). In vivo MRSI was performed on a 3T clinical MR system and ex vivo HR‐MAS on a 14.1T magnet. Relative metabolite concentrations were calculated by LCModel fitting of in vivo spectra and by peak integration of ex vivo spectra. Spearman's rank correlations (ρ) between CCS/C from in vivo and ex vivo MR spectra, and with their corresponding Gleason score, were calculated. There was a strong positive correlation between the Gleason score and CCS/C measured both in vivo and ex vivo (ρ = 0.77 and ρ = 0.69, respectively; p < 0.001), and between in vivo and ex vivo metabolite ratios from spatially matched regions (ρ = 0.67, p < 0.001). Our data indicate that MR metabolic profiling is a potentially useful tool for the assessment of cancer aggressiveness. Moreover, the good correlation between in vivo‐ and ex vivo‐measured CCS/C demonstrates that our method is able to bridge MRSI and HR‐MAS molecular analysis. Copyright © 2012 John Wiley & Sons, Ltd.     

Effects of footwear fixation on joint angle variability during straight gait in the elderly

BackgroundVarious types of footwear fixation can dramatically alter gait characteristics, and could potentially contribute to an increased risk of falls in the elderly. However, no studies have been conducted to analyze the effects of footwear fixation on joint angle variabilities, particularly during the entire gait cycle.Research questionDoes the fixation of footwear significantly affect the lower limb joint angle variabilities during the gait cycle?MethodsPrincipal component analysis (PCA) was conducted on 20 healthy adults using 3D spatio-temporal data of the pelvis and lower limb joint angle that were collected during the entire gait cycle with the footwear in various conditions (well-fixated footwear, less-fixated footwear, slippers, and bare feet). Kinematic waveforms were reconstructed from the PCA data, which were used to determine the distinct differences in joint angle variabilities between footwear conditions.ResultsThe results showed large variability in the knee- and ankle-joint angles on the sagittal plane when walking in the loose condition (less-fixated footwear, slippers, and bare feet) compared with those in the well-fixated footwear condition.SignificanceThese results demonstrate the effect of footwear fixation on the joint angle variabilities of the elderly while walking. The increase in the knee- and ankle-joint angle variabilities when walking with less-fixated footwear could be a risk factor for falls.     

Cerebral peduncle angle: Unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases

IntroductionThe significant symptom overlap between progressive supranuclear palsy (PSP) and other parkinsonian neurodegenerative diseases frequently results in misdiagnosis. However, neuroimaging can be used to quantify disease-related morphological changes and specific markers. The cerebral peduncle angle (CPA) has been shown to differentiate clinically diagnosed PSP from other parkinsonian diseases but this result has yet to be confirmed in autopsy-proven disease.MethodsMagnetic resonance imaging (MRI) scans were obtained for 168 patients representing 69 medical facilities. Following randomization, the images were divided into two groups (Type 1 and Type 2) based upon midbrain morphological differences. Two readers were blinded and independently measured the CPA of 146 patients with autopsy-proven progressive supranuclear palsy (PSP; n = 54), corticobasal degeneration (n = 16), multiple system atrophy (MSA; n = 11) and Lewy body disease (n = 65).ResultsApplying two separate measurement techniques revealed no statistically significant differences in CPA measurements among any study groups regardless of classification measurement approach. The interobserver agreement showed significant differences in measurements using the Type 2 approach.ConclusionMeasuring the CPA on MRI is not a reliable way of differentiating among patients with PSP, corticobasal degeneration, MSA, or Lewy body disease.     

Dermatoglyphic patterns as possible predictor of treatment resistance in schizophrenia

IntroductionDermatoglyphic patterns have been studied in schizophrenia and there is now evidence relating aspects of the dermatoglyphic profiles of the hands to schizophrenia.^1,2 But there has been no study on whether treatment resistance can be predicted from the dermatoglyphic profile of an individual. This study was done to determine whether abnormal neurodevelopmental markers were more frequent in schizophrenics non-responsive to routine treatment and whether treatment resistance can be predicted by studying the dermatoglyphic profile of an individual.MethodsFinger and palm prints of 144 schizophrenic patients responsive to treatment and 44 schizophrenic patients non-responsive were taken. Finger print patterns, palmar patterns, palmar flexion creases, total ridge counts and atd angles were studied. The analysis was done using SPSS 11.0.ResultsThe results showed there was increased pattern frequency in the I3 area of the left hand of non-responders and in the I4 area of the right hand of responders. atd angle was decreased in the left hand of non-responders. There was increased frequency of the Simian type I crease in male non-responders and Sydney line in female non-responders.DiscussionCertain dermatoglyphic abnormalities occur more frequently in non-responders and with the help of these abnormalities, a schizophrenic patient likely to develop treatment resistance can be detected.