Deleterious effects of the prone position in the full-term infant throughout the first year of life

Summary Seventy-one first-born infants who had been nursed in prone position since birth, were referred for motor assessment at 3 months, 5 months and 9 months. All infants were administered the same checklist of motor items, based on the Amiel-Tison Infant Neurological Evaluation and on the Brunet-Lézine Developmental Psychomotor Scale. Abnormalities in muscular shortening and delay in motor skills were found. These findings are critical as regards environmental influences on postural development, continuities in motor development and issues of early primary prevention. Early identification and follow-up programmes, including frequent changes in posture, are suggested in order to avoid abnormalities of motor behaviour and subsequently in postural patterns.     

The Cathlocator: A novel non-radiological method for the localization of enteral tubes

Safe placement of nasogastric tubes requires reliable positioning of the tip of the tube within the stomach. Radiology and aspiration are currently used to confirm tube position, but suffer from significant problems of cost and efficacy, respectively. We have developed a novel method to locate the position of a catheter tip within the body, using the detection of a low energy electromagnetic field generated in a coil located in the catheter with an external hand-held unit (Cathlocator). In vitro, the unit detected the distance of the coil from the detector with an accuracy of 0.1 cm over a range of 4–12 cm. In vivo studies were performed in 11 healthy volunteers using a purpose-built manometric assembly that incorporated the signal generating coil in its tip. In all subjects the Cathlocator showed the position of the signal generating coil to be cranial to the xiphisternum when manometric and transmucosal potential difference criteria showed it to be located above the lower oesophageal sphincter. When the coil was within the stomach, the Cathlocator identified its position within the epigastric, umbilical and left hypochondrial regions of the abdomen. The distance of the coil from the surface was significantly greater when in the duodenum mean (±s.e.m. 7.6±0.3 cm; P<0.001) and oesophagus (8.6±0.2 cm; P<0.002) than the stomach (5.0±0.4 cm). In one subject studied twice there was a close correlation between the location and depth measured by the device on each occasion. The Cathlocator is a novel non-radiological device that has the potential to be useful in the placement of gastrointestinal catheters.     

Effects of isoflurane on oxygenation during one-lung ventilation in pulmonary emphysema patients

Background: Hypoxic pulmonary vasoconstriction has an important role in human one-lung ventilation (OLV) in the lateral decubitus position under general anesthesia. During OLV, inhalational anesthesia may inhibit hypoxic pulmonary vasoconstriction and the decrease in arterial oxygenation. We studied the effect of isoflurane administration on arterial oxygen tension in chronic obstructive pulmonary disease patients.
Methods: Ten patients who had thoracoscopic laser ablation of bullous emphysema were studied. Patients received 2% isoflurane in oxygen from induction until the first 20 min of OLV in the lateral decubitus position, then were switched to 1% isoflurane lasting 20 min and next were switched to 0.5% isoflurane lasting 20 min. After each 20-min inhalation, pulmonary and hemodynamic parameters were measured. The given concentrations for isoflurane were merely vapor meter concentrations.
Results: PaO₂/FIO₂, Qs/Qt respiratory rate peak inspiratory pressure and PaCO₂ showed no significant changes at each point of isoflurane. Expiratory tidal volume significantly decreased (P<0.05) with 0.5% isoflurane compared to that with 2% isoflurane. Cardiac output, mean arterial pressure, mean pulmonary arterial pressure, systemic vascular resistance and pulmonary vascular resistance showed no significant changes at each point of isoflurane.
Conclusions: In patients with pulmonary emphysema, arterial oxygenation is not affected by low isoflurane concentration during OLV in the lateral decubitus position.     

全口义齿异常颌位排牙的体会

牙列缺失后,由于未及时的进行全口义齿修复,常常造成上下颌骨及上下颌弓在形状、大小、位置等方面的不协调,表现为异常颌位,给全口义齿的修复带来一系列的不便,使全口义齿的修复难以达到理想的修复效果。为获得满意的修复效果,异常颌位的排牙成了关键的一步,它不能按常规的排牙方法来进行,必须根据患者的具体情况作适当的调整。只有这样,才有利于全口义齿的固位和稳定,有利于全口义齿功能发挥。     

Sex and Intrauterine Position Influence the Size of the Gerbil Hippocampus

Sex differences in home range size and spatial ability are predictive of sex differences in the relative size of the hippocampus in rodents. Such differences in behavior and hippocampal volume are presumed to be, in part, the result of differences in perinatal exposure to hormones. We predicted from differences in the size of home ranges of male and female Mongolian gerbils (Meriones unguiculatus) in the wild that the hippocampus of male gerbils would be relatively larger than that of females. We examined the effect of prenatal hormonal influences on hippocampal size by comparing hippocampal volume of males and females from 2F and 2M intrauterine positions to that of randomly selected males and females. We found that, as predicted, randomly selected males had a significantly larger hippocampus, relative to telencephalon, than did randomly selected females. However, males and females from 2F and 2M intrauterine positions did not differ in relative hippocampal size. Possible explanations for the absence of a sex difference in hippocampal size in male and female gerbils from 2F and 2M intrauterine positions are discussed.     

头颈部肿瘤射野摆位误差的差异性研究

目的：研究采用电子射野系统评价头颈部肿瘤患者摆位误差时的观察者间变异和观察者自身变异。方法：两队研究小组，分别由四名医师和四名技师组成，两组分别对6名头颈部肿瘤的患者，采用电子射野影像仪（electronic portal imaging device，EPID）拍摄验证片（electronic portal images，EPIs），在EPIs上勾画骨性标志，以放疗计划生成的数字重建图像（digitally reconstructed radiographs，DRRs）做为参考图像，定量分析不同观察研究人员之间和研究人员自身采用EPID确定头颈部肿瘤患者的射野摆位误差（field placement errors，FPEs）的差异性。结果：在前／后位射野图像上．不同医师之间、医师自身及技师自身对摆位误差的判断无明显差异，但在技师之间出现了明显的自身差异性．医师组和技师组在前／后射野图像上的均方根（root-mean—square，RMS）分别为2．52±0．46和3．43±0．43，两者具有明显差异；在侧位野图像上，医师自身对摆位误差的判断有较好的稳定性，但部分不同医师之间在腹背、头足方向上部分患者中出现差异，而不同的技师之间存在明显差异性，医师组和技师组在侧位射野图像上的RMS分别为2．72±0．16和2．62±0．22．两者无明显差异。结论：医师和技师组在采用电子射野系统对头颈部摆位误差进行判断时存在人员之间的误差，应对所有人员进行统一训练才能减少射野摆位误差，从而提高IMRT治疗效果。     

全脑全脊髓照射仰卧位CT模拟定位技术

目的：探讨全脑全脊髓照射仰卧位CT模拟定位技术。方法：7名患者分别躺在真空负压袋固定器上，进行CT模拟定位，打印正侧位数字重建射线彩像（DRR）图，放射治疗前拍摄正侧位定位验证片，测量解剖参考点和射野边界之间的距离。结果：患者左右方向及背腹方向误差在2mm以内。人体上下方向误差在4mm以内；放疗后，患者受照射的皮肤部位均出现色素沉着。结论：仰卧位全脑全脊髓照射CT模拟定位技术可用于俯卧位不合作的患者。     

腹主动脉与其主支夹角的空间定位

甲醛固定的成人尸体32具(男19,女13),造影拍片和实地解剖对照观察,测量腹主动脉主支的发出高度、起点方位、与主动脉的夹角,以及与矢状面的交角。综合以上四项指标,即能构想腹主动脉与其主支夹角的空间位置和变动范围。     

Representation of heading direction in far and near head space

Manipulation of objects around the head requires an accurate and stable internal representation of their locations in space, also during movements such as that of the eye or head. For far space, the representation of visual stimuli for goal-directed arm movements relies on retinal updating, if eye movements are involved. Recent neurophysiological studies led us to infer that a transformation of visual space from retinocentric to a head-centric representation may be involved for visual objects in close proximity to the head. The first aim of this study was to investigate if there is indeed such a representation for remembered visual targets of goal-directed arm movements. Participants had to point toward an initially foveated central target after an intervening saccade. Participants made errors that reflect a bias in the visuomotor transformation that depends on eye displacement rather than any head-centred variable. The second issue addressed was if pointing toward the centre of a wide-field expanding motion pattern involves a retinal updating mechanism or a transformation to a head-centric map and if that process is distance dependent. The same pattern of pointing errors in relation to gaze displacement was found independent of depth. We conclude that for goal-directed arm movements, representation of the remembered visual targets is updated in a retinal frame, a mechanism that is actively used regardless of target distance, stimulus characteristics or the requirements of the task.     

Changing patterns of binocular visual connections in the intertectal system during development of the frog,Xenopus laevis

Summary In the frog, Xenopus laevis, a system of intertectal connections underlies the visual projection from an eye to its ipsilateral tectal lobe and is involved in the topographic representation of binocular visual space. Rotation of one eye in early life may be followed by a radical rearrangement of the connections in this system. The modified pattern which later emerges is that which keeps the visual projection through the ipsilateral eye in topographic registration with the direct visual projection from the contralateral eye to the same tectal lobe. This plasticity requires visual experience.In this paper we describe the time-course and sequence of events by which this plasticity is effected. Following rotation of one eye in larval animals or in animals undergoing metamorphic climax, the earliest evidence of intertectal modification was found 3–4 weeks after metamorphosis. With increasing intervals after metamorphosis an increasing proportion of animals displayed modified intertectal systems. At intermediate intervals many animals showed partial modifications, which were interpreted as transitional stages in the modification process. Analysis of these transitional stages indicated that the sequence of events involved in the elaboration of a modified intertectal system following the experimental alteration of eye alignment exhibits features in common with rearrangements of the system that occur during normal development in response to growth-related alterations in eye alignment.