Primary orthostatic tremor is an exaggeration of a physiological response to instability.

Primary orthostatic tremor (POT) is a rare disorder characterised by an intense sense of unsteadiness upon standing and a 16-Hz tremor in which the timing between tremor bursts in different muscles (unilateral and bilateral) remains constant. Hitherto, similar EMG activity has not been described in healthy subjects and it has been postulated that the oscillations seen in POT are primarily pathological. In this study, EMG was recorded from tibialis anterior in healthy subjects who were made unsteady through vestibular galvanic stimulation or leaning backwards. Under these conditions, a peak at approximately 16 Hz was seen in the coherence between the left and right tibialis anterior. This bilateral coherence was absent when the subjects activated the same muscles when not unsteady. These data indicate the existence of a physiological system involved in organising postural responses under circumstances of imbalance and characterised by a highly synchronised output at approximately 16 Hz. In addition, the results suggest that the core abnormality in POT may be an exaggerated sense of unsteadiness when standing still, which then elicits activity from a 16-Hz oscillator normally engaged in postural responses.     

Empowering practice nurses in the follow-up of patients with established heart disease: lessons from patients' experiences

This paper reports on the views of patients with established heart disease of a structured programme of follow-up care provided by practice nurses (PNs) in general practice in England. It is based on in-depth interviews with 22 patients receiving an integrated primary and secondary care intervention being developed and piloted for patients following heart attack or diagnosis of angina. Patients identified the important features of follow-up care to be easy access to a health professional who possessed knowledge and social and emotional skills. A range of views about the ability of PNs to provide such care emerged from patients' accounts. patients' perceptions about the seriousness of their condition and the way PN follow-up care was provided in practices emerged as important issues affecting patients' views. In addition, perceptions about the practice nurse's role, status and knowledge, existing relationships with general practitioners, and issues of communication were also important factors. It is concluded that in order to develop high-quality PN-led services for patients with established heart disease, four issues need to be taken into account: practice nurse training; continuity of follow-up care; the integration of the primary and secondary care interface; and development of the practice nurse's status within the primary health care team.     

原发性青光眼的激光治疗

目前在青光眼的临床治疗中，激光治疗已成为介于药物和手术治疗之间的一种方法，本文仅就原发性闭角型青光眼的激光周边虹膜透切术和开角型青光眼的激光滤帘成形术做一介绍。     

原发性肝癌中医单证证型专家观点文献分析

目的整理原发性肝癌辨证分型文献中的专家观点,分析原发性肝癌各中医单证证型在专家观点中的出现状况,初步明确其主要的单证证型.方法对建国以来国内公开报道的有关原发性肝癌中医辨证分型的文献进行整理,运用χ2检验对文献中的专家观点进行统计分析.结果气滞(肝气郁结)型、血瘀型、脾气虚型、肝阴虚型、肾阴虚型、肝胆湿热型在专家观点中出现频率较高(均超过50%),它们之间没有显著性意义,但与其它出现频率较低的各单证证型相比,均有显著性差异(P<0.00091).结论原发性肝癌常见的中医单证证型依次为①气滞(肝气郁结)型;②血瘀型;③脾气虚型;④肝阴虚型;⑤肾阴虚型;⑥肝胆湿热型.     

第二原发胰腺癌临床特征分析

目的:探讨第二原发胰腺癌的临床特征.方法:以96例普通原发胰腺癌作为对照,回顾性分析了病理确诊的32例第二原发胰腺癌的临床特征.结果:32例第二原发胰腺癌15例(46.9％)发生于乳腺癌、胃癌之后.性别、年龄、部位、临床症状、常规实验室检查及肿瘤标志物检测与普通进展期胰腺癌具有可比性,仅年龄略为提前,消化不良稍多,腹痛、黄疸比例稍降.B型超声、CT、MRI、逆行胰胆管造影诊断敏感率较普通胰腺癌高.处于Ⅰ期者仅2例(6.3％).总体半年存活率为50.0％,较普通胰腺癌略低.病理显示84.4％为腺癌,分化差.结论:第二原发胰腺癌症状更不典型,诊断更为滞后,预后更差,故应加强联系与第一次癌肿的早期检测手段(如肿瘤标志物)研究.     

Executive cognitive deficits in primary dystonia.

Primary dystonia is a disorder of movement for which no consistent pathophysiology has been identified; in the absence of evidence to the contrary, it is assumed to be cognitively benign. We have studied a clinically heterogeneous group of 14 patients with primary dystonia on a battery of neuropsychological tests. Despite well-preserved speed of information processing, language, spatial, memory and general intellectual skills relative to normal controls, we have identified a constellation of attentional-executive cognitive deficits on the Cambridge Neuropsychological Test Automated Battery (CANTAB). Specifically, patients demonstrated significant difficulties negotiating the extra-dimensional set-shifting phase of the IED task. The implications of these findings for the pathophysiology of primary dystonia are discussed. This is, to the best of our knowledge, the first report of a significant cognitive deficit in patients with primary dystonia.     

中国食管癌高发区食管原发性腺癌组织病理学研究Ⅰ．食管原发性腺癌的临床病理学分析

中国食管癌高发区河南省近１５年（１９８０～１９９４）病理确诊的７３６４例食管癌中，其中食管原发性腺癌（ＰＥＡ）２３９例，占３．２５％。通过对２３９例ＰＥＡ手术标本（包括早期癌２０例，其余为中、晚期癌）切片系统观察，指出中国食管癌高发区ＰＥＡ主要起源于食管固有腺体的各级导管部分。ＰＥＡ的病理组织学可分６型：腺导管癌（１０９例）、腺鳞癌（５４例）、腺样囊性癌（２９例）、粘液表皮样癌（２０例）、基底细胞样癌（１５例）、胃型腺癌（１２例）。每型的组织图象及预后均各有特点，提示ＰＥＡ组织学再分型有意义。     

Multiple primary malignant neoplasms in urologic patients

Methods: Second primary cancers constitute approximately 9–10% of malignancies diagnosed in the United States. We aimed to show the risk and incidance of second primary tumor occuring associated to urologic tumors and show the distrubution of tumors in Tracia region. We retrospectively examined the patients' files with the diagnosis of malignant disease between the years 1985–2000. Hazard function analysis was performed to estimate the relative risk of secondary malignancy occuring. Age, sex and tumor number were examined to find out if they affect on mortality rate. Results: A total number of 25 MPMNs were diagnosed. In 52 percent of the cases the second primary neoplasm developed within six months. The relative risk of development of a second neoplasm is found as increasing 1.111 times per month. The incidence of secondary malignancy occuring in the patients with one tumor was found as 6.31%. Age (p < 0.001) and tumor number (p < 0.001) are found as statistically effective predictor on mortality rate where the sex is not. Conclusions: In the patients with a primary tumor not only the metastasis must be investigated but also second primary tumors should be taken in to consideration. This revised version was published online in August 2006 with corrections to the Cover Date.     

Traumatic dental injuries and associated factors among Brazilian preschool children

Abstract –  The main objective of this study was to assess the epidemiology of traumatic dental injuries (TDI) to the primary teeth of preschool children and second, to investigate whether TDI were related to anterior open bite and, third, whether TDI are related to socio-economic circumstances in an urban Brazilian population. A clinical examination was performed during the National Day of Children's Vaccination. TDI were classified according to the modified classification proposed by Ellis. In addition to those criteria the presence of tooth discoloration was recorded. An interview was carried out with mothers or guardians. The data collected included mother's level of education and living conditions. The prevalence of TDI was 9.4%. The maxillary central incisors were the most affected teeth. Most children with a TDI experienced traumatic injuries to one tooth (6.3%), while 2.8% had two and 0.4% had three traumatized teeth. The most common crown fracture was in enamel only (68.8%), followed by crown fracture of enamel and dentin (13.8%). Missing teeth following trauma occurred in 10.9% of those with TDI. The prevalence of tooth discoloration was 5.1%. Children with anterior open bite had twice the level the level of TDI compared to those with normal occlusions ( P  = 0.001). Socio-economic factors were not statistically significantly associated with the occurrence of TDI. The prevalence of dental injuries in Brazilian preschool children was low. Children with anterior open bite experienced more dental injuries. Neither of the indicators of socio-economic status was related to the prevalence of TDI.     

Pulpal reactions to glutaraldehyde and paraformaldehyde pulpotomy dressings in monkey primary teeth

Abstract Pulpotomy was performed in primary teeth of 4 vervet monkeys to compare the effect of an experimental dressing containing glutaraldehyde (GL) to a similar formula with paraformaldehyde (PF). Forty teeth were examined histologically 2 weeks to 5 months post-operatively. In the PF group, calcifications were more frequently observed and the central core of tissue in the root canal was heavily laden with debris. Pathologic apical resorption and lesions were more frequent. The pulp in the apical third of the root canal was usually uninflamed in the GL group and peripheral calcifications were seldom observed in it. Reaction to GL seemed, therefore, more favorable clinically. Defects were not observed in the permanent teeth that erupted following shedding or extraction of the experimental primary ones of either group.