Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm.

We present a patient with a facial movement disorder that has characteristics of both blepharospasm and bilateral asynchronous hemifacial spasm. Because of the increased incidence of blepharospasm in patients with hemifacial spasm, our patient's clinical presentation is probably not a chance occurrence, but rather a manifestation of some predisposition for these two movement disorders. This unusual constellation of signs and symptoms challenges the current diagnostic criteria and suggests that some of these facial movement disorders may lie on a spectrum, rather than represent distinct entities.     

Aortic root dilatation may alter the dimensions of the valve leaflets

Objective: Valve-sparing surgery can be used in patients with dilated aortic roots and aortic insufficiency (AI) but has not become a common practice, in part because the spared valve may be incompetent. Our goal was to study how the dimensions of the aortic root and leaflets have changed in such patients. Methods: Fourteen patients with dilated aortic root and AI were examined by transesophageal echocardiography. The annulus diameter, sinotubular junction (STJ) diameter, sinus height, leaflet free-edge length, and leaflet height were measured. Correlations among these dimensions and with the AI grades were explored. Measurements were also made in 19 normal human aortic valves from silicone molds. Results: There was no evident change in the average diameter of the annulus between the normal valves and those in the dilated aortic roots. The STJ diameter was obviously increased in the dilated aortic roots; the aortic sinuses also appeared to be taller and the leaflets larger than normal. The leaflet free-edge length, the leaflet height, and the sinus height were found to increase with the dilated STJ diameter. The degree of AI was not found to correlate well with any of the dimensions measured. Conclusions: The dimensions of the leaflets may change parallel to aortic root dilatation with AI. Therefore, during valve sparing, it may be necessary to correct both the dilatation of the root and the leaflet free-edge length to achieve a competent valve.     

竹根化学成分的研究(Ⅱ)

目的 研究竹根的化学成分.方法 采用色谱方法 分离化学成分,根据波谱数据及理化常数分析进行结构鉴定.结果 分离鉴定了9个化合物,分别为3-(p-羟基苯)-(2,3)环氧-1-丙酸(Ⅰ),2,3-二羟基-1-(4-羟基-3,5-二甲氧基苯基)-1-丙酮(Ⅱ)、(+)-鹅掌揪树脂醇B(Ⅲ)、原儿茶醛(Ⅳ)、原儿茶酸(Ⅴ)、荭草苷(Ⅵ)、牡荆苷(Ⅶ)、异荭草苷(Ⅷ)、异牡荆苷(Ⅸ).结论 化合物Ⅰ为新化合物,命名为环氧香豆酸(epoxy coumaric acid).     

Topical application of fluorides on teeth

Abstract Prevention of caries in exposed root surfaces constitutes an important clinical problem. It is thus important that clinicians involved with periodontology have an insight into fluoride prophylaxis. The understanding of the cariostatic mechanism of fluoride has improved during recent years. The aim of the present review is to give a short account of the present concept. Calcium fluoride appears to be the only product which is formed on enamel, dentin or cementum during brief topical treatments with fluoride or use of toothpaste containing fluoride. This calcium fluoride is stable in the oral environment: this is contrary to what was believed until recently. The calcium fluoride constitutes a pH-dependant reservoir of fluoride which releases fluoride when pH drops. The practical consequences of this concept is discussed.     

Differential effects of the pyrethroid tetramethrin on tetrodotoxin-sensitive and tetrodotoxin-resistant single sodium channels

The differential effects of the pyrethroid tetramethrin on tetrodotoxin-sensitive (TTX-S) and tetrodotoxin-resistant (TTX-R) single sodium channel currents in rat dorsal root ganglion (DRG) neurons were investigated using the outside-out configuration of patch-clamp technique. Channel conductances were 10.7 and 6.3 pS for TTX-S and TTX-R sodium channels, respectively, at a room temperature of 24–26°C. The single-channel current of TTX-S sodium channels at the test potential of −30 mV was −1.27 ± 0.25 pA, and was not changed after exposure to 10 μM tetramethrin (−1.28 ± 0.23 pA). The open time histogram of TTX-S single-channel currents could be fitted by a single exponential function with a time constant of 1.27 ms. After exposure to 10 μM tetramethrin, the open time histogram could be fitted by the sum of two exponential functions with time constants of 1.36 ms (τ_fast) and 5.73 ms (τ_low). The percentage of contribution of each component to the population was 62% for the fast component representing the normal channels and 38% for the slow component representing the tetramethrin modified channels. The amplitudc of TTX-R single-channel currents was slightly changed from −0.72 ± 0.14 to −0.83 ± 0.07 pA by 10 μM tetramethrin. The open time histogram of TTX-R single-channel currents could be fitted by a single exponential function with a time constant of 1.92 ms. In the presence of 10 μM tetramethrin, the open time histogram could be fitted by the sum of two exponential functions with time constants of 2.07 ms (τ_fast) and 9.75 ms (τ_slow). The percentage of contribution of each component was 15% for the fast, unmodified component and 85% for the slow, modified component. Differential effects of tetramethrin on the open time distribution of single sodium channel currents explains the differential sensitivity of TTX-S and TTX-R sodium channels.     

Inter-rater reliability of the original and modified Barthel Index,and a comparison with the Functional Independence Measure

The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision-making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter-rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter-rater reliability of this tool following the changes. The purpose of this research was to examine the inter-rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty-five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter-rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format.     

Concomitant intrusive luxation and root fracture of a central incisor - report of a case

Abstract A case of a 9-year-old boy who presented with intruded maxillary central incisors, one of which had also sustained a middle third root fracture, is reported. The root fracture was diagnosed after orthodontic extrusion was started, which resulted in separation of the apical and coronal fragments. The hypermobile coronal fragment was stabilised by passing a K file through a palatal access cavity into the root canal of the apical fragment. Orthodontic alignment was completed and the fractured incisors were restored with the file left in situ. At a 10-year follow-up, the incisors were clinically healthy and continued to satisfy aesthetic and functional demands.     

2%戊二醛在根管治疗中的应用

应用戊二醛、甲醛甲酚消毒感染根管各80例，观察其细菌学培养情况，结果表明戊二醛消毒根管后细菌培养阳性率4％，甲醛甲酚消毒根管后细菌培养阳性率为18％，说明戊二醛对感染根管的消毒作用显著优于甲醛甲酚消毒剂。     

碘伏用于超声根管预备预防根管治疗期间痛的临床研究

目的观察碘伏用于超声根管预备对死髓牙根管治疗期间痛(endodontic interappointment pain EIP)发生率的影响及防治效果.方法对159例180颗慢性根尖周炎患者,随机分为3组(每组60颗患牙).第1组为传统手持器械对照组,第2组为超声生理盐水对照组,第3组为超声碘伏治疗组.采用临床观察分析法,观察治疗组与对照组临床反应的差异.结果超声治疗组Ⅱ～Ⅲ级EIP发生率为10%,对照组为36.67%(P＜0.01),有显著差异性.结论碘伏应用于超声根管预备能预防和降低EIP的发生并减轻其疼痛程度.     

Axonal regeneration in dorsal spinal roots is accelerated by peripheral axonal transection

Regeneration of crushed axons in rat dorsal spinal roots was measured to investigate the transganglionic influence of an additional peripheral axonal injury. The right sciatic nerve was cut at the hip and the left sciatic nerve was left intact. One week later, both fifth lumbar dorsal roots were crushed and subsequently, regeneration in the two roots was assessed with one of two anatomical techniques. By anterograde tracing with horseradish peroxidase, the maximal rate of axonal regrowth towards the spinal cord was estimated to be 1.0 mm/day on the left and 3.1 mm/day on the right. Eighteen days after crush injury, new, thinly myelinated fibers in the root between crush site and spinal cord were 5-10 times more abundant ipsilateral to the sciatic nerve transection. The central axons of primary sensory neurons regenerate more quickly if the corresponding peripheral axons are also injured.