Meta-analysis of brain structural changes after electroconvulsive therapy in depression

BackgroundIncreases in the volume of the amygdala and hippocampus after electroconvulsive therapy (ECT) are among the most robust effects known to the brain-imaging field. Recent advances in the segmentation of substructures of these regions allow for novel insights on the relationship between brain structure and clinical outcomes of ECT.ObjectiveWe aimed to provide a comprehensive synthesis of evidence available on changes in brain structure after ECT, including recently published data on hippocampal subfields.MethodsA meta-analysis of published studies was carried out using random-effects models of standardized mean change of regional brain volumes measured with longitudinal magnetic resonance imaging of depressive patients before and after a series of ECT.ResultsData from 21 studies (543 depressed patients) were analysed, including 6 studies (118 patients) on hippocampal subfields. Meta-analyses could be carried out for seven brain regions for which data from at least three published studies was available. We observed increases in left and right hippocampi, amygdalae, cornua ammonis (CA) 1, CA 2/3, dentate gyri (DG) and subicula with standardized mean change scores ranging between 0.34 and 1.15. The model did not reveal significant volume increases in the caudate. Meta-regression indicated a negative relationship between the reported increases in the DG and relative symptom improvement (−0.27 (SE: 0.09) per 10%).ConclusionsECT is accompanied by significant volume increases in the bilateral hippocampus and amygdala that are not associated with treatment outcome. Among hippocampal subfields, the most robust volume increases after ECT were measured in the dentate gyrus. The indicated negative correlation of this effect with antidepressant efficacy warrants replication in data of individual patients.     

A conceptual framework for treating jaw deformities in patients with abnormal condyles: preservation versus replacement of the glenoid fossa–disc–condyle–ramus

This article outlines a conceptual approach to the reconstruction of jaw deformities associated with abnormalities in the mandibular condyle. The authors describe a hierarchy of reconstruction, emphasizing use of the least invasive and progressing to the most complex and invasive techniques, depending on the nature and severity of the underlying deformity, prior operations, patient age, and stage of growth. Consider joint preservation orthognathic surgical correction, followed by biological techniques for replacement of the condyle, and avoid replacing a functional temporomandibular joint based only on radiographic remodeling and concerns about potential future flare-ups of disease based on anecdotal data.     

Bilateral acute iris transillumination following a fumigation therapy: a village-based traditional method for the treatment of ophthalmomyiasis

Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber and atonic pupilla. We report herein a 50-year-old female who presented with bilateral ocular pain, severe photophobia and red eyes. One month ago, a fly hit her eye, and she instantly complained of a discomfort and sensation of a foreign body in both eyes. She used a fumigation therapy, a traditional method for the treatment of ophthalmomyiasis. During follow-up examinations, intraocular pressures increased over 40?mmHg bilaterally despite maximal medical therapy, which necessitated trabeculectomy surgery with mitomycin. This is a typical BAIT case with no antecedent fluoroquinolone use or viral disease, but a fumigation therapy. There might be a possible relationship between BAIT and traditional fumigation therapy or this association might be coincidental, both of which need further evaluation.     

Remind to move – A novel treatment on hemiplegic arm functions in children with unilateral cerebral palsy: A randomized cross-over study

Objective: To investigate the effects of ‘remind to move’ treatment on hemiplegic arm function in children with unilateral cerebral palsy (CP). Methodology: Twelve students with unilateral CP aged 6–18 were recruited from a special school and randomly assigned into two groups. Participants in the experimental group underwent a 3-week sensory cueing treatment followed by a 3-week sham treatment. Participants in the waitlist group completed the sham treatment first followed by the sensory-cueing treatment. There was a 4-week washout period between treatments. Results: Both functional hand use and arm impairment level significantxly improved after the 3-week sensory cueing treatment for the combined sample between groups. However, no significant carryover effects were found for either treatment. Conclusion: Three weeks of ‘remind to move’ treatment is useful in improving hemiplegic arm function and quantity of hand use in children with unilateral CP but the long-term carryover effect requires further investigation.     

单侧固定椎间融合术在腰椎间盘突出症伴椎间不稳手术中应用

目的探讨单侧固定椎间融合术治疗腰椎间盘突出症伴椎间不稳的临床应用价值,报告其初步临床疗效。方法自2010-01-2013-10,使用单侧固定椎间融合术治疗腰椎间盘突出症伴椎间伴不稳36例,采用JOA评分,分析术前与术后评分及融合情况。结果术后JOA平均改善率为(85.1±8.2)%,应用t检验,P0.05,具有统计学差异。结论该术式治疗腰椎间盘突出症伴椎间不稳,具有创伤小、融合率高、术后恢复快等优点,适合临床运用。     

单开门微型钢板在颈后路椎管扩大成形术中的应用

2013年3月～2014年5月,我科采用 Centerpiece 微型钢板治疗12例脊髓型颈椎病患者,近期疗效满意,报道如下。     

Spondylocostal dysostosis with tetralogy of Fallot and herniation of the spleen through the diaphragm

Spondylocostal dysostosis (SCD) is a very rare syndrome characterized by vertebral malformation and rib deformity. Some of the patients with SCD have other birth defects in the central nervous system, the genitourinary tract, diaphragm or heart and so forth. There have been reported SCD with complex congenital heart disease, such as pulmonary atresia, double outlet right ventricle, and d‐transposition of great arteries. However, there have been no reported SCD patients with confirmed tetralogy of Fallot (TOF). Here, a patient with SCD having a very rare combination of rib defects on the right side and left‐sided scoliosis, tetralogy of Fallot, and diaphragmatic spleen herniation, which had not been reported before, was described.     

附着体应用于单侧上颌骨缺损修复的模型设计与制作

目的:探讨附着体应用于单侧上颌骨缺损修复的支架设计及制作方法。方法:在健侧余留牙舌面设计制作连续的舌面导板,MiNiSG附着体位于中切牙的近中,与舌面导板相结合。然后在此基础上设计制作赝复体基托,与腭部及舌面板紧密贴合。对制作完成的支架与基托做固位力测试。结果:获得了所设计的附着体支架及赝复体金属基托的实物模型,平均固位力达47N。结论:附着体应用于单侧上颌骨缺损修复在操作技术上切实可行,可增加整个修复体的固位与稳定。     

儿童单侧后牙反患者下颌及颞颌关节的对称性研究

目的研究儿童单侧后牙反牙合患者下颌及颞颌关节的对称性。方法以26例替牙期单侧后牙反牙合患儿为试验组,28名正常牙合替牙期儿童为对照组,分别摄定位颏顶位片及双侧颞颌关节中位断层片进行比较。结果替牙期单侧后牙反牙合患儿在下颌骨坐标系中DMP点更靠颊侧。在颅底坐标系中,反牙合侧DMP点更靠远中,DMP、MM、DM点更靠颊侧。双侧髁突位置不对称、非反牙合侧关节前间隙减小,上后间隙均增大。结论相对于下颌坐标系,反牙合侧第一磨牙位置与对侧相比更靠远中及颊侧。在骨性结构上,未见下颌的不对称。试验组双侧髁突位置及关节间隙有差异,说明下颌发生功能性侧方移动。     

唇裂术后鼻部对称性的变化及其影响因素

目的 评价华西法修复单侧完全性唇裂术后鼻底宽度及其对称性的变化以及与裂隙宽度的关系,为一期手术鼻畸形整复提供参考.方法选择应用华西法修复单侧完全性唇裂患者27例,分别于术前、术后1周及术后1年拍摄面部正位照片,测量鼻小柱中点偏离程度、鼻底宽度及裂隙宽度,计算鼻小柱中点回归率、鼻底宽度对称率和鼻底宽度变化,并采用SPSS...