不典型帕金森患者皮质脊髓束损害的电生理特点——三重刺激技术研究初探

目的 分析三重刺激技术（TST）对评价不典型帕金森患者皮质脊髓束损害的临床应用价值。方法 病例组为2009年7月在北京协和医院就诊的6例不典型帕金森患者（多系统萎缩5例，进行性核上性麻痹1例），对照组为12例年龄匹配的正常人或非神经系统疾病患者。对受试者进行右上肢小指展肌TST和传统运动诱发电位（MEP）测定，分析TST波幅比（TST测试/TST对照）、中枢运动传导时间（CMCT）、静息运动阈值（RMT）、MEP潜伏期特点。对上述电生理指标进行与病程和年龄的相关性分析。结果 与对照组相比，不典型帕金森患者的TST波幅比明显降低[（40.7%±18.6%） vs （96.8%±3.0%），P＝0.001]，RMT明显升高[（63.3±5.2） vs （48.6±8.4），P＝0.001]，MEP潜伏期和CMCT在两组间差异无统计学意义（P＞0.05）。TST和传统MEP相关参数与病程或年龄之间均未见显著性相关，但是TST波幅比与病程呈现负相关趋势。结论 TST较传统MEP能更好地评价不典型帕金森患者的皮质脊髓束损害。     

A worthy technique for transcanal drilling during endoscopic ear surgery

ObjectiveTo evaluate the necessity and effectiveness of a preplanned technique for drilling during transcanal endoscopic ear surgery.MethodsStudy design: Retrospective case series study from June 2011 to June 2015. Setting: Private tertiary care hospital. Patients: Eighty-five ears of 78 patients, age ranging from 9 to 57 years underwent transcanal endoscopic drilling for various types of pathology in their middle and external ear. Interventions: Application of a preplanned technique for transcanal drilling in endoscopic ear surgery that involved short timed drilling with use of intermittent irrigation and suction. Every events of the procedure were done one after another with the single hand of the surgeon. An attachment providing protecting sheath around rotating burr was used during each time of drilling. Main outcomes measure: Efficacy of such drilling technique in single handed endoscopic ear surgery. Presence of any postoperative thermal injury of facial nerve and any lacerated injury of skin of external ear.ResultsThis preplanned technique was found suitable for transcanal endoscopic drilling with the single hand of the surgeon. Postoperative facial nerve palsy or laceration of skin of external ear was not noted in any patient.ConclusionAfter using the present technique, transcanal endoscopic drilling could be done easily and safely with single hand of the surgeon.     

Evaluation of Central Venous Access with Accelerated Seldinger Technique Versus Modified Seldinger Technique

Background

Central vein catheter (CVC) placement using the modified Seldinger technique is a common procedure in the emergency department, but can be time consuming due to the multiple pieces of equipment included in central line kits and the number of steps in the procedure. Preassembled devices combine a needle, guidewire, dilator, and sheath into one unit and potentially simplify the process and reduce time required for CVC placement using the accelerated Seldinger technique.

Microspheres of essential oil in polylactic acid and poly(methyl methacrylate) matrices and their blends

This study is focussed on micro-encapsulation of essential oils in polylactic acid (PLA) and a poly(methyl methacrylate) (PMMA) matrix as well as blends of the same. Microspheres were prepared by the solvent evaporation technique and characterised by scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and Fourier transform infra-red spectroscopy (FTIR). The encapsulation efficiencies and release profiles of the essential oils were studied by gas chromatography mass spectrometry (GC-MS) and head-space solid-phase microextraction GC-MS, respectively. Furthermore, the microspheres were tested for antibacterial activity against both Gram-negative and Gram-positive bacterial strains.

The results showed that the microspheres compositions (PLA/PMMA ratio) have significant effect on their characteristics. The process adopted for preparing the microspheres promoted formation of spherical particles at the sizes of 1.5–9.5?µm. The highest encapsulation efficiency of the prepared microspheres was observed in systems consisting of linalool (81.10?±?10.0?wt. % for PLA system and 76.0?±?3.3?wt. % for PMMA system). Confirmation was also made that the release rate of the microspheres was affected by the size of the same.     

Buzzing away the pain: Using an electric toothbrush for vibration anesthesia during painful procedures

Many dermatologic procedures are painful and traumatic, for both pediatric patients and providers alike. Vibration anesthesia has recently been discussed as an effective method for reducing pain associated with injections, but some vibration machines can be cost prohibitive for providers. We describe how to employ an electric toothbrush as an inexpensive and effective option to provide vibration anesthesia during painful pediatric procedures.     

Total Knee Arthroplasty in Severe Valgus Deformity Using a Modified Technique—A 10-Year Follow-Up Study

Background

Valgus knee deformity accounts for only 10% of total knee arthroplasties (TKAs), but is frequently considered the most challenging to manage. This study provides a 10-year follow-up on a previously reported series of severe valgus knees performed using an unconstrained mobile-bearing TKA with a modified technique to validate this technique.