Can a congenital dysfunctional bladder be diagnosed from a smile? The Ochoa syndrome updated

During the last 40 years over 100 patients have been reported with a dysfunctional lower urinary tract associated with a peculiar distortion of the facial expression. This most unusual disorder was initially considered a local observation. Time, however, has proven otherwise, since patients with this syndrome have now been reported from various countries throughout the world. This association of lower urinary tract and bowel dysfunction with an abnormal facial expression was named the urofacial (Ochoa) syndrome. Genetic studies have demonstrated that this condition is inherited as an autosomal recessive trait, and a potential gene has been mapped to chromosome 10q23-q24. There is also enough evidence to suggest that patients with this syndrome as well as those with subclinical neurological bladder, occult neuropathic bladder, non-neurogenic neurogenic bladder or Hinman syndrome, dysfunctional voiding, or dysfunctional elimination may be affected by the same congenital disorder of neurological origin.     

Systemic and intraocular manifestations of West Nile virus infection

Since the introduction of West Nile virus in the Western Hemisphere in 1999, the incidence of human infection has increased dramatically. As this virus spreads westward across the United States, ophthalmologists should be aware of this presently uncommon but important condition. Systemic features of West Nile virus infection are well characterized; however, the ophthalmic presentations are not widely known. Intraocular involvement with West Nile virus infection was first described in February 2003, and a variety of ophthalmic manifestations have since been recognized. A complete survey of the systemic and intraocular manifestations of West Nile virus infection relevant to the ophthalmologist is presented.     

Recurrent pleomorphic adenoma of the parotid gland

BACKGROUND: Surgery of recurrent pleomorphic adenoma presents an increased risk of facial nerve injury and a considerable re-recurrence rate. METHODS: A series of 33 patients with first recurrence of pleomorphic adenoma of the parotid gland was analyzed. The data were derived from medical records as well as from interviews and clinical examinations of all living patients. Histologic material of the initial and recurrent tumor were reviewed. RESULTS: Multifocal recurrence and carcinoma in pleomorphic adenoma were observed in 73% and 9% of patients, respectively. The incidence of permanent partial facial nerve injury after surgery was 23% in patients with initial enucleation and 14% in those with initial superficial parotidectomy (including 1 patient with facial nerve resection and 1 patient with a partial facial paresis before recurrence surgery). A subsequent recurrence occurred in 6 patients, all with initial enucleation after a mean time interval of 9 years. CONCLUSIONS: The preservation of the facial nerve was possible in all but 1 patient treated for the first recurrence with a relatively low rate of permanent partial facial paresis because of the use of the operating microscope and facial nerve monitor. To evaluate the re-recurrence rate, a follow-up of at least 10 years is necessary.     

Morphometric study of the cervical course of the hypoglossal nerve and its application to hypoglossal facial anastomosis

The hypoglossal nerve is used classically in salvage of facial paralyses in the absence of spontaneous recovery. A variety of ways of transferring and suturing the hypoglossal nerve to the distal segment of the facial nerve have been reported. In order to determine which mode of reconstruction is the best for neurotisation of the facial nerve, the caliber of the hypoglossal nerve was studied in ten subjects at the level of proximal and distal parts of the trunk and the cervical loop. The fascicular surface area of the cervical branch is inadequate for use. The distal extremity of the hypoglossal nerve has an ideal caliber to be sutured to the facial nerve trunk and the proximal part is large enough to allow partial harvesting of the hypoglossal nerve for neurotisation of the facial nerve.     

Anatomic study of the tendinous insertion lamina of the temporalis muscle

Lengthening temporalis myoplasty is indicated in long-standing and congenital facial paralysis. Its principle is the transfer of the coronoid tendinous insertions onto the lip and the nasolabial fold. Knowledge of the anatomy of this strong and wide tendon is necessary for successful use of its anatomic advantages. A study on 10 cadavers (20 temporalis muscles) confirmed the surgical anatomy found during lengthening temporalis myoplasty procedures: the strong tendon, when freed from the coronoid process, is 4–6 cm wide.     

面神经额支的分布与面部上提术的关系

目的明确面神额支在颧弓及颢部的软组织走行层次和分布。方法对9具尸头(18侧)颜面行大体解剖观察。结果面神经额支的分支数目为3～7支,平均5支,无恒定的行径及体表投影。将颧弓均分成三段,统计跨过各段表面的额支分支数,发现额支并非仅限于颧弓的中后段,而是近全颧弓均有额支分支跨过,其分布密度以中1/3段最高,占总数的44.44%(40/90);前1/3段次之,占38.89%(35/90);后1/3段又次之,占16.67%(15/90)。额支分布于颧弓和颞部的浅筋膜层(即 SMAS)的深面,其前段表面分支支配下外侧的眼轮匝肌,中段表面分支支配外侧的眼轮匝肌及少部分额肌,后段表面分支支配额肌和耳前肌。结论行骨膜下剥离面部上提术时,为减少面神经额支的损伤,应注意辨认颞部和颧弓部位的软组织层次,并非靠限制颧弓部位的解剖范围。     

几丁质再生室修复面神经缺损的实验研究

寻求适合临床应用的可吸收性面神经修复材料。方法：用几丁质管作为人工再生室修复兔面神经颊支８ｍｍ缺损,观察神经再生及其功能恢复情况。结论可吸收性几丁质再生室能有效地引导面神经再生并恢复其功能,有一定的临床应用价值。     

睫状神经营养因子对面神经损伤的修复作用

目的：探讨局部应用睫状神经营养因子（ＣＮＴＦ）对成年大鼠面神经损伤的修复作用。方法：将雄性ＳＤ大鼠颞骨内面神经垂直段横断后端端吻合,ＣＮＴＦ组以ＣＮＴＦ明胶海绵覆盖损伤处;对照组以生理盐水（ＳＡＬ）的明胶海绵覆盖损伤处。术后ＣＮＴＦ组每周２次耳后皮不注射ＣＮＴＦ５μｇ,对照组同法注射等量ＳＡＬ。术后２,４和１２周各组进行电生理学、组织病理学观察及开矿学定量分析。结果：术后２周,两组电刺面神经均未能     

口腔颌面部血管瘤和血管畸形的肥大细胞数量与雌激素受体水平分析

分析口腔颌面部血管瘤和血管畸形的肥大细胞数量与雌激素受体（ER）水平及其在血管瘤增殖中的作用。方法：采用甲苯胺蓝染色法及免疫组化法对34例血管成和14例血管畸形病理标本进行分析。结果：血管瘤增殖期与退化期肥大细胞数量之间的差别有高度统计学意义（P＜0．01）;ER（－）与ER（＋＋）时的肥大细胞数量之间的差别有高度统计学意义（P＜0.01）;血管瘤增殖期与退化期ER阳性率的差别无统计学意义（P＞0．20）。结论：肥大细胞计数有助于血管瘤与血管畸形的鉴别诊断;ER（＋＋）时有较多的肥大细胞参与血管瘤的生长。血管瘤增殖期比退化期的ER可能更具有活性。     

Long time echo STIR sequence magnetic resonance imaging of optic nerves in optic neuritis

Magnetic resonance images of optic nerves were obtained in 20 patients with acute optic neuritis (ON), and assessed by means of clinical, visual field and visual evoked potential evaluations; the imaging was repeated 1 year later. The results of the conventional Short Tau Inversion Recovery (STIR) sequence obtained using short time echo (STE-STIR: 22 msec) were compared with those of the long time echo sequence (LTE-STIR: 80 msec). The conventional STE-STIR sequence revealed lesions in 57.2% cases of acute ON and in 42.9% of the optic nerves affected by previous ON: the LTE-STIR sequence was diagnostic in 95.2% of acute ON cases and in 85% of patients with previous ON. The calculated length of the optic nerve lesions was significantly longer in the images obtained using the LTE-STIR sequence than in those obtained using conventional STE-STIR sequences.

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Sommario Si descrivono i risultati ottenuti con indagini di Risonanza Magnetica (RM) dei nervi ottici (eseguite all'esordio e 12 mesi dopo) in 20 pazienti affetti da Neurite Ottica (NO) acuta, valutata in funzione della sintomatologia clinica e delle alterazioni campimetriche e del potenziale evocato visivo.Sono state analizzate le immagini RM in Short Tau Inversion Recovery (STIR) mettendo a confronto i rilievi ottenuti con sequenza Short Time Echo (STE-STIR: 22 msec) rispetto a quelli ottenuti con Long Time Echo (LTE-STIR: 20 msec). Mentre con la convenzionale STE-STIR è stato possibile rilevare lesioni a carico dei nervi ottici nel 57.2% delle Neuriti Acute e nel 42.9% delle Neuriti Pregresse, la metodica LTE-STIR è risultata diagnostica nel 95.2% delle Neuriti Acute e nel 85% delle Neuriti Pregresse.Sia nelle NO acute che nelle pregresse, la lunghezza delle lesioni a carico dei nervi ottici sono risultate significativamente maggiori rispetto a quelle ottenute con la convenzionale metodica STE-STIR.