Anglo-French neurological interactions in the 19th and early 20th centuries: Physicians,places and events

The development of neurology as an independent discipline in the mid-19th century was considerably influenced by the almost simultaneous foundation of the Charcot School at the Salpêtrière Hospital in Paris and the National Hospital for the Paralysed and Epileptic and it's School at Queen Square in London in the 1860's. We have reviewed the early interactions between Charcot's school and the leading neurologists at the National Hospital and also discussed their neurological antecedents and subsequent links up to the outbreak of World War 1 in 1914. Earlier interactions involved Trousseau and Duchenne in France and Graves, Todd, Laycock and Allbutt in Britain. The French Brown–Séquard was one of the first two physicians appointed to the National Hospital. Charcot was a frequent visitor to Britain culminating in his influential role in the 1881 International Medical Congress in London. He first suggested the terms “Parkinson's Disease” and “Jacksonian Epilepsy”. He attracted numerous British visitors to Paris and his studies of hysteria were influenced by Laycock, Todd and Russell Reynolds. Hughlings Jackson drew upon the anatomical studies of Gratiolet in his interactions with Broca and Charcot which influenced French views on aphasia, epilepsy and cortical localisation. Ball, an Englishman, was the first Professor of mental and brain diseases in Paris in 1877. Bruce in Edinburgh and Kinnier Wilson in London both maintained frequent contacts with Paris, where the latter first presented his studies of hepatolenticular degeneration in 1912. The Entente Cordiale of 1904 led to further interactions with the leading role of the French and British physicians Raymond and Duckworth. Two outstanding British women, Elizabeth Garrett and Blanche Edwards, qualified in Medicine in Paris with neurological interests. Our review emphasises the constructive influence of the French and British Schools on each other and thus on the development of neurology. The French influence was primarily the establishment of the anatomo-clinical method and the use of photographic illustrations in publications. The British School influence was its Clinical Assessment Skills and scientific studies of newly recognised diseases and concepts and its early development of neurosurgery.     

Multi-segment spine kinematics: Relationship with dance training and low back pain

BackgroundSpine posture, range of motion (ROM) and movement asymmetry can contribute to low back pain (LBP). These variables may have greater impact in populations required to perform repetitive spine movements, such as dancers; however, there is limited evidence to support this.Research questionWhat is the influence of dance and LBP on spinal kinematics?MethodsIn this cross-sectional study, multi-segment spinal kinematics were examined in 60 female participants, including dancers (n = 21) and non-dancers (n = 39) with LBP (n = 33) and without LBP (n = 27). A nine-camera motion analysis system sampling at 100 Hz was used to assess standing posture, as well as ROM and movement asymmetry for side bend and trunk rotation tasks. A two-way ANOVA was performed for each of the outcome variables to detect any differences between dancers and non-dancers, or individuals with and without LBP.ResultsCompared to non-dancers, dancers displayed a flatter upper lumbar angle when standing (p < 0.01, ηp² = 0.15), and achieved greater frontal plane ROM for the upper lumbar (p = 0.04, ηp² = 0.08) and lower thoracic (p = 0.02, ηp² = 0.09) segments. There were no differences between dancers and non-dancers for transverse plane ROM (p > 0.05) or movement asymmetry (p > 0.05). There was no main effect for LBP symptoms on any kinematic measures, and no interaction effect for dance group and LBP on spinal kinematics (p > 0.05).SignificanceFemale dancers displayed a flatter spine posture and increased spine ROM compared to non-dancers for a select number of spine segments and movement tasks. However, the overall number of differences was small, and no relationship was observed between LBP and spinal kinematics. This suggests that these simple, static posture, ROM, and asymmetry measures often used in clinical practice can provide only limited generalisable information about the impact of dance or LBP on spinal kinematics.     

内镜辅助方型脸改型术

目的探讨内镜在方型脸改型术中的临床应用效果。方法采用口内入路，在内镜辅助下，用高速涡轮气钻截除肥大下颌角、切除部分咬肌和颊脂垫，进行方型脸的面部改型。结果本组共38例，其中男3例，女35例，年龄21～40岁。内镜完全可以清楚显示下颌升支、下颌角、下颌体下缘，视野清晰。使用高速涡轮气钻截除肥大下颌角可以更加精确和容易，且创伤小，出血少，手术时间短，感染风险低。下面部轮廓改善满意。结论内镜辅助方型脸改型术，有助于获得良好的手术效果。     

咬肌与颅面形态的关系

目的探讨咬肌与颅面形态之间的关系，了解咬肌体积与邻近骨骼结构的大小及形态的相关性。方法对40例要求改变脸型者进行磁共振成像（MRI）测量，人体测量，头部正位、侧位和下颌骨曲面断层X线检查，测量并计算咬肌体积（MsV），测量头长（HL）、头宽（HB）、面长（FL）、面宽（FB）、下颌角间宽（IB）、下颌骨体长（CL）、下颌角切线长（MAL）、下颌角角度（JA），计算颜面形态指数FI（FL／FB）、头颅指数C（IHB／HL）。用SPSS11．5软件统计分析MsV与HI。HB、FL、FB、IB、CL、MAL、JA、FI、CI之间的相关性。结果MsV与JA呈明显负相关，与CL、MAL、IB、FB、HL呈明显正相关，与CL、FI、HB无明显相关性。结论咬肌肥大可能是方脸面型的成因之一，是影响面型的重要因素。     

矩形瓣成形术治疗严重内眦赘皮

我院自１９９０年以来，引用、改进矩形瓣成形术，对严重内眦赘皮１４例２６个内眦进行整复，取得了良好的效果。文中阐述了手术设计、方法及本术式的优点和注意事项，并与其它常规术式做了比较，认为矩形瓣成形术是一种较为理想的严重内眦赘皮整复法。     

Measurement of contact impedance of electrodes used for deep brain stimulation

High frequency electrical stimulation by means of electrodes implanted into the brain has become an accepted technique for treatment of Parkinson's disease. The electrical field distribution normally inserted into the sub thalamic nucleus minimise abnormal brain activity. Square wave pulses of 1–3.6 V with duration of 60–90 μs at a frequency range of 130–185 pps are generally used. Every electrode unit consists of four cylindrical electrodes positioned in a row and can be switched on independently. This paper determines the contact impedance of the electrodes for different frequencies and proposes improvement to reduce the contact impedance between the electrodes and the brain. Measurements were performed by placing the electrodes in a tank filled with saline. Different frequencies were applied on two electrodes via a resistor. The current was measured through the resistor and the voltage was registered between one of the electrodes and a third non current carrying electrode. The obtained values were used to calculate the contact impedance. The result shows large contact impedance for the used frequency compared to the impedance of the treated tissue, which means that variation in contact impedance can result in variation in the electrical field applied to the tissue.     

Mesure de l''impédance vasculaire par effet Doppler chez des patients hémodialysés

L'objet de ce travail a été de rechercher une grandeur hémodynamique fiable permettant une évaluation des conditions circulatoires au sein des fistules artérioveineuses et la détection de dysfonctionnements circulatoires, de développer un système permettant la mesure non invasive de l'impédance vasculaire du membre supérieur, puis d'évaluer cette mesure chez le volontaire sain et chez l'insuffisant rénal porteur de fistule artérioveineuse radiale fonctionnelle ou pathologique. Quatorze patients insuffisants rénaux chroniques hémodialysés porteurs de fistules artérioveineuses radiales (FAV) fonctionnelles (groupe HDN), cinq patients porteurs de FAV présentant une anomalie fonctionnelle (groupe HDP) et seize volontaires sains (groupe VS) ont été inclus dans ce travail. L'évaluation de l'impédance (amplitude exprimée en dynes secondes par centimètre cube) était réalisée à partir de l'obtention des vélocités sanguines par Doppler ultrasonore et détermination de la pression artérielle et de la fréquence cardiaque aux deux bras des patients inclus. L'appareil Doppler Multidop X4 DWL par l'intermédiaire d'une carte d'acquisition et de conversion analogique numérique autorisait l'acquisition de ces données dont le traitement sous Labview permettait d'obtenir l'amplitude et la phase de l'impédance vasculaire pour les six premières harmoniques. Concernant le membre sans fistule, les amplitudes pour chaque harmonique du spectre de l'impédance vasculaire humérale étaient plus faibles dans le groupe VS que dans le groupe de patients dialysés (p ≤ 0, 04). Une différence existait pour la phase des harmoniques 1 (p = 0,0003) et 4 (p = 0,0044) entre les groupes VS et les patients dialysés. De plus pour les harmoniques 1 et 4 il existait une différence entre les groupes HDP et HDN (p < 0,002). Chez les patients porteurs de fistule, une différence significative était observée entre le membre sans fistule et celui avec fistule que ce soit pour l'amplitude (p < 0,0001) pour les trois premières harmoniques avec un retard de phase plus important sur le membre sans FAV. La mesure de l'impédance vasculaire au membre supérieur est donc possible par une méthode non-invasive. Cette méthode à permis de mettre en évidence des différences de comportement vasculaire sur le membre sans FAV entre les sujets sains et les hémodialysés et entre les deux bras. En revanche, aucune différence n'a été trouvée entre les FAV fonctionnelles et pathologiques.     

Polydrug use at raves by a Western Australian sample

This study aimed to quantify the patterns of drug use among a group of participants in the rave scene in Perth, Western Australia. Interviews were conducted with 83 people who had recently been to a 'rave'. The study incorporated a semi-structured qualitative interview and a structured quantitative questionnaire. This paper reports on the quantitative data collected concerning patterns of drug use in association with the last rave attended. Use of 'dance drugs' (ecstasy, amphetamines or LSD) was reported by 86.8% of the 76 respondents who had used at least one drug in association with their last rave. Nearly 80% of these had also used at least one other drug on this occasion (mean number used = 2.4). Cannabis and inhalants were the drugs most commonly combined with the 'dance drugs', several respondents used more than one 'dance drug' concurrently and 16.7% had used alcohol. It seems that a significant proportion of those using 'dance drugs' in association with raves and dance parties are mixing these drugs with other substances despite harm reduction advice to the contrary. The need for more research in this area is discussed.     

Launch of Body,Movement & Dance in Psychotherapy

This article explores time-limited dance movement psychotherapy (DMP) with a female offender diagnosed with borderline personality disorder looking particularly at the development of the therapeutic relationship and attachment theory. DMP can help increase the ‘capacity to think’ and provide alternative approaches for managing emotions opposed to ‘acting out’ difficulties in relating. The therapeutic relationship in DMP can provide a containing, holding environment in the absence of healthy attachments, early experiences of deprivation and trauma. Laban Movement Analysis, psychodynamic and mentalisation approaches were used to underpin the assessment, formulation and therapeutic interventions.