Safety and efficacy of botulinum toxin type A following long-term use

Botulinum toxin serotype A (BoNT-A) has long heritage of use leading to confidence in its safety and efficacy. The application of BoNT-A does not lead to persistent histological changes in the nerve terminal or the target muscle. Clinical trials defined the safety and tolerability profile of BoNT-A across common therapeutic indications and showed an incidence of adverse events of approximately 25% in the BoNT-A-treated group compared with 15% in the control group. Focal weakness was the only adverse event to occur more often following BoNT-A treatment. Long-term BoNT-A administration has been assessed in various treatment settings, with the level and duration of BoNT-A efficacy response being maintained over repeated rounds of injection with no major safety concerns. The treatment of children with cerebral palsy often require long-term, repeated, multimuscle BoNT-A injections that lead to the administration of comparably higher toxin doses. Despite the high total body doses used, their distribution over multiple muscles and injection sites means that systemic side effects are rare. Recent formulation changes have reduced the incidence of antibody development following treatment with BOTOX^®. These findings show long-term BoNT-A treatment to be both safe and efficacious for a wide variety of indications.     

高分辨率CT对颞部疾病的检查价值

目的：探讨高分辨率CT（HRCT）对颞部疾病的检查价值。方法：对43例颞部疾病患者行常规CT和高分辨率CT（HRCT）检查所获图像对比分析，并讨论HRCT的检查技术和图像后处理。结果：HRCT对病变的显示率及病变引起骨质破坏的程度，病变边缘，轮廓的显示均明显优于常规CT，尤其能清楚显示常规CT难以显示的中耳及内耳的细微结构，结论：高分辨率CT是颞部疾病的首选检查方法，使用高分辨率CT对颞部疾病的检查给临床提供更多，更准确的诊断信息。     

Intratemporal vascular tumors: detection with CT and MR imaging

The diagnostic contributions of computed tomography (CT) and magnetic resonance (MR) imaging were compared in 12 patients with benign intratemporal vascular tumors (hemangioma or vascular malformation). The tumors included six in the internal acoustic canal and six in the geniculate ganglion region. Clinical and histologic correlations were made. Two of the six patients with tumors in the internal acoustic canal underwent CT, and both required gas cisternography to show the tumor. Five patients in that group underwent MR imaging, and all five studies showed the tumor. All six patients with geniculate ganglion tumors underwent CT. Results in one study were questionable, and five showed the tumor. Five patients in this group underwent MR imaging, but the MR findings were positive in only two cases. MR imaging should therefore be performed before CT in the evaluation of facial nerve dysfunction, as it demonstrated all tumors in the internal acoustic canal and some in the geniculate ganglion region. If MR findings are negative, CT should then be performed to rule out a possible geniculate ganglion lesion.     

螺旋CT在肺动脉栓塞诊断中的价值

目的:评价螺旋CT在诊断肺动脉栓塞中的作用。方法:16例肺动脉栓塞患者行螺旋CT肺动脉造影 (SCTA)检查,层厚3mm,扫描时间0.8s,对比剂注射速度3.5ml/s,总量100ml,扫描延迟时间15s。结果:16例 共644支,其中134支肺动脉及分支显示了栓塞,占20.8%。228支肺段肺动脉中,有56支显示肺动脉栓塞,占分 析肺动脉支的24.5%。204支亚段肺动脉中37支显示肺动脉栓塞,占分析肺动脉支15.4%。肺动脉栓塞的CT形 态:①直接征象为不同程度的肺动脉分支内充盈缺损。中心型充盈缺损17支,偏心型充盈缺损44支,附壁血栓型 34支,完全阻塞型39支。②间接征象胸膜下肺梗死灶,内乳动脉一侧增粗,肺纹理稀少,胸水,肺动脉高压。结论: 螺旋CT肺动脉造影是诊断肺动脉栓塞的快速、有效、无创伤的诊断方法。     

Prevalence, clinical characteristics, quality of life, and prognosis of patients with congestive heart failure and isolated left ventricular diastolic dysfunction.

Prevalence of isolated left ventricular (LV) diastolic dysfunction has been reported to be as high as one-third of all heart failure (HF) cases, with an increasing prevalence in the elderly population. However, there is a paucity of prospective data about the prevalence and prognosis of isolated LV diastolic dysfunction in an unselected population of patients hospitalized with HF. Therefore, we prospectively evaluated 179 consecutive patients discharged from our hospital with HF to assess the prevalence of systolic versus diastolic LV dysfunction among patients hospitalized with HF and to compare their demographics, clinical features, self-perceived quality of life (QOL), and 6-month readmission rate and mortality. Among them, 133 (59% men, median age 74 years) showed in sinus rhythm and had no significant primary valvular disease. LV diastolic dysfunction was diagnosed on the basis of the European Study Group on Diastolic HF echocardiographic criteria. QOL was assessed at hospital discharge and 6-month follow-up visit using the Minnesota Living with HF questionnaire. Survival of patients with HF was compared with that of age- and sex-matched general population. In all, 29 patients (22%) had isolated LV diastolic dysfunction and 102 (78%) had prevalent LV systolic dysfunction (ie, LV ejection fraction 相似文献   

骨巨细胞瘤的MRI诊断价值

目的探讨骨巨细胞瘤的MRI表现特点及其病理基础。资料与方法搜集经手术病理证实的12例骨巨细胞瘤患者资料，分析其MRI征象并与病理结果对照。结果T1WI上肿瘤实体表现为低、等信号，T2WI上为不均匀高信号，Gd-DTPA增强扫描呈中度到明显强化。此外，MRI还可显示肿瘤内坏死、出血、含铁血黄素沉着等。结论MRI能够提供比较全面的影像学信息，可提高对骨巨细胞瘤诊断的准确性。