Median nerve entrapment. pronator teres syndrome

Summary The surgical anatomy of interest in the pronator teres syndrome was studied to shed light on the ramifying pattern of the median nerve, the number of its muscular branches and their branching levels and to pinpoint the location of the fibrous bands which may cause median nerve entrapment. The fibrous arch of the pronator teres muscle (pronator arch) was found to lie 3 cm to 7.5 cm below Hueter's line, that of the flexor digitorum superficialis muscle (superficialis arch), which is distal to the pronator arch, was found to lie 6.5 cm below Hueter's line in its most proximal position. Symptom patterns in terms of muscle weakness caused by median nerve entrapment at different levels were also evaluated.

---

Compression du nerf médian. Syndrome du rond pronateur. Anatomie chirurgicale et corrélation aux tableaux cliniques

Résumé L'anatomie chirurgicale relative au syndrome du rond pronateur a été étudiée pour éclairer les modalités de ramification du n. médian, le nombre de ses branches musculaires et leur niveau d'origine, et pour préciser la situation des arcades fibreuses qui peuvent comprimer le n. médian. L'arcade fibreuse du m. rond pronateur a été trouvé'e à 3 à 7,5 cm au-dessous de la ligne de Hueter, celle du m. fléchisseur superficiel des doigts, qui est distale par rapport à celle du m. rond pronateur, a été retrouvée à 6,5 cm au-dessous de la ligne de Hueter dans sa position la plus proximale. Les tableaux cliniques de déficit musculaire causés par la compression du n. médian à divers niveaux sont également analysés.

     

A new approach to the management of malignant esophageal obstruction and esophagorespiratory fistula

Successful palliation of 6 patients with total or nearly total malignant esophageal obstruction is reported. In 5 of the patients, laser vaporization, dilation, and placement of an endoesophageal prosthesis resulted in an esophageal lumen that allowed adequate swallowing of soft food. In 1 patient with an esophagorespiratory fistula, the prosthesis successfully occluded the fistula and prevented aspiration or pulmonary infection until the patient's death. This rapidly achieved endoscopic palliation represents a major advance in the management of a serious medical problem.     

竹叶椒化学成分的研究

自芸香科花椒属植物竹叶椒Zanthoxylum planispinum Sieb. et Zucc根的石油醚提取物中分离得到三种结晶。经物理常数测定,光谱(IR.NMR和MS)及X-射线单晶衍射分析,确定了化合物Ⅲ的绝对构型为(1R,2R,5R,6S)-2-(3′,4′-二甲氧基苯基)-6-(3″,4″-亚甲二氧苯基)双骈四氢呋喃,是一个新化合物,命名为竹叶椒脂素(L-planinin)。化合物Ⅰ为β-香木脂醇(β-amyrin),化合物Ⅱ为L-细辛脂素(L-asarinin),这三种化合物均系首次从本植物中分离得到。     

Exacerbated synucleinopathy in mice expressing A53T SNCA on a Snca null background

Alpha-Synuclein is a major component of Lewy bodies, neuronal inclusions diagnostic for Parkinson's disease (PD). While an Ala53Thr mutation in alpha-synuclein can cause PD in humans, in mice the wildtype residue at position 53 is threonine, indicating that mice are either too short-lived to develop PD, or are protected by the six other amino acid differences between the proteins in these two species. Mice carrying an Ala53Thr human SNCA transgene driven by the mouse prion promoter show a mild movement disorder and only rarely develop severe pathology by 2 years of age. To determine whether the presence of mouse alpha-synuclein affects the pathogenicity of the human protein, the transgene was crossed into mice lacking endogenous alpha-synuclein. Mice that express only human alpha-synuclein developed a neuronopathy characterized by limb weakness and paralysis with onset beginning at 16 months of age. The neuronopathy is probably due to high levels of expression of the transgene in the ventral spinal cord leading to motor neuron damage and Wallerian degeneration of the ventral roots. These data suggest mouse alpha-synuclein is protective against the deleterious effects of the human mutant protein.     

A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site

In 2002, approximately 38,000 vertebroplasties and 16,000 kyphoplasties were performed in the United States. As the use of both modalities for the treatment of vertebral compression fractures has increased, so have questions regarding safety and efficacy. The authors addressed this by reviewing both the current literature and complications data reported to the Food and Drug Administration (FDA) Center for Devices and Radiological Health through the on-line database (http://www.fda.gov/cdrh/maude.html) and through the Office of the Freedom of Information Act at the FDA. Although both procedures are largely safe, the FDA data highlight two main concerns: reactions to the use of acrylic (polymethylmethacrylate) bone cement, including hypotension and, in some cases, death, especially when multiple vertebral levels are treated in one setting; and a possible increased risk with kyphoplasty of pedicle fracture and cord compression.