Multiple myocardial abscesses successfully treated with medical management in an immunosuppressed patient

Myocardial abscess is usually resulted from the septicemia ofvarious microorganisms such as Candida, Staphylococcus, Aspergillus,Streptococcus, and Salmonella species. Since     

Contributions of semantic and facial information to perception of nonsibilant fricatives.

Most studies have been unable to identify reliable acoustic cues for the recognition of the English nonsibilant fricatives [see text]. The present study was designed to test the extent to which the perception of these fricatives by normal-hearing adults is based on other sources of information, namely, linguistic context and visual information. In Experiment 1, target words beginning with /f/, /theta/, /s/, or [see text] were preceded by either a semantically congruous or incongruous precursor sentence. Results showed an effect of linguistic context on the perception of the distinction between /f/ and /theta/ and on the acoustically more robust distinction between /s/ and [see text]. In Experiment 2, participants identified syllables consisting of the fricatives [see text] paired with the vowels /i, a, u/. Three conditions were contrasted: Stimuli were presented with (a) both auditory and visual information, (b) auditory information alone, or (c) visual information alone. When errors in terms of voicing were ignored in all 3 conditions, results indicated that perception of these fricatives is as good with visual information alone as with both auditory and visual information combined, and better than for auditory information alone. These findings suggest that accurate perception of nonsibilant fricatives derives from a combination of acoustic, linguistic, and visual information.     

Treatment of congenital cystic adenomatoid malformation-does resection in the early postnatal period increase surgical risk?

OBJECTIVE: The recent development of fetal ultrasonography has allowed for an increasing number of prenatal diagnoses for congenital cystic adenomatoid malformation (CCAM). However, the appropriate surgical timing of these patients has not been studied as of yet. The aim of this study is to suggest a safe strategy for the treatment of CCAM by identifying the relationship between the timing of surgery and postoperative outcome. METHODS: Between 1987 and 2003, 40 patients (28 males, 12 females) underwent surgical resection for CCAM. The mean age was 38.6+/-9.1 (2 days-13 years) months. CCAM was diagnosed by prenatal ultrasonography in eight patients. Early operations were performed in four out of the eight. Operation was deferred until 2-12 months of age for the remaining four patients. RESULTS: Type I CCAM was found in 20 patients, type II in 20 and no patient exhibited type III. Five patients had associated pectus excavatum anomaly. There were no cases of operative mortality. Seventeen minor postoperative complications developed in 16 patients (40.0%): prolonged chest tube drain in 10, wound infection in 4, and 1 case of pneumonia, empyema and pleural space, respectively. The average hospital stay was 11.8 (6-29) days. During the mean follow-up period of 67.5 months, one patient died of accidental aspiration 7 months after operation during the postoperative recovery course of Ravich operation for pectus excavatum. The remaining patients reported doing well with normal physical activity. All five patients who underwent surgery at the age of under 1 month did not exhibit increased postoperative morbidity. CONCLUSIONS: We concluded that surgery for CCAM could be safely performed in all age groups with satisfactory long-term outcomes. It is suggested that early elective surgical correction can be recommended for a patient whose diagnosis was made in utero.     

PS15PAEDIATRIC GUN SHOT INJURIES IN NEW ZEALAND: A DEMOGRAPHIC ANALYSIS OF AN AVOIDABLE CAUSE OF SIGNIFICANT CHILDHOOD MORBIDITY

Purpose New Zealand has a reputation for an outdoors lifestyle that includes hunting and tramping. New Zealanders own over a million guns and these are widely distributed throughout the rural and urban communities. Although its gun laws are not liberal, children still suffer gun shot injuries. The aim of this study was to examine the injuries children receive from firearms in New Zealand, their circumstances and long term morbidity. Methodology A retrospective review of all children admitted to the four New Zealand paediatric surgical hospitals (at Auckland, Hamilton, Wellington and Christchurch) with gun shot injuries over 10 yr period 1996–2005 was undertaken. Data were compared with published literature from elsewhere. Results Overall, the incidence of gunshot injuries in New Zealand is low compared with many other developed countries. The majority are caused by air rifles. Most are superficial but some may lead to long term morbidity. Conclusions Although New Zealand gun laws require air rifle owners to be over 18 yrs of age, children often are victims of air rifle misuse, particularly in urban areas. Mortality is rare, but some children suffer long term morbidity. Our data may enable preventative measures to be better focused.     

Measuring central corneal thickness with ultrasound pachymetry.

PURPOSE: To determine how many ultrasound pachymetry measurements are required to obtain a reasonable estimate of central corneal thickness. METHODS: Five central corneal thickness measurements were obtained from each eye of 101 patients with normal corneas. The means of fewer than five readings were compared with the mean of five values for each eye to determine the incremental clinical value of additional measurements. RESULTS: Compared with the mean of five values, fewer than three measurements per eye provided a mean central corneal thickness value with inadequate confidence. Conversely, means of more than three readings provided little additional confidence over means of three values. CONCLUSIONS: Central corneal thickness by ultrasound pachymetry can be adequately assessed in the majority of eyes by taking three measurements per eye.     

Bilateral perioral sensory symptom after unilateral stroke: Does it have a localizing value?

Bilateral perioral sensory dysfunction due to unilateral cerebral lesion is rare, and has been thought to be caused by midline brainstem lesions. Six patients are described herewith, with bilateral perioral sensory symptoms due to unilateral strokes that do not involve the mid-brainstem region. Brain-computed tomographic scan and magnetic resonance imaging demonstrated unilateral cerebral strokes in the thalamus, posterior limb of the internal capsule, basal ganglia, fronto-parietal cortex and the insular-frontal subcortical area. This observation suggests that bilateral perioral sensory symptoms do not have a localizing value. Possible pathogenetic mechanisms for this sign are discussed.     

Thymidine labeling index in breast tumors

The relationship between primary tumor proliferative activity and clinical and pathologic characteristics was analyzed in relation to menopausal status in 32 patients with malignant or benign breast disease. The thymidine labeling index (TLI) showed significantly higher median values in the cancer patients (3.48 per cent) than in the patients with benign diseases (1.02 per cent). TLI was not significantly affected by delayed incubation at room temperature for about 1 hour. In the breast cancer patients, TLI did not significantly correlate to tumor size, the presence of axillary lymph node metastasis or pathologic nuclear grading. The only significant difference was limited to the breast cancer patients without axillary lymph node metastasis in relation to menopausal status; the TLI in the premenopausal patients (5.10 per cent) was significantly higher (p<0.05) than that in the postmenopausal patients (2.28 per cent). These data thus suggest that among premenopausal patients without axillary lymph node metastasis, those with a high TLI could be potential candidates for adjuvant chemotherapy.