Abnormal cerebellum density in victims of rape with post‐traumatic stress disorder: Voxel‐based analysis of magnetic resonance imaging investigation

Introduction: Based on early studies of non‐motor function in the cerebellum and dysfunction in the cerebellum of post‐traumatic stress disorder (PTSD) patients, we presumed that the cerebellum was involved in the neuropathology of cognitive and emotional processing of PTSD patients, while the density of some sub‐areas of the cerebellum of PTSD patients was most likely abnormal. Methods: Eleven female victims of rape with PTSD and 12 age‐matched female normal controls received 1.5 T 3D magnetic resonance imaging (MRI) scan. The scans were then analyzed using the voxel‐based morphometry 2 (VBM2) toolbox. Results: Victims of rape with PTSD showed increased cerebellum density on the left side compared with normal controls (P<0.001), especially in the pyramis (x=?9, y=?72, z=?36; k=519; t=4.70), uvula (x=?4, y=?66, z=?35; k=256; t=4.02), declive (x=?6, y=?69, z=?30; k=213; t=3.84) and nodule (x=?4, y=?63, z=?31; k=147; t=3.93). In addition, compared with normal controls, the PTSD group showed significant differences in gray matter density of other brain areas, including the frontal lobe, parietal lobe, occipital lobe (P<0.001), insula, posterior cingulate, amygdala and hippocampus (P<0.005). Discussion: These finding suggest that the cerebellum may be involved in the neuropathology and functional compensation in the neurocircuitry of PTSD.     

A review of ultraviolet treatment for psoriasis at Waikato Hospital

Details of 79 courses of UVB and 40 courses of PUVA for patients with chronic plaque psoriasis at Waikato Hospital were prospectively collected when a new Phototherapy Unit opened. Efficacy was assessed by clearance rates (73% for UVB, 87.5% for PUVA). There was significant improvement in Psoriasis Disability Index, which was derived from a questionnaire assessing functional disability and completed by the patients before and after treatment. It took a median number of 24 treatments for psoriasis in the patients receiving UVB to clear, and for the PUVA patients the median was 19 treatments. The efficacy could not be correlated with skin type. Fifty per cent of UVB patients and 25% of PUVA patients received symptomatic burns, all localized and minor in nature. Lifetime PUVA dose was calculated, 90% of patients having received less than 400 J/cm².     

Ciliary motility at light microscopy: a screening technique for ciliary defects?

To verify whether or not ciliary motility can be reliably assessed by light microscopy alone, we examined the nasal brushings of 53 patients with suspected ciliary dyskinesia and 10 healthy controls. The results of light microscopy were compared with cilia ultrastructure assessed with electron microscopy. Ciliary motility was significantly related with cilia ultrastructure. However, eight cases of lung disease due to bronchiectasis of unknown origin had immotile cilia on light microscopy, but normal ciliary ultrastructure on electron microscopy. Instances of normal and abnormal ultrastructure were detected in one case with motile cilia. There was an 83% agreement between electron microscopy and light microscopy. Sensitivity and specificity of light microscopy were 92% and 80%, respectively. In conclusion, light microscopy evaluation of ciliary motility does not appear to be a reliable screening test for ciliary dyskinesia because it does not quantify ciliary beat activity, which is a criterion for deranged ciliary motion. A complete evaluation of ciliary ultrastructure together with in vivo, if applicable, or in vitro function test (namely, the analysis of ciliary beat frequencies and/or waveform) is required for a definite diagnosis of ciliary dyskinesia.     

Acute Achilles tendon rupture: minimally invasive surgery versus non operative treatment,with immediate full weight bearing. Design of a randomized controlled trial

Background  

We present the design of an open randomized multi-centre study on surgical versus conservative treatment of acute Achilles tendon ruptures. The study is designed to evaluate the effectiveness of conservative treatment in reducing complications when treating acute Achilles tendon rupture.     

Acute kidney injury after cardiac arrest of ventricular fibrillation and asphyxiation swine model

Purposes

The purposes of the study are to investigate the renal function in ventricular fibrillation (VF) and asphyxiation cardiac arrest in a swine model and to estimate the value of novel biomarkers in the acute kidney injury (AKI) after cardiac arrest.

Method

Thirty-two healthy inbred Wu-Zhi-Shan miniature piglets were randomized into 2 groups (n = 16 per group). Cardiac arrest was induced by programmed electric stimulation and clamping the endotracheal tube in the VF group and asphyxiation group, respectively. Cardiopulmonary resuscitation was done for return of spontaneous circulation (ROSC).

Results

One hundred percent (16/16) ROSC was observed in the VF group, and 50% (8/16) in the asphyxiation group (P < .01). All AKI biomarkers elevated significantly after ROSC. The novel biomarkers changed much earlier than the creatinine. The concentration of novel biomarkers in the asphyxiation group was higher than the VF group. Live animals had an oliguria and developed AKI. Characteristic morphological injuries in renal tissues were observed under light microscope and transmission electron microscope and were more serious in the asphyxiation group.

Conclusions

Acute kidney injury at early stage of postresuscitation is common in different causes of cardiac arrest. Asphyxiation has more severe kidney injury and gets worse prognosis.