Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic

Aim:  To describe the characteristics, developmental status and severity of head shape deformation in infants presenting to a plagiocephaly clinic.
Methods:  Head shape was measured and neck function assessed in 287 consecutive infants presenting to a plagiocephaly outpatient clinic. Information was obtained on demographic and obstetric factors, plagiocephaly history and current positioning strategies. Development was assessed by the Ages and Stages Questionnaire (ASQ).
Results:  After clinical examination, craniosynostosis was suspected in seven infants (2%) and a skull computed tomography (CT) scan was performed; five showed suture abnormalities. Fifty-eight percent of cases had a history of limitation of neck function; this was more likely in plagiocephalic infants than brachycephalic infants. Males, firstborn infants, instrument-delivered infants, supine sleep position and right-sided flattening were predominant. One or more delays on the ASQ were seen in 36% of infants.
Conclusion: Physical examination of infants with head shape deformities is essential in order to rule out craniosynostosis. Infants with deformational plagiocephaly frequently have neck muscle dysfunction. We postulate that the higher than expected number of developmental delays may be related to the effects of supine sleep position, low or variable tone, lower activity levels, male gender and neck muscle dysfunction.     

A step forward for the undulation pump total artificial heart

In the University of Tokyo, various types of total artificial heart (TAH) have been studied. Based on the experiences of TAH research, the development of the undulation pump total artifical heart (UPTAH) started in 1994. The undulation pump is a small-size, continuous-flow, displacement-type blood pump, and the UPTAH is a unique implantable total artificial heart that uses the undulation pump. To date, three models of UPTAH have been developed. The first model, UPTAH1, was developed to investigate the possibility of reducing the size of the device so it could be implanted in small adults, such as Japanese patients, in 1994. The second model, UPTAH2, which was the prototype of the animal experimental model, was developed in 1996 to investigate the possibility of survival with the UPTAH. The third model, UPTAH3, which is the present model, was developed in 1998 to enable long-term survival in animal experiments and to investigate the pathophysiology of the UPTAH. From July 1996 to October 1999, 22 implantations of UPTAH2 or UPTAH3 were performed in goats. In spite of the limitation of their small chest cavity, the UPTAH could be implanted into the chest of all goats. Using UPTAH3, survival of 31 days could be obtained. The research and development of UPTAH are ongoing.     

沙苑子化学成分研究

从沙苑子80%的乙醇提取物中,首次分得八个化合物。其中沙苑子新甙(neocomplanoside,Ⅶ)和沙苑子杨梅甙(myricomplanoside,Ⅷ)为两个新的黄酮类化合物,其它六个为已知成分。     

External argon laser choroidotomy for subretinal fluid drainage

Purpose: To evaluate the efficacy and safety of external argon laser choroidotomy for drainage of subretinal fluid (SRF) during scleral buckling procedures for the repair of rhegmatogenous retinal detachments. Methods: Fifty eyes of 50 consecutive patients presenting to a hospital-based retinal outpatient clinic with rhegmatogenous detachments underwent choroidotomy with argon endolaser for SRF drainage. The laser parameters used were 0.5 s duration and 0.8 W power. The primary outcome measures were successful drainage of SRF and incidence of complications. The drainage was considered successful if it was sufficient to complete the planned scleral buckling procedure. The extent of subretinal haemorrhage was graded. Results: The mean age of patients was 55 years (range 16–80 years). Successful drainage of SRF was obtained in 47 eyes (94%). The complications observed at the drainage site included subretinal haemorrhage of less than I disc diameter in six eyes (12%) and retinal perforation in one eye (2%). Conclusion: External argon laser choroidotomy appears to be an effective method of draining SRF in rhegmatogenous retinal detachments.