Diplophonia in unilateral vocal fold paralysis and intracordal cyst

Diplophonia is the production by the voice of 2 separate tones through quasiperiodic variations in the vocal fold vibration (Ward PH, Moore GP. Ann Otol Rhinol Laryngol 1969;78:771-7). Clinically, diplophonia can be observed in patients with unilateral vocal fold paralysis with incomplete glottal closure and a mass lesion of the vocal fold, intracordal cyst, and granuloma (Kiritani S, et al. Ann Bull RILP 1991;25:55-62; Hirano M, et al. Ann Otol Rhinol Laryngol 1989;98:791-5). In this study we report 16 subjects with unilateral vocal cord paralysis or an intracordal cyst characterized perceptually by diplophonia. Diplophonia during tension imbalance may occur after surgery and is characterized by an improved perceptual score, a reduced number of vibratory cycles in each quasiperiodic waveform, and a reduced occurrence rate of the diplophonic waveform. During mass imbalance, no diplophonia occurred after surgery. Regarding the relationship of diplophonia with glottal condition at production of stops, in our study diplophonia varied significantly according to the different phonologic environments of stops during tension imbalance. We presume that there is a close relationship between the occurrence of diplophonia and the glottal conditions in tension imbalance, but not in mass imbalance.     

韩茵陈等3种药材基源rDNA内转录间隔区的序列分析鉴定

目的:建立一种简便、实用的亲缘关系相近的茵陈类药材DNA分子鉴定方法;找出中韩两国茵陈药材在遗传学上的差异.方法:采用聚合酶链反应产物直接测序法对3种茵陈(茵陈蒿、韩茵陈和白莲蒿)进行鉴别.从3种茵陈的组织材料中提取DNA,扩增rDNA的内转录间隔区(internal transcribed spacers, ITS)和5.8 s的序列.对扩增产物进行了DNA序列分析.结果:韩茵陈、白莲蒿在PCR产物凝胶电泳图谱上有明显差异,且DNA序列分析结果差异为3.96%,韩茵陈和茵陈蒿在遗传学上存在差异.结论:用rDNA的ITS序列分析法鉴别茵陈类药材,方法简便、准确.     

Reliability of mothers' reports of birth data

To determine the reliability of recall of birth and early childhood events, a group of 47 mothers was asked details of their child's birth and about any child-rearing problems at an average of 5–6 years after the birth. Thirty-four of these mothers were asked similar questions 3 years later. The information given by the mothers was compared with the information documented in the hospital records when the children were born. The mothers overestimated the length of pregnancy and overestimated the number of neonatal problems. Only half could recall the birth weight accurately. When asked the same questions 3 years later there was a tendency for memory to have mellowed with fewer pregnancy complications and child-rearing difficulties being recalled than on the previous interview. Information given by mothers about such objective data as length of gestation, birth weight and obstetric complications is not necessarily accurate. Less objective data may be recalled even less accurately.     

Transesophageal Echocardiography Findings of an Infected Quadricuspid Aortic Valve with an Anomalous Coronary Artery

We describe a patient with severe aortic regurgitation in whom transesophageal echocardiography coupled with cardiac catheterization and pathological examination confirmed the diagnosis of a quadricuspid aortic valve, anomalous coronary artery, and aneurysm of the noncoronary sinus of Valsalva.     

BACK PAIN IN OSTEOPATHIC PRACTICE

The case records of 5310 patients attending Registered Osteopathswere examined in this retrospective study. Analysis of the datarevealed that over half presented with low back pain and werecomparable to those normally seen in orthodox medical practice,except that their symptoms were of longer duration. The patientswere generally examined in a conventional manner but it wasnot possible to identify specific diagnostic categories. Themajority received one or more manual therapeutic techniquesbut 6% were rejected as unsuitable for treatment. The implicationsof the results for future research are discussed.     

How I do it — Laparoscopic Cholecystectomy

Abstract: One thousand consecutive patients underwent a laparoscopic cholecystectomy from September 1990 to January 1993 at our institution. A total of 435 presented with complications acute cholecystitis (83), common bile duct stones (61), or previous abdominal surgery (321). Of the 1,000 patients, 37 (3.7%) were converted to an open cholecystectomy, usually because of marked inflammation and unclear anatomy. There were no deaths and the total postoperative complication rate was 91 of 1,000 (9.1%). Major complications (1.1%) included 3 bile duct injuries, 2 postoperative bleedings, 5 residual common duct stones and 1 case of peritonitis caused by stone spillage. All bile duct injuries were detected and suspected in the operating room and repaired by a Roux-en-Y hepaticojejunostomy. Minor complications occurred in the remaining 80 patients(8.0%). The most common complication encountered was urinary retention (6.1%). Intraoperatively, the two-hand technique, electrosurgical dissection, selective cholangiography and selective use of closed drainage were used. When common bile duct stones were encountered during the performance of laparoscopic cholecystectomy, they were primarily managed by a simultaneous laparoscopic choledochotomy. These experiences suggested that the immediate detection of operative injury was very important to prevent later serious complications, and wider operative indications can be applied safely and carefully by trained general surgeons.     

Contact laser turbinate surgery for the treatment of idiopathic rhinitis

To evaluate the value of contact laser turbinate surgery using a diode laser in the treatment of idiopathic rhinitis, 53 patients were examined before and after surgery. Six months following surgery, nasal obstruction was significantly improved and a significant decrease in nasal airway resistance was noted on active rhinomanometric measurements (P < 0.05). There were no significant post-operative changes in olfactory acuity using the butanol threshold test and in mucociliary transport using the saccharin transit time. The results of this study suggest that contact laser turbinate surgery may be a valuable alternative form of surgical treatments for patients with idiopathic rhinitis.     

The Treatment of Syringomas by CO2 Laser Using a Multiple-Drilling Method

BACKGROUND: Syringomas are relatively common benign adnexal tumors, predominantly developing in middle-aged women. They frequently involve the periorbital areas and cause cosmetic problems. Up to now, various treatment modalities such as electrodesiccation, laser ablation, cryosurgery, and some chemical peelings have been tried. All of them, however, have the possibilities of frequent recurrences and postoperative complications such as scarring or pigmentary changes. OBJECTIVES: The objective of this study was to determine the effectiveness of a multiple-drilling method in the treatment of syringomas. METHODS: We tried a new multiple-drilling method using CO(2) laser for 11 patients having syringomas. Clinical improvement and complications were evaluated by medical records and pre- and postlaser photograph review. RESULTS: All patients had good or excellent cosmetic results. No complications, such as scarring, erythema, and pigmentary changes, were observed. CONCLUSION: The multiple-drilling method by CO(2) laser might be an alternative to gain good cosmetic results without complications if applied repeatedly. The authors have indicated no significant interest with commercial supporters.