Attentional set shifting modulates the target P3b response in the Wisconsin card sorting test

For years the Wisconsin card sorting test (WCST) has been used as a test of frontal lobe function. Recent event-related potential (ERP) research has shown large differences in the amplitude of P3b responses evoked by early and late trials within each WCST series ([8]: Barceló F., Sanz M., Molina V., Rubia FJ. The Wisconsin Card Sorting Test and the assessment of frontal function: A validation study with event-related potentials. Neuropsychologia 1997;35:399-408). In this study, 16 normal subjects performed a WCST adaptation to investigate the role of attentional set shifting in these WCST P3b effects. Two control tasks were designed to examine whether early-late WCST P3b changes reflect category selection (attention) or category storage (memory) operations. Results suggest both a sharp P3b attenuation during shift WCST trials, followed by a gradual P3b build-up during post-shift trials. This P3b modulation could not be attributed to selection or storage of simple sensory stimulus dimensions, nor was it observed when the new rule was externally prompted by the first card in the WCST series. Instead, WCST P3b changes seem related to the endogenously generated shift in the perceptual rule used to sort the cards (i.e., the shift in set). The gradual build-up in P3b amplitude paralleled a progressive improvement in sorting efficiency over several post-shift WCST trials. A model based on formal theories of visual attention and attentional set shifting is proposed to account for these effects. The model offers firm grounds for prediction and bridges the gap between related clinical and experimental evidence.     

山莨菪碱对妊娠高血压综合征子宫胎盘血流影响

目的：观察山莨菪碱对妊娠高血压综合征(妊高征)子宫动脉、脐动脉血流的短期影响.方法：妊高征患者14例给予山莨菪碱10～20 mg加入5%葡萄糖溶液500 mL中,静脉滴注,观察用药前后血压、体重、蛋白尿变化,多普勒超声监测用药前后子宫动脉、脐动脉的收缩期峰值(S)/舒张末期血流速度(D)(S/D),阻力指数(RI)、搏动指数(PI).结果：用药后收缩压及舒张压明显下降(P＜0.05)；水肿、蛋白尿减轻或消退；子宫动脉和脐动脉的S/D、RI、PI均明显下降(P＜0.01).结论：山莨菪碱治疗妊高征能降低子宫、胎盘血流阻力,增加其血流灌注,同时改善孕妇临床症状,有利于母婴预后.     

鼻腔应用丙酸氟替卡松对鼻息肉组织中水通道蛋白-2表达的影响

目的 :探讨鼻腔局部应用丙酸氟替卡松 (FP)喷雾剂对鼻息肉组织中水通道蛋白 2 (AQP 2 )表达的影响及类固醇激素治疗鼻息肉的作用机制。方法 :将 2 6例慢性鼻窦炎鼻息肉患者分为Ⅱ型组 (3期Ⅱ型 14例 )和Ⅲ型组 (Ⅲ型 12例 ) ;Ⅱ型组又分为FP组 (7例 )和对照组 (7例 ) ,Ⅲ型组亦分为FP组 (6例 )和对照组 (6例 )。Ⅱ型组和Ⅲ型组中的FP组术前应用FP喷雾剂喷鼻 7d ,对照组术前鼻腔不予任何处理。术中取 2 6例患者的鼻息肉组织 ,采用SP免疫组化技术检测鼻息肉组织中AQP 2的表达。结果 :Ⅱ型组和Ⅲ型组中的FP组鼻息肉体积明显缩小 ,鼻息肉组织中AQP 2表达的阳性细胞数和面密度值均明显低于对照组 (均P <0 .0 1)。结论 :在FP作用下鼻息肉水肿减轻、体积缩小 ,可能与AQP 2表达减少有关 ,这为类固醇激素治疗鼻息肉作用机制的阐明提供了新的方向     

嗅觉诱发电位的实验研究

目的：观察电刺激家兔嗅区黏膜记录的诱发电位的波形及其稳定性，探讨一种可以客观评价嗅觉功能的方法。方法：将双极刺激电极经家兔前鼻孔置于嗅区黏膜，给予电刺激，在颅顶记录嗅觉诱发电位(OEPs)；改变刺激参数和部位，观察对电位潜伏期、阈值和波形的影响。结果：在颅顶前方近嗅球处记录到一组波形稳定的N1-P1-N23相复合波。潜伏期为：N1波20．6ms，P1波33．5ms，N2波58．3ms；改变刺激强度对各波无明显影响；改变刺激频率对各波影响较大，频率过高．波形分化较差。结论：正常OEPs是一组波形稳定的负-正-负3相复合波，波形稳定、重复性好，各参量可作为评价嗅觉功能变化的有用指标。     

电位滴定法的计算原理及Excel软件应用

阐述了电位滴定法的计算原理以及Excel软件在电位滴定数据处理中的应用。     

茎突CT薄层冠状扫描在诊断茎突过长综合征中的价值

目的 探讨“一点一线垂直法”茎突CT薄层冠状扫描在诊断茎突过长中的价值。方法测量72例双侧茎突的长度、方位、形态、厚度、尖端与咽侧壁距离,总结茎突过长病人的临床症状与诊断。 结果 ①41例67侧长度超过3.0cm,符合茎突过长的诊断;②12例12侧茎突虽未超过3.0cm(均在2.5～2.9cm),且茎突方位角>20°、末端与咽侧壁的距离<20mm,并有临床症状的应考虑茎突过长综合征;③按茎突的形态进行分型:锥型(分直锥、弧锥),束状型,分节型,发育不良型。其中分节型与临床症状有密切关系。结论 ①茎突CT薄层冠状扫描能清晰显示茎突的长度、形态、厚度、末端与咽侧壁距离,是诊断茎突过长的一种可靠方法;②“一点一线垂直法”茎突CT薄层冠状扫描无需进行图像重建,可操作性强、简捷易行、便于推广。     

Pelvic lipomatosis: clinical review and report of 4 new cases

First described by the end of the fifties, pelvic lipomatosis is an uncommon disease that develops as a result of an excessive proliferation of benign fat tissue within the perivesical and perirectal spaces. The compressive effect on the urinary, and to a lesser degree, the digestive and vascular structures result in the well-known symptoms. Diagnosis is reached through X-ray studies, primarily computerised tomography. Contribution of four new cases in young males diagnosed through imaging studies as well as biopsies in three of them. Evolution has been varying, with medical control of symptoms in two cases and renal function impairment due to upper obstructive uropathy in the other two.     

Analysis of anti-reflux surgery failure

Recurrent gastroesophageal reflux following fundoplication is a challenging problem, because it is usually refractory to medical treatment and a second, technically difficult, antireflux operation is required. Different factors that may contribute to surgery failure have been identified in children. We present 8 cases who underwent redofundoplication after failed procedures, from a total number of 96 patients operated on due to gastroesophageal reflux. Four patient's had their initial fundoplication performed at our institution. Six patients were neurologically impaired, six had chronic pulmonary disease, and two had esophageal atresia. The main presenting symptoms were recurrent vomiting (n = 8) and aspiration (n = 4). Gastroesophageal reflux was confirmed by barium swallow and endoscopy. Operative findings showed wrap breakdown in two cases, warp breakdown associated with hiatal hernia in five, wrap breakdown associated with paraesophageal hernia in two cases, and paraesophageal hernia with normal wrap in one. A second Nissen procedure were performed in five cases, whereas a Collis-Nissen gastroplasty was realized in three with a short esophagus. Six patients had a successful outcome remaining symptom free, one has severe disphagia, and one has recurrent vomiting. In our experience, patients with recurrent gastroesophageal reflux disease should undergo an antireflux procedure tailored to specific anatomic or functional abnormalities.     

Progressive acquired lymphangioma: report of a case and review of the literature

We present 2-year-old patient with a allopecia lesions in scalp, and clinique diagnostic of Cutis Aplasia. The anatomopathologic study have diagnosed the lesions as Acquired Progressive Lymphangioma (APL). Is a rare vascular tumour that has a tendency to appear in childhood an to progress slowly over the years. It could present as a solitary erythematous macule or plaque and a simple excision is usually curative. Our patient is the youngest reported in the literature.     

Intensity modulated radiation therapy with electrons using algorithm based energy/range selection methods.

BACKGROUND AND PURPOSE: In recent years photon intensity modulated radiation therapy (IMRT) has gained attention due to its ability to improve conformity of dose distributions. A potential advantage of electron-IMRT is that the dose fall off in the depth dose curve makes it possible to modulate the dose distribution in the direction of the beam by selecting different electron energies. This paper examines the use of a computer based energy selection in combination with the IMRT technique to optimise the electron dose distribution. MATERIALS AND METHODS: One centimetre square electron beamlets ranging from 2.5 to 50 MeV were pre-calculated in water using Monte Carlo methods. A modified IMRT optimisation tool was then used to find an optimum mix of electron energies and intensities. The main principles used are illustrated in some simple geometries and tested on two clinical cases of post-operated ca. mam. RESULTS: It is clearly illustrated that the energy optimisation procedure lowers the dose to lung and heart and makes the dose in the target more homogeneous. Increasing the energy at steep gradients compensates for lack of target coverage at beam edges and steep gradients. Comparison with a clinically acceptable four segment plan indicates the advantage of the used electron IMRT technique. CONCLUSIONS: Using an intensity optimised mix of computer selected electron energies has the potential to improve electron treatments for mastectomy patients with good target coverage and reduced dose to normal tissue such as lung and heart.