Alcohol-responsive writer's cramp

Writer's cramp is a rare movement disorder of unknown etiology, in which a cramp is elicited primarily or exclusively with writing. We describe a patient with primary writer's cramp that was completely improved by drinking a small amount of alcohol. Although it is unclear how "alcohol" ameliorated the dystonia, this case suggests that alcohol might reverse the pathophysiologic changes in the entire basal ganglia circuit. In addition, we cannot rule out the possibility that the anxiolytic influence of alcohol may contribute to the beneficial effects on dystonia.     

Early repeat endoscopic retrograde cholangiopancreatography: Predictive factors and interventions required

Background/aims: Early repeat endoscopic retrograde cholangiopancreatography may be required due to various conditions in patients who underwent planned endoscopic retrograde cholangiopancreatography. We aimed to assess the factors leading to early repeat endoscopic retrograde cholangiopancreatography and to determine the patients who need closer follow-up. Materials and Methods: A total of 691 patients with a mean age of 60.3±16.4 years who had naive papilla on endoscopic retrograde cholangiopancreatography were involved in the study. The patients who required repeat endoscopic retrograde cholangiopancreatography were identified. Presentations, predictive factors, treatment modalities, and outcomes of the patients were investigated. Results: Early repeat endoscopic retrograde cholangiopancreatography was needed in 19 (2.7%) patients. The most common presentation was cholangitis in 10 (52.6%) and unresolved jaundice in 4 (21.1%). Multivariate analysis identified biliary stricture (p=0.024), stricture at the hilus (p=0.005) and unilateral drainage in the presence of hilar stricture (p=0.017) as the independent risk factors for early repeat endoscopic retrograde cholangiopancreatography. Stent migration or dysfunction was the most common underlying cause. Therapeutic interventions were nasobiliary drainage in 13, stent exchange in 4 and stone removal in 2. Additionally, percutaneous drainage in 4 patients, drainage of abscess in 2 patients and percutaneous drainage of gallbladder in 1 patient were performed. Three patients died due to their underlying illness. Conclusions: Unilateral stenting especially in hilar strictures is a predictive factor for early repeat endoscopic retrograde cholangiopancreatography with high mortality. These patients should be under close follow-up.     

数字化摄影与多层螺旋CT在足踝部骨折及脱位的诊断价值比较

目的:比较数字化摄影(DR)与多层螺旋CT(MSCT)在诊断足踝部骨折及关节脱位的应用价值。方法:分析2010年8月至2012年8月收治的52例足踝部骨折及脱位患者(男37例,女15例,年龄15～49岁)的DR及MSCT资料,并与手术或出院诊断对比,比较两者诊断骨折数量、关节脱位的区别,采用R统计软件Wilcoxon符号秩检验(Wilcoxon signed rank test)进行统计学分析。结果:52例MSCT结果与术后或出院诊断结果完全相符。MSCT诊断骨折172处,DR诊断骨折98处,两者在骨折诊断中差异有统计学意义(V=1081,P<0.05);MSCT诊断关节脱位24例,DR诊断关节脱位16例,两者在关节脱位诊断中差异有统计学意义(V=21,P<0.05)。MSCT纠正DR骨折诊断定位6例。结论:MSCT对足踝部骨折及关节脱位的诊断优于DR。DR应首选2个部位的检查。当DR诊断结果不明确或与临床症状不相符时应选择MSCT及多平面重建(MPR)检查,可避免漏诊及误诊。     

Bilateral supra- and infrahyoid EMG activity during eccentric jaw clenching and tooth grinding tasks in subjects with canine guidance or group function

This study compares the effect of tooth clenching and grinding on supra- and infrahyoid electromyographic (EMG) activity during different laterotrusive jaw posture tasks. The study included 30 healthy subjects with natural dentition and bilateral molar support, 15 with bilateral canine guidance and 15 with bilateral group function. Bipolar surface electrodes were located on the left and right supra- and infrahyoid muscles. EMG activity was recorded during the following tasks: A. eccentric grinding from intercuspal position to the right lateral edge-to-edge contact position; B. clenching in right edge-to-edge lateral contact position; C. concentric grinding from right lateral edge-to-edge contact position to intercuspal position. EMG activity was not significantly different between tasks on the working side, nonworking side, or between both sides, in subjects with canine guidance or group function (Wilcoxon rank-sum test). When comparing EMG activity by occlusal scheme, no significant differences were found either on the working side or the non-working side (Mann-Whitney U test). This result suggests that supra- and infrahyoid EMG activity in its predominant stabilizing role of the hyoid bone is not significantly modified by the type of laterotrusive occlusal scheme.     

MC3T3‐E1 Cells Behavior on Surfaces Bombarded by Argon Ions in Planar Cathode Discharge

To evaluate the effect of topography in nanoscale, titanium surfaces were bombarded by argon ions (a chemically inert gas), in an atmosphere of plasma. The effects of surface parameters on morphology, adhesion, proliferation, and MC3T3‐E1 preosteoblasts differentiation were analyzed. Nontreated (smooth) surfaces were used as a control. The levels of average roughness (Ra) observed in bombarded and smooth titanium surfaces were of 95 and 14 nm, respectively. The wettability increased on treated surfaces. The number of attached cells (30 and 60 min) was significantly higher on the bombarded surface. The cell proliferation after 3 and 7 days was also significantly higher on the ion‐bombarded surface. In addition, the ALP activity and expression of osteocalcin were higher in cells grown on the treated surface. The results showed that bombardment with argon ions increased the roughness and the wettability of the Ti surface, promoting a significant increase in the adhesion, proliferation, and differentiation of preosteoblasts.