Visual command hallucinations in a patient with pure alexia

Around 25% of patients with visual hallucinations secondary to eye disease report hallucinations of text. The hallucinated text conveys little if any meaning, typically consisting of individual letters, words, or nonsense letter strings (orthographic hallucinations). A patient is described with textual visual hallucinations of a very different linguistic content following bilateral occipito-temporal infarcts. The hallucinations consisted of grammatically correct, meaningful written sentences or phrases, often in the second person and with a threatening and command-like nature (syntacto-semantic visual hallucinations). A detailed phenomenological interview and visual psychophysical testing were undertaken. The patient showed a classical ventral occipito-temporal syndrome with achromatopsia, prosopagnosia, and associative visual agnosia. Of particular significance was the presence of pure alexia. Illusions of colour induced by monochromatic gratings and a novel motion-direction illusion were also observed, both consistent with the residual capacities of the patient's spared visual cortex. The content of orthographic visual hallucinations matches the known specialisations of an area in the left posterior fusiform gyrus--the visual word form area (VWFA)--suggesting the two are related. The VWFA is unlikely to be responsible for the syntacto-semantic hallucinations described here as the patient had a pure alexic syndrome, a known consequence of VWFA lesions. Syntacto-semantic visual hallucinations may represent a separate category of textual hallucinations related to the cortical network implicated in the auditory hallucinations of schizophrenia.     

Comparison of horizontal corneal diameter measurements using Galilei,EyeSys and Orbscan II systems

Background: White‐to‐white corneal measurement is used frequently in cataract and refractive surgery as well as in diagnosing various corneal diseases and monitoring congenital glaucoma. In this article, we determine agreement in horizontal corneal diameter measurements in normal eyes among the Galilei V4.01, the EyeSys and the Orbscan IIz. Methods: In this prospective study, 37 consecutive volunteers were enrolled. All 74 eyes were measured with all three devices. Galilei, EyeSys and Orbscan II measurements were compared with one another. In addition, the data from the right and left eyes were compared for each device. Results: The mean horizontal corneal diameter measurements with the Galilei, the EyeSys and the Orbscan II were 12.01 ± 0.61 mm, 12.09 ± 0.87 mm and 11.67 ± 0.29 mm, respectively. The difference between the Galilei and EyeSys systems was not statistically significant (p = 0.76), however, the Orbscan II showed smaller measurements (p < 0.001). The best 95% limits of agreement between devices were for the Galilei and the Orbscan II (‐0.72, 1.48; r = 0.4, p < 0.01). The best 95% limits of agreement between two eyes for each device were found with the Orbscan II (‐0.15, 0.17; r = 0.996, p < 0.01). There was no correlation between measurements of right and left eyes for the Galilei or the EyeSys (r = 0.274, p = 0.176 and r = 0.31, p = 0.065, respectively). Conclusions: These results suggest that measurements made with the Orbscan II are smaller than those obtained with the EyeSys Corneal Analysis system and the Galilei. Among the three devices, the Galilei and the Orbscan II showed the best agreement, however, it is inadvisable to use the three devices interchangeably in every clinical situation.     

Cognitive abilities in children with congenital muscular dystrophy: correlation with brain MRI and merosin status.

The aim of the study was to evaluate whether children with merosin-positive or merosin-deficient congenital muscular dystrophy (CMD) show any cognitive impairment and whether this is related to brain abnormalities on magnetic resonance imaging (MRI). Twenty-two patients (age range: 5.8-15.3 years) were assessed by the Wechsler Intelligence Scales. Twelve were merosin-positive and ten merosin-deficient. One child had severe mental retardation and could not be tested. The full scale IQ in the remaining 21 ranged from 51 to 134, the verbal IQ ranged from 78 to 136 and the performance from 51 to 136. Of the twelve children with normal merosin one had a mild delay (IQ < 75) and two were borderline (IQ 75-95). Of the ten children with merosin-deficiency, one showed severe mental retardation and could not be tested, one showed a mild delay and two had borderline results. While the children with merosin deficiency with the typical diffuse white matter changes on MRI had normal scores, the children who in addition had cerebellar hypoplasia had lower performance IQ. The child with cortical dysplasia had severe mental retardation. Our results suggest that the spectrum of cognitive abilities in CMD is very wide even within genetically homogeneous conditions.     

In vitro and in vivo study of the efficacy of a new sebum control essence

Background

People with oily skin often suffer from skin problems such as oily face, blackheads, acne, and enlarged pores. It is necessary to regulate oily skin with skin care products.

Aims

To develop an effective sebum control essence to reduce oiliness of skin.

Methods

The composition of the essence was designed in consideration of different oil control mechanism targets. The skin irritation was assessed in 30 volunteers by a single application close patch test. The efficacy of the essence was evaluated by in vitro experiment, short- and long-term clinical trials with over 60 volunteers.

Results

The results of both in vitro and clinical trials showed that the essence had significant oil control and moisturizing effect, the skin oil content decreased by 21.8% within 8 h and 30.05% after 28 days, which indicated that the essence could achieve rapid and persistent sebum control efficacy. In addition, the essence could relieve the problems of enlarged pores, blackheads and whiteheads in long-term use.

Conclusions

The essence developed in this study can alleviate the problems of oily skin from many aspects, and achieve an excellent effect in oily skin regulation. It is suitable for a daily application in oily skin regulation.     

Operative Effect Comparison of Flexible Drill Guiding vs. Traditional Drill Guiding Template for Lower Cervical Pedicle Screw Insertion: A Retrospective Analysis

Objective

Accurately inserting pedicle screws is the key point of posterior pedicle screw fixation for lower cervical spine (C3–C7) instability. 3D printing technology can improve the accuracy of screw placement. This study compared the safety of 3D-printed flexible drill guiding template vs. traditional rigid drill guiding template for lower cervical pedicle screw insertion.

Methods

This was a retrospective study. A total of 34 patients who underwent lower cervical pedicle screw fixation from March 2018 to May 2021 were enrolled in this study, and they were divided into the flexible drill flexible drill group and the traditional drill group. A total of 18 patients in the flexible drill flexible drill group underwent pedicle screw fixation assisted by 3D printed flexible drill guiding templates for the lower cervix, and 16 patients in the traditional drill group underwent pedicle screw fixation assisted by 3D printed regular drill guiding templates for the lower cervix. The length of the incision and intraoperative blood loss during surgery were recorded and compared for the two groups. The grade, deviation of the screw entry point, deviation of the screw medial angle and screw length were measured and compared after surgery for the two groups by independent-sample tests.

Results

There was a significant difference in the length of the incision and blood loss between the two groups (P < 0.05). There was a significant difference between the two groups for grade (P = 0.016). The deviation of the screw entry point was 0.65 ± 0.50 mm in the flexible drill group and 0.78 ± 0.83 mm in the traditional drill group. The deviation of the screw medial angle was 2.14 ± 1.78 in the flexible drill group and 4.23 ± 2.51 in the traditional drill group, with a significant difference between the two groups (P < 0.05).

Conclusion

Compared with regular guiding techniques, lower cervical pedicle screw placement assisted by multistep navigation templates and flexible K-wires results in less trauma and better safety.