Pure word deafness due to left subcortical lesion: Neurophysiological studies of two patients

ObjectiveThis study investigated the auditory processing in two patients with pure word deafness (PWD) using neurophysiological experimental methods.MethodsWe recorded the auditory brainstem response (ABR), the middle latency auditory-evoked response (MLR) and the auditory-evoked event-related potentials (ERPs) in two patients with PWD after subcortical hemorrhage in the left temporal lobe.ResultsBoth patients showed normal response in ABR and abnormality in MLR. The latency of P300 evoked by right-ear stimulation was 51 ms longer in one patient and 26 ms longer in the other patient than that evoked by left-ear stimulation.ConclusionsOur results suggested that the prolongation of P300 latency could be caused by the deterioration of auditory stimulus processing and supported the hypothesis that the defect in auditory temporal resolution was an important factor in the development of PWD.SignificanceThis study demonstrated that recordings of ERP with auditory-evoked response such as ABR and MLR are useful to elucidate the deterioration of auditory stimulus processing in patients with PWD.     

The cubital fossa

The boundaries and floor of the cubital fossa are described. Its contents and their clinically important relationships are emphasised. The commonest variation of the fossa’s venous anatomy is described, and details of a method of blocking the median nerve in the fossa is given.     

金属支架治疗大气道狭窄

目的　探讨气管支架成形术缓解大气道狭窄的方法、安全性和疗效。资料与方法　气管狭窄患者 32例 ,其中气管切开或插管后局部组织过度增生 7例 ,转移性肿瘤压迫气管 12例 ,多发性软骨炎引起气管塌陷 1例 ,肺癌 12例 ;单纯气管狭窄 2 8例 ,主支气管狭窄 1例 ,气管支气管同时有狭窄者 3例。术前均经CT检查及气管体层片证实气管、支气管狭窄。 13例术前用的卡因喷喉麻醉 ,19例在全身麻醉下置入支架。结果　 32例共放置 37枚气管支架 ,均一次置入成功 ,无操作失败 ,通气全部得到改善 ,手术成功率 10 0 %。 2例气管狭窄经置入支架后复发狭窄再次置入支架。 33枚置于气管 ,4枚置于主支气管。 1例狭窄严重仅容 4F导管通过 ,用球囊导管扩张至 12mm后置入支架 ;其余均直接置入支架。术后通气功能明显改善 ,无需吸氧 ,无明显胸痛、咯血等并发症。 1周后X线复查无支架移位 ,可见支架进一步扩张。 1例甲状腺癌支架置入术后 2周复发呼吸困难 ,CT扫描示支架内有新生物 ,经支架内放射治疗后症状消失。结论　气管内支架成形术方法简单、安全 ,缓解呼吸困难疗效迅速、确实 ,适合良恶性气道狭窄姑息治疗     

介入治疗移植肾动脉狭窄的疗效观察

目的　评价介入治疗移植肾动脉狭窄 (TRAS)的疗效。资料与方法　 2 0 0 0年 1月～ 2 0 0 2年 11月 ,采用经皮血管内成形术 (PTA)和 /或内支架治疗 2 0例TRAS患者 ,其中PTA治疗 14例次 ,内支架治疗 9例次。对治疗前后的血压、降压药物和血肌酐进行随访。结果　采用PTA治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的(15 7± 17)mmHg、(97± 7)mmHg、(1.5± 1.0 )种、(5 12± 2 96 ) μmol/L ,术后 1周降为 (137± 11)mmHg(P <0 .0 5 )、(86± 7)mmHg(P <0 .0 1)、(0 .9± 1.0 )种 (P >0 .0 5 )、(2 76± 2 2 6 ) μmol/L(P <0 .0 5 ) ,术后 6个月降为 (12 8±10 )mmHg(P <0 .0 1)、(83± 7)mmHg(P <0 .0 1)、(0 .8± 0 .9)种 (P >0 .0 5 )、(14 5± 5 5 ) μmol/L(P <0 .0 1)。采用内支架治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的 (15 4± 31)mmHg、(93± 12 )mmHg、(1.6± 1.0 )种、(338±14 2 ) μmol/L ,术后 1周降为 (134± 17)mmHg(P >0 .0 5 )、(82± 7)mmHg(P <0 .0 5 )、(0 .8± 1.0 )种 (P >0 .0 5 )、(197±76 ) μmol/L(P <0 .0 5 ) ,术后 6个月为 (132± 9)mmHg(P >0 .0 5 )、(83± 4 )mmHg(P <0 .0 5 )、(0 .5± 0 .8)种 (P >0 .0 5 )、(2 0 4± 16 9) μmol/L(P <0 .0 5 )。总     

Prevention of sexually transmitted HIV infection: A meta-analytic review of teh behavioral outcome literature

Social learning theory-based models have recently provided the foundation for a series of twelve controlled human immunodeficiency virus (HIV) risk reduction intervention studies that have examined sexual behavior change. These interventions have been tested with adolescents, gay and bisexual men, inner-city women, college students, and seriously mentally ill adults. We report the first meta-analysis of these intervention studies. We found that, as expected, the mean weighted effect of HIV-risk reduction interventions on behavioral outcomes was positive and strongly significant (d₊=0.25). Moreover, the studies’ effect sizes were consistently positive, ranging from 0.11 to 0.53, and were largest when the outcomes were measured close in time to the intervention. We discuss other methodological challenges that, if solved, should enhance the success of future HIV-risk reduction interventions.     

Transcatheter arterial embolization of abnormal neovessels in a swine model of knee arthritis

BackgroundIn recent years, transcatheter arterial embolization (TAE) using imipenem/cilastatin (IPM/CS) has attracted attention as a treatment for relieving osteoarthritis (OA) pain. However, IPM/CS is not approved by Japanese medical insurance for use as an embolic material. Therefore, it is necessary to develop new embolic materials for TAE to relieve OA pain. The purpose of this study was to develop a swine model of knee arthritis and embolize abnormal neovessels (ANs) using two different embolic materials. We compared the embolic effects and tissue damage in knees.MethodsKnee arthritis was induced by intra-articular injection of papain into 12 knees in six female swine. The swine were divided into two groups of three swine each (six knees per group) for embolization of ANs in the knees with either IPM/CS or soluble gelatin sponge particles (SGSs). Three days after embolization, we compared the embolic effects using angiography and the tissue damage histopathologically.ResultsANs were observed in all 12 knees at 42 days after papain injection. The ANs disappeared and the patent arteries were recanalized 3 days after TAE in all 12 knees. Histopathological evaluation revealed synovitis changes, such as synovial thickening and inflammatory cell infiltration, in all 12 knees. There was no evidence of skin or muscle necrosis in either group. The appearance of ANs, recanalization of the parent arteries, and histopathological outcomes were not significantly different between the two groups.ConclusionSGSs were as safe as IPM/CS for TAE of ANs in this swine model of knee arthritis.