Bilateral perioral sensory symptom after unilateral stroke: Does it have a localizing value?

Bilateral perioral sensory dysfunction due to unilateral cerebral lesion is rare, and has been thought to be caused by midline brainstem lesions. Six patients are described herewith, with bilateral perioral sensory symptoms due to unilateral strokes that do not involve the mid-brainstem region. Brain-computed tomographic scan and magnetic resonance imaging demonstrated unilateral cerebral strokes in the thalamus, posterior limb of the internal capsule, basal ganglia, fronto-parietal cortex and the insular-frontal subcortical area. This observation suggests that bilateral perioral sensory symptoms do not have a localizing value. Possible pathogenetic mechanisms for this sign are discussed.     

Rounded atelectasis: diagnosis by fine-needle aspiration cytology.

Rounded atelectasis, a rare, benign mass lesion, is most often seen in association with asbestos-related pleural changes. Often a presumptive diagnosis can be made on the basis of characteristic CT and chest radiographic findings. However, not infrequently radiographic imaging fails to differentiate rounded atelectasis from primary bronchogenic carcinoma, a disease which is seen with increased frequency in patients with asbestos exposure. We describe two cases where the diagnosis of rounded atelectasis was made by fine-needle aspiration (FNA) cytology. The cytologic features included abundant pulmonary parenchymal material with thickened alveolar walls containing pulmonary macrophages and connective tissue. It is important to realize that this is a useful positive finding indicating rounded atelectasis, rather than a negative finding suggesting the absence of neoplasm. Needles with a cutting action may be necessary to obtain sufficient material to make the diagnosis of rounded atelectasis.     

Bilateral complete discoid medial meniscus combined with posterior cyst formation

Bilateral discoid medial menisci is an extremely rare condition of the knee and it can be associated to other pathological findings, including anterior portion cyst formation. We report on the clinical features, radiographic findings, treatment and results of one patient who presented a bilateral medial discoid meniscus combined with posterior portion cyst of the left knee. To the best of the author’s knowledge, this is the first case of bilateral medial discoid meniscus associated with posterior portion cyst formation.     

基底节脑出血开颅手术与钻颅抽吸治疗的疗效比较（附136例报告）

目的比较基底节脑出血开颅手术治疗与钻颅抽吸治疗的有效性与安全性。方法回顾性分析我院近5年来基底节出血行外科开颅治疗和钻颅抽吸治疗的所有病例，应用统计学方法进行疗效比较。结果共136例基底节出血病例，其中30例行外科开颅清除血肿治疗，106例行钻颅抽吸治疗。两组病例在年龄、出血量、意识状态等预后影响因素方面差异无统计学意义（P〉0．05）。基底节出血开颅手术治疗有效性与安全性与钻颅抽吸治疗相比差异无统计学意义（P〉0．05）。结论基底节出血外科开颅治疗有效性与安全性并不优于钻颅抽吸治疗。     

双侧声带麻痹及固定的治疗：附12例报告

文中总结了１２例双侧声带麻痹或固定的治疗。气道通畅型２例，行病因治疗。气道阻塞型１０例，８例作了气管切开术，声带外移术３例，２例呼吸发音功能恢复较好，１例失败者行一侧声带切除＋喉扩张术。另外２例行Ｔ型管扩张术，均顺利拔管。药物治疗共５例。并讨论各种手术治疗现状。     

“Skull punch” for craniotomy in neonates and infants

We have designed a new instrument that we have called a skull punch, which is useful and safe for making a burr hole for a purely osteoplastic craniotomy in neonates and infants. The instrument is described in detail.     

An unusual clinical presentation of bilateral schizencephaly

Summary We present a case with a characteristic magnetic resonance image (MRI) of bilateral open-lipped schizencephaly and atypical clinical presentation. The patient is still alive and in good health in her forties, she has never presented seizures, and although the motor dysfunction is well correlated with cerebral lobe involvement, neurobehavioral dysfunction is not proportional to the MR image of the cerebral malformation.

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Un cas inhabituel de schizencéphalie bilatérale

Résumé Nous présentons un cas de schizencéphalie bilatérale ouverte caractérisé par une présentation clinique atypique et une imagerie par résonance magnétique nucléaire caractéristique. La patiente est encore vivante, en bonne santé, à plus de 40 ans, elle n'a jamais présenté de crise comitiale et, bien que les troubles moteurs soient bien corrélés aux altérations cérébrales, les troubles neuro-comportementaux ne sont pas proportionnels aux images IRM de cette malformation cérébrale.

     

The bilateral bulbar projections of the primary olfactory neurons in the frog

Summary Whether or not the frog olfactory neuroreceptor cells project bilaterally to the olfactory bulb is still a debated question. We therefore decided to ascertain whether bilateral projections of the primary olfactory input exist and if so to investigate their extent. Reproducible extracellular bilateral bulbar potentials were recorded in the frog following electrical stimulation of dorsal or ventral olfactory nerve bundles. The general features of the contralateral evoked responses were very similar to those of the ipsilateral response. The contralateral response disappeared after transection of the rostral part of the olfactory interbulbar adhesion but not following transection of the habenular or anterior commissures. Horseradish peroxidase labelling showed that the fiber terminations of the olfactory nerve bundle was not restricted to the ipsilateral olfactory bulb but included the medial aspects of the contralateral bulb. The intertelencephalic sections increased the magnitude of the ipsilateral evoked responses. Olfactory bulb isopotential maps revealed a rough topographical correspondence between the olfactory neuroepithelium and bulb along the medio-lateral axis as well as along the dorso-ventral axis. In addition, a projection of the medial and central part of the olfactory sac to the medial part of the contralateral olfactory bulb through the interbulbar adhesion was confirmed. These findings suggest first, that the fibers from the neuro-receptors located in either the ventral or the dorsal olfactory mucosae project to both olfactory bulbs, and second, that the left and right bulbs exert a constant inhibition on each other via the habenular commissure.Abbreviations AON anterior olfactory nucleus - ax olfactory neuroreceptor axon - BA bulbar adhesion - D_I latero-dorsal olfactory nerve bundle - D_II centro-dorsal olfactory nerve bundle - D_III mediodorsal olfactory nerve bundle - EPL external plexiform layer - GL glomerular layer - gl glomerulus - GRL granular cell layer - MOB main olfactory bulb - m mitral cell - MBL mitral cell body layer - ON olfactory nerve - V lateral ventricule - V_I latero-ventral ol-factory nerve bundle - V_II centro-ventral olfactory nerve bundle - V_III medio-ventral olfactory nerve bundle - VN vomero-nasal nerve     

Bilateral receptive field neurons in the hindlimb region of the postcentral somatosensory cortex in awake macaque monkeys

Single-neuron activities were recorded in the hindlimb region of the primary somatosensory cortex and part of area 5 in awake Japanese monkeys. A total of 1050 units were isolated from five hemispheres of four animals. Receptive fields (RFs) and submodalities were identified for 90% of isolated neurons in areas 3a and 3b. The percentage decreased as the recoding site moved to the more caudal areas. Deep or skin submodality neurons were dominant in area 3a or area 3b, respectively. Deep submodality neurons increased in more caudal areas and were the majority in areas 2 and 5. These observations were consistent with those in the hand and/or digit or arm and/or trunk region. The identified neurons were classified by their RF positions into four types: the foot, leg, foot and leg, or hindlimb and other body parts type. Among 831 identified neurons, 33 neurons had bilateral RFs, 14 had ipsilateral RFs, and the rest (N=784) had contralateral RFs. The relative incidence of neurons with bilateral or ipsilateral RFs among identified neurons was less than 1% in areas 3a, 3b, and 1, and 16% or 25% in areas 2 or 5, respectively. Within areas 2 and 5, the percentage of neurons with bilateral or ipsilateral RFs was significantly smaller in the foot type (5%) than in other RF types (24-57%). RFs of the foot type were on the sole or single toe but never on multiple toes. These observations contrasted with the previous findings that neurons with bilateral RFs were more frequently seen in the hand and/or digit region and that RFs on multiple digit tips were dominant there. The present study thus demonstrated that neurons with bilateral RFs do exist in the hindlimb region. Similarly to the forelimb region, they were found mostly in areas 2 and 5, the caudalmost areas of the postcentral gyrus and hierarchically higher stages in information processing. The relative paucity of neurons with bilateral RFs on the foot, especially those with RFs on multiple toes, may reflect functional differences between the foot and the hand.     

Bilateral receptive fields of cells in rat Sm1 cortex

Summary Single cells in the primary somatosensory (Sm1) cortex were investigated for responses to bilateral hindpaw stimulation in Wistar rats anaesthetised by continuous intravenous administration of Althesin. Fifty-one percent of cells sampled (N = 134) responded to equivalent punctate mechanical stimuli delivered to both the contralateral and ipsilateral hindpaws under light anaesthesia. The distribution by cortical depth of cells with receptive fields (RFs) on both hindpaws was not significantly different from cells which had only contralateral RFs. No cell was found with a purely ipsilateral RF. For 86% of cells tested (N=44) the ipsilateral RF was partly or completely homologous with areas within the contralateral RF. The sizes of ipsilateral RFs were smaller on 66% of occasions when tested against their contralateral RFs. Modal latencies to ipsilateral mechanical stimulation were longer than to contralateral stimulation (34.1±9.1 ms (S.D) cf. 26.4±7.2 ms, N=44). Ipsilateral RFs were lost for 77% of cells tested following a 33% increase in anaesthetic infusion rate. Conditioning mechanical stimuli applied to the centre receptive field (CRF) on the ipsilateral hindpaw reduced or abolished a cell's responses to equivalent test stimuli applied to it's contralateral CRF with C-T intervals of 20–200 ms. Conditioning stimuli applied to the CRF contralateral to the cell reduced or abolished responses to test stimuli on the cell's ipsilateral CRF using C-T intervals of 0–900 ms. Responses in one cortex to stimulation of the ipsilateral hindpaw were unaffected by elimination of responses from the same hindpaw in the opposite contralateral Sm1 cortex, where responses had been suppressed by topical Lignocaine administration. Retrograde transport of horseradish peroxidase from hindpaw Sm1 cortex labelled many cells in homolateral thalamus, but failed to label cells in the entire forebrain contralateral to the injection site. It is concluded that direct crossed thalamocortical and callosal Sm1-Sm1 pathways do not contribute to the production of hindpaw ipsilateral receptive fields.