Pattern electroretinogram plus visual evoked potential: A decisive test in patients suspected of malingering

Along the processing chain in the visual pathway the pattern electroretinogram (PERG) is a better indicator of the peripheral function than the visual evoked potential (VEP). Therefore the PERG and the VEP will be impaired equally by disturbances before the ganglion cell layer (e.g., blurred image or retinal disease) and differently by further centrally located diseases (e.g., tumor compression of the optic nerve). Thus in patients complaining of reduced visual acuity who show disturbed VEP but a normal PERG, malingering can be definitely ruled out. Representative combinations of PERG and VEP findings are described.     

Maturational topography of the visual evoked potential in fetal lambs

The normal maturational course of the visual evoked potential (VEP) in human newborns and infants is well documented. Unfortunately, there is a paucity of data about VEP maturation in the normal preterm infant. Since this population is at risk to develop many abnormalities affecting the VEP (intraventricular hemorrhage, hydrocephalus, and retinopathy of prematurity), one must question whether such VEP data collected from this group is representative of normal maturation. To provide normative parametric developmental data we have been studying VEP development in fetal lambs. Six fetal lambs between 105 and 120 days gestational age were externalized and surgically instrumented with subcutaneous recording electrodes placed over the occipital and parietal regions. High-intensity light-emitting diodes (LEDs) externalized fiberoptic cables were secured adjacent to the orbit. from 108 to 141 days gestation, fetal VEPs were recorded in response to bright flash stimulation and the maturational topography was investigated.Over the occipital regions, the emergence of major positivities at P400 and P650 were observed beginning around 120 days gestation. Over the parietal area, the emergence of P200 and P500 components was observed by 128 days gestation. The latency-maturation functions revealed that the slope of the parietal function was steeper than the occipital counterpart, suggesting that the maturation of parietal neurons occurs at a faster rate than neuronal development in the occipital regions.     

Prevalence of mental disorder in an urban population in central Sweden

The principal reason for this epidemiological study was the lack of psychiatric morbidity studies in a predominantly urban population, by psychiatrists in direct interviews. The psychiatric examination, covering 1970-71, included a representative selection of 2,283 persons, 18-65 years old from "former" Stockholm County, and the 12-month prevalence of mental disorders was measured. The total of non-participants was 12%. Forty-seven percent had a psychiatric diagnosis - significantly more women (54%) than men (40%). Excluding the psychosomatic diagnoses, 31% of the population received a psychiatric diagnosis, which agrees closely with other contemporary studies of mental disorder in the Nordic countries. The primary diagnoses were: neuroses 26%, psychosomatic diagnoses 16%, schizophrenic/paranoid conditions or other psychoses 0.6%, affective disorders 0.2%, psychoorganic syndromes 1.2%, psychopathy 0.2%, character neurosis 1%, drug dependence 0.2% (as a primary or a secondary diagnosis 0.6%), alcoholism 1.4% (as a primary or a secondary diagnosis 3.1%) and mental retardation 0.4% (as a primary or a secondary diagnosis 0.8%).     

Hyperosmolarity response of ocular standing potential as a clinical test for retinal pigment epithelium activity normative data

The standing potential of the eye is decreased by intravenous administration of hypertonic solutions. This hyperosmolarity-induced response has been recorded in normal subjects by the use of electro-oculography (EOG) in the dark. An intravenous administration of Fructmanit^® (1.4 × 10³ mOsmol) (150 500ml, 2.37 9.70ml/kg, 0.08 0.36 ml/kg/min) was used to evoke the hyperosmolarity response. The amplitude of the response was expressed in percentage, V₀ – V_min/V₀ × 100, where V₀ is the base value of the EOG before administration of the hypertonic solution and V_min is a minimum EOG amplitude after administration. The distribution of the amplitude of the hyperosmolarity response was approximated by the normal distribution in normal subjects. The minimum, the maximum, the mean and the standard deviation of the amplitude of the hyperosmolarity response were respectively 34.2%, 52.3%, 42.6% and 4.6% in normal subjects. The normal range of the hyperosmolarity response would be 33.4 51.8% (M ± 2SD). The hyperosmolarity response, which originates mainly in the retinal pigment epithelium, is a useful new quantitative and specific test of the activity of the retinal pigment epithelium in clinical practice.     

Hyperosmolarity response of ocular standing potential as a clinical test for retinal pigment epithelium activity rhegmatogenous retinal detachment

The hyperosmolarity response of the ocular standing potential was recorded in unilateral rhegmatogenous retinal detachment (8 eyes) and in the fellow healthy eye (8 eyes). The hyperosmolarity response was greatly suppressed (M-4 SD: M and SD indicate respectively the mean and the standard deviation in normal subjects) in all affected eyes (p < 0.005), and slightly abnormal in 2 fellow eyes. The L/D ratio was normal in 2 affected eyes and in all fellow eyes. The hyperosmolarity response in the affected eyes was still greatly suppressed 14 months after successful surgical treatment.     

脊髓损伤患者撑起动作相关影响因素分析

目的：分析脊髓损全国各地患者撑起动作实施过程中的相关影响因素。方法：采用撑起问卷表形式分析影响撑起动作完成的主要相关因素。结果：撑起动作正确完成受多种因素的影响,其中最主要的影响因素是重心的调查问题。结论：实施撑起动作时应分析相关影响因素再进行有针对性的训练。     

Cardiovascular events in patients undergoing hip fracture surgery treated with remote ischaemic preconditioning: 1-year follow-up of a randomised clinical trial

Remote ischaemic preconditioning reduces the risk of myocardial injury within 4 days of hip fracture surgery. We aimed to investigate the effect of remote ischaemic preconditioning on the incidence of major adverse cardiovascular events 1 year after hip fracture surgery. We performed a phase-2, multicentre, randomised, observer-blinded, clinical trial between February 2015 and September 2017. We studied patients aged ≥ 45 years with a hip fracture and a minimum of one cardiovascular risk factor. Patients were allocated randomly to remote ischaemic preconditioning applied just before surgery or no treatment (control group). Remote ischaemic preconditioning was performed on the upper arm with a tourniquet in four cycles of 5 min ischaemia and 5 min reperfusion. Primary outcome was the occurrence of major adverse cardiovascular events within 1 year of surgery. A total of 316 patients were allocated randomly to the remote ischaemic preconditioning group and 309 patients to the control group. Major adverse cardiovascular events occurred in 43 patients (13.6%) in the remote ischaemic preconditioning group compared with 51 patients (16.5%) in the control group (adjusted hazard ratio (95%CI) 0.83 (0.55–1.25); p = 0.37). Fewer patients in the remote ischaemic preconditioning group had a myocardial infarction (11 (3.5%) vs. 22 (7.1%); hazard ratio (95%CI) 0.48 (CI 0.23–1.00); p = 0.04). Remote ischaemic preconditioning did not reduce the occurrence of major adverse cardiovascular events within 1 year of hip fracture surgery. The effect of remote ischaemic preconditioning on clinical cardiovascular outcomes in non-cardiac surgery needs confirmation in appropriately powered randomised clinical trials.     

Analysis of types of chromosomal aberrations following the combined action of chemical mutagens

Types of chromosomal aberrations in cultures of human lymphocytes exposed to the combined action of various concentrations of thiophosphamide and dipin, with different proportions of each, were studied. The mutagens acted on the G₀ stage. The range of concentrations used was from 3.17·10^–5 to 22.19·10^–5M. Equimolar concentrations of thiophosphamide inhibited more chromatid exchanges and fewer sister-strand (isolocus) unions than dipin, and it also induced a greater proportion of single breaks and a greater proportion of breaks in chromatid exchanges relative to the total number of chromosome breaks. Both the absolute and the relative frequencies of chromosomal aberrations depended on the concentration of the mutagens. A change in the ratio between thiophosphamide and dipin, if the total number of molecules of the two mutagens at the different concentration levels remained constant, gave rise to an effect whose level was between the effects of action of equimolar concentrations of the pure mutagens. This effect depended on the proportion of each mutagen in the combined treatment. It is concluded that the action of thiophosphamide and dipin is additive.Laboratory of Mutagenesis, Institute of Medical Genetics, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR A. V. Smol'yannikov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 1, pp. 79–81, January, 1978.