Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Background:The measurement of cross-sectional area (CSA) is a diagnostic tool to detect entrapments syndrome. The aim of this study was to compare the clinical outcome in elbows undergoing endoscopic and “in situ” open cubital tunnel release for cubital tunnel syndrome (CuTS) using ultrasound-related changes in the largest CSA of the ulnar nerve. The purpose is to determine the association between clinical outcome and CSA. Methods: From May 2011 to April 2016, 60 patients with CuTS were prospectively followed and not randomly divided in two groups: 30 patients undergoing an endoscopic release (ER) and 30 patients with “in situ” open neurolysis (OR). A sonographic examination was performed by the senior authors at baseline and 3, 6, and 12 months after surgical decompression. Results: CSA values were statistically significantly lower in the ER. Hand grip strength difference with Jamar test was not statistically significant a 12 months (39 kg vs 27 kg). Static-2 point discrimination test difference was only statistically significant lower in the endoscopic group at 3, 6 and 12 months but not clinically relevant (5 mm vs 6 mm). The American Shoulder and Elbow Surgeons—Elbow questionnaire (ASES-e) function score, ASES-e Pain score, and ASES-e Satisfaction score were not statistically significant different between the two groups at 3, 6, and 12 months post operatively. Conclusions: The study confirms that in spite of lower values of CSA in the ER, there is not a statistically significant difference between the two techniques in terms of subjective outcomes. Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve.Type of study/LOE: Prognostic Level III     

恒力法测量运动对动物肌腱,韧带横截面积的影响

本文介绍一种方便，适用的肌腱，韧带横截面积的测量工具－软组织横截面积测微计。通过对兔屈趾肌腱反复测量，其重复性精密度在０．０４４ｍｍ以内，变异系数在１．４％以下，用该测微计对大强度训练一段时间后的兔屈趾肌腱，跟腱和膝内侧副韧带的测量发现，训练训练后ＦＤＰ，ＡＣ的横截面积减小，ＭＣＬ有增大的趋势，据此，作用认为肌腱的变化与长期大强度训练后试件的“疲劳蠕变”有关，ＭＣＬ的变化则与在体内的负荷形式有关。     

Corticostriatal projections from the somatic motor areas of the frontal cortex in the macaque monkey: segregation versus overlap of input zones from the primary motor cortex, the supplementary motor area, and the premotor cortex

It is an important issue to address the mode of information processing in the somatic motor circuit linking the frontal cortex and the basal ganglia. In the present study, we investigated the extent to which corticostriatal input zones from the primary motor cortex (MI), the supplementary motor area (SMA), and the premotor cortex (PM) of the macaque monkey might overlap in the putamen. Intracortical microstimulation was performed to map the MI, SMA, and dorsal (PMd) and ventral (PMv) divisions of the PM. Then, two different anterograde tracers were injected separately into somatotopically corresponding regions of two given areas of the MI, SMA, PMd, and PMv. With respect to the PMd and PMv, tracer injections were centered on their forelimb representations. Corticostriatal input zones from hindlimb, forelimb, and orofacial representations of the MI and SMA were, in this order, arranged from dorsal to ventral within the putamen. Dense input zones from the MI were located predominantly in the lateral aspect of the putamen, whereas those from the SMA were in the medial aspect of the putamen. On the other hand, corticostriatal inputs from forelimb representations of the PMd and PMv were distributed mainly in the dorsomedial sector of the putamen. Thus, the corticostriatal input zones from the MI and SMA were considerably segregated though partly overlapped in the mediolateral central aspect of the putamen, while the corticostriatal input zone from the PM largely overlapped that from the SMA, but not from the MI. Received: 30 June 1997 / Accepted: 2 October 1997     

伴颈5/6椎间孔狭窄神经根型颈椎病影像学特点及临床意义

目的 观测伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔形态及三维空间下的各相关径值,分析并探讨其临床意义。方法 随机选取492例伴C5/C6椎间孔狭窄,在上海长征医院于2014年9月至2019年7月期间行手术治疗的神经根型颈椎病患者,行颈椎正侧位X线、颈椎CT、颈椎磁共振等检查,数字骨科系统重建后观测椎间孔形态并测量最佳投射角度下的纵径、上前后径、下前后径、横截面积、椎间隙高度等径值并对其进行统计学处理,比较病例组与正常成人组C5/C6椎间孔之间、病例组病变椎间孔与对侧椎间孔以及病例组中男女患者之间的差异。结果 病例组C5/C6椎间孔形态因骨赘增生等,以纺锤形、不规则形为主,病例组C5/C6椎间孔横径均值、纵径、横截面积、椎间隙平均高度分别为（5.81±1.40）mm、（10.45±1.70）mm、（50.02±15.46）mm2、（4.99±0.89）mm,均比正常成人组减小,且差异有统计学意义（P<0.01）;男女间比较差异无统计学意义（P>0.05）。结论 伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔的形态发生改变,导致椎间孔的横径均值及横截面积值均明显减小;椎间孔的横径在诊断颈椎间孔狭窄方面敏感性及特异性高;术中减压时应更加注重椎间孔横径的有效扩大,以提高手术效果。     

The human motion onset VEP as a function of stimulation area for foveal and peripheral vision

We studied amplitude of the wave N200 of the motion-onset VEP by varying the side length of a square stimulation field between 0.5 and 7 degrees. A significant increase in amplitude was obtained between 0.5 and 1 degree of side length in central stimulation and between 0.5 and 5 degrees in 10-degree peripheral stimulation. Variations of spatial frequency between 0.34 and 6.8 c/deg did not modify the amplitude size, ie, no tuning effect could be found. The results of simultaneous and separate stimulation of foveal and parafoveal regions support the observation that the stimulation field size is a minor influence. Features of motion-sensitive cortical neurons, such as those found in monkeys, could account for this behavior.     

立体定向显微手术切除脑内病灶

目的探讨立体定向显微手术切除脑内病灶的可行性。方法应用F.L.FischerZD定向仪,CT定位,对24例脑重要功能区及脑深部病灶进行立体定向开颅显微手术。病变性质胶质瘤14例,脑囊虫2例,转移瘤2例,脑脓肿1例,脑膜瘤1例,动静脉畸形(AVM)1例,海绵状血管瘤1例,异物1例,炎性肉芽肿1例。病灶直径为1.5～3.0cm,＞3.5cm     

癌高发区非癌症患者血清铜、锌水平及影响因素

目的：探讨癌高发区非癌症患者的血清铜、血清锌水平及其影响因素。方法：用原子吸收法测定血清铜、血清锌值。并对膳食、健康状况和经济水平等因素进行问卷调查,采用单因素相关、逐步回归分析方法来研究癌高发区、对照区年龄在40～60岁长期居住的非癌症患者人群及其多种因素影响的关系。结果：癌高发区人群血清铜、血清铜锌比值明显高于对照区,血清锌值明显低于对照区。血清铜值与现病史和地区有关．男性血清铜高于女性,血清锌值随经济水平和肉摄入量的增加而增高。地区、现病史和性别对血清铜锌比值影响比其它因素更明显。结论：现病史和地区是影响血清铜锌比值的重要因素。血清铜锌比值可考虑作为评价癌高发区的因素之一。     

血管运动性鼻炎激光治疗鼻腔粘膜致敏区的筛选

目的 :随访和对比激光治疗血管运动性鼻炎鼻腔粘膜不同区域的致敏性 ,以明确最佳治疗点。方法 :随机选择确诊的血管运动性鼻炎 1 0 3例 ,分为下鼻甲、中鼻甲、中鼻甲前 1 /3段 3组进行激光治疗。结果 :下鼻甲组总有效率为 66.7% ,中鼻甲组为 97.1 % ,中鼻甲前 1 /3段为 94.4% ,两中鼻甲组与下鼻甲组总有效率差异有显著性 (P<0 .0 0 5) ,中鼻甲组与中鼻甲前 1 /3段组总有效率差异无显著性 (P>0 .0 5)。结论 :中鼻甲前 1 /3段是血管运动性鼻炎患者鼻粘膜最敏感的区域 ,是最佳激光治疗点。     

家兔面神经核背内侧区对颏舌肌肌电活动的调制作用

目的研究电、化学刺激面神经核背内侧区(dMNF)对颏舌肌肌电活动的影响。方法在24只氨基甲酸乙脂麻醉、断双侧迷走神经的健康成年家兔上进行实验。结果①长串电脉冲刺激dMNF导致颏舌肌肌电活动明显增强;②在dMNF内微量注射谷氨酸钠,颏舌肌肌电活动出现明显的易化效应;③单脉冲电刺激dMNF引起颏舌肌出现两次肌电反应,潜伏期分别为(50．8±0．6)ms和(94．7±0．5)ms。结论dMNF对颏舌肌的肌电活动具有调节作用,dMNF的兴奋能增强颏舌肌的肌电活动,从而具有降低上呼吸道阻力的作用。