Properties and localization of the anterior semicircular canal-activated vestibulocollic neurons in the cat

Summary Unit activites of secondary vestibular neurons that selectively responded to stimulation of the anterior semicircular canal nerve (ACN) were recorded extracellularly in the anesthetized cat. Axonal pathways and projections in the spinal cord of the ACN-activated neurons were examined by recording their antidromic responses to stimulation of the lateral and medial vestibulospinal tracts (LVST and MVST), and the bilateral neck extensor motoneuron pools in the C₁segment (C₁dorsal rami [DR] motoneuron pools). In order to determine whether the neurons had ascending axon collaterals to the extraocular motoneurons, the contralateral (c-) inferior oblique (IO) motoneuron pool was also stimulated. Twenty-seven neurons sent their axons to the ipsilateral (i-) C₁DR motoneuron pool via the LVST without any projection to the extraocular motoneuron pool. All the cells except one were located in the ventral part of the lateral vestibular nucleus. This pathway produced monosynaptic EPSPs with short time-to-peak and short half-width in C₁DR motoneurons (16/16 motoneurons). Eight neurons sent axons to the i-C₁DR motoneuron pool via the MVST without any to the extraocular motoneuron pool. Cell somata were located in the descending nucleus or in the ventral part of the lateral nucleus. These neurons did not produce postsynaptic potentials (PSPs) in any C₁DR motoneurons. All thirty-five neurons sending axons to the c-C₁DR motoneuron pool have ascending axon collaterals to the c-IO motoneuron pool.     

Prognostic factors determining response to antidepressant drugs in psychiatric out-patients and general practice

The outcome of antidepressant drug treatment was measured in 200 patients, 145 seen in psychiatric out-patient clinics and 55 in general practice, after 4 weeks of therapy. The results of the 200 patients taken together suggested that prognosis was largely determined by factors dependent on the natural history of the disorder and that clinical symptoms were unimportant, but when the results for patients in each drug group were analysed separately symptoms were more important than natural history factors. We conclude that clinical symptoms are only important predictors of response to antidepressant drugs when the patients studied are homogeneous with regard to natural history factors, particularly duration of illness.     

Anatomical basis of inguinal surgery in children

Summary This paper begins with a review of the embryology of the inguinal region. The authors then point out the special morphological and topographical features of the inguinal canal in male children. These observations were based on the study of 50 inguinal canals from male children. From the anatomical observations described in this study guidelines are proposed for the surgical approach and dissection of the spermatic cord used in the treatment of congenital hernias or abnormal descent of the testis.

---

Bases anatomiques de la chirurgie inguinale de l'enfant

Résumé Après une étude embryologique de la région inguinale, les auteurs décrivent les particularités morphologiques et topographiques du canal inguinal en croissance de l'enfant de sexe masculin, se basant sur l'étude de 50 cas. De ces notions anatomiques découlent des règles chirurgicales sur la voie d'abord et la dissection du cordon spermatique lors des cures de hernies congénitales ou d'anomalies de migration testiculaire.

     

Physicians at the roadside: Pre-hospital emergency care in the United Kingdom

In some parts of the United Kingdom (UK), family doctors (or "general practitioners" as they are called in the UK) are routinely called upon by the emergency medical services (EMS) system to attend road accidents. The doctors are volunteers and travel to the scene of the accident in their own cars. Members of one such general practitioner accident service operating in Mid-Anglia complete an accident report form after attending each incident. In 1983, the Mid-Anglia General Practitioner Accident Service (MAGPAS) received 1,715 calls for medical assistance, and in 95% of these a doctor was sent immediately. Of these calls, 57% were passed to the doctor within one minute of the receipt of the call in the MAGPAS control room, and 78% were relayed within two minutes. This rapid call-out, combined with the close proximity of the local doctor to the accident site, resulted in the doctors arriving ahead of the ambulance in 42% of the calls. A total of 54 patients with airway obstruction were treated by the doctors prior to the arrival of the ambulance. Ninety-nine patients required immediate intravenous fluid replacement in the pre-hospital phase of their medical care. This report suggests that general practitioners in rural areas can play a vital role in the early management of trauma patients, especially in the absence of ambulance personnel trained in advanced life support skills.     

Association of habitual exercise with adults’ mental health following the Fukushima Daiichi nuclear power plant accident: the Fukushima Health Management Survey

IntroductionThe Great East Japan Earthquake and the Fukushima Daiichi nuclear power plant accident in March 2011 impacted survivors’ mental health. This study examined whether exercise habits and mental health conditions were associated, and whether the degree of the effect varied depending on time.MethodsA self-administered questionnaire was sent annually to former residents (born before April 1, 1998) in registered evacuation areas. Exercise habit was evaluated by participants’ exercise frequency, and responses were categorized into “almost never,” “once a week,” and “twice a week and more.” Data were tracked during three periods: fiscal year (FY) 2011–2012, 2012–2013, and 2013–2014. The association between baseline habitual exercise and new onset of psychological distress was assessed using the Japanese version of the Kessler 6-item Psychological Distress Scale and logistic regression analysis.ResultsA total of 1304 (5.7%) of 22,741, 1060 (4.7%) of 22,709, and 759 (3.6%) of 21,220 respondents had psychological distress in FY 2011–2012, 2012–2013, and 2013–2014, respectively. An association between exercise and psychological distress was observed in men in FY 2011–2012 (P for trend: 0.010) and in women in FY 2013–2014 (P for trend: 0.026). “Almost never” was associated with onset of psychological distress in men in FY 2011–2012 [odds ratio (OR): 1.317, 95% confidence interval (CI): 1.054–1.645] and in women in FY 2013–2014 (OR: 1.296, 95% CI: 1.027–1.636).ConclusionsExercise habit was associated with psychological distress, and its effect in time varied according to sex.     

马尾神经根松弛症诊断及治疗研究

目的 :探讨马尾神经根松弛症的诊断及治疗。方法 :对我院开展椎管造影以来 ,发现马尾神经根松弛症9例患者的临床表现、椎管造影及治疗结果进行分析。结果 :9例患者除具有腰椎管狭窄症的一般临床表现之外 ,椎管造影结果显示狭窄节段上方马尾神经根呈波浪状蛇形卷曲 ,甚至“环状”改变 ,9例患者均行手术治疗。经随访 ,除1例患者症状无明显改善外 ,均完全恢复。结论 :椎管造影是诊断马尾神经根松弛症的有效手段 ,手术外围减压及神经根粘连松解是治疗的有效方法     

腰椎间盘突出症并神经根管狭窄的治疗

目的：探讨腰椎间盘突出症合并神经根管狭窄的临床诊断和手术治疗。方法：对1996-1999年间,因腰椎间盘突出症合并神经根管狭窄38例行手术治疗,术中均行神经根管探查并彻底松解受压神经根。结果：术后随访38例,优20例,良15例,一般2例,差1例,优良率92.11%。结论：神经根管扩大和神经根探查彻底减压是手术成功的关键。     

视神经管减压术治疗视神经挫伤20例分析

目的：报告视神经挫伤行视神经管减压术的治疗效果。方法：手术治疗限定于外伤后不超过1月且无严重颅脑损伤及无严重全身疾病者。采用局麻筛蝶窦入口法,手术前后常规用糖皮质激素及神经生长因子。结果：20例术前无光感16例,术后1周视力有光感及手动以上12例,占75％;术前视力在手动－0．04以内4例,术后视力均提高。术后随访3个月除2例外视力均有提高,最好达到0．3。结论：视神经挫伤病期不超过1月虽视力已无光感也不应放弃行视神经管减压术。     

Liposomal Bupivacaine vs Ropivacaine for Adductor Canal Blocks in Total Knee Arthroplasty: A Prospective Randomized Trial

BackgroundThe purpose of this study is to determine the benefit of the analgesic liposomal bupivacaine compared to ropivacaine, by assessing pain and joint stiffness, and total oral opioid consumption by milligram morphine equivalent (MME) after total knee arthroplasty.MethodsPatients were randomized to receive either the study drug (liposomal bupivacaine admixed with bupivacaine) or the control drug (ropivacaine) in an adductor canal block. Only the anesthesiologist performing the block was aware of which arm of the study the patient was randomized to. MME, pain, Knee injury and Osteoarthritis Outcome Score Joint Replacement, and overall benefit of analgesia scores were recorded 24, 48, and 72 hours post-surgery either face-to-face or via telephone depending on patient discharge status.ResultsOne hundred patients were enrolled into the study and analyzed: 54 in the control group and 46 in the experimental group. Primary outcomes measured were pain as a numerical rating scale, MME, and length of stay in hours. Secondary outcomes were joint pain and stiffness recorded as Knee injury and Osteoarthritis Outcome Score Joint Replacement outcome and overall benefit of analgesia score. No statistically significant between-group differences were observed for any measured outcome.ConclusionWe did not find any supporting evidence that liposomal bupivacaine yields increased pain relief following total knee arthroplasty compared to the control drug, ropivacaine.