Dysphagia in Parkinson's disease: Pharyngeal manometry and fiberoptic endoscopic evaluation

ObjectiveDysphagia is a common symptom in Parkinson's disease (PD) and it represents a negative prognostic factor because of its complications. This study is to evaluate pharyngeal dysphagia for boluses of various consistencies with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM) in a group of PD patients, making a comparison between the information provided by the two exams.MethodsGroup of 20 patients affected by PD was selected and initially subjected to a qualitative evaluation of the swallowing performing FEES. Subsequently, they were evaluated by PHRM to identify quantitative measures associated with pressures expressed by pharyngeal organs during swallowing. Values obtained in the study group were compared with those recorded in a group of 20 healthy subjects.ResultsStudy showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower than the control group (p<0.05) for all the boluses and consistency tested, in particular for the Tongue base and the Cricopharyngeal muscle. Pmean pre-swallowing pressure (represents the mean value of a contraction in which basal and maximal pressure where normally calculated) was significantly higher compared to normal subjects for the Tongue base and the Cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the Velopharynx and the Cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently to the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. Images displayed at the FEES, found the corresponding biomechanical explanations in the PHRM, which also allowed us to quantify the extent of the dysfunction, through the calculation of the pressures generated in the various structures studied.ConclusionPHRM is particularly useful in the early detection of dysphagia, when FEES may still show no evidence of abnormal swallowing.     

Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects

ObjectiveTo determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects.DesignParticipants underwent bilateral earplugging before completion of anthropometry, the author's developed questionnaire, the Hamilton Anxiety and Depression Inventory, pure tone audiometry (PTA), stapedial reflex thresholds (SRT), distortion products otoacoustic emissions input/output (DPOAE-I/O), and uncomfortable loudness levels (ULLs). Afterward, the participants were randomly divided into group A, starting at 8:00 a.m. and finishing at 8:00 p.m., and group B, starting at 4:00 p.m. and ending at 4:00 a.m. Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured.Study sampleThirty healthy volunteers.ResultsPTA was 2.68 and 3.33 dB HL in groups A and B, respectively, with no statistical difference between them. ULLs were significantly lower in group A compared to group B, with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B (p < 0.0001). A SRT shift was observed in group A, with no difference in group B, and a night shift in DPOAE-I/O in group B.ConclusionsReduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime; this may be due to increased central gain in the awake cortex.     

Periventricular- intraventricular hemorrhage in the premature infant- A historical perspective

The objective of this chapter is to trace the evolution of intraventricular hemorrhage in the premature infant highlighting the importance of the germinal matrix, a critical role for cerebral blood flow changes in the genesis of hemorrhage, clinical factors that increase the bleeding risk, and potential preventative strategies. In 1976, neuropathological studies demonstrated capillary rupture within the germinal matrix as the precursor of hemorrhage. In 1980, introduction of cranial ultrasound facilitated diagnosis of intraventricular hemorrhage. In 1979, loss of cerebral autoregulation in sick newborn infants was demonstrated. In the 1980’s, studies demonstrated the importance of intravascular factors in provoking hemorrhage. In 1983, the association of cerebral blood flow velocity fluctuations and subsequent hemorrhage was demonstrated. In 1994, antenatal steroids use to accelerate lung development was recommended. This was associated with an unanticipated reduction in hemorrhage. In the mid 1990’s early indomethacin administration was associated with a reduction of severe hemorrhage.     

Interleukin-6 levels in co-culture of human in vitro fertilization embryos with Vero cells are not predictive of future successful development

PROBLEM: In an attempt to predict successful embryo transfer and implantation, we measured interleukin (IL)-6 levels in culture supernatants of co-cultured preimplantation human embryos. We tested whether all in vitro fertilized human embryos in co-cultures do secrete IL-6, and whether there was any difference in such production between embryos that successfully reached the blastocyst stage and blocked embryos. We also addressed the question of IL-6 secretion by co-culture support cells, namely Vero cells themselves. METHOD OF STUDY: Each fertilized oocyte was cultured individually and transferred in culture wells supplemented with a feeder layer of Vero cells at day 2. In vitro IL-6 production was measured by bioassay of the culture media. RESULTS: Because Vero cells themselves secrete IL-6, it became impossible, in co-culture, to quantify production of IL-6 by the sole embryos. On the other hand, the co-culture technique has shown us that embryos are likely to consume IL-6. There was no difference between blastocysts and blocked embryos. CONCLUSIONS: IL-6 levels in human embryo co-cultures do not correlate with future successful embryo transfer.     

中药配合低能量氦—氖激光血管内照射为主治疗缺血性中风疗效观察

目的：观察中药配合低能量氦－氖激光血管内照射为主治疗缺血性中风疗效。方法：治疗组：用中药配合低量氦－氖激光血管内照射为主治疗缺血性中风６９例;对照组：用降纤酶、尼莫通治疗缺血性中风４２ 例。结果：治疗组基本痊愈４８ 例,显效８例,有效７例,无效５ 例,恶化１ 例,有效率为９１．３０％ 。对照组基本痊愈２０例,显效１例,有效９ 例,无效１１ 例,恶化１例,有效率为７１．４３％ 。经χ２ 检验,χ２＝ ７．６,Ρ＜ ０．０１,有显著差异。结论：治疗组中药配合低能量氦－氖激光血管内照射为主治疗缺血性中风综合疗效明显优于对照组用降纤酶和尼莫通治疗缺血性中风     

角膜移植患者术前、术后IL-6、IL-8及T淋巴细胞亚群的测定

目的：探讨 Ｉ Ｌ ６、 Ｉ Ｌ ８ 与角膜移植的关系。方法：采集 １９ 例角膜移植患者术前 １ ｄ 及术后３～５ ｄ空腹静脉血,应用 Ｅ Ｌ Ｉ Ｓ Ａ 法测定血清中 ｓ Ｉ Ｌ ６、ｓ Ｉ Ｌ ８ 水平,应用流式细胞仪测定 Ｔ 淋巴细胞亚群的变化。结果：患者术前ｓ Ｉ Ｌ ６、ｓ Ｉ Ｌ ８ 水平接近正常人,术后明显升高,而 Ｔ 淋巴细胞亚群的改变则无统计学意义。结论： Ｉ Ｌ ６、 Ｉ Ｌ ８ 作为细胞因子较早参与了角膜移植术后的免疫反应。     

尼龙1010／6及尼龙1010／66动态力学分析

通过动态力学参数温度谱,研究了尼龙１０１０／６、尼龙１０１０／６６两个共聚物系列的动态力学参数与组成的关系。研究表明尼龙１０１０／６、尼龙１０１０／６６在测试温度范围内出现三个明显的松驰转变：α、β、γ,其中各共聚物的β、γ松驰温度相差不大,而α松驰温度随组成改变有明显改变。一般均聚物的α松驰温度较高,共聚物的α松驰温度均低于均聚物,二个系列以尼龙１０１０／６（２９．８／７０．２）、尼龙１０１０／     

血浆中萘丁美酮活性代谢物的反相高效液相色谱法测定

为研究萘丁美酮的相对生物利用度,建立了用反相高效液相色谱法测定血浆中萘丁美酮的活性代谢物６－甲氧基－２－萘乙酸（ＭＮＡ）浓度的方法。实验结果表明,以萘普生作内标,甲醇∶０．０２ｍ ｏｌ／Ｌ醋酸盐缓冲液（ｐＨ３．０）为７４∶２６ 作流动相,用ＹＷＧ－Ｃ１８ 柱有良好的分离效果;血浆样品在ｐＨ３．０醋酸盐缓冲液存在下,用二氯甲烷萃取,回收率高,在２７０ｎｍ 波长下检测杂质峰少。该法标准曲线在０．５～６４ｍ ｇ／Ｌ范围内有良好线性,最低检测浓度为０．０２ｍ ｇ／Ｌ,萃取回收率为８８％ ～９４％ ,方法回收率为９６％ ～１０２％ ,日内相对标准差小于３．５％ ,日间相对标准差小于５％ 。具有快速简便,灵敏准确等特点,适用于萘丁美酮血药浓度测定及药代动力学和生物利用度研究用     

海南省流动儿童计划免疫现况分析

为更好地了解流动儿童计划免疫管理现况,１９９７年海南省组织了专题调查,发现流动儿童以县内流动为主,流动儿童上卡率为７６．６％,五苗接种率分别为卡介苗６９．４％,脊灰糖丸６５．１％,百白破６３．６％,麻疹５９．９％,ＨＢＶ５６．９％,均远未达到目标要求,脊达抗体ＧＭＴ流动儿童为１：１５３．２０,常住儿童为１：２４３．６１,两者有显著性差异,这表明,加强流动儿垢计划免疫管理,最今后计免工作的重点和难点