Risk factors for decreased distance between internal carotid artery and pharyngeal wall

Objectives

The risk of disastrous bleeding during pharyngeal surgery is increased in cases of an internal carotid artery (ICA) that is medially displaced due to its anomalous course. We attempted to assess the distance between the ICA and the pharyngeal wall (DIP) and to evaluate the predisposing factors associated with ICA variation.

Methods

The course of ICA was studied in 509 CT scans, and a retrospective chart review was performed. The course of ICA and DIP were evaluated at each level of the pharynx: nasopharynx (NP), oropharynx (OP), and hypopharynx (HP).

Results

The mean DIP value was greatest (15.8 ± 4.6 mm) at NP, decreased at OP (15.8 ± 4.6 mm), and was shortest at HP (13.5 ± 6.0 mm). DIP was significantly shorter in females compared with males at all three pharyngeal levels. Age was inversely correlated with DIP at NP and OP. Tortuous ICA was most common (51.4%), followed by straight (41.2%), kinking (6.9%), and coiling (0.5%) types. DIP was longest in the straight type and decreased as the curvature of ICA increased. The most common ICA type differed between younger (<60 years; 56.2% having the straight type) and older groups (≥60 years; 66.2% having the tortuous type). Females older than 60 years displayed a higher incidence of kinking ICA compared with males.

Conclusions

Hypopharynx, old age, female gender, and tortuous or kinking ICA types were risk factors for a decreased distance between the ICA and the pharyngeal wall. Meticulous examination of the pharyngeal wall should therefore be performed prior to pharyngeal surgery in patients with these associated risk factors.     

Effects of symbol type and numerical distance on the human event-related potential

This study investigated the influence of the symbol type and numerical distance of numbers on the amplitudes and peak latencies of event-related potentials (ERPs). Our aim was to (1) determine the point in time of magnitude information access in visual number processing; and (2) identify at what stage the advantage of Arabic digits over Chinese verbal numbers occur. ERPs were recorded from 64 scalp sites while subjects (n = 26) performed a classification task. Results showed that larger ERP amplitudes were elicited by numbers with distance-close condition in comparison to distance-far condition in the VPP component over centro-frontal sites. Furthermore, the VPP latency varied as a function of the symbol type, but the N170 did not. Such results demonstrate that magnitude information access takes place as early as 150 ms after onset of visual number stimuli and the advantage of Arabic digits over verbal numbers should be localized to the VPP component. We establish the VPP component as a critical ERP component to report in studies of numerical cognition and our results call into question the N170/VPP association hypothesis and the serial-stage model of visual number comparison processing.     

Strategies for success in online learning

The nursing and nursing faculty shortages have created a greater need for effective online learning strategies. Today's learners require the flexibility offered by online learning, but only when well grounded in sound teaching-learning principles. This article describes strategies for online learning designed to keep the needs of today's learners in mind. These strategies are focused on the resolution of technology problems as well as the learning process.     

国内外远程医学教育的发展与思考

远程医学教育作为一种新型的教育方式,在全球范围内正在掀起一场医学教育的革命,对不断提高卫生技术人员的素质和技术水平,建立终身教育体制和改变知识传授方式有着重要的作用。本文介绍了国内外远程医学教育的发展历程,其目的是借鉴国外的先进经验,推动远程医学教育在我国的发展,达到合理利用教育资源,提高医务工作者整体素质,最终满足人民群众日益增长的健康需求、构建和谐社会的目的。     

吉林省远程医学继续教育及会诊平台系统

通过远程视频、X线诊断平台完成吉林省远程继续教育培训和会诊，解决农村继续教育和看病难、看病贵的根本问题。指出远程医学继续教育为乡村培养医技人才提供了方便，会诊平台系统为患者看病提供了新技术。     

Evaluating the urban-rural paradox: The complicated relationship between distance and the receipt of guideline-concordant care among cervical cancer patients

Objective

Urban-rural health disparities are often attributed to the longer distances rural patients travel to receive care. However, a recent study suggests that distance to care may affect urban and rural cancer patients differentially. We examined whether this urban-rural paradox exists among patients with cervical cancer.

Wilms' tumor and exposures to residential and occupational hazardous chemicals

This case-control study examines the association between residential and occupational exposures to hazardous chemicals and the risk of Wilms' tumor. The study included 303 cases recruited from six state cancer registries, who were diagnosed between January 1, 1992 and December 31, 1995. A total of 575 controls selected through random digit dialing were frequency matched to the cases. A standard questionnaire was administered to participants during a telephone interview. Parental residential addresses and locations of US Environmental Protection Agency National Priority List (NPL) sites were geocoded and analyzed, along with occupational exposure information. There were no cases of Wilms' tumor found in individuals living within one-half mile distance of a hazardous waste site. However, elevated odds ratios were found for using hairdressing chemicals, motor oil, paint, paint stripper, and pesticides during the pregnancy term and during the 2-year period prior to birth. The findings do not support the hypothesis that Wilms' tumor is associated with residing near an NPL site.     

上海市零售药店合理布局问题初探

目的:探讨在市场经济初级阶段零售药店的合理布局问题。方法:对2003年~2005年上海市零售药店开办距离限制规定的实施情况与由此产生的结果进行分析。结果与结论:距离限制对上海市零售药店的合理布局有一定的积极作用。建议政府在制定合理布局规定时,考虑其可操作性和我国社会的发展阶段。     

Mechanisms for distance reproduction in perceptual and motor tasks

Two experiments were carried out: the control experiment and the doubling-distance experiment. In the control experiment subjects were presented with two visual stimuli whose distance was randomly varied. Subjects were required to reproduce the interstimulus remembered distance in two conditions. In one condition (reproduction by pointing) they pointed to a virtual position in space. In the other condition (visual reproduction) they matched the distance by using two other visual stimuli. In the doubling-distance experiment, distances between the two randomly presented stimuli were half of the distances used in the control experiment. Subjects were required to reproduce the double of the presented distance. As in the control experiment, reproduction was executed in two conditions: reproduction by pointing and visual reproduction. In both experiments variable and constant errors were measured. Pointing kinematics were also analysed. The results of the control experiment showed that subjects underestimated distance in reproduction by pointing, whereas they overestimated distance in visual reproduction. Variable errors increased with increasing distance, whereas they were not influenced by the type of reproduction. In the doubling-distance experiment, subjects generally overestimated distance by the same amount in both conditions. However, overestimation decreased with distance during reproduction by pointing. Pointing kinematics varied between the two experiments. The results of the control experiment confirm the hypothesis that perceptual judgement and visuo-motor transformation are two separate processes during which the same object attributes are independently analysed. However, the results of the doubling-distance experiment suggest that perceptual judgement and visuo-motor transformation use the same mechanisms when object attributes are deduced by mental elaboration.     

Multisensory integration in the estimation of relative path length

One of the fundamental requirements for successful navigation through an environment is the continuous monitoring of distance travelled. To do so, humans normally use one or a combination of visual, proprioceptive/efferent, vestibular, and temporal cues. In the real world, information from one sensory modality is normally congruent with information from other modalities; hence, studying the nature of sensory interactions is often difficult. In order to decouple the natural covariation between different sensory cues, we used virtual reality technology to vary the relation between the information generated from visual sources and the information generated from proprioceptive/efferent sources. When we manipulated the stimuli such that the visual information was coupled in various ways to the proprioceptive/efferent information, human subjects predominantly used visual information to estimate the ratio of two traversed path lengths. Although proprioceptive/efferent information was not used directly, the mere availability of proprioceptive information increased the accuracy of relative path length estimation based on visual cues, even though the proprioceptive/efferent information was inconsistent with the visual information. These results convincingly demonstrated that active movement (locomotion) facilitates visual perception of path length travelled.