Infective Endocarditis Due to Treponema pallidum: A Case Diagnosed Using Polymerase Chain Reaction Analysis of Aortic Valve

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Syphilitic aortitis might coexist in a dysfunctional aortic valve, but the etiology remains unclear, because microbiological diagnosis is difficult. A 62-year-old man with low-grade fever was diagnosed with aortitis and infective endocarditis, due to Treponema pallidum infection, using polymerase chain reaction analysis. This case suggests that syphilis might cause infective endocarditis.     

Diagnostic sensitivity of electrophysiology and ultrasonography in ulnar neuropathies of different severity

ObjectiveTo assess the diagnostic performance of electrophysiology and nerve ultrasound in ulnar neuropathies of varying clinical severity in 135 consecutive patients.MethodsClinical severity of ulnar neuropathy was graded on a 4 point scale from very mild (symptoms only) to severe (marked atrophy of intrinsic hand muscles). Sensitivity and localization ability of electrophysiology and nerve ultrasound were assessed for each point of the scale.ResultsUltrasound had higher sensitivity than electrophysiology in clinically very mild (20% and 3% for ultrasound and electrophysiology, respectively) and mild (62% and 47% for ultrasound and electrophysiology, respectively) neuropathies, had greater localizing ability in axonal ulnar neuropathies, and identified nerve hypermobility.Ultrasound nerve cross-sectional area had strong positive correlation with both clinical and electrophysiological severity scores, but with significant overlap across the severity groups.ConclusionThe diagnostic work-up of ulnar neuropathies was improved by using both electrophysiology and ultrasound at all levels of clinical severity. Ultrasound increased the diagnostic yield in very mild and mild neuropathies, localized all the ulnar neuropathies with abnormal non-localizing electrophysiology and identified nerve hypermobility.SignificanceThis is the first detailed analysis of the diagnostic performance of electrophysiology and ultrasound in ulnar neuropathies of varying severity.     

Bayesian estimation of a random effects heteroscedastic probit model

Summary Bayesian analysis is given of a random effects binary probit model that allows for heteroscedasticity. Real and simulated examples illustrate the approach and show that ignoring heteroscedasticity when it exists may lead to biased estimates and poor prediction. The computation is carried out by an efficient Markov chain Monte Carlo sampling scheme that generates the parameters in blocks. We use the Bayes factor, cross‐validation of the predictive density, the deviance information criterion and Receiver Operating Characteristic (ROC) curves for model comparison.     

Cross talk in surface electromyograms of human hamstring muscles.

Signals generated from muscles other than the muscle(s) of interest (cross talk) can confound the interpretation of surface electromyograms (EMGs). In this study, the amount of cross talk in surface EMGs of human hamstring muscles was estimated using a protocol in which the quadriceps femoris was electrically stimulated via the femoral nerve. EMGs were recorded from the vastus lateralis and the medial and lateral hamstring muscle groups. The amplitude of the EMG response of the vastus lateralis to electrical stimulation was adjusted to match that of its maximum voluntary effort (MVE) under isometric conditions. Subsequent power density spectrum analysis showed that the median frequencies of the signals generated by electrical stimulation and MVE were not significantly different. In conventional bipolar recordings, cross talk in lateral hamstring EMGs averaged 17.1% MVE and in medial hamstring EMGs 11.3% MVE (average-rectified values). The double differential technique significantly reduced cross talk to 7.6% MVE for the lateral hamstrings, and to 4.2% MVE for the medial hamstrings. The double differential technique appears to be more selective than the bipolar technique when recording EMGs from muscles with highly active neighbors and thus should be used in such situations. Software simulations of the double differential technique also appear to be more selective than the bipolar technique and may be used when the number of amplifiers available is limited.     

肛旁脓肿行Ⅰ期根治性手术疗效的探讨

目的：探讨肛旁脓肿行Ⅰ期根治性手术的疗效。方法：对78例肛旁脓肿患者交叉设计分成两组。分别行Ⅰ期根治性手术（RS）和单纯脓肿切开引流（ID），比较术后疗效。结果：RS组病人术后形成肛瘘的发生率远低于ID组。而并发症却无升高趋势，且明显缩短了伤口愈合时间。结论：Ⅰ期根治性手术治疗肛旁脓肿疗效满意，临床使用价值高，值得推广。     

廊坊市农村儿童1987～1993年头胸围及交叉月龄变化的分析

本文通过对我市农村1987、1990、19933个年份中10～24月龄男女儿童头围和胸围及头胸交叉所在月龄变化的分析。表明我市农村儿童随着家庭生活水平的不断提高,其生长发育正处在长期加速阶段。同时可以看到:由于基础较差,在科学育儿方面还有较大差距,尽快克服普遍存在的落后喂养习惯和断奶食品的缺乏已成为进一步提高我市农村儿童生长发育水平的关键.应予充分重视,加以解决。     

Magnetization transfer imaging of multiple sclerosis

While conventional magnetic resonance imaging (MRI) measures signal primarily from the hydrogen nuclei of water, magnetization transfer (MT) MRI indirectly detects macromolecular associated hydrogen nuclei via their magnetic interaction with the observable water. In the normal adult CNS, white matter exhibits the largest MT effect due to the macromolecular content of the highly structured and lipid rich myelin. Pathologies which alter the structural integrity and the relative macromolecular-water composition, such as multiple sclerosis (MS), therefore show abnormal MT. Conventional MRI, which has a high MS lesion detection sensitivity but poor specificity in terms of differentiating the pathological state of a plaque, can thus be supplemented by MT to provide more specific information on the extent of demyelination and axonal loss. In this paper we review the basic concepts of MT imaging and its role in MS lesion characterization.Financial support was provided by the Medical Research Council of Canada, Fonds de la Recherche en Santé du Québec, and the Killam Foundation.     

床边纤维支气管镜检查在可疑院内获得性肺炎诊断中的意义

目的评价床边纤维支气管镜检查在可疑院内获得性肺炎诊断中的意义。方法对25例可疑院内获得性肺炎患者进行床边纤维支气管镜检查，同时进行痰标本和支气管肺泡灌洗液标本涂片细菌检测和培养。结果1例为肺出血，2例肺不张，1例肺水肿；21例为院内获得性肺炎，其中14例(72．7％)细菌培养阳性，革兰阴性杆菌占57．1％(12／21)，以铜绿假单胞菌、不动杆菌属、嗜麦芽假单胞菌、肺炎克雷伯菌最常见，革兰阳性球菌2例(9．5％)，主要是耐甲氧西林金黄色葡萄球菌。痰涂片和支气管肺泡灌洗液涂片阳性者分别为3例和10例。支气管肺泡灌洗液细菌涂片阳性率和细菌培养阳性率均高于痰标本(P=0．02和P=0．005)。结论床边纤维支气管镜检查有助除外疑似院内获得性肺炎的非感染性疾病。支气管肺泡灌洗液标本病原学检测优于痰标本。     

Cotinine determination by immunoassays may be influenced by other nicotine metabolites

Polyclonal rabbit anticotinine antiserum, which can be used for biomonitoring nicotine uptake by the determination of cotinine in body fluids, was checked by a competitive ELISA for its cross-reactivity with nine nicotine metabolites. The highest percentage of relative crossreactivity (about 30%) was observed with trans-3-hydroxycotinine, a metabolite which is known to be excreted in 3-fold higher amounts than cotinine in the urine of human smokers. Therefore, it is possible that cotinine determinations performed by immunochemical methods — especially in urine — may yield overestimated cotinine concentrations.     

Cross education of muscular strength during unilateral resistance training and detraining

Abstract. The purpose of the present study was to examine the changes in maximum voluntary isometric contraction (MVC) in the contralateral untrained limb during unilateral resistance training and detraining, and to examine the factors inducing these changes by means of electrophysiological techniques. Nine healthy males trained their plantar flexor muscles unilaterally 4 days·week^–1 for 6 weeks using 3 sets of 10–12 repetitions at 70–75% of one-repetition maximum a day, and detrained for 6 weeks. Progressive unilateral resistance training significantly (P<0.05) increased MVC, integrated electromyogram (iEMG), and voluntary activation in the trained and contralateral untrained limbs. The changes in MVC after training were significantly correlated with the changes in iEMG in both limbs. No significant changes occurred in MVC, voluntary activation, and iEMG in the contralateral limb after detraining. The changes in MVC after detraining did not correlate with the changes in voluntary activation or iEMG in either limb. Training and detraining did not alter twitch and tetanic peak torques in either limb. These results suggest that the mechanisms underlying cross education of muscular strength may be explained by central neural factors during training, but not solely so during detraining. Electronic Publication