Radiological assessment of elongated styloid process and ossified stylohyoid ligament

In this study a radiological assessment of elongated styloid processes and ossified stylohyoid ligaments was performed on 900 panoramic radiographs of 900 patients. The styloid process(s) were found to be longer than 30 mm in 12 cases; in 8 of these cases elongation was bilateral, and in 4 cases it was unilateral, making a total of 20 elongated processes out of a possible 1800--an incidence of 1.1%. The mean length of the elongated processes was 48.15 mm. Symptoms were present in one case of bilateral elongation.     

Correlation between ossification of the stylohyoid ligament and osteophytes of the cervical spine

OBJECTIVE: To investigate the correlation between ligamentous ossification or osteophytes of the cervical spine and ossification of the styloid process and stylohyoid ligament, and to determine any relation between diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and ossification of the styloid process and stylohyoid ligament. METHODS: Four patients having cervical spine DISH, an elongated styloid process and/or variable patterns of stylohyoid ligament ossification, and clinical findings compatible with Eagle's syndrome are described. Cervical computed tomography scans of 100 patients who also had lateral radiographs of the thoracic spine were reviewed. Point biserial and Spearman rank correlation analysis, McNemar test, chi-squared test, and Fisher's exact test were used to determine correlation between elongation of the styloid process and/or ossification of the stylohyoid ligament and (1) ligamentous ossification or osteophytes of the cervical spine (the characteristic spinal manifestation of DISH), and/or (2) DISH of the thoracic spine. RESULTS: (1) Elongation of the styloid process and variable patterns of ossification of the proximal, middle, and distal parts of the stylohyoid ligament, and (2) enlargement of this ligament were significantly correlated with transverse and anteroposterior dimensions of ligamentous ossification or osteophytes of the cervical spine at various levels. The prevalence of such abnormalities of this process and ligament was not significantly different between the patients with and without thoracic spine DISH. CONCLUSION: Variable types of styloid process-stylohyoid ligament complex abnormalities have significant correlation with ligamentous ossification and osteophytes of the cervical spine.     

Eagle's syndrome and the trauma patient. Significance of an elongated styloid process and/or ossified stylohyoid ligament

The elongated styloid process has been noted in medical literature for hundreds of years and is commonly referred to as Eagle's Syndrome. The presence of anomalous structures is always a concern to therapists and surgeons. The anatomy, embryology, etiology, plus treatment risks are reviewed. The affects of hyperflexion/hyperextension (whiplash) injuries are exacerbated in the presence of this unexpected calcified structure. The clinical significance of Eagle's Syndrome in the treatment of the trauma patient is explored.     

Calcified solitary renal cyst in childhood

There is a 20% incidence of malignancy in renal masses with rim calcification in adults. A case of rim calcification in a solitary renal cyst in a child is presented and the diagnostic approach and surgical management are described. Solitary renal cysts are extremely rare in children, with no reported cases of rim calcification.     

Pioneer in orotracheal intubation: Eugen Tschudy. The first emergency intubation for airway obstruction?

Presented is a case in which there was significant accumulation of In-111 Octreotide in brain infarcts. It is likely that the accumulation was nonspecific and due to breakdown of the blood-brain barrier.     

Tracheal intubation in infants

BACKGROUND: So far only a few cases of carcinoma in situ of the fallopian tube have been reported, but its detailed clinical and pathologic findings, including cytology, have not been fully described. CASE: A 70-year-old female was admitted to our hospital because of irregular genital bleeding. Endometrial smear revealed a small number of atypical cells with a clear background. Hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. Grossly, a grayish white papillary tumor, measuring 1.5 x 1.0 cm, was observed within the lumen of the left fallopian tube. Microscopically, the diagnosis of papillary adenocarcinoma in situ of the left fallopian tube was made according to 1992 International Federation of Gynecologists and Obstetricians fallopian tube staging. CONCLUSION: Although endometrial brush cytology is not sensitive enough to detect a primary carcinoma of the fallopian tube, our case indicates that it may contribute useful information on extrauterine diseases and can detect a stage 0 cancer of the fallopian tube. Clinicians, as well as pathologists, should consider the possibility of fallopian tube cancer if cervical or endometrial cytology shows atypical cells with papillary patterns with a clear background but endometrial curettage cannot prove malignancy.     

Nasotracheal intubation in calves

Nasotracheal intubation can be accomplished in calves by use of a silicone nasotracheal tube of a Murphy design. For intubation, the calf's head and neck should be extended to facilitate tube passage through the naris into the ventral meatus and then through the larynx into the trachea. Preanesthetic medication may assist in tube passage by decreasing the alertness of the calf and decreasing the ability of the calf to swallow the tube into the esophagus. Nasotracheal intubation allows the inhalant anesthetic agent to be delivered with minimal room pollution and less stress to the calf. It would be useful for oral surgery when an orotracheal tube would obstruct the surgical site.     

Medial collateral knee ligament healing. Combined medial collateral and anterior cruciate ligament injuries studied in rabbits

BACKGROUND: Antineutrophil cytoplasmic antibodies (ANCA), particularly perinuclear ANCA (p-ANCA), have been found more frequently in sera from patients with ulcerative colitis (UC) than in sera from Crohn's disease (CD) or unclassified enterocolitis (UE) patients. This 2-center study examined sera from 102 pediatric patients with inflammatory bowel disease (IBD) to evaluate their diagnostic value and assess their relationship with disease features, distribution, activity and treatment. METHODS: The serum ANCA of 102 children with IBD were measured: 33 UC, 64 CD and 5 UE with various disease locations and degrees of activity. The mean age at the onset of symptoms was 10.7 years (1 to 16.3 years). Sera from 26 unaffected first degree relatives and 20 children without IBD were also investigated. ANCA were detected using indirect immunofluorescence of ethanol-fixed granulocytes. RESULTS: There were ANCA in the sera of 24/33 children with UC (73%), 9/64 with CD (14%) and 4/5 with UE (80%). p-ANCA were more frequent than cytoplasmic-ANCA in positive sera: UC = 67%, CD = 57% and UE = 75%. The presence of ANCA was 73% sensitive and 81% specific for a diagnosis of UC, compared to other IBD (p < 0.001). Three children with proved sclerosing cholangitis associated with UC were all positive. There was no link between ANCA-positive sera and disease activity, or other endoscopic or clinical criteria. ANCA were detected in 4/26 first degree relatives (15%) and in 1/20 control subjects (5%). CONCLUSIONS: Because of their sensitivity and specificity, ANCA may be helpful in the clinical assessment of patients with IBD, and especially those with UC. However, there is no link between the pressure of p-ANCA and the site of UC or its activity, so that it cannot be used to monitor medical treatment or surgical indications.     

Laryngotracheal stenosis in children after intubation. Report of five cases

In this study we present a modified diagnostic routine PCR (polymerase chain reaction) technique for the detection of specific enteroviral nucleic acid sequences in human body fluids, the use of which would reduce the number of false-positive results, the costs and the concentration of reagents required in PCR. Cerebrospinal samples, pharyngeal swabs and faeces were tested. To this end, general primers, selected in the highly conserved 5' non-coding region were used, with a closed-tube RT semi-nested PCR protocol, and the PCR product was analysed using a hybridization in solid phase. A total of 32 patients with suspected enteroviral infection, 17 with suspected viral meningitis and 15 with a possible acute enteroviral infection different from meningitis were analysed, and 80% of the patients with possible acute enteroviral infection were PCR-positive. A broad range of enteroviruses can be detected and false-positive results can be reduced. The availability of results in less than 12 h and the lack of need for radiolabelled probes also increase the convenience of this protocol.     

陕西某钒矿石钙化焙烧—酸浸工艺研究

研究了采用钙化焙烧—酸浸工艺从陕西某钒矿石中浸出钒,考察了焙烧温度、添加剂种类与用量、焙烧时间、空气通量、矿石粒度、浸出条件等对钒浸出的影响。试验结果表明,在矿石粒度-100目、焙烧温度920℃、加入4%CaCO3+2%CaCl2作添加剂、空气通量50m3/(m2·h)条件下焙烧4h,然后在硫酸总用量8%、液固体积质量比1.5∶1、常温条件下2段逆流浸出3h,钒浸出率达70%以上。     

Calcified thrombus in the inferior vena cava in infants and children

Calcified thrombi in the prerenal (suprarenal) segment of the inferior vena have a characteristic radiographic appearance that permits accurate "plain film" diagnosis. Most have been fortuitously discovered in infants and young children. None of the affected individuals has had clinical evidence of venous obstruction. Vena caval obstruction is usually incomplete. Uncalcified clot caudal to the calcified thrombus caused complete obstruction of the inferior vena cava and renal veins in one of our patients, a healthy infant; since collateral flow was adequate surgery was not advised. We believe that aggressive diagnostic and therapeutic measures are unnecessary in the management of infants and children with calcified thrombi in the inferior vena cava.     

Awake tracheal intubation in anaesthesia

Endotracheal intubation in the awake patient was used on 500 occasions. Indications and results are discussed and analysed.     

Orotracheal intubation in the newborn

Two patients with Hodgkin's disease and hypoplastic bone marrow underwent splenectomy in an attempt to reverse pancytopenia and to improve chemotherapeutic tolerance. Although the peripheral blood counts were improved, the clinical course was not significantly affected. Infectious complications occurred. This suggests that the peripheral hematologic improvement following splenectomy may not reflect a true improvement in marrow tolerance.     

Difficulty in removal of certain intramedullary nails

Intramedullary nailing is the most common treatment for displaced diaphyseal fractures of the femur and tibia. Gerhard Küntscher introduced the technique of intramedullary nailing to clinical practice in the 1940s, and this method has been the focus of many authors with regard to indications, technique, complications, and outcome. The five cases presented here represent a complication not often reported in recent years: the difficulty in removing an intact intramedullary nail. Inspection of the interlocking nails in four of the cases presented reveals a specific design characteristic: the cross sectional design of the nail prevents the distal, unslotted end of the nail from being extracted from the medullary cavity. This problem is preventable by a change in nail design or the development of absorbable implants.     

Calcified right ventricular fibroma causing outflow obstruction. Report of a case with successful excision

A 5-year-old boy with clinical findings of pulmonic stenosis was found to have a large calcified mass in the right ventricular outflow region and a gradient of 120 mm Hg between the right ventricle and the pulmonary artery. At surgery, an ovalshaped tumor attached to the interventricular septum and obstructing the right ventricular outflow tract was removed. The child survived and is doing well. Histologically, the tumor had the characteristics of fibroma. A hemodynamic study three months after surgery showed almost complete abolishment of the gradient. To our knowledge this is the fifth reported case of calcified right ventricular fibroma with successful operation. In childhood intracardiac calcifications, together with obstruction, are highly suggestive of this lesion.     

Grade Level and Task Difficulty in Learning by Discovery and Verbal Reception Methods.

The present study compared the acquisition, retention, and transfer performance of subjects taught by the verbal reception and discovery methods. First-, third-, and sixth-grade subjects acquired a simple or complex conceptual rule by either the verbal reception or discovery method. The results indicated that discovery subjects took significantly longer than verbal reception subjects to reach the original learning criterion. Verbal reception subjects generally demonstrated performance which was superior to discovery subjects on all measures of retention and transfer. The level of task difficulty interacted with the method of instruction so that increases in task difficulty led to an increase in the differential effectiveness of the two teaching methods. Differences in experience with the two instructional methods was proposed as one of the variables contributing to the above results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple Causes of Difficulty in Insight: The Case of the Nine-Dot Problem.

Theories of insight problems are often tested by formulating hypotheses about the particular difficulties of individual insight problems. Such evaluations often implicitly assume that there is a single difficulty. We argue that the quantitatively small effects of many studies arise because the difficulty of many insight problems is determined by multiple factors, so the removal of 1 factor has limited effect on the solution rate. Difficulties can reside either in problem perception, in prior knowledge, or in the processing of the problem information. We support this multiple factors perspective through 3 experiments on the 9-dot problem (N.R.F. Maier, 1930). Our results lead to a significant reformulation of the classical hypothesis as to why this problem is difficult. The results have general implications for our understanding of insight problem solving and for the interpretation of data from studies that aim to evaluate hypotheses about the sources of difficulty of particular insight problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)