Outcomes of endoscopic percutaneous suture lateralization for neonatal and infantal bilateral vocal ford paralysis

Abstract Objective: Bilateral Vocal Fold Paralysis (BVFP) is a rare but significant resource of respiratory distress in neonates and infants. The objective of this study was to evaluate the efficacy and functional outcomes of Endoscopic Percutaneous Suture Lateralization (EPSL) for the treatment of BVFP in neonates and infants. Methods: A case series study of nine patients undergoing EPSL for BVFP between January 2019 and June 2021 was conducted. All patients were candidates for tracheostomy prior to EPSL. Demographic features including gender, age at diagnosis and surgery, main symptoms, airway comorbidities, airway support, and etiology were collected preoperatively. Patients were evaluated for breathing, swallowing and phonation postoperatively. Surgical success was defined as the ability to avoid tracheostomy. Functional Endoscopic Evaluation of Swallowing (FEES) was conducted to identify aspiration. Voice evaluation was based on clinical observation. Results: Nine patients underwent ten EPSL procedures (one in the left vocal fold, and nine in the right vocal fold). Eight patients (8/9) were able to successfully avoid tracheostomy and feed orally without aspiration after the procedure. One patient experienced clinical improvement in respiratory support requirements and underwent laparoscopic nissen and gastrostomy tube placement. At the last follow-up, two patients regained normal voice, two patients had mild dysphonia, and five patients had moderate dysphonia. Five patients showed partial return of the contralateral vocal fold function. Conclusion: EPSL is an effective and safe treatment for neonatal and infantal BVFP, which enables patients free from tracheostomy without significant impact on swallowing function or phonation. Level of evidence: Level 4.

Adrenocorticotrophic hormone stimulation in adrenal vein sampling / 中华内分泌代谢杂志

Objective:To explore the value of adrenocorticotrophic hormone (ACTH) stimulation in adrenal vein sampling (AVS) with its effect on the sampling success rate and lateralization determination.Methods:The clinical data of 54 patients with primary aldosteronism (PA) who underwent AVS in Nanjing Drum Tower Hospital from July 2018 to June 2020 were collected retrospectively. Blood samples from bilateral adrenal veins were collected simultaneously at baseline and after ACTH stimulation. The selectivity index (SI), lateralization index (LI), and relative aldosterone secretion index (RASI) were examined.Results:The concentration of serum cortisol level in left and right adrenal vein and peripheral vein increased significantly after ACTH stimulation ( P<0.001). SI of left adrenal vein increased from 18.00 (2.29, 20.29) to 34.76 (12.10, 46.86) , and the SI of right adrenal vein increased from 26.61(5.24, 31.85) to 28.40 (27.65, 56.05, P<0.001). The bilateral vein sampling success rate increased from 80%(43/54) to 93%(50/54). LI decreased from 2.85(1.78, 6.20) at baseline to 2.45(1.40, 6.10) after ACTH stimulation without significant difference( P>0.05). Eleven patients who identified unilateral secretion at baseline demonstrated bilateral after ACTH stimulation, and the RASI of these patients decreased from 0.50 (0.38, 1.25 ) to 0.37 (0.22, 0.84, P=0.019). Conclusion:ACTH stimulation significantly increased SI and the AVS success rate in patients with PA: ACTH stimulation decreased the relative aldosterone secretion in the dominant side of some patients with aldosterone producing adenoma, thus reduced the proportion of identified unilateral PA.

Research progress in the application of functional near infrared spectroscopy in children language development / 中华实用儿科临床杂志

Functional near infrared spectroscopy (fNIRS) is an emerging neuroimaging technology, which has such advantages as non-invasiveness, portability, robustness to motion and no noise over other neuroimaging tools.Therefore, it has important values in the research of children language development.fNIRS has been currently applied to the study of neonatal word recognition, infant speech perception, language functional lateralization, bilingual cognitive mechanism, language related neurodevelopmental disorders, etc.It has a bright future of applications in the field of children language development.

Análisis comparativo de tres modelos de prótesis reversa de hombro basados en los nuevos ángulos de distalización y lateralización / Comparative analysis of three models of reverse shoulder prosthesis based on the new angles of distalization and lateralization

Resumen: Objetivo: Comparar resultados funcionales e imagenológicos de tres modelos protésicos según el índice de lateralización y distalización. En un grupo heterogéneo de diagnósticos (fractura, artropatía de manguito, secuela de fractura y artrosis glenohumeral). Material y métodos: Cohorte prospectiva de 33 pacientes sometidos a prótesis reversa de hombro entre Diciembre 2014 y Julio 2017 con un seguimiento mínimo de un año. Se definieron tres grupos, G: 10 pacientes con Grammont clásico (155o, Glena medializada); B: nueve pacientes con Bio-RSA (155o, glena lateralizada ósea); y A: 14 con Arrow (135o, glena lateralizada metálica). Las variables fueron: datos demográficos, clínicos, funcionales y radiológicos (ángulo de lateralización y distalización). Para el análisis estadístico se utilizaron pruebas de ANOVA, T-test y regresión lineal, con una significancia estadística de 5%. Resultados: El ángulo de lateralización del hombro (LSA) fue significativamente mayor en el grupo A (98o A, 79o G, 80o B) (p < 0.05). El ángulo de distalización del hombro (DSA) del grupo B fue significativamente superior al A (52o B, 39o A) (p < 0.05) y no significativamente superior al G (48o G) (p = 0.06). No se demostró una correlación entre el LSA y DSA con la rotación externa (p = 0.51) y elevación activa (p = 0.41), respectivamente. En índices clínicos (elevación anterior, rotación externa, rotación interna) y funcionales (índice Constant ajustado y evaluación subjetiva de hombro) no encontramos diferencias significativas entre los distintos modelos protésicos (p > 0.05). Conclusiones: El ángulo de lateralización fue mayor en el modelo Arrow y distalización en el modelo Bio-RSA. No encontramos correlación clínica-radiológica en esta serie heterogénea de pacientes.

Abstract: Purpose: Compare functional and radiological outcomes of three different designs of reverse shoulder arthroplasty according to distalization and lateralization shoulder angle, in heterogenic diagnostics (fracture, cuff arthropathy, fracture sequela and osteoarthritis). Material and methods: Prospective cohort of 33 patients of reverse shoulder arthroplasty (RSA) between December 2014 and July 2017 with a minimum one year of follow-up. We defined three groups, G: 10 patients with Grammont (155o, Medialized Glena), B: 9 patients with Bio-RSA (155º, lateralized bone glena) and A: 14 patients with Arrow (135o, lateralized metallic glena). We analyze demographic, clinical, functional and radiological outcomes (lateralization shoulder angle (LSA) and distalization shoulder angle (DSA)). For the statistical analysis, ANOVA, T-tests and linear regression tests were used, with a statistical significance of 5%. Results: The LSA was significantly higher in group A (98o A, 79o G, 80o B) (p < 0.05). In DSA, group B was significantly higher than A (52o B, 39o A) (p < 0.05) and not significant to G (48o G) (p = 0.06). There was no correlation of LSA and DSA with external rotation (p = 0.51) and active elevation (p = 0.41), respectively. There was no significant clinical (anterior elevation, external rotation, internal rotation) and functional outcomes (adjusted Constant score and subjective shoulder evaluation) differences between the different RSA models (p > 0.05). Conclusions: The LSA was higher in the Arrow and the DSA was higher in Bio-RSA. We did not find Clinical - Radiological correlation in this heterogeneous series of patients.

Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty / Resultados clínicos iniciais da utilização de radiofrequência e lateralização das conchas nasais inferiores combinadas à septoplastia

Abstract Introduction: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. Objective: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. Methods: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients' preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. Results: The mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05). Conclusion: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Resumo Introdução: A obstrução mecânica é a forma mais comum de obstrução nasal. Entre os tipos de obstruções mecânicas, o desvio do septo e a hipertrofia de conchas inferiores são os mais prevalentes. Objetivo: Avaliar os resultados clínicos iniciais da aplicação de radiofrequência nas conchas inferiores e a lateralização delas combinada com septoplastia no tratamento dos sintomas de obstrução nasal. Método: O estudo avaliou retrospectivamente dados de 33 pacientes (24 homens, nove mulheres) que foram submetidos a septoplastia e aplicação de radiofrequência no concha inferior (grupo RF) e 32 pacientes (24 homens, oito mulheres) submetidos a septoplastia e lateralização de concha inferior (grupo LAT), que foram admitidos com queixas de obstrução nasal na University of Health Sciences, Departamento de Otorrinolaringologia, entre 1° de janeiro de 2017 e 1° de janeiro de 2018. Os sintomas pré-operatórios e pós-operatórios de 6 meses dos pacientes foram avaliados pela escala NOSE, do inglês Nasal Obstruction Symptom Evaluation. Resultados: Os escores médios pré-operatórios da escala NOSE foram 10,3 ± 4,2 no grupo RF e 10,9 ± 4,9 no grupo LAT e os escores médios pós-operatórios de seis meses foram 1,09 ± 1,3 no grupo RF e 1,2 ± 1,3 no grupo LAT. Não houve diferença significante nos escores da escala NOSE entre os dois grupos (p > 0,05). Conclusão: Os dados obtidos neste estudo mostram que ambos os métodos têm resultados semelhantes em termos de alívio dos sintomas de obstrução nasal em pacientes que necessitam de intervenção nas conchas inferiores. Portanto, os pesquisadores acreditam que, em cada caso, o método de intervenção deve ser selecionado a critério do paciente e do cirurgião.

Activación Hemisférica Cerebral en Adultos Jóvenes Mientras Ejecutan Tareas Ortográficas Utilizando fMRI / Hemispheric Brain Activation in Young Adults While Performing Orthographic Tasks Using fMRI

Resumen El dominio del lenguaje escrito se basa en la consolidación de representaciones neurales complejas de los patrones ortográficos de las palabras. En virtud de explorar las características presentes en procesos neurales relacionados con la especialización ortográfica, se estudiaron con métodos de imagen por resonancia magnética funcional los niveles neurales de activación intrahemisférica de 27 jóvenes con alto y bajo rendimiento ortográfico mientras ejecutaban tareas ortográficas. Los resultados sugieren que, en participantes con alto rendimiento ortográfico, la intensidad de activación neural en el hemisferio izquierdo no difiere ante el estímulo de palabras o pseudohomófonos (palabras con error ortográfico); en cambio, difieren cuando se emiten respuestas correctas vs. incorrectas. En participantes con bajo rendimiento ortográfico no se encontró diferencia interhemisférica en ninguna tarea. Se encontró tendencia de que los participantes con bajo rendimiento ortográfico tienen mayor dispersión de la activación neural, respecto a los participantes con alto rendimiento, en el hemisferio derecho e izquierdo, además, en participantes con bajo rendimiento ortográfico se encontró tendencia de que la detección consciente aumenta la variación de la activación neural; sin embargo, no se encontró evidencia estadística concluyente. Este estudio ha abonado a la evidencia de la existencia de la especialización neural orientada a habilidades ortográficas.

Abstract The written language domain is based on the consolidation of complex neural representations of words' orthographic patterns. Here, we studied the characteristics and differences of the neural activation levels that occur in the neural processes related to orthographic specialization, with functional magnetic resonance imaging, in each hemisphere, of 27 young adults with low and high orthographic abilities when they performed orthographic tasks. The results suggest that in high-orthographic-performance participants' left hemispheric neural activation does not vary between words and pseudohomophones; otherwise, their neural activation variates in incorrect vs. correct responses. There were not found interhemispheric differences in low-orthographic-performance participants where they performed any type of task. There were some tendency in the low-orthographic-performance participants to have greater neural activation dispersion, regarding the high-orthographic-performance participants, in both hemispheres, also, there were found tendency in low-orthographic-performance participants to have greater neural activation variation in explicit tasks; nevertheless, there is not enough conclusive statistic evidence. This study increases the evidence of lateralized neural specialization of orthographic abilities.

Skull asymmetries in wild boar (Sus scrofa LINNAEUS, 1758) / Assimetrias do crânio de javalis (Sus scrofa LINNAEUS, 1758)

Organisms can develop different kinds of asymmetry when deviations from expected perfect symmetry occur. Among others are fluctuating asymmetry (FA) and directional asymmetry (DA). FA represents small random differences between corresponding parts on the left and right sides of an individual in bilaterally paired structures. It is thought that FA reflects an organism's ability to cope with genetic and environmental stress during growth. DA occurs whenever one side on the plane of symmetry develops more than the other side, and has a genetic component. In this research, we examined the expression of morphological symmetry in 38 skulls of different age groups of wild boar (Sus scrofa), on their ventral aspect, using two-dimensional coordinates of 27 landmarks. Analyses showed the presence of significant FA and DA in the entire sample, detecting also distinctive differences between age groups. The obtained results show that the shape differences in different age groups could reasonably be a consequence of a response to environmental factors for FA and a masticatory lateralization for DA.(AU)

Os organismos podem desenvolver diferentes tipos de assimetria quando ocorrem desvios da pefeita simetria esperada. Entre os diversos tipos de assimetria existentes duas merecem especial destaque: a flutuante (AF) e a directional (AD). A AF é representada por pequenas diferenças casuais entre as partes correspondents das laterais direita e esquerda de um indivíduo em estruturas pareadas bilateralmente; acredita-se que elas reflitam a habilidade de um organismo adaptar-se a fatores estressantes genéticos e ambientais observados durante o seu crescimentos. A AD ocorre quando um lado da assimetria plana desenvolve-se mais do que o outro e há um componente genético. No presente trabalho foi analisada a expresssão da simetria morfológica de 38 crânios de diferentes grupos etários de javalis (Sus scrofa), nos seus aspectos ventrais, com o emprego de duas coordenadas dimensionais de 27 pontos anatômicos homólogos. As análises efetuadas revelaram a existência de valores significantes de AF e AD em toda a amostra trabalhada, detectando inclusive diferenças entre os grupos etários. Os resultados obtidos demonstraram que as diferentes formas observadas nos diferentes grupos etários podem ser consequência de uma resposta a fatores ambientais para a AF e a lateralização da mastigação para a AD.(AU)

Anestesia espinal unilateral para cirugía ortopédica ambulatoria: evaluación de una dosis mínima de bupivacaína hiperbara asociada a lateralización: ¿es posible el éxito? / Unilateral spinal anaesthesis for orthopaedic ambulatory surgery: evaluation of a mininal dose of hyperbaric bupivacaine associated with side positioning: Is success posible?

INTRODUCCIÓN: la anestesia espinal unilateral (AEU) es una alternativa para el desarrollo de la cirugía ortopédica ambulatoria (COA). el OBJETIVO de este ensayo clínico fue el evaluar una dosis baja de bupivacaína hiperbara (BHB), asociada a fentanilo intratecal (FI) para obtención de AEU en COA. MATERIALES Y MÉTODOS: ensayo clínico, prospectivo, controlado en pacientes ASA I a II. la AEU se efectuó con el paciente en decúbito lateral (DL), con el lado operatorio hacia abajo, a nivel de L3-L4. se inyectó 5 mg de BHB 0,75% asociado a 20 µg de FI. se evaluó el bloqueo sensitivo (BS) y motor (BM) cada 3 minutos, los primeros 20 minutos y luego cada 15 minutos. Se midió el nivel máximo alcanzado, el tiempo de regresión a T12 y el tiempo de regresión de dos segmentos. se registró la incidencia de complicaciones. RESULTADOS: 50 pacientes fueron incluidos, 66% de sexo masculino. Se obtuvo anestesia unilateral en el 84% y BM total unilateral en el 86%. La altura del BS osciló entre T9 y T11. la duración del BS fue 116 min. (SD± 23). la regresión a T12 fue de 47 min (SD±19). No se encontró correlación entre talla, dosis y duración de bloqueo. ningún paciente necesitó anestesia general. 1 paciente presentó bradicardia. DISCUSIÓN: la AEU con dosis bajas de BHB asociado a FI es eficiente en COA. se obtuvo adecuados BS y BM en la mayoría de los pacientes. la AEU mostró ser confiable, permitiendo una alta precoz y segura.

INTRODUCTION: The unilateral spinal anesthesia (USA) is an alternative for orthopedic ambulatory surgery (OAS). The AIM of this study was to evaluate a low dose of hyperbaric bupivacaine (HB) associated with intrathecal fentanyl (ITF) to produce USA. MATERIALS AND METHODS: Prospective, controlled clinical trial in ASA I ­II patients. The USA was developed in lateral position with the operating side downwards between L3-L4 space with 5 mg of HB + 20 µg ITF. We evaluated sensitive level block (SB), motor level block (MB), maximum level obtained, discharge time (DT) and collateral effects incidence. RESULTS: 50 patients were included, 66% male. The USA was obtained in 84% and total BM was present in 86% of cases. The level obtained of SB was between T9-T11 and the duration was 116 min (SD± 23). No correlation was obtained between patients height, BH dose and block duration. 1 patient presented bradycardia. No general anesthesia was necessary. DISCUSSION: The USA with a low dose of HB and ITF it's safe to developed OAS. Only 11 min were necessary to obtain a good SB and MB.

Técnicas de transposição/lateralização do nervo alveolar inferior ­ uma revisão da literatura sobre o déficit neurossensorial e a taxa de sucesso dos implantes dentários / Transposition/lateralization techniques for the inferior alveolar nerve ­ a literature review on the neurosensorial and dental implant success rates

Objetivo: comparar as técnicas de lateralização (LNAI) e transposição do nervo alveolar inferior (TNAI) com a taxa de disfunção neurossensorial, bem como a taxa de sucesso dos implantes dentários. Material e métodos: uma pesquisa foi realizada no período de 1987 a 2016, no banco de dados Medline/PubMed, com as palavras-chave "implantes dentários", "nervo alveolar inferior", "lateralização", "transposição", "neurossensorial" e "taxa de sucesso". Foram incluídos artigos retrospectivos e prospectivos em seres humanos, e que apresentassem relatos de disfunção neurossensorial e taxa de sucesso dos implantes dentários na região posterior da mandíbula, após procedimentos de lateralização ou transposição do nervo alveolar. Resultados: dos 142 artigos encontrados na primeira fase de seleção, apenas 26 foram incluídos na técnica LNAI, com um total de 524 procedimentos, sendo 228 na técnica de TNAI e 296 na LNAI, que foram incluídos neste estudo. O número de implantes instalados pela técnica de TNAI foi de 625, e pela técnica de LNAI foi de 401. As técnicas de TNAI apresentaram um índice inicial maior de disfunção neurossensorial, quando comparadas à técnica de LNAI. A taxa de sucesso dos implantes para a té cnica de TNAI ficou entre 80% e 100%, e para a té cnica de LNAI fi cou entre 90,5% e 100%. Conclusão: a LNAI vem sendo uma boa indicação para a reabilitação de mandíbulas atróficas verticalmente, e sua execução com o piezo diminui o risco de distúrbio sensorial. As altas taxas de sucesso dos implantes podem ser atribuídas à possibilidade da instalação de implantes longos com ancoragem bicortical, favorecendo a estabilidade primária e a biomecânica.

Objective: to compare lateralization techniques (LNAI) and transposition of the inferior alveolar nerve (TNAI) with the rate of sensorineural dysfunction, as well as the success rate of dental implants. Material and methods: a survey was carried out between 1987 and 2016 in the Medline/PubMed database, with the key words "dental implants", "inferior alveolar nerve", "lateralization", "transposition", "neurosensorial", "success rate". Retrospective and prospective articles in humans that presented reports of sensorineural dysfunction and success rate of dental implants in the posterior region of the mandible after procedures of lateralization or transposition of the alveolar nerve were included. Results: in the fi rst phase of the selection, 142 articles were retrieved, but only 26 articles on LNAI, with a total of 524 procedures, 228 on TNAI technique and 296 the LNAI, were included in the study. The number of implants installed by the TNAI technique was 625 and by the LNAI 401. The TNAI present a higher initial index of sensorineural dysfunction than the LNAI and the success rate of the implants was for the TNAI between 80% to 100%, and for the LNAI between 90.5% and 100%. Conclusion: LNAI has been a good indication for the rehabilitation of atrophic mandibles vertically and its execution with piezo reduces the risk of sensory disturbance. The high success rates of implants can be attributed to the possibility of installing long implants with bicortical anchoring favoring primary stability and biomechanics.

Effects of an Auditory Lateralization Training in Children Suspected to Central Auditory Processing Disorder

BACKGROUND AND OBJECTIVES: Central auditory processing disorder [(C)APD] refers to a deficit in auditory stimuli processing in nervous system that is not due to higher-order language or cognitive factors. One of the problems in children with (C)APD is spatial difficulties which have been overlooked despite their significance. Localization is an auditory ability to detect sound sources in space and can help to differentiate between the desired speech from other simultaneous sound sources. Aim of this research was investigating effects of an auditory lateralization training on speech perception in presence of noise/competing signals in children suspected to (C)APD. SUBJECTS AND METHODS: In this analytical interventional study, 60 children suspected to (C)APD were selected based on multiple auditory processing assessment subtests. They were randomly divided into two groups: control (mean age 9.07) and training groups (mean age 9.00). Training program consisted of detection and pointing to sound sources delivered with interaural time differences under headphones for 12 formal sessions (6 weeks). Spatial word recognition score (WRS) and monaural selective auditory attention test (mSAAT) were used to follow the auditory lateralization training effects. RESULTS: This study showed that in the training group, mSAAT score and spatial WRS in noise (p value≤0.001) improved significantly after the auditory lateralization training. CONCLUSIONS: We used auditory lateralization training for 6 weeks and showed that auditory lateralization can improve speech understanding in noise significantly. The generalization of this results needs further researches.

Speech-ABR Representations and Non-lateralization Effect for the Stimulation Intensity / 听力学及言语疾病杂志

Objective To investigate the effects of stimulation intensity on subcortical auditory processing of speech and assess the subcortical asymmetry of speech elements at the brainstem level using speech evoked auditory brainstem response (s-ABR) ,so as to provide more clues for the mechanism of speech cognitive behaviors .Meth‐ods Speech syllables /da/with three intensities(40 dB HL ,60 dB HL and 80 dB HL) were presented monaurally to 29 normal hearing adults ,and corresponding s-ABRs were recorded .The stimulus and response parameters ,inclu‐ding latency and amplitude in time domain ,fundamental frequency and formants in frequency domain were analyzed statistically .Results With the increase of stimulation intensity ,significant shorter latency and larger amplitude were observed for the feature peaks of s-ABR (P<0 .05) .The latency changes corresponding to the same intensity increment were at variance with the periodic components and the transient components .The fundamental frequency and formants of the stimulus syllables that extracted preferably from s - ABRs were encoded less vigorously in ascending order which was the same as that for the intensity .The responses to the right and left monaural stimula‐tion resembled without significant lateralized difference .Conclusion The s -ABR is able to encode faithfully the speech sound in terms of timing and spectrum components with high correspondence with the stimulus intensity .The different latency characteristics of periodic components and transient responses may imply more underlying coding information of speech sound .However ,lateral asymmetry speech processing is not considerable at the brainstem level .

Asymmetry, handedness and auricle morphometry / Asimetría, lateralidad y morfometría de la oreja

The aims of this study were to determine various morphometric measurements of auricle, to investigate asymmetry and its relation with handedness in both sexes. Main morphometric measurements of both auricles and hand preferences were determined on 200 male and 200 female healthy university students. All measurements of the auricles were larger in males than the corresponding ones in females and all the differences except earlobe widths were statistically significant. All measurements of left and right auricles were statistically significantly different in both sexes except earlobe length in males, and distance from the highest point of the auricle to the bottom of the intertragic notch and earlobe length in females. Auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch had higher values at the left side and all other measurements were larger at the right side. There was no significant difference between the measurements of the corresponding auricles of the righthanded and lefthanded subjects. All measurements were larger at the right side except auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch in righthanded and lefthanded subjects and all differences except earlobe length were significantly different in righthanded subjects as in the total population but in lefthanded subjects the difference of the auricle width was not significant, either. There was an apparent asymmetry of right and left auricles of normal people in the current study which should be taken in to consideration in plastic surgeries of the external ear, designing the ear devices and forensic applications of earprints.

El objetivo de este estudio fue determinar diversas mediciones morfométricas de la oreja, para investigar la asimetría y su relación con el uso de las manos en ambos sexos. Se realizaron mediciones morfométricas de los pabellones auriculares y las manos de 400 estudiantes universitarios (200 hombres y 299 mujeres). Todas las medidas de las orejas fueron mayores en los hombres y todas las diferencias, excepto las correspondientes al ancho del lóbulo auricular, fueron estadísticamente significativas. Todas las mediciones de los pabellones auriculares izquierdos y derechos presentaron diferencias estadísticamente significativas en ambos sexos, excepto en el caso de la longitud del lóbulo auricular en los hombres, y la distancia desde el punto más alto de la oreja a la parte inferior de la incisura intertrágica en el lóbulo auricular de las mujeres. La longitud de la oreja y la distancia desde el punto más alto de la misma a la parte inferior de la escotadura intertrágica tenían valores más altos en el lado izquierdo y todas las demás mediciones fueron más elevadas en el lado derecho. No hubo diferencia significativa entre las mediciones de las orejas correspondientes a los sujetos diestros y zurdos. Todas las mediciones fueron superiores en el lado derecho, excepto la longitud del pabellón auricular y la distancia desde el punto más alto de la oreja a la parte inferior de la incisura intertrágica en sujetos diestros y sujetos zurdos, y todas las diferencias, excepto la longitud del lóbulo auricular, fueron significativamente diferentes en los sujetos diestros como en la población total, pero en sujetos zurdos la diferencia de la anchura de la oreja no fue significativa. Se encontró una aparente asimetría en las orejas derecha e izquierda de los sujetos del presente estudio que debe tenerse en consideración en las cirugías plásticas del oído externo, para el diseño de los dispositivos de audición y para su aplicación en estudios forenses de las huellas de la oreja.

Exploración de las propiedades psicométricas de la Batería Montreal de Evaluación de Amusia en una muestra de sujetos con epilepsia de lóbulo temporal / Exploration of the psychometric properties of the Montreal Battery of Evaluation of Amusia in a sample with temporal lobe epilepsy

ANTECEDENTES: La Batería Montreal de Evaluación de Amusia (MBEA) es un instrumento de reciente creación, utilizado para evaluar percepción y memoria musical asociadas al funcionamiento de lóbulos temporales. La epilepsia de lóbulo temporal no sintomática (ELTns) es una condición de alta prevalencia en México; esto proporciona una oportunidad para evaluar la MBEA, considerando que las crisis epilépticas pueden producir alteraciones neuropsicológicas específicas según la localización lobular y la lateralización de foco epileptogénico (LFE). OBJETIVO: Explorar las propiedades psicométricas y diagnósticas de la MBEA. MÉTODO: Dos muestras no probabilística de 31 controles y 22 casos de epilepsia ELTns fueron evaluados con la MBEA. Se utilizaron asimismo los datos estandarizados originales de la MBEA para comparación de controles. RESULTADOS: El análisis con prueba t mostró desempeños significativamente menores de los casos en comparación con los controles y significativamente menores entre controles y la norma. No se encontraron diferencias significativas en los puntajes según LFE. El análisis por Curvas ROC mostró propiedades cuestionables de sensibilidad y especificidad en la MBEA utilizando la ELTns como variable de estado. DISCUSIÓN Y CONCLUSIÓN: Se hallaron alteraciones en funciones de percepción musical en los casos; sin embargo, se detectaron inconsistencias teóricas con respecto a la relación de funciones afectadas. Las diferencias entre el grupo control y la norma apuntan a continuar evaluando la MBEA en población mexicana. La MBEA parece ser una medida poco precisa en términos de sensibilidad y especificidad para las alteraciones amúsicas en la ELTns, y su utilidad como medida de apoyo en la determinación de LFE permanece incierta.

BACKGROUND: The Montreal Battery of Evaluation of Amusia (MBEA) is a newly developed instrument to assess music perception and memory, associated to temporal lobe functioning. The non-symptomatic temporal lobe epilepsy is a prevalent condition in Mexico, and it gives an opportunity to test the MBEA, considering the fact that epileptic seizures can cause neuropsychological impairment according to lobar localization and hemispherical lateralization of the epileptogenic foci. OBJECTIVE: To explore the psychometric and diagnostic properties of the MBEA. METHOD: Two non-probabilistic samples of 31 control subjects and 22 cases with non-symptomatic temporal lobe epilepsy were assessed with the MBEA. Data from the original validation were used to compare with the control group. RESULTS: Analysis with t test showed significantly lower performances in the case group relative to controls, and a general lower performance of controls compared to the norm. There was no significant difference in performance between cases with left epileptogenic foci and cases with right epileptogenic foci. ROC curve analysis showed questionable properties of sensitivity and specificity in the MBEA. DISCUSSION AND CONCLUSION: Impairments in music perception were found in cases, although theoretical inconsistences with respect to relation between impaired functions were also detected. The performance of the control group relative to the norm aims to the continuation of the validation process, considering cultural differences. The MBEA seems to be a poor measure in terms of sensibility and specificity for the detection of amusic impairments in subjects with non-symptomatic temporal lobe epilepsy, and its utility for determining hemispheric lateralization of epileptogenic foci remains uncertain.

Effects of Attention Training on Interference Effect of Dual-task Paradigm in Poststroke Nonfluent Aphasiacs:A Functional Magnet-ic Resonnce Imaging Study / 中国康复理论与实践

Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference ef-fect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respec-tively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by in-terference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateraliza-tion index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solv-ing the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.

Isometric muscle force, rate of force development and knee extensor neuromuscular efficiency asymmetries at different age groups / Assimetrias na força muscular isométrica, taxa de desenvolvimento de força e na eficiência neuromuscular de extensores do joelho em diferentes faixas de idade

The aim of this study was to evaluate force, rate of force development and knee extensor neuromuscular efficiency asymmetries in children, adults and elderly. Each subject performed maximal isometric voluntary contractions (MIVC) and submaximal trials (15% and 30% MIVC). Maximal force, rate of force development (RFD) and neuromuscular efficiency were evaluated and compared between groups and between preferred and non-preferred lower limb. Children (mean age 8.4, SD 0.7 yrs), female adults (mean age 23.2, SD 3.5 yrs) and elderly (mean age 65.9 SD 7.0 yrs) were evaluated. RFD was higher in young adults, and similar between children and elderly. Neuromuscular efficiency decreased significantly with aging (P<0.05). Inter-limb asymmetries were observed for force and RFD in favor of the preferred lower limb in the elderly (P<0.05). Force and RFD asymmetries in the elderly are supported by the right hemisphere-aging model contributing to increased motor asymmetries. It was suggested that both physical assessment and training in the elderly should consider asymmetries that apparently are inherent to the aging process. A simple protocol for maximal and submaximal force assessment may be useful for delineating impairments in force and power in the elderly.

Neste estudo, avaliamos assimetrias na força, taxa de desenvolvimento de força (TDF) e eficiência neuromuscular de extensores de joelho em crianças, adultos e idosos. Cada sujeito realizou contrações isométricas voluntárias máximas e submáximas (15% e 30% da contração isométrica voluntária máxima). Força máxima, TDF e eficiência neuromuscular foram avaliadas e comparadas entre os grupos e entre perna preferida e não-preferida. Foram avaliadas crianças (média de idade de 8,4 ± 0,7 anos), adultos (média de idade de 23,2 ± 3,5 anos) e idosos (média de idade de 65,9 ± 7,0 anos), do sexo feminino. A TDF foi maior em adultos jovens, e similar entre crianças e idosos. A eficiência neuromuscular diminuiu significativamente com o envelhecimento (P<0,05). Foram observadas assimetrias em força e TDF em favor da perna preferida em idosos (P<0,05). Assimetrias em força e TDF em idosos podem ser justificadas por fatores neurais, como a mudança em favor do hemisfério cerebral direito, levando a assimetrias motoras. Este resultado sugere que tanto a avaliação física quanto o treinamento em idosos deve levar em consideração assimetrias, que parecem ser inerentes ao processo de envelhecimento. Assim, um protocolo simples para avaliar a força máxima e submáxima pode ser útil para quantificar déficits de força e potência em idosos.

Cerebral Lateralization of Pro- and Anti-Social Tendencies

Mounting evidence suggest that the right-hemisphere (RH) has a relative advantage, over the left-hemisphere (LH), in mediating social intelligence - identifying social stimuli, understanding the intentions of other people, awareness of the dynamics in social relationships, and successful handling of social interactions. Furthermore, a review and synthesis of the literature suggest that pro-social attitudes and behaviors are associated with physiological activity in the RH, whereas unsocial and anti-social tendencies are mediated primarily by the LH. This hemispheric asymmetry is rooted in several neurobiological and functional differences between the two hemispheres. (I) Positive social interactions often require inhibiting one's immediate desires and considering the perspectives and needs of others. Given that self-control is mediated by the RH, pro-social emotions and behaviors are, therefore, inherently associated with the RH as it subserves the brain's self-restraint mechanisms. (II) The RH mediates experiences of vulnerability. It registers the relative clumsiness and motor weakness of the left limbs, and it is involved, more than the LH, in processing threats and mediating fear. Emotional states of vulnerability trigger the need for affiliation and sociality, therefore the RH has a greater role in mediating pro-social attitudes and behaviors. (III) The RH mediates a holistic mode of representing the world. Holistic perception emphasizes similarities rather than differences, takes a long-term perspective, is associated with divergent thinking and seeing other points-of-view, and it mediates a personal mode of relating to people. All these features of holistic perception facilitate a more empathetic attitude toward others and pro-social behaviors.

Chinese Characters Processing of Healthy Subjects:A Functional Magnetic Resonnce Imaging Study / 中国康复理论与实践

Objective To investigate the Chinese characters processing in healthy subjects with functional magnetic resonance imaging (fMRI). Methods 10 healthy subjects were asked to finish the dual-task paradigm Keying/Reading and single-task paradign Keying or Read-ing. The active area and partial lateralization index in brains of them were investigated with fMRI with block design. Results and Conclu-sion The tasks activated the right inferior frontal gyrus, bilateral parietal and cerebellar cortex. The laterality index showed that the left brains were more active in the tasks.

Dichotic Perception of Modern Chinese Tones by Mexican Chinese Learners / 听力学及言语疾病杂志

Objective To investigate the relationship between the advantageous ear (cerebral hemisphere) of Spanish-speaking Mexican Chinese learners and category's perception of the Chinese tones .Methods Four types of Chinese syllables tones were used as experimental materials with dichotic listening technology to test the Spanish -speaking Mexican Chinese learners who studied Chinese about 60~70 hours ,20~27years old(mean is 21 .29 ± 2 .3) , and then the correct response time and error rate were made a count on .Results In terms of reaction time for iden-tifying the four Chinese tones ,the Spanish-speaking M exican Chinese learners's reaction to the first tone suggested that their right ear were the advantageous ear (the left cerebral hemisphere) .As for the main effects of both hands , the first tone suggested that the Spanish -speaking Mexican Chinese learners had a left hand advantage .The Span-ish -speaking Mexican Chinese learners's reaction to the sencond tone suggested that their right ear were the advan-tageous ear(the left cerebral hemisphere) with the left hand used as a hand of reaction ,and the Spanish-speaking Mexican Chinese learners's reaction to the second tone suggested that their left ear were the advantageous ear (the right cerebral hemisphere) with the right hand used as a hand of reaction .In terms of error rate for identifying the four Chinese tones ,the Spanish-speaking M exican Chinese learners's reaction to the third tone suggested that their right ear were the advantageous ear (the left cerebral hemisphere) with the left or right hand used as a hand of reac-tion ,but the fourth's identification didn't show the advantageous ear .Conclusion M exican Chinese learners identify the first and third tones of Modern Chinese the right ear (the left cerebral hemisphere) main effects were significant . Identifying the second tone of Modern Chinese ,Mexican Chinese learners'right ears (the left cerebral hemisphere)or right ears (the left cerebral hemisphere) were the advantageous ear (the advantageous cerebral hemisphere) or not depend on the reaction of hands .Identifying the fourth tones ,Mexican Chinese learners'left or right ear (left or right cerebral hemisphere) main effects weren't significant .

An experiment set-up for analysis of lateralization judgments of binaural stimuli

INTRODUCTION: The aim of this work is to present a physical implementation of a noninvasive methodology to analyze the directional sensitivity of human auditory system. A computer controlled experiment set-up has been designed and developed to study the behavior of human subjects under the presentation of interaural time delays and interaural amplitude differences for several sensation levels. METHODS: The proposed methodology comprises: the application of trains of low-pass filtered narrow pulses as acoustic binaural stimuli; the automatic, simultaneous and random variation of interaural time delays and interaural amplitude differences; the absence of human interference along the experimental sessions, except for the decision of the listener under test; the minimization of adaptation effects. RESULTS: Numerous lateralization judgments have been accomplished in order to investigate the transduction mechanism which allows deciding which side of subjects medial plane the source of binaural acoustic stimuli is located in. The behavior of decision time with the order of judgment, the sensation levels and the interaural differences in time and amplitudes has been analyzed. CONCLUSION: The noninvasive, reliable and automatic approach here presented allows obtaining psychophysical responses associated to the neuro-physiological phenomena underneath lateralization capability.

Right cerebral hemisphere and central auditory processing in children with developmental dyslexia / El hemisferio cerebral derecho y el procesamiento auditivo central en ninos con dislexia del desarrollo

Objective We hypothesized that if the right hemisphere auditory processing abilities can be altered in children with developmental dyslexia (DD), we can detect dysfunction using specific tests. Method We performed an analytical comparative cross-sectional study. We studied 20 right-handed children with DD and 20 healthy right-handed control subjects (CS). Children in both groups were age, gender, and school-grade matched. Focusing on the right hemisphere’s contribution, we utilized tests to measure alterations in central auditory processing (CAP), such as determination of frequency patterns; sound duration; music pitch recognition; and identification of environmental sounds. We compared results among the two groups. Results Children with DD showed lower performance than CS in all CAP subtests, including those that preferentially engaged the cerebral right hemisphere. Conclusion Our data suggests a significant contribution of the right hemisphere in alterations of CAP in children with DD. Thus, right hemisphere CAP must be considered for examination and rehabilitation of children with DD. .

Objectivo Examinamos si las habilidades del procesamiento auditivo central (PAC) del hemisferio derecho se encuentran alteradas en niños con dislexia del desarrollo (DD), por medio de pruebas específicas. Método Realizamos un estudio comparativo transversal. Estudiamos 20 niños diestros con DD y 20 niños controles (C) sanos. Los niños de ambos grupos fueron pareados por edad, género y grado escolar. Utilizamos varias pruebas para medir alteraciones del PAC, tales como: determinación de patrones de frecuencia; duración del sonido; reconocimiento de tono musical e identificación de sonidos ambientales, enfatizando la contribución del hemisferio derecho. Comparamos los resultados entre los niños con DD y C. Resultados Los niños con DD mostraron menores puntuaciones que los C en todas las subpruebas del PAC, incluyendo aquellas que involucran preferencialmente al hemisferio cerebral derecho. Conclusión Los datos obtenidos sugieren una contribución significativa del hemisferio derecho para producir alteraciones del PAC en niños con DD. Por lo tanto, las PAC que involucran al hemisferio derecho deben ser consideradas en la evaluación y rehabilitación de niño s con DD. .