Anatomic considerations of a modified anterior approach to the cervicothoracic junction.

The results of a study on 30 adult human cadavers showed that the anterior aspect of T-3 can be easily exposed through a modified anterior approach to the cervicothoracic spinal junction. Anterior exposure of T-4 caused significant tension on the brachiocephalic vein in 57%; in 7% the vein actually tore. The location of the vital structures is as follows: the left brachiocephalic vein is at T-1 and T-2 in 80%; the aortic arch is at T-2 and T-3 in 90%; the right recurrent laryngeal nerve reaches the tracheoesophageal groove at the level of C-6 in 50%; the thoracic duct empties into the systemic venous system from C-7 to T-2. Adequate exposure of the low cervical to the upper thoracic spine can be obtained with this approach. Preoperative computed tomographic evaluation of the location of the left brachiocephalic vein with respect to the vertebral levels is recommended.

Social skill and depression: a test of cognitive and behavioral hypotheses.

Depression often is characterized by a subjective sense of social inadequacy. Behavioral theories explain this as an accurate perception of a social skills deficit. Cognitive theories explain the experience as the result of a negatively biased self-appraisal, although social skills may be adequate. In order to test these two alternative explanations, 10 depressed and 16 nondepressed female undergraduate students participated in a social interaction task. Performance ratings made by self and others were compared. The depressed subjects did not exhibit either a social skills deficit or a negative bias in their self-evaluation of social skill. However, there were other indications of a negative bias among the depressed subjects. The results do not provide differential support for either cognitive or behavioral theories of depression, but have implications for both.