Is Precise Targeting of the Recipient Artery in a Superficial Temporal Artery–Middle Cerebral Artery Anastomosis Crucial?

Objective To investigate the difference in treatment outcomes according to the method used to select the recipient artery in superficial temporal artery–middle cerebral artery (STA-MCA) anastomoses. Methods We retrospectively analyzed the cases of 35 patients who underwent an STA-MCA anastomosis for internal carotid artery/MCA occlusion or stenosis. Patients were divided into two groups based on whether the recipient artery was precisely targeted by single-photon emission computed tomography (SPECT group) or less precisely targeted by visual assessment (Visual group). Then the bypass results in both groups were evaluated postoperatively based on changes in the regional cerebral blood flow (rCBF) and clinical outcomes. Results The delineated recipient artery in magnetic resonance angiography (MRA) matched the intraoperatively selected artery in 87.6% of the SPECT group cases and 83.3% of the Visual group cases. The SPECT group's digital subtraction angiography (DSA) findings coincided with the intraoperative selection in 76.9% of cases, and the MRA findings corresponded with the DSA findings in 92.3%. The postoperative areas with increased rCBF matched the perfused areas of intraoperatively selected arteries in 80.0% of the SPECT group cases and 77.8% of the Visual group cases. Postoperatively increased rCBF areas matching totally or partially with preoperative low-perfusion areas were observed in all cases. Conclusions The present results revealed no significant differences in the change in rCBF in the low-perfusion area between the patients whose recipient arteries were selected by SPECT or visual assessment.

Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin

Background. Conventional nasogastric tube placement is an essential clinical procedure; however, complications may arise from blind manipulation. We tested the feasibility and efficiency of a visual nasogastric tube insertion system (VNGS) using a manikin. Methods. A microimaging fiber (0.8 mm) was integrated into the nasogastric tube to create the VNGS. Twenty inexperienced physicians were enrolled and assigned to the visual or conventional group. Each physician performed 10 repeated nasogastric tube insertions with visual guidance or the conventional method; another 20 inexperienced medical students received nasogastric tube insertion training using visual guidance or the conventional method. Results. The nasogastric tube successfully reached the stomach and the narrow anatomic structures were visualized with the VNGS. Time required for insertion was significantly shorter in the visual group compared to the conventional group (22.56±3.08 versus 37.30±4.12 seconds, P<0.001). Tube misplacement was observed in 19/100 cases (19%) in the conventional group; no misplacement was observed in the visual group. Less mucosal damage was noted in the visual group (3.43±1.63 versus 9.86±2.31 cm2). Medical students performed better NGT insertions (shorter insertion time and less procedure-related complications) after undergoing the visual guidance training. Conclusions. The VNGS may provide a new technique for nasogastric tube insertion applicable to clinical use or simulation training.

Multimodal Ternus: Visual, Tactile, and Visuo — Tactile Grouping in Apparent Motion

Gestalt rules that describe how visual stimuli are grouped also apply to sounds, but it is unknown if the Gestalt rules also apply to tactile or uniquely multimodal stimuli. To investigate these rules, we used lights, touches, and a combination of lights and touches, arranged in a classic Ternus configuration. Three stimuli (A, B, C) were arranged in a row across three fingers. A and B were presented for 50 ms and, after a delay, B and C were presented for 50 ms. Subjects were asked whether they perceived AB moving to BC (group motion) or A moving to C (element motion). For all three types of stimuli, at short delays, A to C dominated, while at longer delays AB to BC dominated. The critical delay, where perception changed from group to element motion, was significantly different for the visual Ternus (3 lights, 162 ms) and the tactile Ternus (3 touches, 195 ms). The critical delay for the multimodal Ternus (3 light – touch pairs, 161 ms) was not different from the visual or tactile Ternus effects. In a second experiment, subjects were exposed to 2.5 min of visual group motion (stimulus onset asynchrony = 300 ms). The exposure caused a shift in the critical delay of the visual Ternus, a trend in the same direction for the multimodal Ternus, but no shift in the tactile Ternus. These results suggest separate but similar grouping rules for visual, tactile, and multimodal stimuli.

Effects of Performer Attractiveness, Stage Behavior, and Dress on Evaluation of Children's Piano Performances

The purpose of this study was to determine whether selected nonmusical attributes of sixth-grade pianists would affect ratings of their performances. Twenty pianists (10 girl and 10 boys) were videotaped. They and their performances were rated by 123 musically trained evaluators. Members of the visual group viewed a videotape with the sound turned off. They rated pianists on appropriateness of dress, stage behavior, and physical attractiveness. These ratings were the basis for grouping students as being high or low on each of these three attributes. Audiovisual and audio group members rated musical performance on five test items. Results revealed support for the existence of a bias: although high pianists were rated higher than low pianists under the audio condition for all three attributes, the differences between them often were significantly greater under the audiovisual condition than under the audio-only condition. In addition, and unlike finding of earlier studies, videotaped performances were not rated higher than audiotaped performances. Also, female judges were more lenient than male judges. Finally, male and female pianists were affected differently by nonmusical attributes for about half of the test items.