神经根撕脱后脊髓运动神经元的病理表现

目的:观察神经根撕脱后脊髓前角运动神经元的病理表现,探讨在该条件下运动神经元死亡的神经生物学机制。方法:选择成年SD雌性大鼠20只,体重200-300g,撕脱右侧臂丛C₅-T₈神经根,术后动物存活3d、5d、1周后取C₅-C₈节段脊髓,对冰冻切片行NADPH-d组化、c-jun免疫组化、中性红和HE染色。观察神经元的形态,计数脊髓前角NOS阳性运动神经元及存活运动神经元数目,以非损伤侧的前角运动神经元数目为100%,计算百分比。结果:神经根撕脱3d、5d、1周后,损伤侧脊髓前角NOS运动神经元平均阳性率分别为:0.74%±0.59%、24.83%±6.73%、51.16%±8.67%。神经元平均存活率分别为93.00%±4.32%、93.67%±5.27%、89.83%±2.65%;c-Jun从撕脱术后3d就有表达,5d后表达开始减少。运动神经元形态变化不明显。1周时偶见前角运动神经元的胞核偏位,但核膜清晰,核仁尚存,染色体固缩。结论:脊神经根撕脱1周内,脊髓前角运动神经元NOS表达递增,c-Jun表达递减,运动神经元开始死亡。NO/NOS可能通过抑制神经元损伤后的再生反应,促进脊髓前角运动神经元的死亡。     

Age-related alterations in responses of the nucleus basalis magnocellularis neurons to frontal cortex stimulation in rats

The present study investigated the age-related alterations in responses of the nucleus basalis magnocellularis (nbM) neurons to frontal cortex (FCX) stimulation. Single unit extracellular recording from the nbM neurons were obtained with glass micropipettes in urethane-anesthetized rats. A total of 137 units were located within the nbM in the three age groups (young, 3 months; adult, 12 months; old, 24 months). FCX stimulation elicited responses in 91% of the 137 neurons. Most of them were excited. The frequency of occurrence of excitatory responses in the nbM neurons was decreased with aging. The thresholds and latencies of excitatory responses evoked by FCX stimulation were increased in old rats. The mean peak-firing rate of exciting phase was gradually reduced with aging. These findings indicate that there might be some functional changes in the nbM neurons with aging.     

Peak Identification in Visual Evoked Potentials

Waveform patterns evoked by 4 intensities of flash in normal subjects were studied in relation to intersubject variability. Time-frequency distribution curves of all peaks occurring between 11 and 280 msec after flash onset and meeting minimal criteria were obtained from 46 males. These distributions closely corresponded to similar data reported by others for single intensity stimulation. An algorithm was developed which identified in 67 to 100% of instances a single “peak event’ within the time ranges of each of 6 peak distributions. Many peak events appeared and disappeared within the 4 intensity sets of individuals. Latencies were obtained for these peak events. Application of the algorithm to a replicate sample of 29 Ss, which included 8 females, indicated generalizability. Test-retest data on 15 Ss showed its reliability. The data suggest that methodology significantly contributes to the variability of peak identification among subjects. This may be reduced by employing multiple intensities of stimulation.     

Caudal end of the rat spinal dorsal horn

We have previously demonstrated that the transformation of the caudal spinal cord through the conus medullaris to the filum terminale takes place in three steps. In the conus medullaris the twin layers of CGRP-immunoreactive and IB4-labeled primary afferent fibers as well as the translucent portion of the superficial dorsal horn equivalent to the substantia gelatinosa discontinue before the complete removal of the dorsal horn. Parallel with these changes VGLUT1-immunoreactive myelinated primary afferent fibers arborize not only in the deep layers but also in the entire extension of the remaining dorsal horn, while scattered CGRP fibers still remains at the margin of and deep in the dorsal horn. PKCgamma-immunoreactive dorsal horn neurons discontinue parallel with the disappearance of the IB4-labeled nerve fibers. These observations suggest that in the dorsal horn certain neurons are linked to the substantia gelatinosa, while others are substantia gelatinosa-independent neurons.     

大脑中动脉供血区脑缺血后同侧丘脑继发性损害的MR实验研究

本文应用磁共振(magnetic resonance,MR)成像在体观察大脑中动脉(middle cerebral artery,MCA)供血区脑缺血后同侧丘脑的信号变化。结果显示:(1)通过MRA(magnetic resonance angiography)可以观测到单侧MCA的闭塞与血流再通,而供应丘脑的大脑后动脉信号无变化;(2)脑缺血后1d MR T2WI(T2weighted imaging)显示单侧MCA供血区原发病灶呈高信号,3d、7d时此原发病灶信号增高程度有所降低,至14d信号强度再次明显增高;(3)脑缺血后1d和3d时双侧丘脑T2信号无差别,7d和14d时脑缺血同侧丘脑T2信号减低,T2值降低;(4)MCA供血区脑缺血后原发病灶和同侧丘脑T2值的变化不同步。上述结果证实MR能够在活体显示MCA供血区脑缺血后同侧丘脑的继发性损害。     

Malignant peripheral nerve sheath tumor of small round cell type with pleomorphic spindle cell sarcomatous areas

An unusual case of malignant peripheral nerve sheath tumor (MPNST) arising in the posterior mediastinum of a 59-year-old man is reported. Histopathologically, the tumor showed an admixture of a dense proliferation of small round cells resembling a primitive neuroectodermal tumor (PNET) and a pleomorphic spindle cell sarcomatous area. Abortive rosettes, primitive neural tube-like structures, and a few glandular structures were found in the small round cell area. Small round cells were immunoreactive for neural cell adhesion molecule and synaptophysin, but were not immunoreactive for MIC2 and neuron-specific enolase. Pleomorphic spindle cells were occasionally arranged in a storiform pattern and were diffusely immunoreactive for S-100 protein. The MPNST of small round cell type is distinguishable from PNET by its negative immunoreactivity for MIC2, and the present tumor is assumed to be derived from primitive neuroectodermal cells in the peripheral nerve capable of bidirectional (neuron and Schwann cell) differentiation.     

Gastrointestinal Autonomic Nerve Tumor: A Common Type of Gastrointestinal Stromal Neoplasm

Seven of 15 gastrointestinal stromal tumors from the author's file were classified as plexosarcomas when examined by electron microscopy and immunohistochemistry. Electron microscopy was essential for the diagnosis.     

Recommendations for the examination of peripheral nerve biopsies

 Peripheral nerve biopsy is now an established, valuable investigative procedure, but as it can give rise to significant residual symptoms it should only be undertaken after careful consideration of the indications and with informed consent from the patient. Nerve biopsies should only be processed and evaluated in a laboratory with the relevant particular expertise. It is generally recommended that a sural nerve biopsy be performed in combination with a muscle biopsy but not vice versa (muscle biopsies together with a nerve biopsy). Nerve biopsy is not the only means of sampling peripheral nerve tissue to study the peripheral nervous system. Examination of the innervation of the skin may be informative. The same is likely to be true for motor point muscle biopsy. Nerve biopsy is mainly used for morphology although molecular genetic techniques using fresh or archival nerve biopsies are increasingly available. Chemical analysis is undertaken mainly for research purposes. Received: 10 June 1997 / Accepted: 29 October 1997     

Neurogenic polyps

A neoplastic proliferation of peripheral nerve sheath cells (Schwann cells, fibroblasts and perineurial cells) and ganglion cells in the colorectum may give rise to the mucosal or submucosal polyps. Depending upon the predominant cell types, these neurogenic polyps can be classified as schwannomas, granular cell tumours, neurofibromas, perineuriomas, mixed nerve sheath tumours, ganglioneuromas or paragangliomas. Morphologically, the neoplastic cells repeat or mimic the corresponding nerve sheath cells or neurons in terms of growth pattern, histology and immunoreactivity. They are uncommon, but the polyps can occur in any age group, although the vast majority of patients are adults. The polyps can be either solitary (most peripheral nerve sheath tumours) or multiple, especially if associated with systemic diseases (i.e. syndromes involving the peripheral nerve tissue). They are usually incidental findings or may be accompanied by gastrointestinal symptoms. Almost all colorectal neurogenic polyps are benign, and they rarely undergo malignant transformation unless they are part of a syndromatic manifestation. However, these polyps may cause a diagnostic problem during screening for colorectal cancer. An accurate diagnosis of these entities will help clinicians to make appropriate management decisions.