Unusual multiloculated serpiginous ganglion of the foot

Ganglions are cystic lesion more commonly seen around the wrist joint. Gangliomas of plantar aspect of the foot are rare. We have presented a case of an unusual serpiginous ganglioma of the plantar aspect of the foot. Less literature is available regarding plantar foot gangliomas. The treatment is challenging because of occurrence of the lesion at weight bearing zone. Available options for treatment includes conservative with splint, intralesional injection,arthroscopic excision and open excision.     

Efficacy of cross-sectional imaging guided sympathetic neurolysis in abdoiniuopelvic tumors

Aim of work

To study the efficacy of visceral neurolytic blocks in the abdominopelvic cancer when guided by ultrasound/CT.

原发性三叉神经痛应用针刺神经孔及神经节治疗的效果分析

目的 探讨应用针刺神经孔及神经节治疗原发性三叉神经痛的效果.方法 收集2015年9月至2016年9月入院的80例原发性三叉神经痛患者随机分为两组,对照组患者予以常规针刺治疗,实验组患者则予以针刺神经孔及神经节治疗,比较两组患者治疗前后疼痛程度与积分、总体治疗效果与不良反应率.结果 实验组患者治疗后VAS、疼痛范围、疼痛程度、分支数量、触发状况、持续时间、发作频次与疼痛总积分组间比较均显著低于对照组(P＜0.01),治疗期间不良反应率显著低于对照组(P＜0.01),愈显率明显高于对照组(P＜0.05).结论 应用针刺神经孔及神经节治疗原发性三叉神经痛的效果显著,具有借鉴意义.     

Heat shock proteins in the retina: Focus on HSP70 and alpha crystallins in ganglion cell survival

Heat shock proteins (HSPs) belong to a superfamily of stress proteins that are critical constituents of a complex defense mechanism that enhances cell survival under adverse environmental conditions. Cell protective roles of HSPs are related to their chaperone functions, antiapoptotic and antinecrotic effects. HSPs' anti-apoptotic and cytoprotective characteristics, their ability to protect cells from a variety of stressful stimuli, and the possibility of their pharmacological induction in cells under pathological stress make these proteins an attractive therapeutic target for various neurodegenerative diseases; these include Alzheimer's, Parkinson's, Huntington's, prion disease, and others. This review discusses the possible roles of HSPs, particularly HSP70 and small HSPs (alpha A and alpha B crystallins) in enhancing the survival of retinal ganglion cells (RGCs) in optic neuropathies such as glaucoma, which is characterized by progressive loss of vision caused by degeneration of RGCs and their axons in the optic nerve. Studies in animal models of RGC degeneration induced by ocular hypertension, optic nerve crush and axotomy show that upregulation of HSP70 expression by hyperthermia, zinc, geranyl–geranyl acetone, 17-AAG (a HSP90 inhibitor), or through transfection of retinal cells with AAV2-HSP70 effectively supports the survival of injured RGCs. RGCs survival was also stimulated by overexpression of alpha A and alpha B crystallins. These findings provide support for translating the HSP70- and alpha crystallin-based cell survival strategy into therapy to protect and rescue injured RGCs from degeneration associated with glaucomatous and other optic neuropathies.     

L’exploration axillaire en pratique quotidienne dans le parcours diagnostique d’un cancer du sein<br/>Axillary staging in daily practice in the diagnosis of breast cancer

When a breast cancer is diagnosed, the quality of the evaluation before treatment is essential to guide the therapeutic decision. The staging axillary is necessary because it estimates the regional extension of the disease, which makes it a paramount prognosis factor. Some different preoperative medical imaging can reveal metastasis axillary nodes. However, the axillary ultrasound remains the reference imaging and it also leads the biopsies too. Since theACOSOG-Z0011 trial, we are facing a therapeutic deescalation in the axillary surgery. According to recent results, we can note that the position of the axillary imaging is more and more important. The purpose of the ultrasound is to avoid a two-stage dissection after a positive sentinel lymph node when the ACOSOG-Z0011 criteria are not met.

Résumé
Lors de la découverte d’un cancer du sein, la qualité du bilan préthérapeutique est essentielle afin d’orienter la décision thérapeutique. L’exploration axillaire est primordiale, car elle évalue l’extension régionale de la maladie, ce qui en fait un des facteurs pronostiques majeurs. Différents examens d’imagerie préopératoires peuvent révéler une atteinte de ces ganglions axillaires. Cependant, l’imagerie de référence reste l’échographie axillaire, qui permet également de guider des prélèvements. Depuis l’étude ACOSOGZ0011, nous sommes face à une désescalade thérapeutique de la chirurgie axillaire. Selon des résultats récents, on constate que la place de l’imagerie axillaire est encore plus importante. Le but de l’échographie est d’éviter un curage en deux temps après un ganglion sentinelle positif lorsque les critères de l’ACOSOG-Z0011 ne sont pas remplis.     

NGF protects Dorsal Root Ganglion neurons from oxaliplatin by modulating JNK/Sapk and ERK1/2

The involvement of the Mitogen-Activated Protein Kinases (MAPKs) family in platinum derivative-induced peripheral neuropathy has already been demonstrated. In particular, it has been evidenced that in Dorsal Root Ganglion (DRG) neurons prolonged exposure to oxaliplatin (OHP) induces early activation of p38 and ERK1/2, which mediate neuronal apoptosis, while the neuroprotective action of JNK/Sapk is downregulated by the drug treatment. In this study, the exposure of OHP-treated neurons to a neuroprotective stimulus, represented by a high dose of NGF, counteracts OHP-induced neuronal mortality. This effect was achieved by restoring the MAPK activation existing in untreated control cells. Increased viability occurred also after the administration of retinoic acid (RA), a pro-differentiative agent able to activate both JNK/Sapk and ERK1/2. The use of specific chemical inhibitors of MAPKs confirms the importance of this class of proteins for the neuroprotective pathway, since they reverse the protective effect. In summary, our findings assess the validity of MAPKs as the target of neuroprotective therapies during chemotherapeutic treatment. Moreover they also describe a double role for ERK1/2, depending on cellular stimulation, since it mediates neuronal apoptosis after OHP exposure. However, it is also important, as is JNK/Sapk, in preserving the correct cellular differentiation that is pivotal for neuronal survival.     

晚期糖基化终产物对C57小鼠耳蜗螺旋神经节细胞凋亡及其受体表达的影响

目的　研究晚期糖基化终产物（advanced glycation end products,AGEs）对体外培养的小鼠耳蜗螺旋神经节细胞（spiral ganglion cells,SGCs）凋亡及晚期糖基化终产物受体（receptor for advanced glycation end products,RAGE）表达的影响,探讨AGEs诱导SGCs凋亡的可能作用途径,分析神经型老年性聋的可能致病机制。方法　运用Tunel法,采用荧光显微镜观察不同浓度、不同时间AGEs对培养的SGCs凋亡的影响,同时用Real time RTPCR方法检测RAGEmRNA表达。结果　AGEs加入细胞培养中,可明显诱导SGCs凋亡,凋亡率与剂量、时间呈正相关。发生凋亡的同时有RAGEmRNA表达增强。结论  AGEs对SGCs有诱导凋亡的作用,该作用可能通过RAGE介导。AGEs促使SGCs凋亡可能是神经型老年性聋的发病机制之一。     

颈内动脉重度狭窄患者视网膜神经纤维层与神经节细胞复合体的改变

目的 探讨颈内动脉狭窄患者视盘周围视网膜神经纤维层（peripapillary r etinal n erve f iber l ayer, pRNFL）、黄斑区神经节细胞复合体（ganglion cell complex,GCC）厚度的改变,RNFL缺损、GCC丢失比 例的情况。 方法 回顾分析2015年7月-2016年7月在首都医科大学附属北京天坛医院诊治的单侧颈内动脉重度 狭窄（≥70%）或闭塞患者的病例资料,并纳入经颈动脉超声检查明确颈内动脉无明显狭窄的健康者 作为对照组,通过光学相干断层扫描（optical coherence tomography,OCT）检测病例组及对照组双眼 pRNFL及GCC厚度、RNFL缺损、GCC丢失比例。比较病例组狭窄同侧眼和对侧眼及对照组右眼的上述 数据的差异。 结果 共入组56例颈内动脉狭窄患者和56例对照组。颈内动脉狭窄同侧眼的p R N F L平均厚 度、黄斑区GCC平均厚度[（99.44±14.60）μm,（92.61±10.63）μm]较对侧眼[（107.01±9.96）μm, （96.48±9.73）μm]均薄（P =0.008,P =0.047）;较正常对照组眼的pRNFL平均厚度、黄斑区GCC平均 厚度（[ 110.47±6.48）μm,（96.86±5.00）μm]均薄（P=0.001,P=0.013）。狭窄同侧眼出现RNFL缺损、 GCC丢失的比例（33.9%,53.6%）较对侧眼（12.5%,26.8%）均显著增高（P =0.007,P =0.004）。 结论 颈内动脉重度狭窄可导致pRNFL和GCC厚度变薄,通过OCT检查可以更早发现颈内动脉狭窄对 眼部血供的影响。     

Inflammatory arthritis-like and other MR findings in wrists of asymptomatic subjects

Objective To describe magnetic resonance (MR) imaging findings in the wrists of asymptomatic subjects that might be confused with pathologic findings.Design MR examination of the dominant wrist was performed in 30 asymptomatic volunteers aged 22–49 years using pre-contrast and post-contrast sequences in the coronal and axial planes. The bases of the metacarpals, the carpus and the distal radius and ulna were evaluated by two musculoskeletal radiologists for lesions, notches, blood vessels and synovial enhancement.Results There were 24 bright osseous lesions (erosions, intraosseous ganglia, oedema or cysts) in 14 subjects. Intraosseous blood vessels were seen in all but one wrist examined, most commonly in the capitate and lunate bones. Enhancement was present in 26 of 27 notches identified at the base of the second metacarpal and less commonly in the capitate, hamate and triquetral notches. A small joint effusion was present in 14 subjects. Joint or soft-tissue enhancement was identified in 16 wrists.Conclusions Many MR abnormalities and variants may be detected in the wrists of asymptomatic subjects. Many of these could be confused with pathologic findings usually associated with inflammatory arthritis.Partial funding provided by the Royal Australian and New Zealand College of Radiologists College Research Fund.     

星状神经结阻滞抗鼠急性胃黏膜损伤的实验研究

目的:探讨颈交感神经干离断(TCST)对鼠急性胃黏膜损伤的保护作用。方法:30只雄性SD大鼠随机分为三组,每组10只,A组为正常对照组;B组为浸水应激对照组;C组为TCST后浸水组。C组行TCST,将B组、C组大鼠垂直浸水,6 h后取出。测定各组大鼠胃黏膜血流量(GMBF),评价黏膜损伤程度。采用放免法检测血浆内皮素-1(ET-1)及降钙素基因相关肽(CGRP)的含量。结果:B组、C组大鼠胃黏膜可见出血及糜烂,C组较轻。与A组比较,B、C组GMBF降低,B组较低。B、C组血浆CGRP含量均较A组显著降低,B组较低(P0.05)。B、C组血浆ET-1含量较A组显著升高,B组升高明显。结论:TCST对急性胃黏膜损伤有保护作用,其机制可能与其调节血浆的CGRP、ET-1含量有关。