Lumbar synovial cyst in a adolescence: case report

Background  Spinal extradural cysts are a rare cause of spinal cord or nerve root compression which tends to occur in the elderly but rarely reported in the under 20s. History  A 14-year-old girl with a 9-month history of left radicular pain was found to have an intraspinal cystic lesion causing radicular compression. Magnetic resonance imaging showed a 1.1-cm extradural cystic lesion with a low signal on T1-weighted images and high signal on T2-weighted images lying in the spinal canal at the L4 vertebral body level. The patient underwent an L4 hemilaminectomy and excision of a synovial cyst, and the radicular pain completely regressed. Discussion  We discuss the pathogenesis, radiological techniques and management of synovial cyst in a paediatric patient Conclusion  Intraspinal ganglion cysts are extremely rare in children and only two other cases have been reported previously. They are benign lesions, frequently presenting radiculopathy, and should be considered in the differential diagnosis in patients with low back pain and radiculopathy.     

Nidogen Plays a Role in the Regenerative Axon Growth of Adult Sensory Neurons Through Schwann Cells

We previously reported that nidogen is an extracellular matrix protein regulating Schwann cell proliferation and migration. Since Schwann cells play a critical role in peripheral nerve regeneration, nidogen may play a role in it via regulation of Schwann cells. Here, we demonstrate direct evidence that nidogen induces elongation of regenerative axon growth of adult sensory neurons, and that the effect is Schwann cell dependent. Continuous infusion of recombinant ectodomain of tumor endothelial marker 7, which specifically blocks nidogen function in Schwann cells, suppressed regenerative neurite growth in a sciatic nerve axotomy model. Taken together, it is likely that nidogen is required for proper regeneration of peripheral nerves after injury.     

Ganglion cysts at the gastrocnemius origin: a series of ten cases

Objective To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. Design and patients We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27–68 years, mean age 40.6 years. Results The mean maximal dimension of the ganglion cysts was 26 mm, range 15–40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. Conclusions MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding.     

Lumbar Intraspinal Extradural Ganglion Cysts

The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.     

胰岛素样生长因子 1对背根神经节神经元谷氨酸损伤的保护作用

目的探测胰岛素样生长因子 1（IGF 1）对背根神经节（DRG）神经元谷氨酸（Glu）损伤的保护作用。方法Wistar胎鼠DRG神经元分散培养48?h后,用Glu（200?μmol/L）造成神经元损伤,并同时给予IGF 1（10?nmol/L）,观察添加IGF 1和未添加IGF 1孵育的Glu损伤的神经元的活细胞生长状况,并用流式细胞仪检测神经元的凋亡率,用共聚焦激光扫描显微镜（CLSM）检测细胞内钙离子荧光强度。结果用IGF 1孵育的神经元生长状况良好,凋亡率、细胞内钙离子荧光强度均低于无IGF 1孵育的标本。结论IGF 1可通过减低钙离子内流,抑制细胞凋亡,从而对Glu损伤的DRG神经元产生保护作用。     

星状神经节阻滞治疗三叉神经痛脑干听觉诱发电位变化的临床研究

目的探讨三叉神经痛患者行星状神经节阻滞后脑干听觉诱发电位的变化。方法原发性三叉神经痛患者42例,行患侧星状神经节阻滞治疗,并对阻滞前、后的健侧和患侧脑干听觉诱发电位进行监测,记录Ⅰ、Ⅲ、Ⅴ波潜伏期,并计算Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期。结果星状神经节阻滞前健侧和患侧脑干听觉诱发电位的I、Ⅲ波潜伏期和Ⅰ-Ⅲ波间期无统计学差异,Ⅴ波潜伏期、Ⅲ～Ⅴ波间期和Ⅰ～V波间期有统计学差异（P〈0．05）,阻滞后双侧脑干听觉诱发电位无统计学差异;星状神经节阻滞前、后患侧的Ⅰ、Ⅲ波潜伏期和Ⅰ-Ⅲ波间期无统计学差异,Ⅴ波潜伏期、Ⅲ～Ⅴ波间期和I～V波间期有统计学差异（P〈0．05）。结论原发性三叉神经痛患者行星状神经节阻滞后脑干听觉诱发电位可发生明显改变,脑干听觉诱发电位可作为观察三叉神经痛患者治疗效果的一个客观指标。     

Influencia de la longitud axial ocular en el grosor de la capa de fibras nerviosas peripapilar medido con tomografía de coherencia óptica

BackgroundOptical coherence tomography (OCT) allows the measurement of the peripapillary optic nerve fiber layer (RNFL) thickness. The effect of ocular axial length (AL) on RNFL thickness measurement may be relevant in the interpretation of OCT results in diagnosing optic nerve diseases.PurposesTo assess the influence of ocular AL on RNFL thickness and on optic disc topographic parameters (optic disc area, rim area and cup volume) measured by OCT, in healthy individuals.MethodA sample of 109 healthy eyes classified into three groups according to AL (A: AL <22 mm; B: AL 22–24.5 mm; C: AL >24.5 mm) was studied. RNFL thickness and optic disc topographic parameters were measured using Swept-Source OCT Triton (Topcon Corporation, Tokyo, Japan) and were compared between groups using a variance analysis. Correlation between the AL and the study variables was performed using a Pearson's correlation coefficient test.ResultsThe RNFL thickness was lower in eyes with higher AL in the superior (r = −0.41; p < 0.001), inferior (r = 0.58; p < 0.001) and nasal (r = −0.43; p < 0.001) quadrants, in the mean value of the RNFL (r = −0.49; p < 0.001), optic disc area (r = −0.40; p < 0.001) and rim area (r = −0.25; p = 0.01).ConclusionAL is negatively correlated with RNFL thickness and optic disc topographic parameters measured by Swept-Source OCT Triton (Topcon).     

Immunocytochemical study of calretinin and calbindin D-28K expression in the retina of three cartilaginous fishes and a cladistian (Polypterus)

The distribution of two calcium-binding proteins, calbindin D-28K (CB) and calretinin (CR) was studied in the retina of a cladistian, Polypterus senegalus, and three cartilaginous fishes (Scyliorhinus canicula, Raja undulata and Torpedo marmorata). Western blot analysis of brain extracts revealed the lack of cross-reactivity of the used antibodies. In Polypterus, CB and CR immunoreactivities were observed in some amacrine and ganglion cells, but scarce cells showed CR/CB colocalization. Furthermore, CR immunoreactivity was present in a number of displaced bipolar cells and in some putative displaced ganglion cells, whereas CB immunoreactivity was found in some cones. No positive retinal structure was observed with the CB antibody used in cartilaginous fishes. Instead, CR was expressed in some amacrine, horizontal and ganglion cells of the dogfish and skate and, in some ganglion cells of the electric ray. The comparative analysis suggests, (1) the presence of CB-positive photoreceptor cells in the retina of cladistians seems to be apomorphic (in jawed fishes) in contrast with the plesiomorphic condition of this character in land vertebrates; (2) the presence of CR in amacrine and ganglion cells is a conserved feature along vertebrate phylogeny, whereas its variable expression in bipolar and horizontal cells represents a derived character; (3) the absence of CB in horizontal cells in cladistians could represent a derived character; and (4) the presence of CR displaced bipolar and putative displaced ganglion cells in Polypterus is shared with basal groups of actinopterygians.     

Immunohistochemical localization of Ca/calmodulin-dependent protein kinase II in the rat retina

Ca²⁺ / calmodulin-dependent protein kinase II (CaM kinase II) consisting of α and β isoforms is highly expressed in the central nervous system and is implicated in the regulation of various Ca²⁺-dependent physiological processes. We investigated the immunohistochemical distribution of the α and β isoforms of this enzyme in the rat retina, using highly specific monoclonal antibodies which recognize each isoform. Immunoblotting revealed that not only the α but also the β isoform of CaM kinase II were expressed in the retina. The immunohistochemical study showed that highly α-immunoreactive products were localized in amacrine cells in the inner nuclear layer and displaced amacrine cells and ganglion cells in the ganglion cell layer. In addition, two well-defined bands within the inner plexiform layer were densely stained with the anti-α antibody. By contrast, immunoreactivity against the anti-β antibody was very weak in the same neuronal components of the retina. β-Immunoreactive products were homogeneously distributed throughout the inner plexiform layer and no well-defined bands were detected in this layer. Glial cells such as Müller cells were immunoreactive neither to α nor β antibody. A possible co-existence of choline acetyl transferase (ChAT) within CaM kinase II α-immunopositive neurons was examined by evaluating adjacent sections stained with anti-CaM kinase II α antibody and anti-ChAT antibody, respectively. The distribution of CaM kinase II α immunoreactivity in the rat retina was remarkably similar to that of ChAT immunoreactivity. About 32% of total ChAT-immunopositive neurons in the inner nuclear layer contained the CaM II α isoform, whereas only an occasional co-existence of both enzymes was observed in the ganglion cell layer. The present immunoblot and immunohistochemical study elucidated that not only α but also β isoforms of CaM kinase II β were expressed and this enzyme may participate in the cholinergic system in the rat retina.     

缺血性脑卒中并发低钙血症机制及临床意义

目的 :探讨缺血性脑卒中并发低钙血症的机制及临床意义。方法 :回顾性分析 10 2 8例缺血性脑卒中临床及血清钙资料。结果 :10 2 8例中并发低钙血症者 14例 ,发生率为 1.36 % ,以病灶部位为基底节区者发生率最高 (6 .87% ,P <0 .0 5 ) ;发生低钙血症者神经精神症状以潜在型手足抽搦为主 (5 7.14 % ,P <0 .0 1) ;并发低钙血症者较血清钙正常者病死率为高 (P <0 .0 5 )。结论 :下丘脑 -垂体 -肾上腺皮质轴功能紊乱是引起缺血性脑卒中并发低钙血症的主要原因之一。