Morphine antinociception elicited from the ventrolateral periaqueductal gray is sensitive to sex and gonadectomy differences in rats

Sex differences have been observed in antinociception following central administration of morphine into either the lateral ventricles or rostral ventromedial medulla (RVM) such that male rats exhibit significantly greater antinociception than female rats. The present study examined whether sex and adult gonadectomy differences were observed in morphine-induced (1-10 micrograms) antinociception elicited from the ventrolateral periaqueductal gray (vlPAG) on two nociceptive measures. Both sham-operated (ED50=1.20-1.60 microgram) and castrated (ED50=1.08-1.09 micrograms) male rats displayed significantly greater magnitudes and potencies of morphine-induced antinociception on both tests than female rats. Sham-operated female rats tested during the estrous phase (ED50=>50 micrograms) were significantly less sensitive to morphine than ovariectomized female rats (ED50=1.98-2. 51 micrograms). Thus, the vlPAG, a site sensitive to interactions between estradiol-containing hypothalamic loci and opioid peptides, elicits morphine-induced antinociception which is sensitive to sex differences and adult gonadectomy.     

Idiopathic sciatic mononeuropathy

Sciatic nerve lesions are usually painful and secondary to compression, trauma, infarction or part of a systemic illness. The etiology is usually defined by radiographic or blood studies, or by exploratory surgery. In rare cases, as the one being presented, there is clear clinical and electrophysiological evidence for a lesion of the sciatic nerve, but no morphological correlate or defined etiology. These idiopathic sciatic mononeuropathies seem to occur in the nerves of the legs in young adults.     

Conservative treatment of neurogenic bladder dysfunction

Summary In neurogenic bladder dysfunction conservative treatment is preferred whenever possible and preservation of renal function remains the main topic. Additionally, a patient-related form of bladder management with decreased intravesical pressure and social dryness is needed. Therefore many strategies are available and after evaluation of the underlying neurogenic bladder dysfunction an individual kind of treatment can be used. Possible options are the clean intermittent catherization, anticholinergic drugs, detrusor triggering, electrical stimulation and bladder emptying by Valsalva's manouvre.      

超声引导下成人与儿童肾活检术的评价

目的评价经超声引导成人与儿童肾活检术的方法和安全性。方法83例肾脏病患者超声引导下经皮穿刺活检,经右肾或左肾下极进针,方向自外下向内上,沿肾下极皮质取材。结果68例获取足够肾组织,总成功率及3针以内成功率分别为82%、53%,成人与儿童间无差异(P>0.05)。肾活检并发症儿童以疼痛为主,成人以血尿为主。结论超声引导下成人与儿童肾活检术是安全可靠的,其病理诊断对临床治疗具有明确的指导意义。     

Outcome of congenital adrenal hyperplasia

In congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, affected girls are born with ambiguous genitalia due to increased secretion of androgens in utero by the defective adrenal gland. Even though it is generally accepted that there are differences between male and female brain development, determining factors have been difficult to identify. Girls with CAH have frequently been studied to evaluate the impact of prenatal androgen exposure on psychological, psychosocial, and psychosexual development, and impairments in various areas have been identified. However, there is no comprehensive study available regarding the outcome of this chronic disorder in adult life. We studied the quality of life in women with CAH, with particular emphasis on how they cope with genital malformations, genital operations, and chronic disease as well as lifelong medication. The patients filled out questionnaires covering their physical state, psychological well-being, social relationships, and functional capacity, as well as questionnaires on psychosexual identification and psychosocial integration. The results were evaluated using a computerized statistical program for social studies. Out of a total of 94 patients above 18 years of age, 45 agreed to participate and were compared to 46 healthy, age-matched controls. Age at diagnosis was 2.31 ± 1.55 years and 38% suffered from the simple-virilizing, 45% from the salt-wasting, and 17.0% from the late-onset form of CAH. About one-third of patients had Prader stage 3 or 4 genital virilization. While the overall quality of life did not differ significantly, CAH patients were more often single (47.8% vs. 66.7%) and fewer of them had children (22.2% vs. 38.6%) compared to controls. Significant impairments were found in regard to body image and attitudes toward sexuality, but there was no increased homosexual preference. The women were successful in adjusting to illness and receiving social support. It is speculated that improved psychosocial adaptation is part of a coping mechanism that helps to maintain a high level of well-being despite impairment. Coping mechanisms should be identified and strengthened in order to help patients cope with their chronic illness.     

正常成人嗓音频谱分析

为探讨不同性别及不同年龄阶段我国正常成人嗓音的声学特征,应用计算机频谱分析技术对145例18～80岁正常人的嗓音进行声学参数检测.结果表明:各年龄段男女基频(F_0),第二、三共振峰(F_2、F_3),频率微扰商(FPQ)以及中、青年男女间振幅微扰商(APQ)有显著性差异,男性振幅微扰商(APQ)随年龄增长而下降,六十岁以后又明显升高,老年男性基频(F_0)明显升高而老年女性基频(F_0)则明显下降.本研究可为临床嗓音的分析评估提供客观的方法和依据.     

瞬目反射正常值及初步临床应用

目的了解健康成人瞬目反射正常值及其临床应用价值。方法采用Ｅｖｏｌｕｔｉｏｎ型神经肌肉记录仪检测，表面电极直接刺激眶上神经，诱发瞬目反射（ｂｌｉｎｋｒｅｆｌｅｘ，ＢＲ）。在同侧眼轮匝肌记录出短潜伏期波（Ｒ１）和双侧眼轮匝肌记录出长潜伏期波（Ｒ２，Ｒ２’）。对２０名（４０侧）健康人和３０例患者（其中包括三叉神经疾病，面神经疾病及听神经瘤）进行瞬目反射测试。结果ＢＲ潜伏期健康成人平均值Ｒ１为１０．１ｍｓ，Ｒ２和Ｒ２’为３０．４ｍｓ和３０．７ｍｓ。患者组患侧ＢＲ各波潜伏期延长，与健侧和健康人相比较，经ｔ检验，Ｐ＜０．０１，差异有极显著性。结论测试结果表明该技术简单、可靠，对三叉神经、面神经疾病和听神经瘤的早期诊断能提供有价值的电生理测试结果。     

Medulloblastoma in an adult suggestive of external granule cells as its origin: A histological and immunohistochemical study

We describe a rare case of medulloblastoma in an adult woman with histological findings suggesting an origin for this neoplasm in the external granular layer or its remnants. The patient presented with cerebellar dysfunction, and neuroimaging revealed a right cerebellar mass lesion. Pathological examination of the operative specimen revealed a medulloblastoma with occasional areas of neuronal or glial differentiation. Zic protein was also detected immunohistochemically in the tumor cells. The tumor cells were mainly distributed in the subarachnoid space and extended to the cerebellar parenchyma through the perivascular space to form tumor nodules. A suggestive finding, as concerns the origin of this neoplasm, was that the tumor cells were also spread evenly along the subpial zone of the molecular layer, reminiscent of the cellular architecture of the fetal external granular layer.