Localization of the Sphenopalatine Ganglion Within the Pterygopalatine Fossa on Computed Tomography Angiography—A Potential Role in the Setting of Sphenopalatine Ganglion Microstimulator Implantation

ObjectivesA recent approach to treatment of cluster headaches (CH) employs a microstimulator device for on-demand neuromodulation of the sphenopalatine ganglion (SPG) during an acute CH attack. A precise anatomical localization of the SPG within the pterygopalatine fossa (PPF) is optimal in order to position the SPG electrode array. This study aims to investigate a novel approach for SPG localization using computed tomography angiographic studies (CTA).Materials and MethodsTwo independent observers identified the location of the SPG on 54 computed tomography angiographic studies (CTA) and measured its position relative to the vidian canal (VC). The qualitative confidence of identification, morphology, position within the PPF and its relation to vascular structures were also recorded.ResultsThe SPG was detectable in 88% of cases with a variable position. The most frequent positions were superior (56%) and lateral (99%) relative to the VC with a mean (±SD) craniocaudal distance of 0.34 mm (±1.38) and a mean mediolateral distance of 3.04 mm (±1.2). However, in a considerable proportion of cases, the SPG was identified inferiorly to the VC (33%). Interobserver and intraobserver agreement for SPG location were moderate and strong respectively.ConclusionsSince localization of SPG on CTAs is feasible and reproducible, it has future clinical potential to aid placement, optimal positioning and individualized programming of the electrode array.     

Gender ratio of migraine without aura: observations over time

Abstract Migraine without aura is typically considered a female condition. The purpose of this study was to determine if there have been any changes in the female-to-male ratio of the disease over time. We included in the study all patients with migraine without aura (n=3457) referred to the Parma University Headache Centre between 1976 and 1995. They were divided into subgroups with respect to gender and year-range of onset of migraine (before 1960, in the 1960s, in the 1970s, in the 1980s, and between 1990 and 1995). Gender ratio ranged from 3.6:1 (in patients with onset before 1960) to 2.8:1 (in patients with onset in the 1980s), with no statistically significant changes during the observation period.     

电子对生物分子DNA损伤可能性的分析

目的研究电子在人体组织等效材料中形成的“簇点”能量分布情况，以及簇点的产生对生物效应发生的意义。方法针对电子与人体组织等效介质作用的物理机理，利用蒙特卡罗(MC)方法，按一个个相互作用事件(电离、激发、弹性散射、Auger电子发射)方式真实模拟电子在介质中的径迹，通过对这些事件进行统计分析，得到相关结论。结果电子在穿过介质过程中，主要以簇点(大于30％)形式沉积能量，并且80％以上的簇点中的能量沉积在50eV以上；簇点的密集程度与电子能量、簇点直径密切相关，簇点中能量沉积也取决于辐射类型和能量。结论簇点中的能量沉积是诱发组织细胞核内DNA分子各种损伤的最主要因素。     

Ipsilateral cluster headache and chronic paroxysmal hemicrania: two case reports

We report two patients with ipsilateral attacks of cluster headache and chronic paroxysmal hemicrania. The first patient, a 33-year-old man, started having attacks of chronic cluster headache at the age of 27. At 33, they were replaced by typical attacks of ipsilateral chronic paroxysmal hemicrania which showed a dramatic improvement with indomethacin 150 mg daily. After two days of complete remission, cluster headache attacks reappeared and persisted until verapamil, 360 mg a day, was added to indomethacin. The second patient, a 45-year-old man, first developed attacks of episodic cluster headache at the age of 35. At 44, he experienced ipsilateral typical attacks of chronic paroxysmal hemicrania, and two months later attacks of cluster headache. Under verapamil 240 mg daily, attacks of cluster headache disappeared, but those of chronic paroxysmal hemicrania increased in frequency until indomethacin 150 mg daily was added. These observations suggest a close relationship but not a similarity between cluster headache and chronic paraoxysmal hemicrania, and show the practical therapeutic interest of maintaining this distinction.     

内蒙古赤峰地区鼠疫现状和流行趋势预测及控制措施的研究

赤峰地区于１９４８￣１９９６年发现了１６６３２．２ｋｍ＾２鼠疫自然疫源地，分布于１１个旗（县、区）。目前达到控制鼠疫面积１３９１７．８ｋｍ＾２，占疫源地总面积的８３．６８％。选取与疫源地相关的１２种量经因子进行聚类分析，结果可分为：１．疫源性长存区；２．动物鼠疫间断流行区；３．鼠疫动物病控制区；４．疫源性基本消除区。同时对措施进行了探讨。     

Cluster headache after orbital exenteration

A 37-year old man developed an ipsilateral headache which fulfilled the criteria for cluster headache after orbital exenteration because of traumatic lesion of the bulb. The headache could be treated successfully by drugs usually applied in the therapy of cluster headache. Six similar cases of cluster headache after orbital exenteration could be identified in the literature suggesting that the eye itself is not necessarily part of the pathogenesis of cluster headache. We hypothesize that orbital exenteration can cause cluster headache by lesions of sympathetic structures. Possibly, these mechanisms are similar to those of sympathetic reflex dystrophy (Sudeck-Leriche syndrome) causing pain of the limbs.     

Pupil responsiveness in cluster headache: A dynamic TV pupillometric evaluation

In this study the variations in pupil diameter induced by different stimuli (dark-light adaptation, light reflex, electric stimulation of the sural nerve) were investigated in episodic (in the active or remission phases) and in chronic cluster headache (CH) patients. Pupil size monitoring was performed with a monocular, infrared TV pupillometer, and sural nerve stimuli were applied after the pain threshold had been measured as the flexion reflex threshold of the biceps femoris muscle (RIII reflex). The results were compared with those obtained in patients with "peripheral" (third neuron) Horner's syndrome and in healthy sex- and age-matched controls. On the symptomatic side we found an impairment of pupil response to light flashes and nociceptive stimuli; similar findings were sometimes evident on the pain-free side, too. These results substantiate previous observations that in cluster headache a dysfunction of the integrative central nervous system pathways also exists intercritically and mostly bilaterally, involving both autonomic regulation and pain perception mechanisms.     

肝肾胰器官簇移植临床解剖学研究

目的：为了开展肝肾胰器官簇移植提供应用解剖学资料和术式设计方案。方法：对２４具成人尸体进行解剖观察,了解其主要血管分布,胆管、输尿管、胰管的位置以及腹腔内空腔脏器的相互关系。结果：测得主要血管腹主动脉平均长度１９．２０ｃｍ,上端外径２．２１ｃｍ;下腔静脉平均长度１９．４２ｃｍ,上端外径２．６０ｃｍ;门静脉长５．５９ｃｍ,宽度１．４９ｃｍ;肝固有动脉长３．８５ｃｍ,宽０．６４ｃｍ;胆总管长４．１９ｃｍ,宽度０．７８ｃｍ;在输尿管平均长度为２７．１１ｃｍ,右输尿管平均长度为２５．９３ｃｍ。对器管簇移植的整体切取、修整、安放和吻合提供多种方案。结论：肝肾胰器官簇移植手术有应用解剖学依据的可行性,按形态学规律有多种合理的术式设计方案