揉髌手法对实验兔膝关节软骨细胞凋亡及PCNA表达的影响

[摘要] 目的:通过揉髌手法对实验兔膝关节软骨细胞凋亡和PCNA表达影响的研究,探讨手法治疗膝关节骨性关节炎的作用机制。方法:50只新西兰兔随机分为手法组、玻璃酸钠组、模型对照组、假模组、正常组, 每组各10只。前三组采用手术结扎股静脉,臀下静脉、大隐静脉方法造成右下肢骨内高压型模型,假膜组予以手术暴露但不结扎相应血管,正常组不作任何处理。1周后,手法组采用揉髌手法连续治疗5周共17次;玻璃酸钠组每周右膝关节内注射一次,连续5周;其余各组不作任何治疗。造模后12周末处死所有兔子,分别取右膝胫骨平台软骨组织,采用原位末端标记法观察软骨细胞凋亡,免疫组化法观察PCNA表达。结果: 软骨细胞凋亡率手法组为8.67±1.86%,模型对照组为13.57±3.27%,两组比较P<0.01,有统计学意义;PCNA表达率手法组为8.08±1.39%;模型对照组为6.68±0.79%,两组比较P<0.01,有统计学意义。结论:揉髌手法可以降低实验兔膝关节软骨细胞凋亡率及提高增殖细胞核抗原表达率,可能是其治疗膝关节骨性关节炎的作用机制之一。     

EphA2基因在脑星形胶质细胞瘤的表达

目的 检测EphA2基因在脑星形胶质细胞瘤中的表达并探讨其与星形胶质瘤病理分级、增殖和凋亡的关系.方法 选取90例人脑星形胶质瘤标本,以逆转录聚合酶链反应检测EphA2mRNA表达,以免疫组化法检测EphA2和Ki67蛋白表达,以TUNEL法检测凋亡,分别计算EphA2免疫反应评分(IRS)、增殖指数(PI)和凋亡指数(AI)并进行统计学分析.结果 EphA2 mRNA和蛋白阳性表达率分别为47.8%和43.3%.EphA2 IRS、PI及AI分别为(2.90±3.89)%、(30.42±24.91)%和(1.42±0.99)%,三者均随肿瘤病理级别增高而升高.EphA2阳性组PI明显高于阴性组PI,PI与EphA2 IRS呈显著正相关;EphA2阳性组与阴性组之间AI差异无统计学意义,但AI与EphA2 IRS呈显著负相关.结论 EphA2在脑星形胶质瘤中高表达,其表达水平与肿瘤病理分级、增殖和凋亡密切相关,提示EphA2可能是参与脑星形胶质瘤恶性进展的重要分子.     

Inter‐individual differences in audio‐motor learning of piano melodies and white matter fiber tract architecture

Humans vary substantially in their ability to learn new motor skills. Here, we examined inter‐individual differences in learning to play the piano, with the goal of identifying relations to structural properties of white matter fiber tracts relevant to audio‐motor learning. Non‐musicians (n = 18) learned to perform three short melodies on a piano keyboard in a pure audio‐motor training condition (vision of their own fingers was occluded). Initial learning times ranged from 17 to 120 min (mean ± SD: 62 ± 29 min). Diffusion‐weighted magnetic resonance imaging was used to derive the fractional anisotropy (FA), an index of white matter microstructural arrangement. A correlation analysis revealed that higher FA values were associated with faster learning of piano melodies. These effects were observed in the bilateral corticospinal tracts, bundles of axons relevant for the execution of voluntary movements, and the right superior longitudinal fasciculus, a tract important for audio‐motor transformations. These results suggest that the speed with which novel complex audio‐motor skills can be acquired may be determined by variability in structural properties of white matter fiber tracts connecting brain areas functionally relevant for audio‐motor learning. Hum Brain Mapp 35:2483–2497, 2014. © 2013 Wiley Periodicals, Inc .     

脑胶质瘤中细胞凋亡及相关基因Fas、Survivin表达研究

目的探讨脑胶质瘤中细胞凋亡及Fas、Survivin在凋亡中的意义.方法应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷缺口末端标记法(terminal deoxynucleotidyl transferase-mediated-deoxy uridine-5'- triphosphate-X nick end labeling, TUNEL)检测细胞凋亡,免疫组化链酶亲和素-生物素-过氧化物酶复合物 (strept avidin-biotin peroxidase complex, SABC)法检测Fas、Survivin和增殖细胞核抗原(proliferating cell nuclear antigen, PCNA).结果凋亡指数(apoptosis index, AI)随胶质瘤的恶性程度增高而增高(P<0.001).AI/PI则随着胶质瘤级别增高而减小(P<0.001).Fas阳性组的AI较Fas阴性组显著增高(P<0.01).Survivin阳性组的AI较Survivin阴性组显著减低(P<0.05).低AI(<0.94)组与高AI(>0.94)组的术后1年生存率的差异有显著意义(P<0.05).死亡组与存活组的AI差异无显著意义(P=0.34),而两组的AI/PI有显著差异(P<0.001).多因素Logistic回归模型分析显示,病理、Fas、Survivin、AI、AI/PI和手术与预后相关(P<0.01).结论 AI可作提示预后的指标,对脑胶质瘤的生物学行为及肿瘤分级有指导意义.肿瘤级别较低、Fas 阳性、Survivin阴性、AI<0.94%、AI/PI较大、手术全切的患者预后较好.     

Application of non-invasive cerebral electrical impedance measurement on brain edema in patients with cerebral infarction

Abstract

Objective: To investigate the change of brain edema in patients with cerebral infarction by non-invasive cerebral electrical impedance (CEI) measurements.

Methods: An invariable secure current at a frequency of 50 kHz and an intensity of 0.1 mA was given into a person's brain. CEI values of the bilateral hemisphere of 200 healthy volunteers and 107 patients with cerebral infarction were measured by non-invasive brain edema monitor. The results of perturbative index (PI) converted from CEI were compared with the volumes of brain edema, which were calculated by an image analysing system according to magnetic resonance imaging or computed tomography.

Results: (1) In the healthy volunteers, PI values in the left and right hemisphere were 7·98 ± 0·95 and 8·02 ± 0·71 respectively, and there was no significant difference between the two sides (p>0·05). Age, gender and different measuring times did not obviously affect PI values (p>0·05). (2) In the cerebral infarction group, CEI measurements were more sensitive to the volumes of lesion, which were more than 20 ml. The positive ratio of PI was higher when the volumes of infarction were >20 ml (80·0%): the ratio of PI was 75·9% when the volumes of infarction were 20–50 ml and it was 83·3% when the volumes of lesion were more than 50 ml. PI was lower when the volumes were less than 20 ml. (3) PI of the infarction side increased obviously 3–5 days after onset; the difference of two sides was the most significant. There was a positive correlation between PI of the infarction side and volume of infarction.

Conclusions: PI may be a sensitive parameter for non-invasive monitoring of the change of brain edema in patients with cerebral infarction. CEI is a valuable method for the early detection of brain edema.     

Apoptosis in glial tumors as determined by in situ nonradioactive labeling of DNA breaks

Tumor growth depends on cell division and cell death. To investigate the role of apoptosis in tumor cell death, we examined 83 cases of glial tumors using in situ nonradioactive tailing of DNA breaks. In addition, since p53 protein may participate in the regulation of apoptosis in glioblastoma, we compared the apoptosis ratio (AR) with the labeling index (LI) of p53 protein immunopositivity. The AR in glial tumor parenchyma ranged from 0 to 1.4%: mean AR ± standard deviation was 0.4 ± 0.4% (range, 0–1.4) for glioblastoma, 0.3 ± 0.3% (range, 0.01– 0.83) for anaplastic astrocytoma, 0.1 ± 0.1% (range, 0– 0.41) for low-grade astrocytoma, 0.006 ± 0.008% (range, 0–0.02) for pilocytic astrocytoma, 0.2 ± 0.2% (range, 0– 0.62) for oligodendroglioma and 0.003 ± 0.004% (range, 0–0.01) for ependymoma. ARs were significantly higher in higher-grade astrocytic tumors than in lower-grade tumors (Mann-Whitney U test: P = 0.0003), although wide variability in each group resulted in overlapping between the groups. p53 protein immunopositivity (more than 25% of nuclei) was found in 15 of 32 glioblastoma cases, while in the remaining 17 none or only a low percentage (up to 6%) of the nuclei were positive. In p53 protein-positive cases mean AR (0.51 ± 0.47%) was not significantly higher than that in p53 protein-negative cases (0.22 ± 0.23%; P = 0.1681). Received: 17 February 1995 / Revised: 12 June 1995 / Accepted: 30 August 1995     

Apoptosis in cerebral astrocytic tumours and its relationship to expression of the bcl-2 and p53 proteins

Apoptosis is an important determinant of tumour growth which can be regulated by the bcl-2 and p53 genes. This study examines the relationship between apoptosis, growth fraction (Ki-67 immunolabelling index), and accumulation of the bcl-2 and p53 proteins in a spectrum of cerebral astrocytic tumours (n=81). including fibrillary astrocytomas (n=16), anaplastic astrocytomas (n=19), and glioblastomas (n=46). Median apoptosis indices (AIs) increased across this spectrum of tumours, and a significant (P<0.0001) correlation was demonstrated between A1 and Ki-67 labelling index (LI). Immunolabelling with the bcl-2 antibody was found in 44% of fibrillary astrocytomas, 42% of anaplastic astrocytomas, and 28% of glioblastomas. It was also found in the vascular endothelial proliferation typically seen in glioblastomas, and in the giant, multinucleated cells of some glioblastomas. No clear relationship between AI and bcl- 2 accumulation was evident. Immunolabelling with the p53 antibody was found in 56% of fibrillary astrocytomas, 79% of anaplastic astrocytomas, and 50% of glioblastomas. No clear relationship between AI and patterns of p53 immunolabelling was evident. Equal proportions of p53-positive tumours were bcl- 2 positive and bcl- 2 negative, but a small proportion of p53-negative tumours was bcl- 2 positive. The correlation between A1 and Ki-67 LI is in line with findings in other malignant tumours. We suggest that the regulation of apoptosis in astrocytic tumours is too complex for a clear association between A1 and bcl- 2 and p53 protein expression to be demonstrated.     

Effects of deep brain stimulation in dyskinetic cerebral palsy: A meta‐analysis

Secondary dystonia encompasses a heterogeneous group with different etiologies. Cerebral palsy is the most common cause. Pharmacological treatment is often unsatisfactory. There are only limited data on the therapeutic outcomes of deep brain stimulation in dyskinetic cerebral palsy. The published literature regarding deep brain stimulation and secondary dystonia was reviewed in a meta‐analysis to reevaluate the effect on cerebral palsy. The Burke‐Fahn‐Marsden Dystonia Rating Scale movement score was chosen as the primary outcome measure. Outcome over time was evaluated and summarized by mixed‐model repeated‐measures analysis, paired Student t test, and Pearson's correlation coefficient. Twenty articles comprising 68 patients with cerebral palsy undergoing deep brain stimulation assessed by the Burke‐Fahn‐Marsden Dystonia Rating Scale were identified. Most articles were case reports reflecting great variability in the score and duration of follow‐up. The mean Burke‐Fahn‐Marsden Dystonia Rating Scale movement score was 64.94 ± 25.40 preoperatively and dropped to 50.5 ± 26.77 postoperatively, with a mean improvement of 23.6% (P < .001) at a median follow‐up of 12 months. The mean Burke‐Fahn‐Marsden Dystonia Rating Scale disability score was 18.54 ± 6.15 preoperatively and 16.83 ± 6.42 postoperatively, with a mean improvement of 9.2% (P < .001). There was a significant negative correlation between severity of dystonia and clinical outcome (P < .05). Deep brain stimulation can be an effective treatment option for dyskinetic cerebral palsy. In view of the heterogeneous data, a prospective study with a large cohort of patients in a standardized setting with a multidisciplinary approach would be helpful in further evaluating the role of deep brain stimulation in cerebral palsy. © 2013 Movement Disorder Society     

[18F]Nifene test–retest reproducibility in first‐in‐human imaging of α4β2* nicotinic acetylcholine receptors

The aim of this study was to examine the suitability of [¹⁸ F]nifene, a novel α4β2* nicotinic acetylcholine receptor (nAChR) radiotracer, for in vivo brain imaging in a first‐in‐human study. Methods : Eight healthy subjects (4 M,4 F;21–69,44 ± 21 yrs) underwent a [¹⁸F]nifene positron emission tomography scan (200 ± 3.7 MBq), and seven underwent a second scan within 58 ± 31 days. Regional estimates of DVR were measured using the multilinear reference tissue model (MRTM2) with the corpus callosum as reference region. DVR reproducibility was evaluated with test–retest variability (TRV) and intraclass correlation coefficient (ICC). Results : The DVR ranged from 1.3 to 2.5 across brain regions with a TRV of 0–7%, and did not demonstrate a systematic difference between test and retest. The ICCs ranged from 0.2 to 0.9. DVR estimates were stable after 40 min. Conclusion : The binding profile and tracer kinetics of [¹⁸F]nifene make it a promising α4β2* nAChR radiotracer for scientific research in humans, with reliable DVR test–retest reproducibility.     

Vitamin D and disability in relapsing–remitting multiple sclerosis in patients with a Mexican background

Previous studies of multiple sclerosis (MS) patients have reported an inverse correlation between disability, the number of relapses and vitamin D levels in mostly white patients. It is unclear if this relationship has the same behavior in individuals with Hispanic backgrounds. To determine the relationship between vitamin D serum levels and disability in a sample of Hispanics of a Mexican background with relapsing–remitting multiple sclerosis (RRMS). A cross-sectional study was conducted on 50 RRMS individuals of Mexican background. The Expanded Disability Status Scale (EDSS) score, progression index (PI) and annual relapse rate (ARR) were recorded for each patient. Vitamin D levels were assessed during the summer. Pearson’s test was used to evaluate the relationship between vitamin D and EDSS, PI, ARR, and duration of disease evolution. Most patients were females (n = 29, 58%). The mean vitamin D level was 22.3 (± 6.4) ng/ml; the mean EDSS score was 2.2 (± 0.7), ARR 1.3 (± 0.5) and PI1.08 (± 0.6). No correlation was found between vitamin D levels and EDSS scores, ARR, PI or duration of disease. Moderate negative association between vitamin D levels and EDSS was found just in females (<0.0001). No correlation between vitamin D levels and disability was found in this sample of RRMS Mexicans. Longitudinal studies are needed to better understand the impact of Vitamin D in disability and multiple time points.     

Reduced gray matter volume of dorsal cingulate cortex in patients with obsessive-compulsive disorder: a voxel-based morphometric study

Aims: Previous morphometric studies using magnetic resonance imaging (MRI) have revealed structural brain abnormalities in obsessive–compulsive disorder (OCD). The aim of the present study was to investigate the alterations in brain structure of patients with OCD using a voxel‐based morphometry (VBM) method. Methods: Sixteen patients with OCD free of comorbid major depression, and 32 sex‐ and age‐matched healthy subjects underwent MRI using a 1.5‐T MR scanner. OCD severity was assessed with the Yale–Brown Obsessive–Compulsive Scale (mean ± SD: 22 ± 7.6; range: 7–32). MR images were spatially normalized and segmented using the VBM5 package ( http://dbm.neuro.uni‐jena.de/vbm/ ). Statistical analysis was performed using statistical parametric mapping software. Results: Significant reductions in regional gray matter volume were detected in the left caudal anterior cingulate cortex and right dorsal posterior cingulate cortex in the patients with OCD as compared to healthy controls (uncorrected, P < 0.001). No significant differences in white matter volumes were observed in any brain regions of the patients. No significant correlation between Yale–Brown Obsessive–Compulsive Scale score and regional gray matter or white matter volume was observed. Conclusions: Regional gray matter alteration in the dorsal cingulate cortex, which is suggested to play a role in non‐emotional cognitive processes, may be related to the pathophysiology in OCD.     

Evaluation of p53 protein expression and proliferative potential based on the MIB-1 positive index in astrocytic gliomas

Fifty-seven patients with infiltrative astrocytic gliomas, comprising 29 cases of glioblastoma, 13 cases of anaplastic astrocytoma and 15 cases of low-grade astrocytoma, were examined. In 12 cases of astrocytic glioma, the p53 gene mutation was investigated by polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP). p53 overexpression was observed in 20 (35%) of the 57 patients with astrocytic gliomas. The occurrence of p53 overexpression was apparently correlated with the histological grading of the astrocytic gliomas. Of the 20 patients with glioblastoma who were less than 60 years old (mean age ± SD, 39.2 ± 15.0 years), 50% demonstrated p53 overexpression, whereas only 2 (22%) patients with glioblastoma who were more than 60 years old (mean age ± SD, 65.1 ± 5.8 years) had p53 overexpression. A substantial difference in survival associated with glioblastoma was noted between the p53-positive group (mean survival 28.9 months) and the p53-negative group (mean survival 11.3 months) based on Kaplan-Meier survival curves (P= 0.01). Even among patients with glioblastoma who were less than 60 years old, a better survival rate was recognized in those with p53 overexpression than in those without p53 (P= 0.03). The MIB-1 indices tended to increase with tumor malignancy, and a poor survival time was significantly associated with elevated values for the MIB-1 index. A substantial difference in survival between the two groups of patients who had MIB-1 indices of above 5% and below 5% was evident from the Kaplan-Meier survival curves (P= 0.04). The group that had no p53, and MIB-1 indices of above 5%, was found to show the malignant gliomas most frequently. Although most of the gliomas with p53 overexpression demonstrated MIB-1 indices of above 5%, there was no significant correlation between p53 protein expression and the MIB-1 index. Of the 12 patients with astrocytic glioma who were examined by PCR-SSCP, 3 (one glioblastoma and 2 anaplastic astrocytomas) revealed p53 gene mutation correlated with p53 (DO-7) overexpression.     

Specific T‐cell proliferation to myelin peptides in relapsing‐remitting multiple sclerosis

Background: The identification of major immunogenic peptides in multiple sclerosis (MS) is of great importance for the development of antigen‐specific therapies. Cellular reactivity against a selected mix of seven myelin peptides was evaluated in vitro. The evolution of this reactivity over time and its correlation with clinical variables was also analysed. Material and methods: Forty‐two patients with MS, 15 with other demyelinating diseases and 40 healthy donors (HD) were studied. Cell proliferation was measured by 3[H] thymidine incorporation into samples obtained at 0, 3, 6 and 12 months of MS patient follow‐up. Results: A positive reaction to the peptide mix was detected in 31 of the 42 patients (74%), 12 of the 40 HD (30%) and 6 of the 15 (40%) patients with other demyelinating diseases. Patients with positive proliferation had greater disability (EDSS score, 3 [1–5.5] vs. 1.0[1–2], P = 0.021), higher number of relapses (7 ± 4.1 vs. 3 ± 1.2, P < 0.001) and shorter time since the last relapse (9 ± 7.5 vs. 32 ± 12.3 months, P = 0.036). After 12 months of follow‐up, cell reactivity was maintained in 33 patients (78%). Conclusion: A high percentage of patients exhibit a significant and maintained reactivity to myelin peptides over time. Therefore, this mix may be useful as a source of antigen in the development of protocols aimed at inducing specific tolerance in MS.     

MIB‐1 immunolabeling: A valuable marker in prediction of benign recurring meningiomas

Histological analysis has limited value to predict biological behavior of meningiomas. We investigated the utility of cell proliferative indicator in the evaluation of histologically benign meningiomas. We selected 25 benign non‐recurrent meningiomas, 15 benign recurrent meningiomas after complete surgical resection, 30 atypical meningiomas, and 15 anaplastic meningiomas out of 384 cases studied. MIB‐1 Labeling Index was evaluated by two methods: Highest Labeling Index (HLI) and Random Labeling Index (RLI). There was no dependable histological parameter to predict recurrence among benign‐looking meningiomas. HLI had significant difference when compared with RLI in all categories. The mean MIB‐1 HLI values ± SD were 3.47 ± 2.0% for benign meningiomas, 5.08 ± 4.0% for atypical meningiomas and 11.66 ± 7.06% for anaplastic meningiomas. In comparison, the mean MIB‐1 HLI of benign non‐recurrent meningiomas were 2.66 ± 1.7% and with recurrence were 4.21 ± 2.78% (P = 0.0339). Using receiver operating characteristic, it was seen that neoplasm recurred with the MIB‐1 HLI of > 2.6 having the sensitivity of 64.6% and specificity of 68% among benign (grade I) meningiomas. MIB‐1 positive tumor cells were maximally aggregated at the periphery of excised specimen. MIB‐1 HLI, integrated with standard histopathology can provide better information about the disease biological nature in benign meningiomas.     

Transcranial Doppler ultrasonographic evaluation of vertebral artery hypoplasia and aplasia

BACKGROUND AND PURPOSE: Evaluation of vertebral artery (VA) with transcranial Doppler ultrasonography (TCD) is difficult due to anatomical variations of hypoplasia (HP) or aplasia (AP). TCD findings of HP or AP of VA are rarely known. Comparing with magnetic resonance angiography (MRA), we tried to evaluate characteristic findings of HP or AP of VA using TCD. METHODS: Consecutive healthy patients who underwent TCD and MRA were included. VA was classified as normal (NL), hypoplasia (HP), and aplasia (AP) according to MRA. TCD parameters of mean flow velocity (MFV), pulsatility index (PI), vertebral/basilar artery flow velocity ratio (VA/BA FVR), and asymmetry index (AI) of VA were compared between three groups. RESULTS: Four hundred and ten patients were included, and 298 patients (72.7%) were classified as NL, 98 (23.9%) as HP and 14 (3.4%) as AP. MFV, PI and VA/BA FVR of ipsilateral VA were not different between groups. However, MFV of contralateral VA and AI were significantly increased in HP and AP groups (p<0.001). AI was significantly different between the three groups (17.7% and 30.5%, p<0.001). Sensitivity and specificity for HP or AP were 20.5% and 90.9%, if AI over 40% were adopted as diagnostic criteria. CONCLUSION: MFV of VA should be interpreted with caution for its frequent anatomical variations. Increased MFV of unilateral VA may indicate not only as ipsilateral stenosis, but also as contralateral HP or AP. AI over 40% is specific to predict unilateral HP or AP with clinical correlation.     

Epstein–Barr virus neutralizing and early antigen antibodies in multiple sclerosis

Background: Our objective was to determine whether antibodies against the Epstein–Barr virus (EBV) nuclear antigen‐1 (EBNA‐1), early antigen (EA), and EBV neutralizing antibodies (NeutAb) are altered in multiple sclerosis (MS). Methods: We measured EBNA‐1 IgG, EA IgG, and EA IgA using quantitative ELISA. We measured NeutAb using a quantitative competitive ELISA. We studied 80 patients with MS, 80 matched controls, and 19 patients with MS with samples collected both whilst stable and in relapse. Results: Epstein–Barr virus nuclear antigen‐1 IgG and EA IgA were increased in MS compared to controls. The EBNA‐1 index value was 23.3 ± 18.3 in the patients with MS (mean ± SD) and 16.3 ± 17.4 in the controls (P = 0.007, paired t‐test). EA IgA had a median value of 1.964 in the patients with MS and 1.248 in the controls (P = 0.029, Wilcoxon signed rank test). EA IgG and NeutAb were not significantly different. None of the antibody levels were altered in relapse. The correlation between concentrations of different antibodies was minimal. Conclusions: IgG antibodies to EBNA‐1 are significantly increased in MS. IgA antibodies against EBV EA are also increased. The EBV neutralizing antibody response is similar in MS and controls.     

Duodenal levodopa/carbidopa infusion therapy in patients with advanced Parkinson’s disease leads to improvement in caregivers’ stress and burden

Background: Continuous duodenal levodopa infusion (DLI) is an effective therapy that improves quality of life (QoL) in advanced Parkinson’s disease (PD). However, the impact of DLI on caregivers’ stress and burden has not been reported. Methods: We evaluated prospectively open‐label seven advanced PD patients (65.7 ± 9.6 years, 71.4% men) treated with DLI. Schwab & England Activities of Daily Living Scale (ADLS), 39‐item Parkinson’s disease QoL Questionnaire Summary Index score (PDQ‐39SI), Zarit Caregiver Burden Interview (ZCBI), and Caregiver Strain Index (CSI) were used. Comparisons were made between scores obtained at baseline and those at a mean follow‐up of 31.4 ± 7.9 months (range, 23–42). Results: In patients, mean ± SD ADLS was increased from 50 ± 8.2 to 80 ± 11.6 (P = 0.014), and mean ± SD PDQ‐39SI was decreased from 53.7 ± 11.9 to 33.6 ± 12.8 (P = 0.018). In caregivers, ZCBI decreased from 43 ± 13.3 to 20.7 ± 12.1 (P = 0.018) and CSI from 6.3 ± 2.5 to 1.6 ± 0.9 (P = 0.018). At baseline, 57.1% of caregivers reported moderate to severe burden (ZCBI 41–88) compared to 28.6% at the end of the follow‐up (P = 0.015); at that time, no caregiver reported high level of stress (CSI ≥ 7) compared to 57.1% at baseline (P = 0.046). There were significant correlations between ZCBI and CSI improvement (r = 0.813, P = 0.026), ZCBI and PDQ‐39SI (r = 0.875, P = 0.01), and ZCBI and ADLS (r = 0.813, P = 0.026). Conclusions: Duodenal levodopa infusion‐related clinical improvement in patients with advanced PD leads to substantial reductions in caregivers’ stress and burden.     

Neuroprotective effect of L-arginine in a neonatal rat model of hypoxic-ischemia

Abstract

Aim: The aim of the present study is to investigate the neuroprotective effects of l-Arginine (l-arg) in the seven-day-old rat hypoxia-ischemia model.

Materials and methods: L-Arginine (n?=?10) or saline (n?=?8) was administered intraperitoneally to seven-day-old rats before hypoxia-ischemia. In addition, 18 seven-day-old rats were given l-Arginine (n?=?10) or saline (n?=?8) after hypoxic-ischemic insult. Neuronal apoptosis was investigated by terminal dUDP-biotin nick end-labeling (TUNEL) following three days of recovery. The ratios of right side numerical density to the sum of right and left sides’ numerical densities (right apoptosis index) were calculated for every brain region in rats receiving l-arginine and they were compared with the vehicle groups.

Results: Right side apoptosis indexes of the hippocampus (mean?±?SD; 35.0?±?16.1) and striatum (41.9?±?16.0) were significantly decreased in the l-Arginine post-treatment groups when compared to vehicles (61.0?±?17.0 and 62.4?±?27.0 respectively) (p?<?0.05). There was no significant difference in the right apoptosis indexes of the cortex between l-Arginine post-treated group and the vehicle group. There were also no significant differences between the right side apoptosis indexes of the l-Arginine pretreatment groups and those of the vehicle group in any of the three regions (p?>?0.05).

Conclusions: It is concluded that neuronal apoptosis due to hypoxic–ischemic injury may likely to be reduced by post-treatment of l-Arginine in the neonatal rat model and l-Arginine provides a new possibility for neuroprotective strategies based on NO production.     

Weight gain following subthalamic nucleus deep brain stimulation: A PET study

Several hypotheses have been put forward to explain weight gain after deep brain stimulation (DBS), but none provides a fully satisfactory account of this adverse effect. We analyzed the correlation between changes in brain metabolism (using positron emission tomography [PET] imaging) and weight gain after bilateral subthalamic nucleus DBS in patients with Parkinson's disease. Body mass index was calculated and brain activity prospectively measured using 2‐deoxy‐2[18F]fluoro‐D ‐glucose 3 months before and 4 months after the start of subthalamic nucleus deep brain stimulation in 23 patients with Parkinson's disease. Motor complications (United Parkinson's Disease Rating Scale [UPDRS]‐IV scores) and dopaminergic medication were included in the analysis to control for their possible influence on brain metabolism. Mean ± standard deviation (SD) body mass index increased significantly by 0.8 ± 1.5 kg/m² (P = 0.03). Correlations were found between weight gain and changes in brain metabolism in limbic and associative areas, including the orbitofrontal cortex (Brodmann areas [BAs] 10 and 11), lateral and medial parts of the temporal lobe (BAs 20, 21, 22,39 and 42), anterior cingulate cortex (BA 32), and retrosplenial cortex (BA 30). However, we found no correlation between weight gain and metabolic changes in sensorimotor areas. These findings suggest that changes in associative and limbic processes contribute to weight gain after subthalamic nucleus DBS in Parkinson's disease. © 2014 International Parkinson and Movement Disorder Society     

Measurement of cross‐sectional area of cervical roots and brachial plexus trunks

Introduction: The aim of this study was to determine normal reference values for cross‐sectional area (CSA) and the correlation between demographic factors and CSA in the cervical roots and brachial plexus trunks using ultrasonography. Methods: Ninety‐five age‐matched healthy individuals were studied. Ultrasonographic tests were performed via nerve tracing from the cervical root to the brachial plexus trunk. The CSA of each nerve was measured in the C5–8 ventral roots and brachial plexus (trunk level). Results: Normal values of each cervical root were: C5, 5.66 ± 1.02 mm²; C6, 8.98 ± 1.65 mm²; C7, 10.43 ± 1.86 mm²; and C8, 10.76 ± 2.02 mm². Values for the brachial plexus were: upper trunk, 16.70 ± 2.88 mm²; middle trunk, 14.01 ± 2.70 mm²; and lower trunk, 13.75 ± 2.57 mm². The side‐to‐side discrepancy was 11.91 ± 11.11%. Body mass index (BMI) and height correlated frequently with nerve CSA. Conclusions: These reference values may be helpful in investigating pathologies involving the cervical area. Muscle Nerve 46: 711–716, 2012