实验性急性脑梗塞早期MRI表达与病理对照研究

目的 阻断狗大脑中动脉建立急性脑梗塞动物模型，观察早期ＭＲＩ表现及其病理性改变。方法 将１６只成年随机分为实验组（１０只）和对照组（６只）。经颞开颅阻断一侧大脑中动脉（ＭＣＡ），造成ＭＣＡ供应区急性缺血性脑梗塞，术后４、６、８、１２ｈ行ＭＲＩ薄层扫描；取出动物大脑观察病理改变，测定不同时相梗塞区Ｔ２时间和组织水含量。结果 梗塞２ｈＭＲＩＴ２加权可见尾状核头部、豆状核信号增高；６ｈＭＲＩ可见了尾状核     

实验性癫痫大鼠海马结构内一氧化氮-环磷酸鸟苷途径的研究

目的研究实验性癫痫发作大鼠海马结构内一氧化氮（ＮＯ）环磷酸鸟苷（ｃＧＭＰ）信使机制及其意义。方法雄性ＳＤ大鼠４１只，随机分为对照组（５只）、红藻氨酸（ＫＡ）１０、３０、６０分钟组（每组６只）和Ｌ硝基精氨酸甲酯（ＬＮＡＭＥ）＋ＫＡ１０、３０、６０分钟组（每组６只）。用放射免疫法测定ＫＡ诱导性癫痫发作中各时点海马结构内ｃＧＭＰ含量及ＬＮＡＭＥ的干预效应。结果ＫＡ注射引起大鼠海马结构内ｃＧＭＰ浓度升高，并加重大鼠癫痫发作（湿狗样摇动提早出现和发生次数增多）；ＫＡ注射前３０分钟给予ＬＮＡＭＥ可明显抑制ＫＡ１０、３０分钟组ｃＧＭＰ浓度的升高，但ＬＮＡＭＥ对ＫＡ６０分钟组ｃＧＭＰ的抑制作用不显著。结论在ＫＡ发作早期，ｃＧＭＰ浓度升高与内源性ＮＯ有关；ＮＯ的抗发作效应可能与ｃＧＭＰ信使机制存在某种联系。     

脊髓空洞症的MRI与临床17例报告

脊髓空洞症的ＭＲＩ与临床１７例报告曲松滨，王秀华，李增会，谭静江，葛茂振自八十年代磁共振成像（ＭＲＩ）应用于临床，大大提高了脑脊髓空洞症的确诊率。本文对经ＭＲＩ证实的１７例脑脊髓空洞症的ＭＲＩ与临床所见进行总结分析如下。１临床资料１．１一般资料１７例...     

Arnold-chiari畸型合并脊髓空洞发病机理实验研究

目的　建立ＡＣＭ－ ＳＭ 狗动物模型, 并探讨其发病机理。方法　８ 只健康家犬分两组进行梗阻前后压力测定并研究其变化趋势。模型组动物寰枕间隙置入梗阻物; 观察所有实验动物的行为改变; 不同时间行颅底及颈胸段脊髓ＭＲＩ检查; 对模型组动物进行病理学观察。显著性检验采用ｔ检验, 以Ｐ＜ ０－０５ 为显著差异。结果　８ 只动物梗阻前枕大池及脊髓蛛网膜下腔压力差的均数为０－０７５ ±０－０７１ （ Ｐ＞０－０５） 无显著差异。梗阻前后压力差比较Ｐ＜ ０－０１ 差异非常显著。梗阻后即刻与梗阻后３０ 分钟比较Ｐ＞０－０５, 无显著差异; 梗阻后３０ 分钟与梗阻６０ 分钟,Ｐ＜０－０５ 有显著差异; 梗阻即刻与梗阻６０ 分钟,Ｐ＜ ０－０２ 差异较显著。术后６ 只模型组动物均有行为异常。影像学检查, ６ 只模型组动物５ 只有脊髓空洞形成。组织学观察与人类空洞及脑积水周围结构一致。结论　枕大孔处蛛网膜下腔梗阻, 导致枕大池压力升高, 使Ⅳ脑室ＣＳＦ冲开中央管上口进入中央管, 反复冲击中央管,并向外膨胀破坏室管膜进入脊髓实质, 从而形成与中央管相通的多房空洞     

神经生长因子在胎脑组织保存和移植中的应用

大鼠胚胎脑组织放入神经生长因子（ＮＧＦ）溶液或ＤＭＥＭ培养液中保存１～６天，观察不同时间细胞存活率，ＮＧＦ组均高于ＤＭＥＭ组。将这两种液体中保存５天的组织分别植入两组成年大鼠脑内，６～８周后组织学观察发现，ＮＧＦ组移植成活４／１０，对照组移植物成活３／９．尽管两组移植物成活率比较差别不显著（Ｐ＞０．０５），但是移植物生存质量ＮＧＦ组明显优于对照组。     

多发性硬化三例标本MRI长T2信号与病理对照研究

采用磁共振成像（ＭＲＩ）与病理对照方法探讨多发性硬化（ＭＳ）ＭＲＩ异常长Ｔ２信号与病理改变的关系。对３例经１０％福尔马林固定的全脑标本（其中１例含脊髓）行自旋回波（ＳＥ）序列扫描，对照ＭＲＩ图像所示的长Ｔ２信号行标本大体及镜下观察。３例ＭＳ均显示有长Ｔ２信号，其病理基础除ＭＳ斑块外还可见坏死软化灶及空洞形成。斑块状长Ｔ２信号具有特征性的ＭＲＩ表现：直角脱髓鞘征，见于病程长者（例１）。坏死软化灶及空洞形成引起的非斑块状长Ｔ２信号形态分布不一，以病程短、起病急者为著（例２、３），后者脊髓受累程度亦严重。ＭＲＩ是诊断ＭＳ最有价值的影像学检查方法。ＭＳ长Ｔ２信号的病理基础除典型硬化斑外还有坏死软化灶及空洞形成。当临床拟诊为ＭＳ，而ＭＲＩ仅显示非斑块状长Ｔ２信号时，应警惕为急性发病的ＭＳ。     

脊髓空洞症的临床与MRI的研究

脊髓空洞症的临床与ＭＲＩ的研究李淑兰，尹普安，陈炽贤，陈丽英脊髓空洞症（ｓｙｒｉｎｇｏｍｙｅｌｉａ，ＳＭ）是神经系统常见病，磁共振成像（ＭＲＩ）应用以来，我们将影像学改变与临床症状之间进行了比较和分析。６０例ＳＭ病人，男３２例，女２８例；平均年龄３８...     

脊髓空洞症31例手术治疗（摘要）

脊髓空洞症３１例手术治疗（摘要）刘薇赵宪林杨国瑞我院自１９８９年６月至１９９４年６月应用ＭＲＩ诊断颅脊畸形、脊髓空洞症３１例。现将其影像学表现及临床症状及手术术式的选择，报告如下。一、资料和方法１．一般资料：男１７例、女１４例，年龄１３～６４岁，病史...     

多系统萎缩的临床与CT及磁共振分析

目的　评价临床表现与ＣＴ、磁共振（ＭＲＩ） 结合对多系统萎缩（ＭＳＡ） 的诊断价值。方法　选择５６ 例多系统萎缩病人，其中橄榄桥脑小脑萎缩（ＯＰＣＡ）３７ 例，Ｓｈｙ－ Ｄｒａｇｅｒ 综合征（ＳＤＳ）１３ 例，纹状体黑质变性（ＳＮＤ）６ 例。全部病人均行头颅ＣＴ、ＭＲＩ检查，并对其临床表现、分型、ＭＲＩ进行比较。结果　临床发现各型早期各有特点，且ＭＲＩ表现也各不相同。结论　临床表现与ＭＲＩ结合可提高ＭＳＡ 中ＯＰＣＡ、ＳＮＤ的诊断率，但在ＳＤＳ病人ＭＤＩ改变不明显。头颅ＣＴ对ＭＳＡ 诊断意义不大。     

实验性脊髓空洞MRI动态观察及演变分析

目的 :应用 MRI动态观察经皮枕大池穿刺注入 Kaolin诱导的家兔实验性脊髓空洞症模型 ,结合光镜、电镜组织学对比 ,对脊髓空洞症演变过程加以探讨。方法 :取中国白兔 32只 ,16只动物经皮枕大池穿刺注入 Kaolin制作动物模型 ,生理盐水组和假手术组 (各 8只 )作对照。术后行 MRI扫描并与光镜、电镜组织学对比。结果 :2周时 MRI发现上颈髓呈水肿、缺血性改变。 4～ 6周 ,90 %动物形成空洞。空洞随观察时间延长而逐渐增大且受累节段增多。组织学证实了 MRI发现。结论 :Kaolin性肉芽肿引起的上颈髓缺血、水肿和脑脊液循环障碍在脊髓空洞形成中发挥重要作用。其中 ,前者在髓内空洞进展中起主要作用 ,后者在中央管扩张中起主要作用。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -