外周formalin刺激时大鼠脊髓灰质神经元c—Fos蛋白和NMDA受体的 …

利用免疫细胞化学双标技术，研究了大鼠后脚掌注入ｆｏｒｍａｌｉｎ时脊髓ｃ－Ｆｏｓ蛋白和ＮＭＤＡ受体在脊髓灰质不同层次神经元的分布，结果表明，脊髓背角Ｉ－Ⅱ层，Ｖ－Ⅵ层和Ｘ层中的Ｆｏｓ样免疫反应阳性神经元中分别有２８．６％，５８．１％和６４．８％，呈现ＮＭＤＡ受体样免疫反应，此结果提示长时间的外周伤害性刺激作用时，脊髓不同层次的伤害性感受神经元可能由于ＮＭＤＡ受体分布的不同而在持续痛刺激过程中起着不同     

外周formalin刺激时大鼠脊髓灰质神经元c-Fos蛋白和NMDA受体的双标记免疫细胞化学研究(英文)

利用免疫细胞化学双标技术，研究了大鼠后脚掌注入ｆｏｒｍａｌｉｎ时脊髓ｃ－Ｆｏｓ蛋白和ＮＭＤＡ受体在脊髓灰质不同层次神经元的分布。结果表明，脊髓背角Ⅰ－Ⅱ层、Ⅴ－Ⅵ层、和Ｘ层中的Ｆｏｓ样免疫反应阳性神经元中分别有２８．６％，５８．１％和６４．８％呈现ＮＭＤＡ受体样免疫反应阳性。此结果提示长时间的外周伤害性刺激作用时，脊髓不同层次的伤害性感受神经元可能由于ＮＭＤＡ受体分布的不同而在持续痛刺激过程中起着不同的作用。     

E—选择素对局灶缺血性脑皮质血流的影响

目的探讨Ｅ－选择素对局灶缺血性脑皮质血流的影响。方法用Ｅ－ｓｅｌｅｃｔｉｎＬｅｃｔｉｎＤｏ－ｍａｉｎ（以下Ｅ－选择素）Ｎ－末端２３－３０氨基酸残基合成的寡肽（Ｏｌｉｇｏｐｅｐｔｉｄｅ）１０ｍｇ／ｋｇ，或伪Ｅ－ｓｅｌｅｃｔｉｎ或等量生理盐水，在ＳＨＲ（自发高血压性大鼠）ＭＣＡ／ＣＣＡ（大脑中动脉／颈总动脉）闭塞２ｈ后ＣＣＡ再灌注的模型中，静脉内缓慢注入，用激光多普勒血流测定仪从ＳＨＲ缺血前１０ｍｉｎ起至ＭＣＡ／ＣＣＡ闭塞２ｈ、ＣＣＡ再灌注后３０ｍｉｎ止，在大脑皮质背侧测定脑血流的变化。结果生理盐水组、伪Ｅ－选择素和Ｅ－选择素组的局部脑血流分别是２３％、２９％和５４％，有统计学意义（Ｐ＜０．０５）。结论Ｅ－选择素能够有效地增加ＳＨＲ缺血再灌注后脑皮质的血流     

实验性过敏性脑脊髓炎中枢神经系统中NF—kBp65的？…

目的 探讨核转录因子ＮＦ－ｋＢ在中枢神经系统炎性脱鞘病发病中的作用。方法 用牛脊髓髓鞘碱性蛋白加完全福氏佐剂对豚鼠进行免疫，诱发多发性硬化症的经典性动物模型－实验性过敏性脑脊髓炎（ＥＡＥ），并采用免疫组化方法对ＥＡＥ中枢神经系统中核转录因子（ＮＦ）ｋＢｐ６５的表达进行了研究。结果 在ＥＡＥ急性期血管周围浸润细胞和活化的小胶质细胞样细胞呈现ＮＦ－ｋＢｐ６５免疫反应阳性，而恢复期这种免疫反应明显减弱。     

血清CAE—Ab,nAchR—Ab检测对伴发胸腺瘤的重症肌无力患者？…

目的 探讨柠檬酸提取物抗体（ＣＡＥ－Ａｂ）在烟碱型乙酰胆碱受体抗体（ｎＡｃｈＲ－Ａｂ）对临床早期诊断伴发胸腺瘤的重症肌无力（ＭＧ）患者的价值,与改良Ｏｓｓｅｒｍａｎ分型及病理分型的关系。方法 采用酶免疫吸附法检测２０例伴发胸腺瘤的重症肌无力患者的血清ＣＡＥ－Ａｂ、ｎＡｃｈＲ－Ａｂ。结果 ＣＡＥ－Ａｂ阳性率７５％,ｎＡｃｈＲ－Ａｂ阳性率６０％,大多在Ⅱａ型与Ⅱｂ型患者,上皮细胞为主型４例中Ⅱｂ型３例     

TGF—β高调在鼻腔给予AChR抑制EAMG中起重要作用

用放射标记的ｃＤＮＡ寡核苷酸探针，使用原位杂交技术检测表达子γ干扰素（ＩＦＮ－γ）白细胞介素４（ＩＬ－４）和转移生长因子β（ＴＧＦ－β）ｍＲＮＡ的单个核细胞（ＭＮＣ）。结果表明，实验性自身免疫性重症肌无力（ＥＡＭＧ）对照组大鼠Ｇｕｏ窝和腹股沟淋巴结（ＰＩＬＮ）的ＭＮＣ乙酰胆碱受体（ＡＣｈＲ）诱导的ＩＦＮ－γ，ＴＧＦ－βｍＲＮＡ表达细胞数明显增高，与给予ＰＢＳＣＦＡ注射组比较差异显著。鼻腔耐受组与Ｅ     

TNF—α及IL—8在EAE免疫学发病机理中的作用

目的 探讨ＴＮＦ－α及ＩＬ－８在实验性变态反应性脑脊髓炎（ＥＡＥ）免疫学发病机理中的作用。方法 自牛脑提取的髓鞘性蛋白（ＭＢＰ）加福氏完全佐剂（ＣＦＡ）免疫豚鼠，建立ＥＡＥ模型，同时采用生物活性测定法检测了ＥＡＥ模型的ＴＮＦ－α水平，采用双抗体夹心法酶联免疫吸附实验检测了ＥＡＤ模型的ＩＬ－８水平。结果 ＥＲＡＥ组的ＴＮＦ－α及ＩＬ－８水平无明显高于对照组。结论 ＴＮＦ－α及ＩＬ－８在ＥＡＥ免疫学发     

牛磺酸对大鼠脑神经元细胞Fos蛋白表达的影响

研究牛磺酸对神经细胞ｃ－ｆｏｓ基因表达的影响,以期从信号传导的角度探讨牛磺酸促进神经系统生长发育、增殖分化,增强动物学习记忆能力的机制。方法本实验利用图像分析仪通过免疫细胞化学的方法,分别对培养的大鼠海马神经元和整体动物脑神经细胞ｃ－ｆｏｓ基因表达的影响进行了分析。结果牛磺酸浓度在０．４－６．４ｍｏｌ／Ｌ时,Ｆｏｓ免疫反应阳性（Ｆｏｓ－ｌｉｋｅ ｉｍｍｕｎｏｒｅａｃｔｉｖｉｔｙ,Ｆｏｓ－ＬＩ）神经     

EAN血清可溶性细胞间粘附分子—1的测定

目的探讨血清可溶性细胞间粘附分子－１（ｓＩＣＡＭ－１）在实验性变态反应性神经炎（ＥＡＮ）中的作用。方法用兔坐骨神经匀浆加完全福氏佐剂（ＣＦＡ）免疫大鼠，建立ＥＡＮ模型；同时用抗细胞间粘附分子－１（ＩＣＡＭ－１）单克隆抗体注入大鼠体内后再诱导ＥＡＮ；观察自然病程组、抗体注射组及对照组的发病情况与病理特点；应用双抗体夹心ＥＬＩＳＡ法检测不同发病程度ＥＡＮ动物血清中ｓＩＣＡＭ－１的浓度。结果抗体注射组发病率及发病程度明显低于自然病程组；自然病程组ｓＩＣＡＭ－１的浓度高于抗体注射组及对照组；ＥＡＮ发病程度与ｓＩＣＡＭ－１的浓度呈正比。结论ｓＩＣＡＭ－１与ＥＡＮ的发病关系密切，ｓＩＣＡＭ－１的测定是观测自身免疫性疾病的一个有用的指标；抗ＩＣＡＭ－１抗体能够减轻或预防ＥＡＮ的发生。     

腺苷A1受体激动剂CHA对缺血后脑组织β—EP含量的影响

用放射免疫法测定土鼠半球缺血模型脑组织中β－ＥＰ（β－ｅｎｄｏｒｐｈｉｎ）含量，观察缺血后β－ＥＰ含量的变化及腺苷Ａ１受体激动剂ＣＨＡ（ｃｙｃｌｏｈｅｘｙｌａｄｅｎｏｓｉｎｅ）对缺血后β－ＥＰ含量变化的影响。结果显示：沙土鼠缺血８ｈ后β－ＥＰ含量明显增加，且与卒中症状呈正相关，与脑比重呈负相关，ＣＨＡ可以改善卒中症状，减轻脑水肿，抑制缺血后β－ＥＰ的升高，提示缺血后中枢β－ＥＰ增加会加重缺血性损伤     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.