经皮半月神经节射频热凝毁损术治疗原发性三叉神经痛的观察

目的观察经皮半月神经节射频热凝毁损术治疗原发性三叉神经痛的临床疗效。方法总结192例原发性三叉神经痛的射频热凝术治疗效果,并与其他方法相对比。结果术后优良率94.8%,无效率0.5%,眼科并发症出现1例。结论经皮半月神经节射频热凝毁损术治疗原发性三叉神经痛具有安全性高、疗效确切、并发症相对较少等特点,具有推广价值。     

神经导航引导经皮穿刺三叉神经半月节射频热凝治疗三叉神经痛的研究

目的 探讨神经导航引导下经皮穿刺三叉神经半月节射频热凝术在治疗三叉神经痛中的应用.方法 选取我科神经导航引导下经皮穿刺三叉神经半月节射频热凝治疗的156例患者资料.所有患者术前均经头部3D-CT薄层连续平扫,并将影像资料导入SteahhStation Tria Plus手术导航系统,图像经三维重建后,确认患侧卵圆孔作为靶点,在导航实时引导下进行卵圆孔穿刺,并行电生理测试,再次确认靶点的位置无误后,进行射频热凝治疗.结果 所有患者顺利穿刺成功,射频热凝术后,患者原有的面部疼痛均明显缓解或消失,术前患者VAS评分为9.67±0.47,术后VAS评分为0.22±0.57,差异有明显的统计学意义,且所有患者术后均无严重并发症.结论 神经导航引导下经皮穿刺三叉神经半月节射频热凝术是一种微创,安全和疗效显著的三叉神经痛外科治疗手段.     

经皮穿刺三叉神经半月节射频热凝+甘油注射治疗原发性三叉神经痛(附85例报告)

目的 探讨采用经皮三叉神经半月节射频热凝 甘油注射治疗原发性三叉神经痛的临床结果和副作用。方法 仰卧位或坐位，Hartel前入路穿刺法，局麻下经卵圆孔穿刺三叉神经半月节，温控射频热凝对靶点进行毁损并注入甘油0．3～0．55ml。结果 疼痛消失82例，无效3例，总有效率96．5％。随访75例，随访时间平均为2．1年，8例复发，复发率为10．6％。结论 经皮三叉神经半月节射频热凝 甘油注射治疗原发性三叉神经痛，可提高治疗效果、降低复发率和副作用，它是高龄或不能耐受开颅手术病人的较好的治疗方法。     

选择性射频热凝治疗三叉神经痛147例报告（摘要）

选择性射频热凝治疗三叉神经痛１４７例报告（摘要）吴承远，袁春亭，刘玉光，徐淑军我科自１９８６年至１９９４年采用经皮穿刺半月神经节射频热凝治疗三叉神经痛１４７例，疗效满意。一、资料与方法男７７例，女７０例。年龄２０～７４岁，平均５１．２岁。病程２个月至...     

原发性三叉神经痛的射频热凝治疗

1对象与方法 1991年6月～2008年2月,我科采用三叉神经半月神经节射频热凝治疗原发性三叉神经痛485例,其中男232例,女253例;     

经皮半月神经节射频热凝术治疗三叉神经病325例疗效观察

本文报告经皮半月神经节射频热凝术治疗三叉神经痛325例，有效率为98％。一年后复发率为20％，其中46例经再次手术达到止痛目的。本组病未遇到严重并发症及死亡病例。本文对射频热凝半月神经节的手术方法，优点以及并发症的防治进行了讨论。     

薄层CT引导下经皮穿刺圆孔外口射频热凝治疗三叉神经痛

三叉神经半月神经节射频热凝治疗是一种治疗原发性三叉神经痛的方法,对于单纯三叉神经第Ⅱ支痛一直以来采取眶下孔或卵圆孔穿刺射频热凝治疗,眶下孔人路往往存在毁损范围过小、疼痛缓解不明显,而卵圆孔人路因容易累及第Ⅰ支或第Ⅲ支导致相应并发症产生[1].我们探索了一种精确定位三叉神经第Ⅱ支(上颌神经)射频热凝治疗的方法,并取得满意成绩,总结报告如下. 资料与方法 1.临床资料:选择本院2010年3月至2011年9月原发性三叉神经第Ⅱ支痛患者36例,男15例,女21例,年龄45～93岁,平均66岁.病变在右侧22例,左侧14例.病程6个月-8年,平均4.1年.     

半月神经节上颌区CT定位穿刺技术在上颌神经痛射频治疗中的初步应用

为提高射频热凝治疗对上颌神经痛的效果,本研究探索半月神经节上颌区的CT定位穿刺技术。南通大学附属建湖医院神经外科2019年4—9月收治9例上颌神经痛患者,根据术前CT影像分析结果定位射频靶点和靶灶边界,以卵圆孔为必经点设计穿刺路径,然后据此实施穿刺和射频热凝损伤。9例患者均穿刺成功,经射频治疗后上颌区疼痛均消失。所有患者随访13~18个月,无一例复发。依解剖标志设定半月神经节穿刺靶点,可为上颌神经痛射频治疗达到持久止痛提供一个新手段。     

经皮穿刺半月节及外周支射频控温热凝治疗三叉神经痛临床研究

目的探讨经皮穿刺半月节及外周支射频控温热凝治疗三叉神经痛的疗效。方法本组三叉神经痛患者407例,分别经半月节及外周支射频控温热凝治疗。结果半月节射频控温热凝316例,一次治疗完全止痛298例(94.3%),一周后第二次治疗完全止痛18例(5.7%)。随访1￣9年,复发145例,经再次治疗后随访1￣8年又复发53例;该53例经第三次治疗随访至今未见复发。外周支射频控温热凝91例,一次治疗后均完全止痛。随访6年,复发66例,行第二次热凝治疗后随访1￣5年再次复发31例;该31例经第三次治疗后,随访1￣4年再次复发5例;该5例经第四次治疗后至今未复发。结论半月节及外周支射频控温热凝治疗三叉神经痛,能保留触觉仅破坏痛觉,止痛效果确切,相对安全,适应证广,操作较简便,可重复进行。     

半月节射频及Meckel囊注射甘油治疗三叉神经痛并发症的探讨

半月节射频及Ｍｅｃｋｅｌ囊注射甘油治疗三叉神经痛并发症的探讨张强，张杰，黄国芳，项晓波我院自１０００年引进国产ＸＷ－１型射频温控热凝仪以来，徒手经皮穿刺选择性三叉神经半月节射频温控热凝治疗三叉神经痛６０例，其中有４８例在Ｍｅｃｋｅｌ＇ｓ囊注射甘油，取...     

Differences in the Cs block of baclofen and 4-aminopyridine induced potassium currents of guinea pig CA3 neurons in vitro

Single-electrode current- and voltage-clamp techniques were employed to study responses elicited by (?)baclofen or γ-aminobutyric acid (GABA) and 4-aminopyridine (4-AP) induced inhibitory postsynaptic potentials in CA3 pyramidal neurons in guinea pig hippocampal slices. All drugs were applied by the bath to submerged slices in which fast synaptic transmission was blocked by 6-cyano-7-nitroquinoxaline-2,3-dione (10 μM), bicuculline (50 μM), and picrotoxin (50 μM). (?)Baclofen (0.5 μM) and GABA (1 μM) induced equivalent-sized hyperpolarizations and input resistance decreases. The agonist induced hyperpolarization or current and 4-AP induced hyperpolarizations or currents (4-AP induced K-IPSPs or IPSCs) reversed in sign near the K-equilibrium potential (E_K). The GABA_B receptor antagonists, OH-saclofen (500 μM) and CGP 35348 (100 μM), reduced (?)baclofen responses, and 4-AP induced K-IPSPs, suggesting that they were mediated by GABA_B receptors. Intracellular tetraethylammonium-, and extracellular barium-ions (1 μM) diminished the (?)baclofen induced current and 4-AP induced K-IPSCs. Intracellular Cs-ions blocked the (?)baclofen induced outward current at resting membrane potential but did not grossly affect the inward current recorded at membrane potentials negative to E_K. 4-AP induced inwardly or outwardly directed KIPSCs were not blocked by intracellular Cs-ions. Extracellular Cs-ions (5 μM) blocked the (?)baclofen induced inward K-current, but did not block 4-AP induced inwardly directed K-IPSCs. In conclusion, we found differences in the Cs block of K-channels activated by (?)baclofen or the endogenous transmitter GABA. One reason could be that (?)baclofen predominantly activated extra synaptic GABA_B receptors provided that extrasynaptic and subsynaptic receptors couple to different potassium channels. © 1994 Wiley-Liss, Inc.     

Using iPods(®) and iPads(®) in teaching programs for individuals with developmental disabilities: A systematic review

We conducted a systematic review of studies that involved iPods(?), iPads(?), and related devices (e.g., iPhones(?)) in teaching programs for individuals with developmental disabilities. The search yielded 15 studies covering five domains: (a) academic, (b) communication, (c) employment, (d) leisure, and (e) transitioning across school settings. The 15 studies reported outcomes for 47 participants, who ranged from 4 to 27years of age and had a diagnosis of autism spectrum disorder (ASD) and/or intellectual disability. Most studies involved the use of iPods(?) or iPads(?) and aimed to either (a) deliver instructional prompts via the iPod Touch(?) or iPad(?), or (b) teach the person to operate an iPod Touch(?) or iPad(?) to access preferred stimuli. The latter also included operating an iPod Touch(?) or an iPad(?) as a speech-generating device (SGD) to request preferred stimuli. The results of these 15 studies were largely positive, suggesting that iPods(?), iPod Touch(?), iPads(?), and related devices are viable technological aids for individuals with developmental disabilities.     

Use of the Hypomania Checklist-32 and the Mood Disorder Questionnaire for detecting bipolarity in 1,051 patients with major depressive disorder

PurposeTo use the Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ), for detecting bipolarity in depressed patients.PatientsOne thousand and fifty-one patients fulfilling ICD-10 criteria for unipolar major depressive episode, single or recurrent, were studied. Patients were assessed using a structured demographic and clinical data interview, and by the Polish versions of the HCL-32 and MDQ questionnaires.ResultsHypomanic symptoms exceeding cut-off criteria for bipolarity by HCL-32 were found in 37.5% of patients and, by MDQ, in 20% of patients. Patients with HCL-32 (+) or MDQ (+) differed significantly from patients with HCl-32 (?) and MDQ (?) respectively, by being less frequently married, having more family history of depression, bipolar disorder, alcoholism and suicide, earlier onset of illness, and more depressive episodes and psychiatric hospitalizations. The percentage of patients resistant to treatment with antidepressant drugs was significantly higher in HCL-32 (+) vs HCL-32 (?) and in MDQ (+) vs MDQ (?): 43.9% vs 30.0%, and 26.4% vs 12.4%, respectively.ConclusionsThe results confirm a substantial percentage of bipolarity in major depressive disorder. Such patients have a number of clinical characteristics pointing on a more severe form of the illness and their depression is more resistant to treatment with antidepressants.     

Increase of cytochrome c oxidase negative fibers in rimmed vacuole myopathy with inflammatory changes

The physiological significance of cytochrome c oxidase (CCO) deficiency in rimmed vacuole myopathy (RVM) is not fully understood. Frequencies of CCO negative muscle fibers (CCO(?)F) were compared with two cases of in-clusion body myositis (IBM) and another two cases with RVM without inflammatory changes (i.e. oculopharyngeal distal myopathy (OPDM) and distal myopathy with rimmed vacuole formation (DMRV)). The frequencies of CCO(?)F were 6.9% in the case of definite IBM with 10 years of disease duration, 0.3% in possible IBM of 1 year duration, 1.3% in OPDM of 11 years duration, and 0.1% in DMRV of 2 years duration. The frequencies of CCO(?)F were generally higher in RVM than in controls. However, the incidence of CCO(?)F increased with time in patients with IBM compared with patients with RVM without inflammation. The present findings may provide important information on the myopathological distinction of IBM and RVM without inflammation.     

The potential of (−)‐o‐[11C]methylvesamicol for diagnosing cholinergic deficit dementia

(?)‐o‐Methylvesamicol ((?)‐OMV) exhibited in vitro a high affinity for a vesicular acetylcholine transporter (VAChT) (Ki, 6.7 nM), and (?)‐o‐[¹¹C]methylvesamicol [(?)‐[¹¹C]OMV] exhibited appropriate kinetics and bound mainly to VAChTs in the rat brain. In this study, the in vivo distribution and kinetics of (?)‐[¹¹C]OMV were evaluated in comparison with [¹¹C]SA4503 in disability model monkeys produced by selectively destroying the p75NTR‐positive cells in the right hemisphere of the brain using positron emission tomography. Time–activity curves of (?)‐[¹¹C]OMV showed peaks within 20 min in regions rich in acetylcholine transporters (AchT). (?)‐[¹¹C]OMV binding in the ipsilateral cortex to the lesion was significantly reduced by 22.0% ± 6.7% when compared with that in the contralateral region. The decrease (19.3% ± 2.2%) in (?)‐[¹¹C]OMV binding in the ipsilateral temporal cortex to the lesion was greater than that (7.4% ± 4.6%) of [¹¹C]SA4503. These results suggested that (?)‐[¹¹C]OMV may be useful in the study of dementia characterized by degeneration of the cholinergic neurotransmitter system. Synapse 63:167–171, 2009. © 2008 Wiley‐Liss, Inc.     

Ginkgo extract EGb 761? shields from slowly accumulating neurodegenerative-like changes in a newly developed cell culture model induced by the combined action of low doses of antimycin A1 and 2-deoxy-d-glucose

Different cell culture models were already used to analyze the molecular base of the neuroprotective activities of the Ginkgo biloba extract EGb 761(?) after a single or short-term application. In these previous studies cells were severely injured with agents that promptly induce fatal cellular damage, like vast oxidative stress or mitochondrial dysfunction, and the protective effects of EGb 761(?) on such acute damage were evaluated. Our present study aimed to test EGb 761(?) action in cell cultures, where cellular functions are only moderately impaired by a longer lasting, but relatively modest oxidative stress, reduction of mitochondrial function and reduced intracellular energy levels, thereby causing only slow occurence of cellular damage over a time period of 2?weeks. To this end we used neuroblastoma cells (SK-N-MC) that were treated with low doses of a combination of antimycin A1 and 2-deoxy-D: -glucose. Addition of EGb 761(?) to the culture medium efficiently shielded the cells from progressing injury by reduced ATP-levels, oxidized redox state, lipid peroxidation damage and oxidative damage of mitochondrial DNA. As a result the cells were protected from apoptotic death that was observed in cultures without EGb 761(?) after 2?weeks of damage occurence. This cell culture system characterizing moderate cellular stress will be applied in future studies to further investigate the mode of action of single EGb 761(?) compounds.     

Usefulness of MRA‐DWI mismatch in neuroendovascular therapy for acute cerebral infarction

Background: This study evaluated the usefulness of MR angiography (MRA)–diffusion‐weighted imaging (DWI) mismatch in neuroendovascular therapy over 3 h after onset of acute cerebral infarction. Methods: The subjects were 14 cases (age, 73 ± 8.4 years) who had an anterior circulation deficit on DWI/MRA on arrival and underwent neuroendovascular therapy over 3 h after onset. MRA‐DWI mismatch (MDM) (+) was defined as ‘major artery lesion (+) and diffusion‐weighted image‐Alberta Stroke Program Early CT Score (DWI‐ASPECTS) ≥6’; MDM (?) was defined as ‘major artery lesion (+) and DWI‐ASPECTS <6’. Results: Reperfusion was achieved in nine of 14 patients (64%) undergoing neuroendovascular therapy. Within the reperfusion group, in the five MDM (+) patients and the four MDM (?) patients, the outcome was a favorable clinical response in the MDM (+) group. The modified Rankin Scale (mRS) scores after 90 days were 0–2 in 3 (60%) and 3–6 in 2 (40%) of the MDM (+) group patients and 0–2 in 0 (0%) and 3–6 in 4 (100%) of the MDM (?) group patients. In the MDM (+) group, a good outcome was achieved. However, the number of cases was small, so this was not a significant difference. Within the non‐reperfusion group, in the three MDM (+) patients and the two MDM (?) patients, the mRS scores after 90 days were 0–2 in 1 (33%) and 3–6 in 2 (67%) of the MDM (+) group patients and 0–2 in 0 (0%) and 3–6 in 2 (100%) of the MDM (?) group patients. In both groups, the outcome was poor. Conclusions: With neuroendovascular therapy, a good outcome with reperfusion was achieved in the MDM (+) group compared to the MDM (?) group. This suggests that the presence or absence of MDM may be useful in determining prognosis after reperfusion.     

CNTF or (−)-deprenyl in immature rats: Survival of axotomized facial motoneurons and weight loss

The application of ciliary neurotrophic factor (CNTF) to the cut ends of transected facial nerves in newborn rats has been reported to reduce the death of facial motoneurons (FMns) axotomized by the transection. Systemically delivered CNTF has been found to cause cachexia in adult mice. We compared the influence of dosage of CNTF and (?)-deprenyl on FMn death, weight loss, and animal survival in rat pups that underwent facial nerve transection at the 14th postnatal day (P14). CNTF was administered by osmotic mini-pumps connected to tubing ending either intrathecally or extrathecally near the craniocer-vical junction. CNTF caused weight loss and animal death that was similar to the cachexia reported in mice if administered in amounts of 1.1 μg/day or greater. At the same doses, intrathecal CNTF was more effective than extrathecal CNTF in inducing the cachexia. (?)-Deprenyl did not alter animal survival or weight gain, even at high doses (10 mg/kg every 2 days). Intrathecal CNTF and intraperitoneal (?)-deprenyl, but not extrathecal CNTF, significantly increased the survival of the axotomized FMns. (?)-Deprenyl administered twice daily at 0.01 mg/kg was considerably more effective than CNTF in increasing FMn survival due to the limitation on CNTF dosage caused by the animal death. © 1995 Wiley-Liss, Inc.     

Malignant lymphoma of the cranial vault: Analysis of three cases

The clinicopathological features of three cases with a cranial vault tumor as the initial manifestation of malignant lymphoma are described. Two of them (involving a 47-year-old female and a 53-year-old female) were primary cranial vault lymphoma. Another case (a 50-year-old male) was revealed to have multiple tumors in the cranial vault, right iliac bone and spleen at the first admission examination. All of the cranial vault tumors, which were painless and rapidly growing, invaded the muscle and dura mater from the skull, but not the subdural space or the outside of the superficial fascia. Histological diagnosis of the three cranial vault tumors was non-Hodgkin diffuse large lymphoma. Moreover, the expression pattern of the lymphocytic cell markers, which were examined by immunohistochemistry, was identical; LCA(+), CD20/cy(+), CD79a(+), CD45RO(?), VS38c(?) and CD30(?) indicated that the tumors were B-cell origin without plasmacytic differentiation.