腕管综合征孕产妇的神经肌电图分析

腕管综合征（CTS）是最常见的一种嵌压性神经病变,多见于长期、频繁用手或手腕作业的人群。在日常神经电生理检查中,发现妊娠晚期的孕妇及产后妇女也可见到CTS。现对12例孕产妇腕管综合征患者作回顾性分析,并将结果报道如下。     

超声诊断腕管综合征的准确性及应用

腕管综合征(carpal tunnel syndrome,CTS)是由Colles骨折、月骨损伤、脱位、退变等多种因素引起腕管内压力升高而导致正中神经被挤压的一系列症状,是临床上手外科中最常见的一类周围神经卡压症.为了快捷、无创又准确地诊断并采取最合适的手术治疗方法,通过临床症状、体征、神经电生理检查等确诊是远远不够的,而具有直观的影像学资料的超声技术就能更准确地诊断腕管综合征.本研究收集17例腕管综合征病例,通过比较超声测量与术中测量的结果,探讨超声测量在诊断腕管综合征方面的应用价值.     

腕管综合征的神经电生理诊断

腕管综合征（CTS）是临床上最常见的嵌压性周围神经病。诊断上除了基于临床表现和病史外,神经电生理检测是一项必不可少的检查,它具有诊断、鉴别诊断、定位、定性、定量及预后评估的作用。近年来随着国内外神经电生理学技术的快速发展,出现了各种各样的新方法及新观点,本文就此作一综述。     

肘管综合征的电生理特点及分析

肘管综合征（CTS）是临床上常见的尺神经嵌压类疾病之一，在上肢神经压迫综合征中，CTS发病率仅次于最常见的腕管综合征。CTS患者的主要临床表现为前臂及手部疼痛、小指及无名指尺侧半感觉障碍以及手部小肌肉萎缩、无力等，神经电生理检查可以明确尺神经病变部位。我们共收集150例CTS患者的临床资料及电生理检测数据，并与正常人进行比较分析。现报道如下。     

36例腕管综合征的临床与肌电图分析

在所有崁压性神经病中,腕管综合征（CTS）的发病率最高,主要见于手工劳动为主的病人,而其诊断除了依靠病史和查体外,神经电生理检查起着任何其他检查不可替代的作用。我科2011年2月至2012年2月对36例CTS进行回顾性分析。     

腕管综合征患者的临床与神经电生理研究

目的：观察神经电生理检测对腕管综合征(CTS)的诊断价值。方法：对腕管综合征的临床特征及病因进行了分析，并作神经传导速度(NCV)和肌电图检测和分析。结果：40条患病神经中8条正中神经诱发波形消失，32条正中神经感觉潜伏期延长、波幅降低或(和)感觉神经传导速度减慢。25例患者伴有30条正中神经运动末梢潜伏期延长或(和)动作电位波幅降低。22块正中神经支配肌有去神经电位。结论：神经电生理检查在腕管综合征的诊断与鉴别诊断中有重要意义。     

腕管综合征30例临床与神经电生理研究

腕管综合征(carpal tunnel syndrome,CTS),是正中神经在腕管内受压而引起的手指感觉异常为主要特征的症侯群,是嵌压性周围神经病中最常见的一种,临床上易误诊为颈椎病和多发性周围神经病。CTS与手工操作劳动有关,目前我国手工操作劳动人口仍是大量的,故CTS的发病率不少,当属电生理室的重点病种[1]。电生理检测能够帮助诊断,其研究对于临床诊治是必要的。材料与方法一、临床资料:本组全部为南京脑科医院肌电图室2003~2005年检测病例,30例中,女24例,男6例;年龄38~77岁,平均54.2岁。病程15d~5年,平均19个月。农民12例,工人8例,电脑操作员2…     

腕管综合征治疗的研究进展

腕管综合征（carpal tunnel syndrome,CTS）是最常见的周围神经嵌压综合征[1],是正中神经在腕部受压所致.腕管内增高的压力可导致正中神经缺血,从而出现神经传导受损并伴随麻木、疼痛.CTS是一种神经内科常见疾病,自被普遍认识50多年来,其治疗效果一直不理想,多数治疗方法还没有证据或者没有足够证据支持.     

掌到腕正中神经感觉传导速度在轻、中度腕管综合征诊断中的应用

目的：寻找诊断轻、中度腕管综合征（CTS）敏感的电生理检查方法。方法：对临床症状、体征符合CTS，电生理学检查为轻、中度的CTS患者24例（41手）和年龄、性别相匹配的健康对照组14例（28手），采用顺向性感觉神经传导速度（SCV）测定法分别测定指3-腕、指3-掌、掌-腕正中神经（MN）SCV及MN远端潜伏期（DML）。（重症CTS者因易于诊断，不列入本研究。）结果：掌到腕MN SCV％47．12m／s，考虑诊断CTS。在所有诊断轻、中度CTS的研究组中，指3到腕MNSCV减慢的占63％，掌到腕MNSCV减慢的占95％，指3到掌MNSCV减慢的占10％。结论：用指3刺激，腕记录和指3刺激，掌记录（掌至腕测量距离为7～8cm）来分别检测并计算出指3到掌和掌到腕段的SCV，在诊断轻度、中度CTS方面是一个非常敏感的方法，在怀疑CTS时此诊断方法可作为常规的电生理检查。     

掌刺激法在轻度腕管综合症检测中的应用

目的：探讨掌到腕正中神经感觉传导在早期腕管综合症（CTS）诊断中的应用.方法：对临床体征、症状符合腕管综合症（CTS）患者进行常规神经电生理检测.对符合神经电生理腕管诊断正常的患者（即正中神经末梢运动潜伏期DML≤4.5）加做环指刺激法、拇指刺激法、掌到腕正中神经感觉传导（掌刺激法）.结果：掌刺激法中的掌-腕SCV低于41.8m/s考虑诊断为轻度CTS.在三种诊断方法中,掌刺激法敏感度为67％（结合样本量大的相关专业文献中得出的统计数据为敏感度高达100％）,远高于环指刺激法55％和拇指刺激法36％.结论：CTS患者正中神经损害随着病情的进展,损伤由卡压处开始逐步向神经末梢发展,累及正中神经神经末梢,直至重度CTS,导致SNAP消失.腕-掌正中神经感觉神经传导在腕管早期诊断往往非常敏感,掌刺激法中的掌腕SCV低于41.8 m/s考虑诊断为轻度CTS,在患者出现CTS症状,但常规法无法鉴别时,可加做掌刺激法作为常规鉴别诊断.     

Stress augments food 'wanting' and energy intake in visceral overweight subjects in the absence of hunger

Stress may induce eating in the absence of hunger, possibly involving changes in food reward, i.e. ‘liking’ and ‘wanting’. The objective of this study was to assess the effects of acute psychological stress on food reward, and on energy intake, in visceral overweight (VO) vs. normal weight (NW) subjects. Subjects (27 NW, age = 26 ± 9 yrs, BMI = 22 ± 2 kg/m²; 15 VO, age = 36 ± 12 yrs, BMI = 28 ± 1 kg/m²) came to the university twice, fasted, for either a rest or stress condition (randomized cross-over design). Per test-session ‘liking’ and ‘wanting’ for 72 items divided in six categories (bread, filling, drinks, dessert, snacks, and stationery (control)) were measured twice, each time followed by a wanted meal. Appetite profile (visual analogue scales, VAS), heart rate, mood state and level of anxiety (POMS/STAI questionnaires) were measured.High hunger and low satiety (64 ± 19, 22 ± 20 mmVAS) confirmed the fasted state. Elevated heart rate, anger and confusion scores (p ≤ 0.03) confirmed the stress vs. rest condition. Consumption of the first meal decreased hunger, increased satiety, and decreased ranking of ‘liking’ of bread vs. increased ranking of ‘liking’ of the control (p < 0.001). ‘Wanting’ for dessert and snacks, energy intake, carbohydrate and fat intake for the second meal stress vs. rest relatively increased in VO vs. decreased in NW (p < 0.02). During stress vs. rest VO showed a 6 ± 9% increase in percentage of daily energy requirements consumed over the two meals (p = 0.01).To conclude, visceral overweight subjects showed stress-induced food intake in the absence of hunger, resulting in an increased energy intake.     

Haematology and serum biochemistry of golden eagle (Aquila chrysaetos) in Iran

Haematological and serum biochemical values were estimated in blood samples collected from 21 apparently adult golden eagles (Aquila chrysaetos) of both sexes. The mean values of red blood cells, packed cell volume, haemoglobin, white blood cells, heterophils, lymphocytes, monocytes and eosinophils were 1.63 ± 0.11 × 10¹²/l, 0.47 ± 0.009 l/l, 91.73 ± 1.52 g/l, 24.31 ± 1.97 × 10⁹/l, 4.40 ± 0.22 × 10⁹/l, 16.81 ± 0.65 × 10⁹/l, 0.99 ± 0.19 × 10⁹/l and 2.10 ± 0.30 × 10⁹/l, respectively. The leucocytes had 69.14%, 4.09%, 18.12% and 8.65% lymphocytes, monocytes, heterophils and eosinophils, respectively. The results of serum biochemistry in the golden eagle indicated that the concentrations of glucose, total protein, albumin, total globulin, cholesterol, triglyceride, uric acid, blood urea nitrogen, creatinine, calcium, phosphorous, aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase and alkaline phosphatase were 16.42 ± 0.73 mmol/l, 49.76 ± 1.35 g/l, 20.46 ± 0.79 g/l, 29.30 ± 1.47 g/l, 2.14 ± 0.09 mmol/l, 2.04 ± 0.08 mmol/l, 457.67 ± 97.46 μmol/l, 2.74 ± 0.17 mmol/l, 53.27 ± 3.87 μmol/l, 2.37 ± 0.24 mmol/l, 1.73 ± 0.08 mmol/l, 293.24 ± 18.96 IU/l, 28.21 ± 2.36 IU/l, 411.29 ± 58.37 IU/l, 1,209.89 ± 21.73 IU/l and 67.31 ± 5.29 IU/l, respectively. There were no significant differences between haematological and serum biochemical parameters of male and female golden eagles (P > 0.05).     

Proton and phosphorus magnetic resonance spectroscopy of the healthy human breast at 7 T

In vivo water‐ and fat‐suppressed ¹H magnetic resonance spectroscopy (MRS) and ³¹P magnetic resonance adiabatic multi‐echo spectroscopic imaging were performed at 7 T in duplicate in healthy fibroglandular breast tissue of a group of eight volunteers. The transverse relaxation times of ³¹P metabolites were determined, and the reproducibility of ¹H and ³¹P MRS was investigated. The transverse relaxation times for phosphoethanolamine (PE) and phosphocholine (PC) were fitted bi‐exponentially, with an added short T₂ component of 20 ms for adenosine monophosphate, resulting in values of 199 ± 8 and 239 ± 14 ms, respectively. The transverse relaxation time for glycerophosphocholine (GPC) was also fitted bi‐exponentially, with an added short T₂ component of 20 ms for glycerophosphatidylethanolamine, which resonates at a similar frequency, resulting in a value of 177 ± 6 ms. Transverse relaxation times for inorganic phosphate, γ‐ATP and glycerophosphatidylcholine mobile phospholipid were fitted mono‐exponentially, resulting in values of 180 ± 4, 19 ± 3 and 20 ± 4 ms, respectively. Coefficients of variation for the duplicate determinations of ¹H total choline (tChol) and the ³¹P metabolites were calculated for the group of volunteers. The reproducibility of inorganic phosphate, the sum of phosphomonoesters and the sum of phosphodiesters with ³¹P MRS imaging was superior to the reproducibility of ¹H MRS for tChol. ¹H and ³¹P data were combined to calculate estimates of the absolute concentrations of PC, GPC and PE in healthy fibroglandular tissue, resulting in upper limits of 0.1, 0.1 and 0.2 mmol/kg of tissue, respectively.     

Cortical and brain stem projections to the spinal cord of the hedgehog (Erinaceus europaeus). A horseradish peroxidase study

Summary Cortical and brain stem neurons projecting to the spinal cord in the hedgehog were studied by means of the horseradish peroxidase (HRP) tracing method. HRP injections were placed in the first cervical segments, in the cervical enlargement (C₅-T₃) and in the lumbar enlargement. Following injections in the first cervical segments and in the cervical enlargement labelled neurons were observed in the somatic motor and somatic sensory cortices, the paraventricular and the dorsomedial hypothalamic nucleus, the lateral hypothalamic area, the nuclei of field H of Forel, the red nucleus, the mesencephalic reticular formation, the deep layers of the superior colliculus, the Edinger-Westphal nucleus, the periaqueductal grey, the mesencephalic trigeminal nucleus, the loci coeruleus and subcoeruleus, the nuclei raphe dorsalis, centralis superior, raphe magnus, raphe pallidus, and raphe obscurus, the rhombencephalic reticular formation, the lateral, medial and caudal vestibular nuclei, the nucleus ambiguus, the nucleus of the solitary tract and the gracile nucleus. After HRP injections in the lumbar enlargement, labelled neurons were not found in the cortex, the dorsomedial hypothalamic nucleus, the nuclei of field H of Forel, the superior colliculus and the mesencephalic trigeminal nucleus. These results show that cortical and brain stem projection to the spinal cord are comparable to those described in other species.Abbreviations ac anterior commissure - Am nucleus ambiguus - Aq cerebral aqueduct - cc corpus callosum - Cd caudate nucleus - CE cervical enlargement - CeS nucleus centralis superior - CG periaqueductal grey - ci capsula interna - Cq cochlear nuclei - cp cerebral peduncle - Cu cuneiform nucleus - CV caudal vestibular nucleus - DM dorsomedial hypothalamic nucleus - DX dorsal motor nucleus of vagus - EC external cuneate nucleus - EW Edinger-Westphal nucleus - F nuclei of field H of Forel - G gracile nucleus - H nippocampus - IC inferior colliculus - IP interpeduncular nucleus - LC locus coeruleus - LE lumbar enlargement - LH lateral hypothalamic area - LL nucleus of lateral lemniscus - lo lateral olfactory tract - LV lateral vestibular nucleus - MC medial cuneate nucleus - MesV mesencephalic trigeminal nucleus - MG medial geniculate nucleus - MM medial mammillary nucleus - MV medial vestibular nucleus - oc optic chiasm - PH nucleus praepositus - Pn pontine nuclei - Put putamen - PV paraventricular hypothalamic nucleus - R red nucleus - Rd nucleus raphe dorsalis - RGc gigantocellular reticular nucleus - Rl lateral reticular nucleus - Rm nucleus raphe magnus - Rmes mesencephalic reticular formation - Ro nucleus raphe obscurus - Rpa nucleus raphe pallidus - Rpc caudal reticular nucleus of the pons - Rpo rostral reticular nucleus of the pons - Rv ventral reticular nucleus - s solitary tract - SC superior colliculus - SN substantia nigra - SO supraoptic nucleus - SR sulcus rhinalis - STh subthalamic nucleus - siV spinal tract of trigeminal nerve - STV nucleus of spinal tract of trigeminal nerve - subC locus subcoeruleus - SuM supramammillary nucleus - Th thalamus - TS nucleus of solitary tract - VM ventromedial hypothalamic nucleus - ZI zona incerta - 3V third ventricle - 4V fourth ventricle - IV layer IV of the cortex - V layer V of the cortex - VI layer VI of the cortex - 7 facial nucleus - 12 hypoglossal nucleus     

State, not trait, neuroendocrine function predicts costly reactive aggression in men after social exclusion and inclusion

Social exclusion increases aggressive behaviour, and the possible neuroendocrine underpinnings of the effect are largely unknown. Here, we examined the extent to which testosterone and cortisol responses to social exclusion would predict subsequent reactive aggression. Men were randomly assigned to a social exclusion (SE) or inclusion (SI) condition of ‘Cyberball’, a computer ball-toss game. Aggression was then measured using the Point Subtraction Aggression Paradigm (PSAP). Saliva was collected at three points for the measurement of testosterone and cortisol. Regression analyses indicated that testosterone concentrations 10-min into the PSAP (controlling for pre- and post-Cyberball testosterone) were positively correlated with aggressive behaviour, irrespective of SI/SE. Post hoc analyses for the conditions separately, however, suggested the relationship was stronger for SI men (R²_change = 13.3%, F_1,29 = 5.28, p = 0.03) than for SE men (R²_change = 1.8%, F_1,26 = 0.49, p = 0.49). Aggressive behaviour was also positively correlated with cortisol concentrations 10-min into the PSAP (controlling for pre- and post-Cyberball cortisol) irrespective of SE/SI. When both hormones were included in the regression model, the interaction of baseline ‘Cortisol’ × ‘Testosterone’ × ‘Experimental Group’ approached significance (R²_change = 5.4%, F_1,55 = 3.53, p = 0.07), but no significant effects were observed in either group alone. The findings add to evidence that individual differences in state neuroendocrine function map onto variability in human social behaviour.     

Distribution of HLA-A, -B, -C, -DRB1, -DQB1, -DPB1 allele frequencies in patients with COVID-19 bilateral pneumonia in Russians,living in the Chelyabinsk region (Russia)

In this population-based case-control study conducted in the Chelyabinsk region of Russia, we examined the distribution of HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1, in a group of 100 patients with confirmed COVID-19 bilateral pneumonia. Typing was performed by NGS and statistical calculations were carried out with the Arlequin program. HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 alleles were compared between patients with COVID-19 and 99 healthy controls. We identified that COVID-19 susceptibility is associated with alleles and genotypes rs9277534A (disequilibrium with HLA-DPB1*02:01, ?02:02, ?04:01, ?04:02, ?17:01 alleles) with low expression of protein products HLA-DPB1 (pc < 0.028) and homozygosity at HLA-C*04 (p = 0.024, pc = 0.312). Allele HLA-A*01:01 was decreased in a group of patients with severe forms of bilateral pneumonia, and therefore it may be considered as a protective factor for the development of severe symptoms of COVID-19 (p = 0.009, pc = 0.225). Our studies provide further evidence for the functional association between HLA genes and COVID-19.     

Radiological anatomy of the vascularization of cranial dural arteriovenous malformations

Summary Knowledge of the radiological anatomy of the cranial durai vascularization allows a flexible and appropriate approach to the pretherapeutic investigation of cranial durai arteriovenous malformations. The variability of the origin of these arteries requires that several possible sources of vascular supply be investigated — internal carotid, internal maxillary, ascending pharyngeal, occipital and vertebral — and that each of their meningeal branches be known in detail. Finally, familiarity with the radiological anatomy of these vessels allows one to identify on routine angiography those vessels that may be a source of risk when performing techniques of endovascular therapy (pedicles supplying the cranial nerves, internal carotid and vertebral anastomoses).Each foramen at the base and vault of the cranium contains an artery to the dura mater. Accordingly, very precise topographical study, in particular of the cavernous region, can be made.

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Bases radio-anatomiques de la vascularisation des malformations artério-veineuses durales crâniennes

Résumé Les bases radio-anatomiques de la vascularisation durale crânienne permettent de conduire de façon flexible et adaptée à chaque cas l'étude pré-thérapeutique des MAVD crâniennes. La variabilité d'origine de ces artères impose l'exploration de plusieurs sources possibles: carotidienne interne, maxillaire interne, pharyngienne ascendante, occipitale, vertébrale, et la connaissance précise de chacune de leurs branches méningées. La visualisation en routine angiographique des vaisseaux dangereux pour les techniques thérapeutiques endovasculaires (pédicules nourriciers des nerfs crâniens, anastomoses carotidienne interne, vertébrale).Chaque orifice de la base et de la voûte du crâne contient une artère à destinée durale; on peut ainsi arriver à une étude topographique extrêmement précise, en particulier dans la région caverneuse.

     

Perception of limb orientation in the vertical plane depends on center of mass rather than inertial eigenvectors

We performed two experiments to test the hypothesis that the perception of limb orientation depends on inertial eigenvectors (e _i ) against the alternative hypothesis that it depends on the center of mass vector (CM). Whereas e _i constrains the dynamic torques involved in angular rotation, CM constrains the static torque necessary to keep the limb aloft in the gravitational field. Hence, possible effects of e _i and CM on kinesthetic judgments must be related to the dynamic and static torques, respectively, involved in moving and positioning a limb. In the first experiment, blindfolded participants matched, with upper arms supported, the orientation of their forearms while the forearms’ e _i and CM were manipulated relative to the elbow. The manipulation of the vector CM alone induced a matching bias, as did the combined manipulation of e _i and CM, whereas the manipulation of e _i alone did not. In the second experiment, participants positioned their unseen and unsupported right arm at an indicated spatial configuration while e _i and CM of the right forearm were manipulated as in Experiment 1. As in the first experiment, forearm positioning was affected by the independent manipulation of CM and the combined manipulation of e _i and CM, but not by the independent variation of e _i . Moreover, none of the manipulations affected upper arm positioning. These results refute the claim that the perception of limb orientation (in the vertical plane) is based on e _i and demonstrate, for the first time, the implication of a limb segment’s CM in the perception of its orientation. This research was supported in part by The Netherlands Organization for Scientific Research (NWO) Grant 402-01-040.