机械取栓治疗进展性卒中并痉挛状态1例报告

正1临床资料患者,男,67岁,因言语笨拙伴左侧肢体活动不灵15 d,进行性加重2 d于2017年6月27日入院。患者于入院前15d出现言语笨拙,左侧肢体稍感无力,不影响日常生活活动,于当地医院药物治疗4 d后未见加重。入院前2 d,左侧肢体无力进行性加重至活动不能,伴左侧肢体痉挛进行性加重。既往史:糖尿病10 y,现皮下注射"诺和灵30R",平日血糖控     

干燥综合征脊髓病1例及文献复习

1临床资料患者,女性,65岁,因＂左侧肢体无力2月,右侧肢体无力4 d伴小便潴留＂入院。于入院前无诱因缓慢出现左侧肢体乏力,但可以行走,左手可持物。当地医院诊断为＂脑梗死＂并给予相应治疗,肢体无力无缓解。2月后出现右侧肢     

以反复脑梗死伴脑出血为主要表现的原发性抗磷脂抗体综合征一例

临床资料 患者女性,49岁,因"突发头痛伴左侧肢体无力21 d"于2009年6月1日收住我科.患者入院前21 d下午6点左右突发头痛伴左侧肢体无力,伴口齿欠清,于次日至我院门诊,头颅MRI(2009年6月4日)示"右侧丘脑血肿,右侧额叶新鲜梗死、右额顶叶陈旧性梗死灶"(图1～3),诊断"脑梗死合并脑出血"收入院.     

以反复脑梗死伴脑出血为主要表现的原发性抗磷脂抗体综合征一例

临床资料 患者女性,49岁,因"突发头痛伴左侧肢体无力21 d"于2009年6月1日收住我科.患者入院前21 d下午6点左右突发头痛伴左侧肢体无力,伴口齿欠清,于次日至我院门诊,头颅MRI(2009年6月4日)示"右侧丘脑血肿,右侧额叶新鲜梗死、右额顶叶陈旧性梗死灶"(图1～3),诊断"脑梗死合并脑出血"收入院.     

以反复脑梗死伴脑出血为主要表现的原发性抗磷脂抗体综合征一例

临床资料 患者女性,49岁,因"突发头痛伴左侧肢体无力21 d"于2009年6月1日收住我科.患者入院前21 d下午6点左右突发头痛伴左侧肢体无力,伴口齿欠清,于次日至我院门诊,头颅MRI(2009年6月4日)示"右侧丘脑血肿,右侧额叶新鲜梗死、右额顶叶陈旧性梗死灶"(图1～3),诊断"脑梗死合并脑出血"收入院.     

婴幼儿Galen大脑大静脉瘤栓塞术护理1例

<正> 1 病例简介患儿女,7岁,因"左侧肢体无力伴头痛、头晕3 d,突然加重1 d"于2009年3月27日轮椅入院。患儿于2009年3月23日前开始出现左侧肢体无力,行走不稳,伴间断头痛、头晕,在当地医院颅脑计算机     

特发性椎动脉夹层1例

1病例简介患者,男性,36岁,公司职员。主因“突发右侧肢体无力3d”,于2005年10月19日21:00收入我院。患者于入院前3d晨起床刷牙时突发右侧肢体麻木,从右下肢向上肢发展,伴右侧肢体无力及左侧顶枕部疼痛。右肢体无力表现为右手持物不稳,     

继发于肺栓塞的全身多器官栓塞1例报告

矛盾性栓(PDE)系指体循环静脉系统或右心的栓子通过开放的卵圆孔等不同水平的动静脉交通到达左心和体循环动脉系统所造成的栓塞.现报告1例本病患者如下. 1 病例女,57岁.因"左侧肢体无力40余天,右上肢麻木、无力3 d"于2009年2月5 13入院.患者于2008年12月23 日晨起无诱因出现左侧肢体无力,口角右偏,伴头痛、呕吐数次.头颅CT示右侧大脑中动脉分布区大面积梗死灶,后逐渐出现意识障碍,病后第4 d在外院行去骨瓣减压术,术后患者神志恢复,但遗留左侧肢体偏瘫.     

颅内动脉粥样硬化狭窄致多发性脑梗死的血压管理1例分析

1病例介绍
　　患者,男,59岁,因“左侧肢体无力13 d,右侧肢体无力伴言语含糊6 d”入院。患者13 d前无诱因出现左手持物不稳,站立时向左侧摔倒,口角右歪,无意识障碍,无恶心及呕吐等。次日就诊于当地院,测血压180/110 mmHg,行头部计算机断层扫描（computed tomography, C T）示双侧基底节区低密度病灶,诊断为“脑梗死,高血压病”。予“阿司匹林100 mg qd;厄贝沙坦150 mg qd;硝苯地平控释片30 mg qd;阿托伐他汀10 mg qd”及对症支持治疗,患者口角歪斜逐渐恢复,但左侧肢体无力无明显好转。6d前患者出现右手乏力伴构音障碍,持续3 min后自行缓解。入院前10 h患者再次出现右侧肢体乏力伴饮水呛咳、言语含混不清,为进一步诊治入我院。     

急性化脓性脊髓炎一例

患者女性,60岁。主因颈背部疼痛伴左侧肢体麻木、无力2d,于2010年2月22日入院。患者于8d前"受凉"后出现咽痛、发热,无鼻塞、流涕,咳嗽、咳痰及腹痛、腹泻等症状;体温最高达39℃,外院按"上呼吸道感染"治疗(具体治疗过程不详),4d后体温恢复正常,咽痛症状消失。入院前2d无明显诱因出现颈背部疼痛并逐渐加重,伴左侧肢体麻木、无力,左侧下肢活动受限,高热达38℃,但无头晕、头痛,恶心、呕吐,咳嗽、咳痰,腹泻、腹痛,以及肢体抽搐或双侧下     

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.