可逆性胼胝体压部病变综合征1例并文献复习

目的探讨可逆性胼胝体压部病变综合征患者的临床表现及影像学特点、诊断与治疗要点。方法分析我院诊断为可逆性胼胝体压部病变综合征1例患者的临床资料与影像学资料,并结合相关资料对此例胼胝体压部局灶性孤立病变进行分析。结果患者在前驱感染后出现间断视物不清、头晕,头MRI平扫及增强扫描示:胼胝体压部类圆形、边界清楚的稍长T_1、长T_2信号,弥散加权高信号,病变周围无明显水肿,无明显占位效应,增强扫描未见强化。患者治疗1个月后复查头MRI结果显示胼胝体压部病灶消失。结论可逆性胼胝体压部病变综合征是一种单病程脑炎,临床表现多种多样,其特异的影像学特点为胼胝体压部可逆的类圆形病灶,预后良好。     

可逆性胼胝体压部病变综合征的影像表现

目的：探讨可逆性胼胝体压部病变综合征的临床及影像特点。方法对我院收治的9例可逆性胼胝体压部病变综合征患者的临床及影像资料进行回顾性分析。结果9例患者中婴幼儿3例,儿童1例,成人5例;2例婴幼儿及1例儿童有发热等感染病史伴神经症状,1例婴幼儿以缺血缺氧性脑病入院,成人以头痛、发热、昏迷、意识障碍等为主入院,其中伴有癫痫病史2例。头颅MRI显示胼胝体压部类圆形（婴幼儿累及全胼胝体压部）稍长T1稍长T2信号,FLAIR序列呈高或稍高信号,DWI呈高信号;其中3例增强扫描未见强化;头颅CT显示欠佳。经对症治疗后,症状缓解,MRI复查示胼胝体压部异常信号消失。结论可逆性胼胝体压部病变综合征的临床无特异性,而M RI表现有一定特征性,可为临床的诊疗及预后提供指导。     

伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病1例报道并文献复习

目的探讨伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病的临床特点、治疗及预后、发病机制。方法报道1例伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎患者的诊治过程,总结其临床特征并复习相关文献。结果患者表现为发热、头痛、呕吐等非特异性脑膜炎症状,合并出现抗利尿激素分泌不当导致的低钠血症,头颅MRI检查发现胼胝体压部有可逆性的DWI高信号的孤立病灶,经抗病毒及对症治疗,临床痊愈。结论伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病以头颅MRI上发现胼胝体压部可逆性病灶为特点,临床症状轻微,容易合并低钠血症,预后良好,病因及发病机制尚不清楚。     

20例儿童可逆性胼胝体压部病变综合征临床分析

目的探讨儿童轻微脑炎/脑病伴可逆性胼胝体压部病变综合征的病因及发病机制。方法回顾性分析2014-06—2016-06收治的20例轻微脑炎/脑病伴可逆性胼胝体压部病变综合征患儿的临床资料并进行总结分析。结果 20例患儿中男12例,女8例,主要病因为病毒感染及惊厥发作,头颅磁共振(MRI)显示胼胝体压部椭圆形病灶,临床表现无特异性,多轻微,预后好。结论儿童轻微脑炎/脑病伴可逆性胼胝体压部病变综合征临床症状轻微,头颅MRI表现具有特征性及可逆性,病因虽多,临床预后良好。     

胼胝体压部可逆性病变的MRI诊断与临床分析

目的探讨胼胝体压部(splenium of the corpus callosum,SCC)可逆性病变的MRI表现及临床特点。方法回顾性分析8例脑MRI表现为单纯胼胝体压部可逆性病变患者的临床和影像学资料。结果 8例患者的SCC可逆性病变均为继发性,原发病分别为脑内感染5例,肝豆状核变性、低血糖脑病及脑外伤各1例。8例患者均急性起病,临床表现为发热、头痛5例,急性意识障碍2例,肌张力增高2例,颈强2例,均符合原发病的临床表现。8例均行脑MRI检查,均表现为T1低或等信号,T2及FLAIR序列高信号,DWI高信号(提示细胞源性水肿),其中4例行增强扫描未见强化。8例患者均于临床症状好转或消失后复查MRI提示病灶消失。结论 SCC可逆性病变在多种疾病中均可出现,无该病变相关的特异性临床表现,MRI表现提示病灶为细胞源性水肿可能。     

2例可逆性脑病综合征的临床及影像学对比分析

目的 对比可逆性后部白质脑病综合征与可逆性胼胝体压部综合征的临床及影像学特点,以加深对这两种病的认识。方法 对比分析本院收治的可逆性后部白质脑病综合征与可逆性胼胝体压部综合征的临床表现及影像学特点。结果 该例可逆性后部白质脑病综合征的诱因为严重感染,主要临床表现为癫痫发作; 神经影像学以双侧大脑半球后部可逆性白质异常病变为特征。该例可逆性胼胝体压部综合征的诱因为低血糖,主要临床表现为精神症状及言语行为异常; 神经影像学以胼胝体压部的孤立性异常信号和病灶的可逆性消失为特征。结论 可逆性脑病综合征的诱因复杂、临床表现多样,有类似的病理基础,核磁共振成像均有特异性改变,且病灶均为可逆性改变,均为预后良好的可逆性脑病综合征,尽早正确治疗对减轻神经功能损害至关重要。     

可逆性胼胝体压部病变综合征:二例报告并文献复习

目的报告2例临床罕见的可逆性胼胝体压部病变综合征病例,初步总结其诊断与治疗要点。方法与结果回顾分析2例患者之病因、临床表现、影像学特征和临床转归,并复习相关文献。例1主要表现为头晕,例2则以精神障碍、发热、肌强直、震颤、外周血白细胞计数增加、血清肌酸激酶水平升高为主。临床表现均无特异性且无胼胝体离断综合征之证据,发病初期主要表现为上呼吸道感染症状,呈急性病程,经糖皮质激素等药物治疗14和21 d后症状与体征明显好转。头部MRI共同特点为胼胝体压部孤立性病灶,呈类圆形,增强扫描病灶无强化;原发病缓解后胼胝体压部病灶完全消失。结论可逆性胼胝体压部病变综合征是一种具有多种病因、独特的临床影像综合征,除骤然停用抗癫药物和感染等因素外,恶性综合征亦可能是诱因之一。本组2例患者的诊断与治疗结果支持最近文献提出的其预后取决于导致该综合征的原发病而非胼胝体压部病变的观点。     

西藏地区可逆性胼胝体压部病变综合征8例临床特点分析

目的探讨西藏地区可逆性胼胝体压部病变综合征患者的临床和影像学特点。方法回顾性分析8例可逆性胼胝体压部病变综合征患者的临床资料和影像学资料的特点。结果 8例患者的平均发病年龄为27.5岁,其中男6例,女2例;汉族4例,藏族4例;部分患者发病前存在上呼吸道感染、癫痫持续状态、入藏史以及阿托品治疗窦性心动过缓等诱因,以头晕、头痛、视物模糊或抽搐为主要临床表现。所有患者治疗前头颅MRI平扫均表现为胼胝体压部接近中央部位类圆形或条状边界清楚的等或稍长T_1、长T_2信号,弥散加权像(diffusion weighted image,DWI)高信号,表观扩散系数(apparent diffusion coefficient,ADC)值减低,病变周围无明显水肿及明显占位效应。予对症支持治疗后症状缓解,胼胝体压部异常信号消失或减低。结论可逆性胼胝体压部病变综合征一般临床症状轻微、临床表现多种多样,具有特异的影像学特征,预后良好,西藏独特的高原环境对该病的发病可能有一定的影响。     

可逆性胼胝体压部病变综合征四例分析

目的总结可逆性胼胝体压部病变综合征的临床表现和影像学特点,探讨其病因和发病机制。方法回顾分析4例可逆性胼胝体压部病变综合征患者的临床表现、影像学特点和病因。结果4例患者中2例(例1和例2)有颅脑创伤史,1例(例3)于饮酒后出现发作性双眼视物模糊,1例(例4)于感冒后出现头痛、晕厥,伴间断性视物模糊和慢性肾功能衰竭;MRI表现为胼胝体压部孤立性圆形或类圆形、边界清晰的病变,呈T_1WI等或稍低信号,T_2WI、扩散加权成像和FLAIR成像高信号,表观扩散系数低信号,无明显水肿和占位效应,1例(例2)除胼胝体压部病变外,磁敏感加权成像可见额叶出血。均经对因和对症支持治疗后症状完全缓解,病程8~15 d。复查MRI,3例胼胝体异常信号消失,1例(例2)病变信号范围和强度较前明显好转,均未遗留神经功能障碍。结论可逆性胼胝体压部病变综合征是一种临床影像学综合征,病因多样,癫及其相关疾病是最常见病因,颅脑创伤也可以引起可逆性胼胝体压部病变综合征,临床表现无特异性,经对因治疗后预后良好。     

成人可逆性胼胝体压部病变综合征临床分析

目的 总结成人可逆性胼胝体压部病变综合征的临床特征,并探讨可逆性细胞毒性水肿形成机制.方法 与结果纳入2017年1月至2019年5月南昌大学第一附属医院诊断与治疗的23例可逆性胼胝体压部病变综合征患者,临床主要表现为头痛头晕、发热、抽搐、意识障碍等,均存在血清白蛋白水平降低.头部MRI共同特点为可逆性胼胝体压部孤立性病...     

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.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.