Heterotopic brain cyst from middle cranial fossa to submandibular region

The case of a newborn boy with a congenital cystic neck mass causing respiratory distress is reported. This lesion extended from the submandibular region through a bone defect to the middle cranial fossa but remained totally extradural. There was no underlying brain abnormality. The cyst was composed mainly of mature neuroglial tissue, with some ependymal and choroid plexus elements, and was diagnosed as heterotopic brain. After 8 years' follow-up, the child still has no deficits.     

Heterotopic glioneuronal mass of the cerebellomedullary cistern with duct cyst formation of ectopic salivary gland tissue

We report the unique presentation of a glioneuronal heterotopia in the cerebellomedullary cistern in association with salivary gland and adipose tissue in a 56‐year‐old woman. The patient presented with persistent pain of the posterior neck and was diagnosed with a snow‐man shaped cystic solid mass in the cerebellomedullary cistern of the posterior fossa on brain MRI. Surgical exploration revealed a tan to gray solid mass with a cystic portion that was ruptured during surgery. Histologically, the mass consisted of glioneuronal cells in the gliofibrillary or neuropil matrix and was diagnosed as glioneuronal heterotopia. This heterotopic glioneuronal mass contained CD34‐positive neuroglial cells and pericellular stroma. In addition, an island of normal‐appearing salivary gland and adipose tissue was found in close relationship with the mass. The cystic portion of the mass was a duct cyst of the salivary gland. The pathogenesis of this case with heterotopic glioneuronal, salivary and adipose tissues remains unclear.     

DNA extraction from fresh-frozen and formalin-fixed, paraffinembedded human brain tissue

Both fresh-frozen and formalin-fixed,paraffinembedded（FFPE）human brain tissues are invaluable resources for molecular genetic studies of central nervous system diseases,especially neurodegenerative disorders.To identify the optimal method for DNA extraction from human brain tissue,we compared methods on differently-processed tissues.Fragments of LRRK2 and MAPT（257 bp and 483 bp/245 bp）were amplified for evaluation.We found that for FFPE samples,the success rate of DNA extraction was greater when using a commercial kit than a laboratory-based method（successful DNA extraction from 76%versus 33%of samples）.PCR amplicon size and storage period were key factors influencing the success rate of DNA extraction from FFPE samples.In the fresh-frozen samples,the DNA extraction success rate was 100%using either a commercial kit（QIAamp DNA Micro）or a laboratorybased method（sample boiling in 0.1 mol/L NaOH,followed by proteinase K digestion,and then DNA extraction using Chelex-100）regardless of PCR amplicon length or tissue storage time.Although the present results demonstrate that PCR-amplifiable genomic DNA can be extracted from both fresh-frozen and FFPE samples,fresh brain tissue is recommended for DNA extraction in future neuropathological studies.     

重型颅脑损伤中脑温脑组织氧分压持续监测

目的研究重型颅脑损伤中脑温(BT)、脑组织氧分压(PbtO2)的持续变化及其意义.方法应用脑温、脑组织氧分压(PbtO2)探针脑白质温度、脑组织内物理性溶解的氧的压力.结果通过对10例重型闭合性颅脑损伤患者研究分析发现(1)在诱导低温后,直肠温度(RT)与BT的差异比正常体温时明显.(2)在重型颅脑伤后,PbtO2值降低,PbtO2＜10mmHg时,可认为是脑缺氧的阈值.(3)伤后24小时内PbtO2＜5mmHg预示病人预后不良.(4)脑组织氧分压测定技术可指导过度换气的应用.结论在低温状态下,RT与BT的差异加大,因此,在研究低温对脑外伤的影响时,最好能直接测量脑温.脑组织氧分压监测安全可靠,是脑组织氧合程度的一种灵敏的监测方法,它可以提示预后,并且对临床治疗具有重要的指导作用.     

重型颅脑创伤亚低温治疗中脑组织氧分压持续监测的应用

目的 研究亚低温治疗状态下重型颅脑创伤( sTBI)患者伤后早期脑组织氧分压(PbtO2)的动态变化及临床意义.方法 38例sTBI患者进行亚低温治疗,连续监测PbtO2、颈静脉血氧饱和度(SjvO2)、颅内压(ICP)、和脑灌注压(CPP)等指标,对监测结果以及PbtO2和其他指标相关性进行分析,并记录患者伤后3个月的格拉斯哥预后评分.结果 在亚低温治疗初期,患者PbtO2、SjvO2和CPP明显上升,ICP明显下降,而治疗36 h和48 h后PbtO2及SjvO2无明显变化.亚低温治疗后ICP较治疗前明显下降,低PbtO2情况明显改善,ICP和PbtO2之间呈负相关;PbtO2及SjvO2水平明显上升,PbtO2与SjvO2呈直线正相关;PbtO2与CPP呈直线正相关.监测过程中,在SjvO2和CPP水平正常的情况下,仍有较大比例的患者出现低PbtO2情况.治疗过程中没有出现过低PbtO2水平的患者预后良好.结论 PbtO2是监测sTBI患者局部脑组织氧合的一项重要指标,具有很高敏感性,对于指导治疗和判断预后具有重要意义,而亚低温能够明显改善PbtO2降低的情况.     

Herpesviral DNA in brain tissue from patients with temporal lobe epilepsy

OBJECTIVES: Presence of DNA from six herpesviruses were examined in brain tissue from patients operated for temporal lobe epilepsy. MATERIAL AND METHODS: A total of 19 Canadian patients (I) with a median age of 22 years, 17 Swedish patients (II) with a median age of 14 years and a reference group comprising 12 individuals were studied. Presence of herpesviral DNA was detected by nested polymerase chain reaction. RESULTS: Of three children with Rasmussen's encephalitis, Cytomegalovirus (CMV) DNA was found in two, and human herpesvirus type 6 DNA in two. In six children with ganglioglioma, Epstein-Barr virus (EBV) was detected in four. CMV DNA was found significantly more in group I compared with II, while the reverse occurred with EBV DNA. Malformations of cortical development were found significantly more in group II compared with I. CONCLUSION: Detection of DNA from some herpesviruses in epileptic brain tissue may possibly be associated with distinct clinical conditions, but factors such as age and malformations of cortical development should also be considered.     

过度通气对重型颅脑创伤病人的脑血流和脑组织氧分压的影响

目的研究过度通气(HV)对重型颅脑创伤(sTBI)病人的颅内压(ICP)、脑血流(CBF)和脑组织氧分压(PbtO2)的影响。方法20例sTBI(GCS3～8分)病人,伤后2～5dICP超过20mmHg时,应用机械通气法使呼气末二氧化碳分压(PetCO2)维持在27～32mmHg之间30min,同时连续监测ICP、CBF和PbtO2。结果所有病人共进行了46次HV,HV可使ICP明显下降(43/46),而CBF和PbtO2对CO2的反应差异较大,其中大部分试验(38/46)CBF和PbtO2明显下降,但仍然保持在各自的缺血阈值(50AU和10mmHg)之上;5次试验CBF和PbtO2下降低于各自的缺血阈值;3次试验ICP无明显变化,CBF轻度升高,而PbtO2下降。结论HV可降低ICP,但有导致或加重脑缺血的危险,应尽量避免早期长时程应用。HV应在CBF持续监测下应用。     

脑内移植治疗顽固性癫痫的临床研究

目的：寻找提高治疗癫痫的疗效方法。方法：本组采用癫痫灶切除和脑移植结合，治疗此类病人６２例。结果：显示总有效率达９５％，而常规治疗组为９２％，与常规治疗组比有显著差异（Ｐ＜００１）。结论：癫痫灶切除术加脑移植治疗顽固性癫痫是一种有效的治疗方法     

Comparison of the clinical results of STA-MCA anastomosis and the medical treatment in the cerebral low perfusion patients with viable brain tissue

Abstract

The long-term clinical results of STA-MCA anastomosis as well as the medical treatments were compared in cases that were confined as having a focal cerebral perfusion deficit with viable brain tissue, based on either the drug induced EEG and evoked potential test (DEE test) and/or by positron emission tomography (PET). The criteria for viable cerebral tissue was determined by the following four conditions: (1) functional reversibility could be confirmed by the DEE test; (2) a haemodynamic process could be found in the DEE test; (3) a haemodynamic compromise could be confirmed in the PET study; (4) misery perfusion could be confirmed in the PET study.

From 1975 to 1989, 55 cases were confirmed as having viable brain tissue according to the DEE test and the PET study. Of the 55 casesbypass surgery was performed on 35. Conservative treatment was given to the other 20 cases. There were 3 cases of perioperative neurological deterioration. One was permanent and the other 2 were transcient. Results of the long-term follow up are as follows. Ipsilateral attack: 1 case (2.0%) received surgery, and 7 cases (35%) received conservative treatment. Re-attack in the contralateral or posterior circulation: 6 cases (17.2%) received surgery, and 1 case (5%) received conservative treatment. Seventy-seven per cent of the surgical cases improved or had no change in the final functional statuswhile only 55% of the conservative group either improved or showed no change. The incidence of ipsilateral cerebral ischaemia was significantly low in the surgical group. Contralateral and/or posterior circulation ischaemia tended to be high in this group, however. The final functional state was also better in the surgical group. These results show the usefulness of STA-MCA anastomosis in cases that are confirmed to have viable cerebral tissue by either the DEE test or the PET.     

逆转录酶抑制剂AZT对胶质瘤干细胞端粒酶活性和细胞增殖的影响

目的 探讨逆转录酶抑制剂3-叠氮-3-脱氧胸腺核苷(AZT)对脑胶质瘤干细胞增殖的影响及相关机制.方法 原代分离培养脑胶质瘤干细胞和脑胶质瘤细胞并鉴定,两种细胞同时设立为实验组(0.125 mot/L、0.250 mol/L、0.500 mol/L AZT)和对照组.MTT法检测AZT对两种细胞增殖的影响;流式细胞仪检测细胞凋亡和细胞周期的改变;端粒重复序列扩增技术-酶联免疫吸附试验(TRAP-ELISA)检测端粒酶活性的变化.结果 AZT对两组细胞的生长抑制呈浓度-时间依赖性(均P<0.05),在同一浓度和时间点,AZT对脑胶质瘤干细胞的生长抑制作用弱于脑胶质瘤细胞(均P<0.05).0.250 mol/L、0.500 mol/L AZT作用72 h后,脑胶质瘤干细胞的凋亡率分别为(4.21±1.53)%、(10.60±0.38)%,而脑胶质瘤细胞的凋亡率分别为(6.75±1.25)%,(14.30±2,59)%,明显高于胶质瘤干细胞(均P<0.05).AZT对两组细胞端粒酶活性的抑制呈浓度-时间依赖性(均P<0.05),且在同一浓度和时间点对脑胶质瘤细胞的作用明显强于脑胶质瘤干细胞(均P<0.05).结论 逆转录酶抑制剂AZT对脑胶质瘤干细胞和脑胶质瘤细胞均有明显的生长抑制作用,可能机制是通过抑制端粒酶活性、调控细胞周期和诱导细胞凋亡实现.脑胶质瘤干细胞的耐药性强于胶质瘤细胞,其机制有待进一步研究.     

pH measurement as quality control on human post mortem brain tissue: a study of the BrainNet Europe consortium

Aims:  Most brain diseases are complex entities. Although animal models or cell culture experiments mimic some disease aspects, human post mortem brain tissue remains essential to advance our understanding of brain diseases using biochemical and molecular techniques. Post mortem artefacts must be properly understood, standardized, and either eliminated or factored into such experiments. Here we examine the influence of several premortem and post mortem factors on pH, and discuss the role of pH as a biochemical marker for brain tissue quality. Methods:  We assessed brain tissue pH in 339 samples from 116 brains provided by 8 different European and 2 Australian brain bank centres. We correlated brain pH with tissue source, post mortem delay, age, gender, freezing method, storage duration, agonal state and brain ischaemia. Results:  Our results revealed that only prolonged agonal state and ischaemic brain damage influenced brain tissue pH next to repeated freeze/thaw cycles. Conclusions:  pH measurement in brain tissue is a good indicator of premortem events in brain tissue and it signals limitations for post mortem investigations.     

The relationship between lesion and normal appearing brain tissue abnormalities in early relapsing remitting multiple sclerosis

Background In multiple sclerosis (MS), pathological changes have been found both in macroscopic lesions and normal appearing tissue. Magnetisation transfer ratio (MTR) and T1 relaxation time are abnormal in normal appearing tissues in established MS. This study used these MR techniques in early MS to study normal appearing tissues and lesions. The purpose was to determine whether abnormalities are already detectable in normal appearing tissues in early MS, and if so how they correlate with lesion characteristics. Methods Twenty two patients with early relapsing remitting (RR) MS (median disease duration 2 years, range 7 months–3 years) and 11 age-matched controls were studied. MTR and T1 relaxation times were measured in 9 regions of normal appearing white matter (NAWM) and 7 of normal appearing grey matter (NAGM). Gadolinium enhancing, T1-hypointense and T2 lesion loads were measured in all patients. Results When all regions were combined, there was a significant difference between patient and control NAWM for both T1 and MTR; T1 was abnormal in 6/9 and MTR in 3/9 NAWM regions. Global assessment of NAGM revealed a significant difference between patients and controls for T1 but not for MTR; T1 was significantly abnormal only in frontal NAGM. There was no significant correlation between NAWM T1 or MTR and any of the lesion load measurements. Conclusions This study reveals quantitative MR abnormalities in both NAWM and NAGM in early RR MS, with more extensive changes in the former. The lack of correlation between NAWM and lesion abnormalities suggests that they have developed by at least partly independent mechanisms. T1 may be more sensitive than MTR in detecting subtle pathological changes in NAWM and NAGM. Received: 3 April 2001, Received in revised form: 15 June 2001, Accepted: 18 June 2001     

Reliability and reproducibility of brain tissue volumetry from segmented MR scans

Reliable measurement of different tissue volumes in the living brain is of great importance for human brain research. In this article, we report on the inter- and intraoperator reliability and scan-rescan reproducibility of segmented intracranial tissue volumes from MR images using the image analysis software suite BRAINS. The absolute data of tissue volume measurements are also presented. The reliability and consistency of the measurements of the segmented volumes were excellent. The segmentation is robust and rapid and the volume measurements are plausible and suitable for quantitative studies in clinical brain research. Received: 24 April 2001 / Accepted: 24 September 2001     

Cortical gray and white brain tissue volume in adolescents and adults with autism.

BACKGROUND: A number of studies have found brain enlargement in autism, but there is disagreement as to whether this enlargement is limited to early development or continues into adulthood. In this study, cortical gray and white tissue volumes were examined in a sample of adolescents and adults with autism who had demonstrated total brain enlargement in a previous magnetic resonance imaging (MRI) study. METHODS: An automated tissue segmentation program was applied to structural MRI scans to obtain volumes of gray, white, and cerebrospinal fluid (CSF) tissue on a sample of adolescent and adult males ages 13-29 with autism (n = 23) and controls (n = 15). Regional differences for brain lobes and brain hemispheres were also examined. RESULTS: Significant enlargement in gray matter volume was found for the individuals with autism, with a disproportionate increase in left-sided gray matter volume. Lobe volume enlargements were detected for frontal and temporal, but not parietal or occipital lobes, in the subjects with autism. Age and nonverbal IQ effects on tissue volume were also observed. CONCLUSIONS: These findings give evidence for left-lateralized gray tissue enlargement in adolescents and adults with autism, and demonstrate a regional pattern of cortical lobe volumes underlying this effect.     

急性重型颅脑创伤患者脑组织、血清蛋白质组分析

目的评价急性重度颅脑创伤患者脑组织、血清同时筛选损伤标记物的意义；对比出两种组织之间相同的差异蛋白质，以直接利用血清中的蛋白质来评估颅脑损伤。方法应用表面加强激光解析电离时间飞行质谱技术比较创伤组和对照组皮层组织之间、血清之间蛋白质的差异表达，筛选出血清、脑组织之间相同的差异蛋白质。结果每例患者脑组织、血清之间比较出13—39个相同差异蛋白质峰。创伤组脑组织、血清之间比较出8个相同差异蛋白质峰：m／z3178、m／z3412、m／z4201、m／z4692、m／z8605、m／z8676、m／z9387、m／z9607。结论脑组织、血清同时筛选差异蛋白质，发挥出两种组织各自对比的优势，克服彼此的缺点，为直接利用血清中的差异性蛋白质评估颅脑损伤奠定了实验基础。     

亚低温治疗重型颅脑损伤中脑组织氧分压的临床意义

目的观察亚低温治疗重型颅脑损伤过程中患者颅内压及脑组织氧分压的变化及临床意义。方法将80例急性重型颅脑损伤患者,随机分为亚低温治疗组(40例)和对照组(40例)。亚低温组入院后或术后立即给予亚低温治疗,保持肛温在32~34℃,持续24h~5d;对照组给予常规治疗。两组均观察颅内压(ICP)和脑组织氧分压(PbtO2)变化。结果亚低温组治疗后,ICP明显下降,PbtO2逐渐升高,与对照组相比有显著性差异。结论亚低温治疗能降低脑外伤后增高的ICP,提高PbtO2;伤后24h内持续PbtO2<5mmHg预示患者预后不良。     

Oxidative stress induces axonal beading in cultured human brain tissue

Oxidative stress has been implicated in the pathogenesis of a number of human neurodegenerative disorders of the central nervous system (CNS), including Alzheimer's disease (AD). To better understand the pathological effects of oxidative stress on CNS neurons we used a primary human brain cell culture model of hydrogen peroxide-induced oxidative stress. Neuronal and astrocytic morphology was visualised by immunofluorescence with antibodies to the neuron-specific microtubule component beta-tubulin III and against glial fibrillary acidic protein (GFAP), respectively. After exposure to 40 mM H(2)O(2) for 60-90 min, axonal swelling was observed, which developed into axonal beading after 48 h. No beading was observed in GFAP-positive astrocytes. Despite the concentration of H(2)O(2) used, neurons remained attached to the substratum and showed no signs of apoptosis. This was attributed to the neuroprotective effect of the B-27 medium supplement, which contained antioxidants. The axonal swelling and beading was consistent with a disruption of microtubules by oxidative stress and subsequent hold-up of axonal transport.     

神经生长因子在胎脑组织保存和移植中的应用

大鼠胚胎脑组织放入神经生长因子（ＮＧＦ）溶液或ＤＭＥＭ培养液中保存１～６天，观察不同时间细胞存活率，ＮＧＦ组均高于ＤＭＥＭ组。将这两种液体中保存５天的组织分别植入两组成年大鼠脑内，６～８周后组织学观察发现，ＮＧＦ组移植成活４／１０，对照组移植物成活３／９．尽管两组移植物成活率比较差别不显著（Ｐ＞０．０５），但是移植物生存质量ＮＧＦ组明显优于对照组。     

替尼泊甙治疗恶性脑胶质瘤的远期结果

报道替尼泊甙－ＣＣＮＵ治疗恶性脑胶质瘤９６例随诊１～１０年的远期结果．男性６６例、女性３０例．年龄５～７４岁，平均３９．７岁。治疗周期总数４４８个，平均５个／例．远期结果计：ＣＲ１８例、ＰＲ２１例，ＲＲ率４０．７％；ＳＤ１９例、ＰＤ３７例、ＥＤ１例．存活率为：１年８５％、３年２６％、５年１４．６％、１０年１％。目前仍存活之１４例中已逾５年者５例．平均有效时限为ＣＲ组２１２周、ＰＲ组１２１周、ＳＤ组４６周、ＰＤ组１２周。平均存活时限为ＣＲ组２４１周、ＰＲ组１３３周、ＳＤ组５７周、ＰＤ组１８周。