多发性硬化的临床特点分析

目的探讨多发性硬化(MS)的临床表现特点。方法回顾性分析2007-01—2010-06于我院确诊的68例多发性硬化病例,总结其一般资料、临床表现、病变部位、重要辅助检查及治疗转归等。结果 68例患者中,首发症状以肢体无力(28例,41.2%)最常见;肢体无力、感觉障碍、视觉损害是MS患者最常见的症状;MS好发于青壮年,以急性和亚急性起病为主;视、听、体感诱发电位(VEP、BAEP、SEP)有助于发现亚临床病变;脑脊液(CSF)检查可有异常;磁共振(MRI)检查阳性率高;临床定位以大脑半球、脊髓和视神经受累最多见。糖皮质激素及免疫球蛋白治疗有效。结论根据临床特点,结合神经电生理脑脊液及影像学等检查能大大提高MS的临床确诊率。     

多发性硬化35例临床分析

目的 探讨多发性硬化（MS）的临床特点。方法 综合分析35例MS患者的一般临床资料、病变部位、重要辅助检查及治疗转归。结果 MS多见于青壮年女性,病程多缓解与复发、上呼吸道感染、劳累紧张为其主要诱因,脑脊液显示免疫活性增高,视神经、脊髓受累多见,电生理、免疫学及影像学检查有助诊断,糖皮质激素治疗有效。结论 根据临床特点、综合神经电生理、脑脊液免疫学及影像学检查能明显提高临床确诊率。     

105例多发性硬化临床特点及治疗分析

目的 探讨多发性硬化的临床发病特点及临床治疗疗效.方法 从2005-01至2010-10月间收治的多发性硬化患者105例为研究对象.结果 105例患者中以20-40岁女性多见,以急性、亚急性起病,以肢体无力为首发症状最常见,病变部位多以脑和脊髓多见,脑脊液蛋白升高、IgG增高及寡克隆区带阳性常见,核磁共振较计算机断层扫...     

多发性硬化的临床与磁共振成像

目的 :对 4 6例多发性硬化 (multiple sclerosis,MS)患者进行临床与磁共振成像 (MRI)分析 ,从而进一步探讨其常见症状、体征、首发症状及 MRI检查的诊断价值。方法 :总结 4 6例多发性硬化的临床特点 ;结合文献复习对MS的 MRI及头颅 CT扫描所见进行讨论。结果 :MRI可发现 MS早期病变 ,及早作出诊断 ,且明显优于头颅 CT扫描。结论 :MS最常见的发病部位是侧脑室周围白质、视神经、脊髓和脑干。MS诊断的金标准仍然是临床 ,MRI作为MS的辅助诊断是最有效的手段     

多发性硬化66例临床分析

目的 探讨多发性化（ＭＳ）的临床特点。方法 综合分析６６例多发性硬化患者的一般临床资料,病变部位,重要辅助检查及治疗转归。结果 ＭＳ多见于青壮年女性,起病较急,病程多缓解复发,上呼吸道感染及其主要诱因这一脊、视神经受累多见,电生理,免疫学及影像学检查有助诊断,糖皮质激素治疗有效。结论 根据临床特点,综合神经电生理、脑脊液免疫学及影像学检查能大大提高临床确诊率,其中磁共振成像意义较大。     

26例多发性硬化患者的临床与鉴别诊断

目的 分析26例临床确诊的多发性硬化(multiple sclerosis，MS)患者的临床资料。方法 回顾性总结临床确诊MS患者的临床表现、实验室检查以及影像学表现。结果 26例MS患者最常见的临床症状为肢体无力和感觉异常，其次为肌肉痉挛性疼痛、视力障碍、尿便异常、共济失调，个别患者可有周围神经改变。实验室检查示：脑脊液蛋白水平和IgG量增高最常见。磁共振(MRI)异常率高达90．9％。结论 MS是一种临床表现复杂、累及中枢神经系统白质多部位、病程表现多时相的自身免疫性疾病。但临床有周围神经症状及MRI发现皮层病灶也并非是排除MS的绝对标准。在诊断MS时，尤其对于单病灶或多病灶、单时相病程患者应从临床和影像学方面注意与脑梗死、脊髓疾病相鉴别。     

多发性硬化临床特征分析及治疗

目的 探讨多发性硬化(multiple sclerosis,MS) 的临床特征及治疗方法.方法 回顾分析42例MS患者的临床资料.结果 MS 好发于青年女性(29例),常见症状为肢体无力(29例)、视力障碍(22例)和感觉障碍(21例).病变累及大脑半球30例,视神经28例,脊髓23例,脑干9例,小脑4例,所有病例MRI检查均有阳性改变,CSF检查IgG鞘内合成率阳性16例,寡克隆区带阳性19例,抗髓鞘碱性蛋白(MBP)抗体阳性15例.视觉诱发电位(VEP)异常28例,脑干听觉诱发电位(BAEP)阳性16例,体感诱发电位(SEP)异常20例,急性期甲强龙冲击治疗患者临床症状均有改善,缓慢激素减量及小剂量激素长期维持治疗,随访至2008-01仅有7例复发.结论 结合临床特点、MRI、脑脊液免疫学、诱发电位检查能明显提高临床确诊率.急性期甲强龙冲击治疗可改善临床症状,缩短急性期病程,缓慢激素减量及小剂量激素长期维持可能有助于降低复发率.     

多发性硬化20例临床分析

目的 :探讨多发性硬化的临床症状及MRI对其诊断的价值和意义。方法 :综合分析 2 0例多发性硬化患者一般资料、MRI、脑脊液检查及治疗转归。结果 :多发性硬化好发于 10～ 4 0岁 ,女性多见 ,起病形式及临床症状多样 ,病程呈复发与缓解 ,MRI对多发性硬化病灶的发现率可达 10 0 %。糖皮质激素治疗有效 ,但随着病程的延长 ,复发次数的增多 ,激素治疗欠佳。结论 :根据临床特点、影像学检查、脑脊液及神经电生理检查可提高多发性硬化的确诊率     

200例多发性硬化临床分析

多发性硬化(multiple sclerosis,MS)是以中枢神经系统白质脱髓鞘病变为特点,遗传易感个体与环境因素作用发生的自身免疫性疾病.临床上以病变部位及发病次数的多发性为特点,病理上以中枢神经系统多灶性炎性脱髓鞘为特征.临床表现复杂,且不同种族以及不同地理位置的MS患者有不同的特点.该文报道总结200例MS患者临床特点的结果.     

多发性硬化20例临床分析

目的：探讨多发性硬化的临床症状及MRI对其诊断的价值和意义。方法：综合分析20例多发性硬化患者一般资料、MRI、脑脊液检查及治疗转归。结果：多发性硬化好发于10－40岁，女性多见，起病形式及临床症状多样，病程呈复发与缓解，MRI对多发性硬化病灶的发现率可达100％。糖皮质激素治疗有效，但随着病程的延长，复发次数的增多，激素治疗欠佳。结论：根据临床特点、影像学检查、脑脊液及神经电生理检查可提高多发性硬化的确诊率。     

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.