Neuronal activity in the globus pallidus of multiple system atrophy patients.

The pathophysiological changes in neural activity that characterize multiple system atrophy (MSA) are largely unknown. We recorded the activity of pallidal neurons in 3 patients with clinical and radiological features of MSA who underwent unilateral microelectrode-guided pallidotomy for disabling parkinsonism. Findings in these patients were compared with 4 control patients with a clinical diagnosis of Parkinson's disease (PD). The position, firing rates, and firing patterns of single neurons in the pallidal complex were analyzed in both MSA and PD patients. The mean spontaneous firing rate of neurons in the internal segment of the globus pallidus internus (GPii) was significantly lower in MSA than in PD patients. There were no significant differences between MSA and PD patients, however, in firing rates of neurons in the external globus pallidus (GPe) or in the external segment of GPi (GPie). In addition, no significant differences in firing pattern were found between MSA and PD patients. In conclusion, this study has shown that firing rates of neurons in GPii but not in GPie and GPe are different in MSA patients compared with that in PD patients, a finding that may reflect the poor clinical results of pallidotomy reported in patients with MSA.     

臀肌挛缩症的围手术期护理

臀肌挛缩症（gluteal muscle contracture，GMC）是由多种原因引起的臀肌及其筋膜纤维变性、挛缩，导致髋关节功能受限所表现的特有步态、体征的临床综合征。1989年陆裕朴在国内已有系统回顾后，我国病例报道逐渐增多，普及各大省市，特别是那些偏远的山区或基层农村。由于医疗卫生条件差，再加上人们的医疗卫生、保健知识缺乏，导致对本病的认识不足，该病的发病率农村明显的高于城镇。轻者造成患儿异常姿势和特殊步态。严重的可导致骨关节畸形、骨盆倾斜、跛行等。影响患者的正常发育及生活能力。     

Glycolipid and protein profiles of normal and Trypanosoma cruzi infected heart muscle cells.

Using Triton X-114, glycolipids and proteins were extracted from heart muscle cells (HMC) infected with Trypanosoma cruzi clone Dm28c and from uninfected HMC, and analysed by SDS-PAGE and high-performance thin-layer chromatography (HPTLC). Two major differences were observed: (a) two proteins with a molecular mass of 92 kDa and 69 kDa were present in the uninfected cells but absent from the infected cells and (b) a 70-90 kDa protein band was detected only in parasitized cells. These differences would seem to constitute alterations taking place during the process of cell recognition and/or parasite interiorization. No differences were observed in the respective glycolipid compositions, of control and infected cells analysed by HPTLC. A glycolipid with the same mobility as the neutral glycolipid isolated from epimastigotes of T. cruzi was detected in the uninfected cells. This finding may lend support to the previously described hypothesis that molecular mimicry is implicated in the cardioneuropathology of Chagas' disease.     

Diagnostic accuracy of fetal renal pelvis anteroposterior diameter as a predictor of uropathy: a prospective study.

OBJECTIVE: The purpose of this study was to assess the accuracy of prenatal ultrasound measurement of anteroposterior renal pelvis diameter (APD) to discriminate between significant uropathy and idiopathic renal pelvis dilatation. METHODS: One-hundred-and-three neonates who were found to have fetal renal pelvis dilatation, defined as presence of an APD > or = 5 mm, underwent systematic investigation for uropathies and were prospectively followed. An ultrasound scan was performed after the first week of postnatal life and all infants underwent a voiding cystourethrogram. Neonates with an APD larger than 10 mm underwent renal scintigraphy. Ultrasound scans, clinical examination and laboratory reviews were scheduled at 6-month intervals. Receiver-operating characteristics (ROC) curves were constructed to determine the best cut-offs for APD to identify renal units with significant uropathy as well as those requiring surgical intervention. Significant uropathy was defined as the presence of well-established urinary tract abnormalities or when there was abnormal renal scintigraphy. RESULTS: The estimated area under the curve for APD was 0.900 (95% CI, 0.841-0.942) indicating excellent power to discriminate between idiopathic pelvis dilatation and significant uropathy. The sensitivity and specificity for the 7.5 mm cut-off point were 97.9% and 40.6%, respectively. To identify infants who required surgical intervention, the calculated area under the curve was 0.953 (95% CI, 0.908-0.980). CONCLUSION: Our results suggest that measurement of APD is an excellent test to identify fetuses with significant uropathy, as well as those requiring postnatal intervention.