Electromyography and nerve conduction study in autosomal dominant olivopontocerebellar atrophy

Summary Electromyographic examination and studies of motor and sensory conduction velocities were performed in 11 patients with a presumptive diagnosis of olivopontocerebellar atrophy with autosomal dominant transmission. Peripheral nervous system involvement was shown in eight. In two patients with early onset of disease, electrophysiological alterations clearly pointed to severe axonal degeneration, whereas in six they were compatible with slight demyelination.

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Zusammenfassung Bei elf Patienten, bei welchen eine olivopontocerebelläre Atrophie mit autosomal dominanter Übertragung angenommen wurde, führten wir eine elektromyographische Untersuchung und eine Bestimmung der motorischen und sensiblen Erregungsleitungsgeschwindigkeit durch. Bei acht dieser Patienten wurde eine Mitbeteiligung des peripheren Nervensystems nachgewiesen. In zwei Fällen mit frühem Krankheitsbeginn wiesen die elektrophysiologischen Veränderungen eindeutig auf eine schwere axonale Degeneration hin, während bei sechs die Befunde mit einer leichten Demyelinisation vereinbar waren.

     

Investigations on neurotoxicity of chemical substances at the workplace

Summary A cross-sectional study was performed in order to investigate the influence of chronic lead-exposure on the peripheral nervous system. We examined 148 male workers of a storage battery manufacturing plant, who had been exposed to lead metal and inorganic lead compounds for 1 to 28 years (mean 11 years). Fifteen workers with non-occupational risks of peripheral neuropathy (former diseases, alcohol abuse, medication) were excluded from the study. The investigation program comprised: case history, physical examination, analyses of blood- and urine-samples and determination of maximal motor, mixed and sensory conduction velocity (NCV) of the ulnar and median nerve of the right forearm. Objectively no worker showed any signs of health effects related to lead exposure. The Biological Monitoring included the determination of (1) Blood-lead level (Pb-B), (2) Free erythrocyte porphyrins (FEP), (3) -Aminolevulinic acid dehydratase (ALA-D) and (4) -Aminolevulinic acid in urine (ALA-U). Further time-weighted-average (TWA)-values of Pb-B were calculated on the basis of several determinations over the period 1975–1981. The following actual (TWA) median values resulted: Pb-B 53 g/dl (54 g/dl), ALA-U 5.6 mg/l (8.4 mg/l), FEP 2.0 mg/l (2.0 mg/l). The Biologischer Arbeitsstoff Toleranz Wert (BAT) of 70 g//dl for Pb-B was exceeded in 15 workers (11%), and of 15 mg/l for ALA-U in 30 cases (23%). In comparison with age-matched controls, the lead workers showed a mild slowing of NCV with mean values between 0.8 and 2.0 m/s. Multiple stepwise regression analyses revealed statistically significant correlations between the four NCV and age as well as Pb-B. There were better correlations by using TWA than actual data of Pb-B. Consideration of the results of the regression analyses, together with an evaluation of the individual neurophysiological status as a function of internal lead exposure, a dose-effect-relationship was found only in the case of Pb-B exceeding 70 g/dl. From our study it is concluded that chronic lead exposure resulting in blood-lead levels of below 70 g/dl is no occupational risk causing a functionally significant slowing of nerve conduction velocities.With Grants from the Deutsche Forschungsgemeinschaft, Bonn (Project no. Va 23/19-1)     

rGH＋CLS减少电损伤组织坏死的研究

研究rGH CLS局部应用对减少高压电损伤组织进行性坏死的作用。使用该实验室已建立的重度高压电损伤模型,新西兰大白兔45只均分5组。治疗分别使用rCH CLS（1组）,CLS（2组）,rGH(3组）,盐水（4组）和5组对照,临床解剖探查、组织学和超微结构等方法观察。结果：治疗1组有明显的减少组织坏死作用。15d动物伤肢完整,而2,3和4组虽也各有不同程度延缓坏死的作用。但动物伤肢最终坏死丧失,5组7d大部软组织基本坏死,12d坏死离断,光电镜检查1组5d治疗后粒细胞浸润较少,炎性反应轻,有纤维组织细胞再生和新生的线粒体,10d修复过程明显,2,3,4组7d后坏死明显,5组肌坏死迅速,结果表明：CLS持续组织内透析冲洗和rGH局部肌注能有效地减少电损伤坏死速度和范围,值得研究应用。     

膈神经传导时间的测定及其影响因素

目的:探讨用经皮电刺激双侧膈神经法测定膈神经传导时间(ＰＮＣＴ)的正常值及其影响因素。方法:对１３例肺功能正常者和７例慢性阻塞性肺疾病(ＣＯＰＤ)患者用经皮电刺激双侧膈神经法测定ＰＮＣＴ。结果:①１３例肺功能正常者左、右侧ＰＮＣＴ分别为:(７．０２±０．８６)ｍｓ和(８．１３ ±０．９１)ｍｓ,右侧显著长于左侧(Ｐ＜０．００１);②７例ＣＯＰＤ患者左、右侧ＰＮＣＴ分别为:(７．１９ ±０．７２)ｍｓ和(８．０８ ±０．８４)ｍｓ,右侧同样长于左侧(Ｐ＜０．０５);③肺功能正常组ＣＯＰＤ组间,双侧ＰＮＣＴ均没有统计学上的差异(双侧Ｐ＞０．０５);④ＰＮＣＴ与年龄和身高呈直线相关,而与体重无显著性相关;⑤ＰＮＣＴ不随电流刺激量增高而变化。结论;左、右侧ＰＮＣＴ的正常值分别为:(７．０２ ± ０．８６)ｍｓ和(８．１３ ±０．９１)ｍｓ;ＣＯＰＤ肺功能异常者的ＰＮＣＴ基本无变化;ＰＮＣＴ与受试者的身高和年龄相关,不受电刺激强度的影响。     

基于TLR4/MyD88/NF-κB通路探究桃红四物汤对糖尿病周围神经病变大鼠炎症反应的影响

目的:探究桃红四物汤对糖尿病周围神经病变(DPN)大鼠炎症反应及对Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核转录因子kappan B(NF-κB)通路的影响。方法:从45只SD大鼠中随机选取10只为对照组,其余35只大鼠建立DPN模型,3只大鼠建模失败,其余随机分为模型组,桃红四物汤低、高剂量组及α-硫辛酸组,每组各8只。桃红四物汤低、高剂量组分别给予4.5、18 g/(kg·d)的桃红四物汤,α-硫辛酸组给予α-硫辛酸20 mg/(kg·d),对照组及模型组给予等量的0.9%氯化钠溶液,均灌胃给药。连续给药8周后,检测大鼠血清炎症因子、血糖及血脂指标及神经传导情况,观察坐骨神经病理学变化,检测TLR4相关通路蛋白表达情况。结果:与对照组比较,模型组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)及白细胞介素-6(IL-6)水平升高,血糖、糖化血红蛋白(HbA1c)、甘油三酯(TG)及血清总胆固醇(TC)水平升高,感觉神经传导速度(SNCV)及运动神经传导速度(MNCV)水平降低,TLR4、MyD88、NF-κB蛋白表达上调(P<0.05)...     

Nerve Conduction Studies in Surgical Cubital Tunnel Syndrome Patients

Background: Electrodiagnostic studies (EDX) serve a prominent role in the diagnostic workup of cubital tunnel syndrome (CBTS), but their reported sensitivity varies widely. The goals of our study were to determine the sensitivity of EDX in a cohort of patients who responded well to surgical cubital tunnel release (CBTR), and whether the implementation of the Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) criteria improves the sensitivity. Methods: We identified 118 elbows with clinical CBTS who had preoperative EDX and underwent CBTR. The EDX diagnoses were CBTS, ulnar neuropathy (UN), and normal ulnar nerves. We divided the 118 elbows into those that received above-elbow stimulation (XE group) and those that did not (non-XE group). We calculated the sensitivities for all groups and reinterpreted the results according to the AANEM guidelines. Results: Cubital tunnel release provided significant relief in 93.6% of the elbows. Based on the EDX reports, 11% patients had clear CBTS, 23% had UN, and 66% showed no UN. The sensitivities were 11.7% for CBTS and 34.2% for any UN. In the XE group, the sensitivity of the EDX reports for CBTS and UN climbed to 33.3% and 58.3%, respectively. When we calculated the across-elbow motor nerve conduction velocity, the sensitivity for CBTS and UN was 87.5% and 100%, respectively. The XE and non-XE groups showed no difference except for sex, bilaterality, concomitant carpal tunnel release, and obesity (P < .05). Conclusion: Implementing AANEM guidelines results in significant improvement in correlation of clinical and electrodiagnostic findings of CBTS.     

电阻抗断层成像技术用于呼气末正压滴定的研究进展

适当的呼气末正压（PEEP）是保护性肺通气策略的重要组成部分,PEEP可以保持肺泡开放,减少肺萎陷伤。尽管个体化PEEP已被越来越多的临床医师认可,但最佳的PEEP滴定方法尚存争议。电阻抗断层成像（EIT）是一种无创、无辐射的成像技术,可在床边实时动态评估肺功能,将肺通气过程中的阻抗变化以动态图像呈现,能够反映PEEP调整前后肺内通气及气体分布变化,因此,EIT可用于滴定个体化PEEP。本文简要概括EIT的基本原理及监测指标,阐述临床应用EIT指导下的PEEP（PEEPEIT）滴定方法,旨在加强对EIT的优点和局限性的理解,为优化个体化PEEP的设置提供参考。     

红细胞聚集与取向对其悬浮液电阻抗的影响——I.实验研究

本文通过测量具有不同流变特性的红细胞悬浮液电阻抗的动态与静态变化，研究了红细胞聚集与取向对其悬浮液电阻抗的影响。首次得出以下结论：１．红细胞聚集使其悬浮液电阻抗显著减小。２．由于低切变率下红细胞聚集与高切变率下红细胞取向的共同影响，使血液电阻抗随切变率的变化具有双相特性。这增加了对血液电特性的新认识，表明可利用电阻抗测定红细胞聚性。     

Magnetic and electrical stimulation of undulating nerve fibres: a simulation study

Mathematical models of myelinated nerve fibres are highly stylized abstractions of real nerve fibres. For example, nerve fibres are usually assumed to be perfectly straight. Such idealizations can cause discrepancies between theoretical predictions and experimental results. One well-known discrepancy is that the currently used models predict (contradictory to experimental findings) that an activation of nerve fibres is not possible with a pure transverse electric field. This situation occurs when a magnetic coil is placed symmetrically above a straight nerve fibre for magnetic nerve stimulation, or when an anode and a cathode are placed equidistantly on a line perpendicular to the fibre in the case of electrical stimulation. It is shown that this discrepancy does not occur if the physiological undulation of peripheral nerve fibres is included in the models. Even for small undulation amplitudes (e.g. 0.02 mm), it is possible to activate the fibre in these positions. For physiological undulations, as found in the literature, and favourable (off-centre) positions, the typical reduction of the thresholds is in a range between one and five, compared with perfectly straight fibres.     

具有多重玻璃化转变的梳状聚合物的合成,表征和导电性：侧链 …

以分子量为５５０的聚乙二醇单甲醚为侧链,苯乙烯／马来酸酐共的为骨架,合成了苯乙烯／马来酸酐共聚物多缩乙二醇酯。用红外光谱、元素分析、ＤＳＣ、热失重等方法,对合成条件、产物结构和性能进行了研究。结果表明：反应严格按照反应方程进行,精制产物是非晶的梳状聚合物。玻璃化转变温度为３０．６８℃,分解温度为１２０℃。对动态这性能及其锂盐复合物离子导电性进行了研究,表明α转变温度和β转变温度分别是２８℃他－４７