Characteristics of apathy in Parkinson's disease.

The objective of this study was to use the Lille Apathy Rating Scale to assess apathy in a large population of Parkinson's disease (PD) patients and identify several different apathy profiles. One hundred fifty-nine patients with probable PD and 58 healthy controls participated in the study. Apathy was assessed using the Lille Apathy Rating Scale. Motor, cognitive, and depressive symptoms were rated on standardized scales. Data were analyzed using linear regression and multivariate analyses of variance. Thirty-two percent of the PD patients were classified as apathetic. Apathy was more frequent in patients with dementia. The four apathy dimensions contributed differently to the overall severity of the apathetic condition. Action initiation and intellectual curiosity had a marked influence. Linear regression analysis revealed that the apathy level was mainly determined by cognitive impairment, not associated with the severity of motor symptoms, and only associated with the apathy subcomponent of the Montgomery and Asberg Depression Rating Scale. Apathy is highly prevalent in PD patients. Apathy profiles vary according to the clinical presentation of PD. The high prevalence of apathy in PD suggests the involvement of frontal-subcortical circuits. Although the neurochemical substrate of apathy remains poorly characterized, the strong link between apathy and cognitive impairment observed in several studies suggests the participation of nondopaminergic circuits.     

小鼠背根神经节中三个不同的钙激活氯离子通道基因家族的表达(英文)

目的在背根神经节(dorsal root ganglion,DRG)中等大小感觉神经元中可以观察到钙激活氯离子流(I_(Cl(Ca)))。在坐骨神经损伤模型中,在大多数大中神经元上诱导出类似的氯离子流。本文旨在探讨引起这个离子流的分子基础。方法使用常规的定量RT-PCR方法检测在DRG中三个基因家族的表达,这三个基因家族都具有诱导I_(Cl(Ca))的特点。结果在成年小鼠的DRG中,分别显示了在正常状态和坐骨神经损伤3天后CLCA,Bestrophin和Tweety基因家族成员的转录产物。结论mBestl和Tweety2可能在损伤诱导的DRG神经元I_(Cl(Ca))中发挥作用。     

Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm.

We present a patient with a facial movement disorder that has characteristics of both blepharospasm and bilateral asynchronous hemifacial spasm. Because of the increased incidence of blepharospasm in patients with hemifacial spasm, our patient's clinical presentation is probably not a chance occurrence, but rather a manifestation of some predisposition for these two movement disorders. This unusual constellation of signs and symptoms challenges the current diagnostic criteria and suggests that some of these facial movement disorders may lie on a spectrum, rather than represent distinct entities.     

微创穿刺术治疗基底节区脑出血临床随机对照研究

目的评价比较微创穿刺血肿粉碎清除术与内科保守治疗两种方法治疗基底节区脑出血(25～40m l)的疗效异同。方法采用多中心、随机对照试验的方法,42个参研医院共随机入选465例基底节区脑出血患者,根据纳入与排除标准共排除88例,其中资料不全者16例;不符合入选标准者72例,分别为Glasgow评分≤8分(64例)、术前出血量>40m l(7例)、从发病到达急诊室时间>72h(1例)。评价治疗14d时两组患者神经功能缺损程度和日常生活活动能力、治疗3个月时的日常生活活动能力以及3个月和住院期间病死率。结果最终符合入组标准的病例数为377例,其中微创治疗组195例,对照组182例。微创治疗组患者于治疗14d时,神经功能改善明显优于对照组(χ2=7.931,P=0.02);治疗3个月时达良好功能状态的患者比例明显多于对照组(35.91%vs21.82%;χ2=8.294P=0.004)。微创治疗组病,残率明显低于对照组(40.88%vs63.03%,χ2=16.948,P<0.01);两组病死率间差异无显著性意义(6.67%vs8.79%)。结论与单纯内科保守治疗相比,应用微创穿刺血肿粉碎清除术治疗基底节区小血肿不增加病死率,并可明显提高脑出血患者的日常生活活动能力,降低病残率。     

家族性特发性基底节钙化

家族性特发性基底节钙化（familial idiopathic basal ganglia calcification，FIBGC）是一种以影像学上有基底节及脑其他部位钙化为特征的神经系统变性疾病。大多数患在童年及青少年时期是健康的，而到了30-50岁时，典型患会逐渐出现神经精神以及运动障碍。首发症状通常包括动作笨拙、易疲劳、步态不稳、言语缓慢、吞咽困难、不自主运动、肌肉痉挛等，经常会有各种类型的癫痫发作。神经精神症状往往是首发或最突出的表现，轻仅仅为轻度注意力或记忆力的下降，重则会出现人格及行为改变，终致精神病或痴呆。[第一段]     

Aortic root dilatation may alter the dimensions of the valve leaflets

Objective: Valve-sparing surgery can be used in patients with dilated aortic roots and aortic insufficiency (AI) but has not become a common practice, in part because the spared valve may be incompetent. Our goal was to study how the dimensions of the aortic root and leaflets have changed in such patients. Methods: Fourteen patients with dilated aortic root and AI were examined by transesophageal echocardiography. The annulus diameter, sinotubular junction (STJ) diameter, sinus height, leaflet free-edge length, and leaflet height were measured. Correlations among these dimensions and with the AI grades were explored. Measurements were also made in 19 normal human aortic valves from silicone molds. Results: There was no evident change in the average diameter of the annulus between the normal valves and those in the dilated aortic roots. The STJ diameter was obviously increased in the dilated aortic roots; the aortic sinuses also appeared to be taller and the leaflets larger than normal. The leaflet free-edge length, the leaflet height, and the sinus height were found to increase with the dilated STJ diameter. The degree of AI was not found to correlate well with any of the dimensions measured. Conclusions: The dimensions of the leaflets may change parallel to aortic root dilatation with AI. Therefore, during valve sparing, it may be necessary to correct both the dilatation of the root and the leaflet free-edge length to achieve a competent valve.     

Transmitter Release Associated with Long-term Synaptic Depression in Rat Corticostriatal Slices

Using a corticostriatal slice preparation, we have recently shown that tetanic stimulation of the corticostriatal pathway produces long-term depression (LTD) of striatal excitatory synaptic transmission. In the present study we have analysed the relationship between LTD and the striatal release of different endogenous transmitters. Samples of perfusate were collected via a small cannula placed just above the surface of the striatal slice close to the recording electrode, and were analysed by HPLC. The high-frequency stimulation (100 Hz, three trains, 3 s duration, 20 s intervals) used to induce LTD caused a significant but transient increase in the release of both excitatory (aspartate and glutamate) and inhibitory (glycine and GABA) amino acid transmitters. Tetanic stimulation also produced a significant, but transient increase in the release of endogenous dopamine. We conclude that the tetanic stimulation of the corticostriatal pathway is able to induce a large but transient release of excitatory amino acids and of dopamine, whose participation in the induction of striatal LTD has been demonstrated previously. Moreover, the maintenance of this form of synaptic plasticity does not seem to require a sustained change in transmitter release.     

Topical application of fluorides on teeth

Abstract Prevention of caries in exposed root surfaces constitutes an important clinical problem. It is thus important that clinicians involved with periodontology have an insight into fluoride prophylaxis. The understanding of the cariostatic mechanism of fluoride has improved during recent years. The aim of the present review is to give a short account of the present concept. Calcium fluoride appears to be the only product which is formed on enamel, dentin or cementum during brief topical treatments with fluoride or use of toothpaste containing fluoride. This calcium fluoride is stable in the oral environment: this is contrary to what was believed until recently. The calcium fluoride constitutes a pH-dependant reservoir of fluoride which releases fluoride when pH drops. The practical consequences of this concept is discussed.