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11.
Microvascular decompression for hemifacial spasm: postoperative neurologic follow-up and evaluation of life quality 总被引:2,自引:0,他引:2
K. Heuser E. Kerty P. K. Eide M. Cvancarova E. Dietrichs 《European journal of neurology》2007,14(3):335-340
Microvascular decompression (MVD) is an effective and safe treatment in hemifacial spasm (HFS). Postoperative evaluations are usually made by neurosurgeons. Follow-up studies performed by neurologists and postoperative quality of life (QoL) investigations are lacking. All 25 HFS patients operated with MVD in our centre between 2000 and 2004 were evaluated with the recently validated HFS-7 scheme, extended with the item 'sleep disturbance due to HFS' (HFS-8). The patients underwent a careful neurological examination median 3 years after the operation. The evaluation focused on clinical aspects, changes in blood pressure and time until observable effect of MVD. The evaluation of HFS-7 questionnaire and the extended form (HFS-8) showed significant improvement in QoL after MVD. Neurological outcome was in almost all cases excellent or good. Eleven (44%) patients had no neurological deficits at all. Only one patient had serious complications with ipsilateral facial palsy, deafness, balance problems and vertigo. The other patients had minor neurological findings or symptoms. Eighteen (72%) patients experienced early effect within 3 months after MVD; seven (28%) patients had late effect between 6 and 14 months. Median age of the patients with late effect (62.6 years) was significantly higher than in those with early effect (52.7 years). 相似文献
12.
123I-MIBG myocardial scintigraphy as a noninvasive screen for the diagnosis of coronary artery spasm
Jong-Won Ha Jong-Doo Lee Yangsoo Jang Namsik Chung June Kwan Se-Joong Rim Young-Joon Lee Won-Heum Shim Seung-Yun Cho Sung-Soon Kim 《Journal of nuclear cardiology》1998,5(6):591-597
Background It has been suggested that the sympathetic nervous system might play an important role in the development of coronary artery
spasm. However, no cardiac imaging modality has been able to demonstrate abnormal sympathetic innervation in patients with
coronary artery spasm. The purpose of this study was to assess the presence and location of abnormal sympathetic innervation
using iodine 123-metaiodobenzylguanidine (123I-MIBG) single photon emission computed tomography (SPECT) and to evaluate the clinical efficacy of 123I-MIBG SPECT as a noninvasive screening test in patients with coronary artery spasm.
Methods and Results Coronary arteriography and a provocative test with intravenous administration of ergonovine maleate were performed in 26 patients
(20 men, 6 women, mean age 48.2±12.0 years, range 20 to 67 years) who were suspected of having a coronary artery spasm. The
subjects were divided into 2 groups: group 1 (n=18) comprised subjects with negative provocative provocative test result,
and group 2 (n=8) comprised subjects with negative provocative test results. Ten healthy subjects served as controls. No abnormal
MIBG uptake was observed in the control subjects. Abnormal sympathetic nervous innervation using 123I-MIBG SPECT was observed either as a reduced uptake or a defective pattern in the perfused areas in 13 of the 18 regions
supplied by vessels of ergonovine-induced vasospasm. Normal sympathetic innervation, as evidenced by normal 123I-MIBG uptake, was noted in all of the 60 segments of normal vessel territories. Reduced uptake of 123I-MIBG was not detected in the perfused areas of 5 vasospasm-induced vessels (perfusion territory of left anterior descending
coronary artery [LAD] and the right coronary artery [RCA] in 2 and 3 patients, respectively). The sensitivity and specificity
of 123I-MIBG for detection of coronary artery spasm were 72.2% (95% confidence interval, [CI] 55% to 89%) and 100%, respectively.
The positive predictive and negative predictive values were 100% and 92.3% (95% CI 91% to 93%), respectively.
Conclusion
123I-MIBG SPECT is a feasible method to evaluate noninvasively and localize the territories of coronary arteries with spasm.
Invasive diagnostic coronary arteriography with ergonovine provocation test may be unnecessary for diagnosis of coronary artery
spasm in patients with typical resting pain, negative exercise test or normal thallium perfusion scan results, but showing
abnormalities in 123I-MIBG SPECT.
Presented in part at the European Association of Nuclear Medicine Congress, September 1996, Copenhagen, Denmark. 相似文献
13.
Kazumasa Shindo MD Shin-ichi Tsunoda MD Zenji Shiozawa MD 《Clinical autonomic research》1994,4(6):299-302
Microneurography was performed in a 39-year-old woman with demyelination of the pontine white matter associated with muscle spasms in the lower extremities. Single bursts on the microneurogram were observed immediately after cessation of the spasm with no systemic changes in the blood pressure or heart rate. Voluntary tonic flexion of the lower extremities induced similar bursts with small amplitudes. These reflex bursts possessed a characteristic of muscle sympathetic nerve activity, because the latency between the peak of each burst and the prior R-wave on the electrocardiograph was constant. The occurrence of these bursts suggests that a segmental compensatory mechanism in the spinal cord may stabilize the muscle blood flow influenced by muscle contraction. 相似文献
14.
S. Carmagnola P. Cantù D. Savojardo M. Allocca & R. Penagini 《Neurogastroenterology and motility》2004,16(3):287-292
A simple and reliable experimental model would be useful in human research on new drugs which target transient lower oesophageal sphincter (LOS) relaxation. The aim was to investigate the effect of repeated distensions on the rate of transient LOS relaxation, LOS pressure and motor function of the proximal stomach. Twelve healthy subjects were studied with a multilumen manometric assembly incorporating a sleeve sensor for the LOS and a bag positioned in the proximal stomach and connected to a barostat. Intrabag volume was set at 75% of the threshold for gastric discomfort and maintained for two 30-min distension periods separated by a 45-min washout with the bag deflated. The studies lasted 145 +/- 2 min. The rate of transient LOS relaxations was similar during the two distensions, 3.5;2-4 vs 3;2.5-4 (median;interquartile range) and so was LOS pressure. Baseline intrabag pressure, as a measure of gastric tone, and the number of pressure waves, as a measure of phasic contractions, were also similar, 11.3;9.3-12.3 mmHg vs 10.8;9.3-12.5 mmHg and 16;13-28 mmHg vs 19;15-29 mmHg, respectively. Our model allows to perform 1-day studies which can assess two experimental conditions on transient LOS relaxations and motor function of the proximal stomach within an acceptable time span. 相似文献
15.
16.
Cyclooxygenase-2 is expressed frequently and early in Barrett's oesophagus and associated adenocarcinoma 总被引:15,自引:0,他引:15
Lagorce C Paraf F Vidaud D Couvelard A Wendum D Martin A Fléjou JF 《Histopathology》2003,42(5):457-465
AIMS: To establish the prevalence of cyclooxygenase-2 (COX-2) expression in a large series of resected Barrett's adenocarcinoma and associated preneoplastic lesions and to correlate this expression with clinicopathological data and prognosis. METHODS: COX-2 expression was assessed by immunohistochemistry in resected surgical specimens of 66 Barrett's adenocarcinomas and 32 cases of Barrett's mucosa (with dysplasia in 17 cases). RESULTS: Epithelial expression of COX-2 protein was increased in Barrett's mucosa compared with normal oesophagus. Epithelial expression of COX-2 was found in 91% of Barrett's specialized mucosa negative for dysplasia, 94% of Barrett's mucosa with dysplasia, and 97% of Barrett's adenocarcinoma. COX-2 expression was significantly higher in the well-differentiated adenocarcinomas when compared with the poorly differentiated tumours. There was no significant correlation between COX-2 expression and the other pathological features of the tumours. Survival analysis showed no significant prognostic value for COX-2. CONCLUSION: Our results confirm up-regulation of COX-2 in Barrett's oesophagus-metaplastic and dysplastic-and in Barrett's adenocarcinoma. Increased COX-2 expression did not differ during the progression from Barrett's oesophagus negative for dysplasia to Barrett's adenocarcinoma and is related to adenocarcinoma whose histology is well differentiated. This suggests that enhanced expression of COX-2 may occur early during Barrett's-associated neoplastic transformation. 相似文献
17.
18.
目的 探讨婴儿痉挛症患儿血超氧化物歧化酶(SOD),脂质过氧化代谢产物丙二醛(MDA),谷胱甘肽(GSH)今量变化。方法:婴儿痉挛症患儿30例,测静脉血SOD、MDA、GSH含量,以正常组作为对照。以黄嘌呤氧化酶法测血SOD,以硫代巴比酸比色法测MDA,以硫代二硝基苯甲酸比色法测GSH。以头颅CT及脑电图结果作为脑损伤的指标。结果:婴儿痉挛症患儿SOD、GSH含量降低,MDA含量升高,与对照组相比均有显著性差异(P<0.01)。CT示有器质性脑损害者(脑萎缩)血SOD活性更低,MDA更高,与无器质性脑损害者比较,差异非常显著(P<0.01)。结论:血SOD、MDA、GSH是婴儿痉挛症患儿的敏感指标,在婴儿痉挛症发生脑萎缩过程中血SOD、MDA指标可做为病情较重的依据。 相似文献
19.
M E Bertrand J M Lablanche P Y Tilmant F A Thieuleux M G Delforge R A Chahine 《European heart journal》1983,4(8):532-535
Provocative tests for coronary spasm were performed in a groupof 131 patients (124 men and 7 women) with recent (<6 weeks)transmural myocardial infarction. Coronary arteriography wasperformed 27±9 days after the onset of the infarction.The provocative test was performed using a single IV bolus of0.4 mg of ergometrine. Aortic pressure, ECG and arteriogramsof the two coronary vessels were repeated 3 and 5 min later.Provoked spasm was observed in 27 (21%) of the patients. In13 (48%) the coronary spasm occurred in a vessel presumed tobe responsible for the myocardial infarction, while it was observedin coronary artery unrelated to the area of the infarct in 14(52% of the cases with spasm). Thus, this study demonstratesa high degree of reactivity of the coronary tree of patientswith recent transmural myocardial infarction suggesting thelikelihood of a role for spasm in the infarction process andoffering some explanation for subsequent recurrent ischemicevents. 相似文献
20.
Summary A patient with migraine headaches of the cluster variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to her investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed. 相似文献