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81.
Chronic motor cortex stimulation is a treatment option for neuropathic drug-resistant pain and possibly associated movement disorders. Preliminary studies suggest the possibility to treat symptoms of Parkinson disease in selected patients. Recently, MCS has been suggested to enhance motor recovery in patients with poststroke hemiparesis. One or more electrodes are placed extradurally over the motor cortex through a burr hole or a small craniotomy, and then connected to a totally implantable neurostimulator. The accurate positioning of the stimulating electrodes over the motor cortex is the key point of the surgical procedure. Motor cortex identification results from the integration of anatomical, neuroradiological, functional, and neurophysiological data, taking into account the huge population variability. Intraoperative neurophysiological mapping of the motor cortex is of paramount importance, in spite of very sophisticated neuroradiological mathematical reconstructions of the motor area. We discuss and compare the different techniques that are utilized by different authors. Moreover, clinical neurophysiology is also helpful in evaluating the results of this neuromodulation procedure and in hypothesizing the mechanisms that are put in play by MCS. 相似文献
82.
Mirjam Gross-Jendroska Christina J Flaxel Steve D Schwartz Frank G Holz Fred W Fitzke Veit-Peter Gabel Alan C Bird 《Clinical & experimental ophthalmology》1998,26(4):311-317
Purpose: To flatten pigment epithelial detachments (PED) cue to age-related macular degeneration in an attempt to visualize the underlying choroidal neovascularization by fluorescein angiography (FA) and reveal a treatment target. Methods: Nine patients with PED received intravitreal gas injections via the pars plana and postured face down. Fluorescein angiograms were obtained before and after gas injection. In two patients, retinal scotopic sensitivity was also measured. Results: Eight patients demonstrated change in the shape and size of the PED following gas injection. Four patients showed a better delineation of underlying structures on FA. Three patients had focal laser treatment to the newly visible choroidal neovascular complex, but this was successful in only one patient with flattening of the PED. Conclusion: Pigment epithelial detachments can be modified by intravitreal gas injection in some patients, but this treatment did not have a major impact on overall outcome or management. 相似文献
83.
Identification and characterization of a DR4-restricted T cell epitope within chlamydia heat shock protein 60 总被引:11,自引:0,他引:11 下载免费PDF全文
K H O DEANE R M JECOCK J H PEARCE J S H GASTON 《Clinical and experimental immunology》1997,109(3):439-445
An epitope within the 60 kD Chlamydia trachomatis heat shock protein (hsp) 60, recognized by a HLA-DRB1*0401-restricted T cell clone from a reactive arthritis patient, has been characterized. Stimulatory peptides contained a nine amino acid sequence (residues 38–46) predicted by algorithm to confer strong binding to DRB1*0401, with valine in the P1 position. The overall length of the peptide was critical for efficient recognition; peptides with at least one residue N-terminal to the putative P1 position were markedly more stimulatory than a peptide whose N-terminal is the P1 valine. Optimal responses were seen with 14mer peptides having two to three amino acids N- and C-terminal to the core 9mer. The sequence of the defined epitope is identical in hsp60 from both C. trachomatis and C. pneumoniae. Since the latter is a common respiratory pathogen, patients infected with C. trachomatis may already be primed for responses to hsp60 by prior infection with C. pneumoniae. Such secondary responses are important in the pathogenesis of chlamydia-induced inflammatory diseases such as trachoma. Priming by infection with enteric organisms was considered because of the similarity of the epitope sequence in Escherichia coli hsp60. However, although an E. coli-related peptide was recognized, intact E. coli hsp60 was not, suggesting that the epitope is cryptic in E. coli hsp60. Human hsp60 has six amino acid differences from chlamydial hsp60 in the epitope sequence and was not recognized. Thus cross-reactive recognition of self hsp60 could not be implicated in the pathogenesis of chlamydia-induced reactive arthritis in this patient. 相似文献
84.
In the oomycete, Phytophthora infestans, mating type is determined by a locus that segregates in a non-Mendelian manner consistent with its linkage to a system of
balanced lethals. The significance of this unusual phenomenon was addressed by studying the segregation patterns of DNA markers
linked to mating type in the related species, P. parasitica. This was done using loci identified by either RAPD analysis of P. parasitica crosses or by cross-hybridization with RFLP markers linked to mating type in P. infestans. The resulting data revealed that, unlike P. infestans, mating type in P. parasitica was regulated by a locus displaying Mendelian segregation. An improved model for mating-type determination in Phytophthora is presented.
Received: 21 October 1996 / 7 April 1997 相似文献
85.
肝硬化患者的脑电活动地形图 总被引:1,自引:0,他引:1
对20例无临床肝性脑病的失代偿期肝硬化患者进行脑电活动地形图(BEAM)检查,并与33例正常人作对照,以探讨亚临床肝性脑病(SHE)的诊断价值。结果表明,20例肝硬化患者中,BEAM正常5例,轻度异常5例,轻 ̄中度异常5例,中度异常5例,总异常率为75%(15/20)。BEAM异常的分布特点以弥漫性分布为主要表现,主要为慢频域(δ.θ.δ+θ/α+β)活动增强,Z值增高,只有3例波及α频域。提示: 相似文献
86.
Viktoria Werkström Lars Ny Katarina Persson K.-E. Andersson 《Naunyn-Schmiedeberg's archives of pharmacology》1997,356(2):151-158
Neuronal regulation of smooth muscle tone in the female pig urethra has mainly been studied in vitro using electrical field
stimulation (EFS) of nerves. Excitatory control is considered to be exerted by released noradrenaline, whereas inhibitory
control is non-adrenergic non-cholinergic (NANC), and mediated by nitric oxide (NO), and an as yet unidentified agent. We
investigated the functional and morphological effects of α-latrotoxin (αLTX), a spider neurotoxin believed to cause massive
release of vesicle-stored neurotransmitters, on spontaneously developed urethral smooth muscle tone. The effects were compared
to those of EFS and high potassium. In the presence of the NO-synthesis inhibitor Nω-nitro-L-arginine (L-NOARG: 0.3 mM) both αLTX and EFS evoked contractions. After treatment with scopolamine and phentolamine,
no contraction was observed, and under these conditions αLTX and EFS induced relaxation. At low frequencies (<12 Hz), the
EFS-induced relaxations were rapid, whereas at higher frequencies (>12 Hz), they were biphasic, consisting of a rapid first
phase followed by a more long-lasting second phase. L-NOARG abolished the relaxations at low frequencies, as well as the first
phase of the biphasic relaxation. The second phase was not affected by treatment with L-NOARG, but 0.1 μM ω-conotoxin GVIA,
blocker of N-type voltage-operated calcium- channels (VOCCs), markedly reduced or abolished the response. In the presence
of L-NOARG or ω-conotoxin GVIA, the αLTX-induced relaxation was significantly decreased, and the combination of L-NOARG and
ω-conotoxin GVIA further reduced or abolished the relaxation. In preparationstreated with tetrodotoxin or scorpion venom,
believed to inactivate nerves by acting on sodium channels, αLTX and EFS had no effects. αLTX-induced relaxation was not associated
with changes in cyclic GMP or cyclic AMP content. High (80 mM) potassium solution induced a triphasic response of the preparation.
A transient relaxation was followed by a restoration of tone, and then by a persistent relaxation. The persistent relaxation
was slightly reduced by scorpion venom or L-NOARG, but reduced by 50% by a combination of L-NOARG and ω-conotoxin GVIA. Ultrastructural
analysis of the urethral circular smooth muscle layer revealed a moderate amount of nerve profiles supplying the smooth muscle.
In control preparations, the nerve profiles contained both small synaptic vesicles and large dense core vesicles. αLTX caused
a major loss of both types of vesicle. The present data suggest that αLTX has the ability to release not only adrenergic and
cholinergic transmitters, but also NANC mediators of relaxation, including NO, from nerve terminals in the urethra.
Received: 13 January 1997 / Accepted: 17 April 1997 相似文献
87.
OBJECTIVE: We investigate the synaptic factor for the recovery function of evoked responses using a repetitive stimulation technique. METHODS: Somatosensory evoked cortical magnetic field (SEF) was recorded following stimulation of the median nerve using single to 6-train stimulation in 8 healthy subjects. The SEF responses after each stimulus in the train stimulation were extracted by subtraction of the waveforms. RESULTS: An attenuation of the SEF components was recognized after the second of the stimuli, but there was no significant attenuation with the third or later stimulations. The root mean square (RMS) of the 1M (peak latency at 20 ms after stimulation) and 4M (70 ms) components were smaller than that of the single stimulation during the train stimulation, while the 2M (30 ms) and 3M (45 ms) components were not attenuated, but the 3M was facilitated at the fourth to sixth stimulation. CONCLUSION: The synaptic factor was not responsible for the attenuation of the SEF components during repetitive stimulation in healthy subjects. The SEF change disclosed a functional difference among the SEF components during the train stimulation, especially among the later components. 相似文献
88.
Gary W Thickbroom Michelle L Byrnes Rick Stell Frank L Mastaglia 《Movement disorders》2003,18(4):395-402
Previous work has suggested that there may be a widespread disturbance of motor control mechanisms in patients with cervical dystonia. In the present study, we used transcranial magnetic stimulation to investigate the topography of the corticomotor projection to the abductor pollicis brevis (APB) muscle in 10 subjects with idiopathic torticollis. Threshold-adjusted stimuli were delivered at multiple scalp sites during a low-level voluntary contraction of the APB, and maps were generated of motor evoked potential amplitude versus scalp site. The cortical maps for the APB on the side opposite to the direction of head rotation were displaced laterally or posteriorly in all subjects and reverted to a more normal position after botulinum toxin injection of the cervical muscles in 5 subjects. The findings point to a reversible reorganisation of the corticomotor representation of the hand on the same side as the sternocleidomastoid (SCM) muscle that is involved in producing the dystonia. These results provide further evidence for the involvement of cortical centres and for a more widespread abnormality of motor control mechanisms in focal dystonia. The findings also support the notion that head turning is chiefly mediated by the hemisphere ipsilateral to the direction of the head rotation by means of a corticomotor projection to the contralateral SCM. 相似文献
89.
90.
Population aging has become a world wide tendency and according to the UNproject,the proportion of population above60 years old would exceed the proportionof children below1 5years old by2 0 50 .Erectile dysfunction(ED) seriously affectsthe quality of lif… 相似文献