星状神经节阻滞治疗血管性头痛40例报告

目的观察星状神经节阻滞治疗血管性头痛的效果。方法本组病例星状神经节阻滞均采用1％利多卡因经气管旁阻滞,每日1次,12次为1疗程。结果本组40例均经1疗程治疗,优效与良效者共35例,有效率为87．5％。结论星状神经节阻滞是治疗血管性头痛有效的方法之一,值得推广。     

Transneuronal retrograde degeneration of retinal ganglion cells following restricted lesions of striate cortex in the monkey

Transneuronal retrograde degeneration of retinal ganglion cells follows extensive striate cortical removal in macaque monkeys. Its extent depends on the age of the monkey at operation, post-operative survival, species and retinal eccentricity. Some studies of human patients with occipital lobe injury have found no evidence for transneuronal retrograde degeneration, suggesting that either degeneration may not occur or, if present, it is caused directly by secondary damage impinging upon the underlying white matter or the blood supply to the dorsal lateral geniculate nucleus and optic tract. We therefore studied retinal ganglion cell degeneration in three macaques in which only the striate cortex corresponding to the macular retina had been removed, thereby sparing extrastriate cortex and precluding interruption of the vascular supply to the thalamus and optic tract. There was extensive loss of ganglion cells in the central retina, corresponding to the central 10 degrees of vision. As the cortical lesion was too small to affect the thalamus or optic tract directly, the retinal degeneration must be transneuronal. Quantitative analysis showed a 65-80% loss of ganglion cells in the corresponding perifoveal retinae along the horizontal meridian. The results confirm that the loss of retinal ganglion cells following striate cortical lesions is predominantly transneuronal.     

The evaluation of meconium disease by distribution of cathepsin D in intestinal ganglion cells

Meconium disease (MD) results in intestinal obstruction in the neonate where tenacious meconium is found in the distal ileum and proximal colon. The obstructive symptoms improve at several days of age after some of the meconium is passed. We observed premature infants with MD who underwent ileostomy for intestinal obstruction due to tenacious meconium. Afterward, meconium was passed well and the clinical symptoms improved. After closing the ileostomy, growth and defecation became normal. The MD in our cases was documented by histologic changes in the maturation of ganglion cells observed at the time of ileostomy creation and closure. For an objective evaluation of the maturation of intestinal ganglion cells (IGC), we attempted to distinguish immature from mature cells by the expression of cathepsin D. We examined the distribution of cathepsin D in IGC in patients with MD to test the hypothesis that ganglion-cell immaturity might be related to MD. In ganglion cells at the time of ileostomy, cathepsin D was detected in the perinuclear cytoplasm (immature staining pattern), while at the time of ileostomy closure it was detected in intense granules throughout the cytoplasm (mature staining pattern). We propose that it would be possible to evaluate the maturation of IGC by the intracellular distribution of cathepsin D in MD and suggest that immaturity of IGC might be the cause of MD. Accepted: 28 June 1999     

透视下星状神经节阻滞治疗雷诺病的疗效观察

目的观察在透视下作星状神经节阻滞对雷诺病的疗效。方法将36例雷诺病患者分成治疗组20例，在透视下用局麻药由气管旁进针作星状神经节阻滞。对照组16例，采用中西药治疗。结果治疗组有效率95％（19／20例），对照组有效率81％（13／16例），P〈0．05差异有统计学意义。结论在X线透视下作星状神经阻滞对治疗雷诺病是一种准确安全有效的方法。     

Effects of tri-ortho-cresyl-phosphate on spinal ganglia and peripheral nerves of chicken

Summary The spinal ganglia and peripheral nerves of normal and tri-ortho-cresyl phosphate (TOCP)-poisoned chickens were examined with the electron microscope. The normal ganglia contained two main neuron types, a large neuron with light cytoplasm and abundant neurofilaments, and a smaller, darker cell which contained few or no filaments. The light neurons reacted to TOCP with a very great increase in the number of filaments present in the cytoplasm, while the darker cells showed a hypertrophy of the endoplasmic reticulum. These changes were not definitely present until 15 days after TOCP ingestion, while the largediameter fibres of the peripheral nerves showed a proliferation of smooth membranes at 6 days. The possible mechanisms for these changes are discussed.

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Zusammenfassung Es wurden Spinalganglien und periphere Nerven von normalen und mit Tri-Ortho-Cresyl-Phosphat (TOCP) vergifteten Hühnern elektronenmikroskopisch untersucht. In den normalen Ganglien fanden sich zwei unterschiedliche Neuronentypen, große Zellen mit hellem Cytoplasma, in dem sich reichlich Neurofilamente fande, und kleinere Neurone, welche wenig oder keine Filamente enthielten. Die hellen Zellen reagierten auf TOCP mit einer starken Vermehrung der Neurofilamente, während die dunklen, kleineren Neurone eine Hypertrophie des endoplasmatischen Reticulums zeigten. Diese Veränderungen waren eindeutig nach 15 tägiger TOCP-Applikation sichtbar. An den peripheren Nerven traten bereits nach 6 tägiger Vergiftung deutlichen Reaktionen im Sinne einer Proliferation der glatten Membranen auf. Die möglichen Zusammenhänge dieser Veränderungen werden diskutiert.

     

Synovial cyst (ganglion) of the lumbar spine simulating extradural mass

Summary Four additional cases of synovial cyst (ganglion) arising from the facet joint between L₄ and L₅ are reported. Only five such cases have been reported in the past. For the first time impressive and characteristic myelographic findings are described, which make a preoperative diagnosis possible in these cases.     

Local dexamethasone improves the intestinal lesions of gastroschisis in chick embryos

Background and aims. Eviscerated bowel in gastroschisis (Gx) undergoes changes that lead to dysfunctions and create management difficulties. This study tests the hypothesis that exposure of the eviscerated bowel of chick embryos with Gx to dexamethasone might have beneficial effects on the parietal lesions.Methods. Gx was created in chick embryos on incubation day 15 and either dexamethasone (0.047 mg in 0.24 ml) or 0.075% saline were instilled into the amnio-allantoic chamber on day 17. The chicks were recovered near hatching (day 19) and eviscerated and non-eviscerated portions of the intestines were recovered, weighed and processed for HE and synaptophysin staining or for total DNA and protein measurements. Total mural and serosal layer thickness were determined and intramural ganglia were counted. ANOVA was used for comparison among groups with significance level set at p<0.05.Results. Chicks with Gx and Gx + saline controls had reduced body weight and tibial length in comparison with controls. The eviscerated bowel was heavier with marked wall thickening at the expense of all layers but particularly of the serosa. They had decreased total intestinal DNA with normal protein and decreased intramural ganglion density. In contrast, chicks from the Gx + dexamethasone group had normal body weight and tibial length, near-normal intestinal wall thickness with slightly increased serosal width, near-normal intestinal DNA content and normal density of intramural ganglia.Conclusion. Local dexamethasone had beneficial effects on the eviscerated bowel of chicks with Gx as judged by decreased wall thickening, normalization of total intestinal DNA and richer neural population. Late gestational exposure to steroids could represent another alternative for preventing intestinal lesions in Gx.     

Extra-articular soft tissue ganglion cyst around the knee: focus on the associated findings

The aim of this study was to evaluate MR imaging findings of the associated findings in surrounding tissues of the extra-articular soft tissue ganglion cysts around the knee. We retrospectively reviewed MR images of 30 patients who had surgically confirmed extra-articular soft tissue ganglion cysts around the knee with focus on the associated findings in surrounding tissues, such as muscle, subcutaneous fat, bone, and nerve. The most common associated finding was the visualization of channel between ganglion cyst and the joint, which was demonstrated in 20 cases (continuous type in 12 cases and discontinuous type in 8 cases). Other associated findings were seen in 15 cases; pericystic edema (n=9), bony remodelling (n=3), and nerve involvement (n=3). The bony remodelling involved the proximal metaphysis of tibia in all 3 cases. Two patients with nerve involvement had deep peroneal nerve in subacute phase and one involved common peroneal nerve in chronic phase. The MR imaging is a useful imaging modality to evaluate the associated findings in extra-articular soft tissue ganglion cysts around the knee. The evaluation of these associated findings is helpful for the differentiation of ganglion cysts from other cystic lesions around the knee.     

Time course of efferent fiber and spiral ganglion cell degeneration following complete hair cell loss in the chinchilla

Ethacrynic acid (EA) is known to interact with aminoglycoside antibiotics such as gentamicin (GM). In the chinchilla, co-administration of GM and EA can produce hair cell lesions ranging from a small loss of outer hair cells (OHCs) in the base of the cochlea to complete destruction of all hair cells, depending on dosing parameters. Although hair cell loss has been characterized, little is known about the fate of efferent fibers or spiral ganglion neurons (SGNs) in this model. To study the time course of efferent fiber and SGN loss, chinchillas were injected with GM (125 mg/kg IM) followed immediately by EA (40 mg/kg IV). Estimates of efferent fiber loss and density changes were made after 3 days or 1, 2, 3, or 4 weeks of survival. Estimates of SGN loss and density changes were made after 15 days or 1, 2, 4, or 6 months of survival. Cochlear function was rapidly abolished and all cochlear hair cells were missing within 24 h after treatment. Inner hair cells (IHCs) in the middle turn of the cochlea died earlier than cells in the apex or base, and OHCs in Rows 1 and 2 died earlier than OHCs in Row 3. Degeneration of efferent nerve fibers began 3-7 days post-injection, versus 15-30 days for SGNs, and the loss of efferent fibers was essentially complete within 1 month, versus 2-4 months for SGNs. The rapid time course of efferent fiber and SGN loss in the chinchilla may make it a practical model for studying mechanisms of neural loss and survival in the mammalian inner ear.