Ganglion cysts at the gastrocnemius origin: a series of ten cases

Objective To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. Design and patients We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27–68 years, mean age 40.6 years. Results The mean maximal dimension of the ganglion cysts was 26 mm, range 15–40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. Conclusions MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding.     

Lumbar Intraspinal Extradural Ganglion Cysts

The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.     

胰岛素样生长因子 1对背根神经节神经元谷氨酸损伤的保护作用

目的探测胰岛素样生长因子 1（IGF 1）对背根神经节（DRG）神经元谷氨酸（Glu）损伤的保护作用。方法Wistar胎鼠DRG神经元分散培养48?h后,用Glu（200?μmol/L）造成神经元损伤,并同时给予IGF 1（10?nmol/L）,观察添加IGF 1和未添加IGF 1孵育的Glu损伤的神经元的活细胞生长状况,并用流式细胞仪检测神经元的凋亡率,用共聚焦激光扫描显微镜（CLSM）检测细胞内钙离子荧光强度。结果用IGF 1孵育的神经元生长状况良好,凋亡率、细胞内钙离子荧光强度均低于无IGF 1孵育的标本。结论IGF 1可通过减低钙离子内流,抑制细胞凋亡,从而对Glu损伤的DRG神经元产生保护作用。     

星状神经节阻滞治疗三叉神经痛脑干听觉诱发电位变化的临床研究

目的探讨三叉神经痛患者行星状神经节阻滞后脑干听觉诱发电位的变化。方法原发性三叉神经痛患者42例,行患侧星状神经节阻滞治疗,并对阻滞前、后的健侧和患侧脑干听觉诱发电位进行监测,记录Ⅰ、Ⅲ、Ⅴ波潜伏期,并计算Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期。结果星状神经节阻滞前健侧和患侧脑干听觉诱发电位的I、Ⅲ波潜伏期和Ⅰ-Ⅲ波间期无统计学差异,Ⅴ波潜伏期、Ⅲ～Ⅴ波间期和Ⅰ～V波间期有统计学差异（P〈0．05）,阻滞后双侧脑干听觉诱发电位无统计学差异;星状神经节阻滞前、后患侧的Ⅰ、Ⅲ波潜伏期和Ⅰ-Ⅲ波间期无统计学差异,Ⅴ波潜伏期、Ⅲ～Ⅴ波间期和I～V波间期有统计学差异（P〈0．05）。结论原发性三叉神经痛患者行星状神经节阻滞后脑干听觉诱发电位可发生明显改变,脑干听觉诱发电位可作为观察三叉神经痛患者治疗效果的一个客观指标。     

Influencia de la longitud axial ocular en el grosor de la capa de fibras nerviosas peripapilar medido con tomografía de coherencia óptica

BackgroundOptical coherence tomography (OCT) allows the measurement of the peripapillary optic nerve fiber layer (RNFL) thickness. The effect of ocular axial length (AL) on RNFL thickness measurement may be relevant in the interpretation of OCT results in diagnosing optic nerve diseases.PurposesTo assess the influence of ocular AL on RNFL thickness and on optic disc topographic parameters (optic disc area, rim area and cup volume) measured by OCT, in healthy individuals.MethodA sample of 109 healthy eyes classified into three groups according to AL (A: AL <22 mm; B: AL 22–24.5 mm; C: AL >24.5 mm) was studied. RNFL thickness and optic disc topographic parameters were measured using Swept-Source OCT Triton (Topcon Corporation, Tokyo, Japan) and were compared between groups using a variance analysis. Correlation between the AL and the study variables was performed using a Pearson's correlation coefficient test.ResultsThe RNFL thickness was lower in eyes with higher AL in the superior (r = −0.41; p < 0.001), inferior (r = 0.58; p < 0.001) and nasal (r = −0.43; p < 0.001) quadrants, in the mean value of the RNFL (r = −0.49; p < 0.001), optic disc area (r = −0.40; p < 0.001) and rim area (r = −0.25; p = 0.01).ConclusionAL is negatively correlated with RNFL thickness and optic disc topographic parameters measured by Swept-Source OCT Triton (Topcon).     

Immunocytochemical study of calretinin and calbindin D-28K expression in the retina of three cartilaginous fishes and a cladistian (Polypterus)

The distribution of two calcium-binding proteins, calbindin D-28K (CB) and calretinin (CR) was studied in the retina of a cladistian, Polypterus senegalus, and three cartilaginous fishes (Scyliorhinus canicula, Raja undulata and Torpedo marmorata). Western blot analysis of brain extracts revealed the lack of cross-reactivity of the used antibodies. In Polypterus, CB and CR immunoreactivities were observed in some amacrine and ganglion cells, but scarce cells showed CR/CB colocalization. Furthermore, CR immunoreactivity was present in a number of displaced bipolar cells and in some putative displaced ganglion cells, whereas CB immunoreactivity was found in some cones. No positive retinal structure was observed with the CB antibody used in cartilaginous fishes. Instead, CR was expressed in some amacrine, horizontal and ganglion cells of the dogfish and skate and, in some ganglion cells of the electric ray. The comparative analysis suggests, (1) the presence of CB-positive photoreceptor cells in the retina of cladistians seems to be apomorphic (in jawed fishes) in contrast with the plesiomorphic condition of this character in land vertebrates; (2) the presence of CR in amacrine and ganglion cells is a conserved feature along vertebrate phylogeny, whereas its variable expression in bipolar and horizontal cells represents a derived character; (3) the absence of CB in horizontal cells in cladistians could represent a derived character; and (4) the presence of CR displaced bipolar and putative displaced ganglion cells in Polypterus is shared with basal groups of actinopterygians.     

Immunohistochemical localization of Ca/calmodulin-dependent protein kinase II in the rat retina

Ca²⁺ / calmodulin-dependent protein kinase II (CaM kinase II) consisting of α and β isoforms is highly expressed in the central nervous system and is implicated in the regulation of various Ca²⁺-dependent physiological processes. We investigated the immunohistochemical distribution of the α and β isoforms of this enzyme in the rat retina, using highly specific monoclonal antibodies which recognize each isoform. Immunoblotting revealed that not only the α but also the β isoform of CaM kinase II were expressed in the retina. The immunohistochemical study showed that highly α-immunoreactive products were localized in amacrine cells in the inner nuclear layer and displaced amacrine cells and ganglion cells in the ganglion cell layer. In addition, two well-defined bands within the inner plexiform layer were densely stained with the anti-α antibody. By contrast, immunoreactivity against the anti-β antibody was very weak in the same neuronal components of the retina. β-Immunoreactive products were homogeneously distributed throughout the inner plexiform layer and no well-defined bands were detected in this layer. Glial cells such as Müller cells were immunoreactive neither to α nor β antibody. A possible co-existence of choline acetyl transferase (ChAT) within CaM kinase II α-immunopositive neurons was examined by evaluating adjacent sections stained with anti-CaM kinase II α antibody and anti-ChAT antibody, respectively. The distribution of CaM kinase II α immunoreactivity in the rat retina was remarkably similar to that of ChAT immunoreactivity. About 32% of total ChAT-immunopositive neurons in the inner nuclear layer contained the CaM II α isoform, whereas only an occasional co-existence of both enzymes was observed in the ganglion cell layer. The present immunoblot and immunohistochemical study elucidated that not only α but also β isoforms of CaM kinase II β were expressed and this enzyme may participate in the cholinergic system in the rat retina.     

Separation of calcium currents in retinal ganglion cells from postnatal rat

A culture system of the postnatal rat retina was established to investigate Ca²⁺ currents and synaptic transmission in identified neurons. Methods are described that allowed us to select retinal ganglion neurons (RGNs) in short term cultures (up to 48 h in vitro) and in long-term cultures (3 to 21 days in vitro). The specific aim of the present study was to identify channel specific components in whole-cell Ca²⁺ currents of RGNs and to clarify the potential use of the lanthanide Gd³⁺ as a selective Ca²⁺ channel blocker. About one third of freshly dissociated RGNs generated both low voltage activated Ca²⁺ currents (I_Ca(LVA)) and high voltage activated Ca²⁺ currents (I_Ca(HVA)). The remaining 2/3 of RGNs in short term culture and most RGNs in long-term culture displayed only I_Ca(HVA). The latter comprised at least three different components that were functionally rather similar, but could be separated pharmacologically. A significant portion (about 40%) of I_Ca(HVA) was irreversible blocked by the N channel antagonist ω-CgTx (5 μM). The L channel antagonist nifedipine (10 μM) eliminated about 25% of I_Ca(HVA). Thus, about 1/3 of the HVA Ca²⁺ or Ba²⁺ current remained unaffected by either ω-CgTx or nifedipine. ω-AgaTx (200 nM) completely failed to block HVA Ca²⁺ or Ba²⁺ currents in RGNs. Gd³⁺ exerted contrasting actions on LVA and HVA Ca²⁺ currents. While I_Ca(LVA) consistently increased in the presence of Gd³⁺ (0.32–3.2 μM), I_Ca(HVA) always decreased, especially when using higher concentrations of Gd³⁺ (10–32 μM). The blocking action of Gd³⁺ was not restricted to the ω-CgTx-sensitive HVA current component, but also concerned ω-CgTx- and nifedipine-resistant components. The decay of Ca²⁺ currents was accelerated in the presence of Gd³⁺. Even in RGNs lacking I_Ca(LVA), application of 3.2 μM Gd³⁺ significantly reduced the time constant of decay from an average of 64 ms to 36 ms (voltage steps from −90 to 0 mV; 10 mM [Ca²⁺]₀; 26°C). This is in contrast to what had to be expected if an N-type HVA current component was selectively suppressed by Gd³⁺. Gd³⁺ diminished glutamatergic spontaneous synaptic activity in retinal cultures tested during the 3rd week in vitro. Both frequency and amplitude were reduced. Occasionally, the application was followed by a rebound increase of EPSC frequency. A stimulatory effect during application of Gd³⁺ has never been observed. These experiments indicate that RGNs express at least 4 different types of Ca²⁺ currents, that resemble in some aspects T, N and L channel currents. A significant component of the HVA Ca²⁺ current was resistant to the available HVA channel blockers suggesting the presence of a pharmacologically distinct type of HVA Ca²⁺ channel type in RGNs. Our experiments also show that Gd³⁺ is not suitable for isolation of HVA subcomponents in RGNs, but it can be used to distinguish between LVA and HVA Ca²⁺ currents, as these currents reacted to Gd³⁺ in an opposite way. The purely depressive effect of this lanthanide on spontaneous synaptic activity is consistent with the assumption that in retinal neurons LVA Ca²⁺ channels are not involved in the regulation of glutamate release.     

护理干预在奇神经阻滞治疗妇产科术后会阴痛的疗效研究

目的：探讨奇神经节阻滞治疗妇产科术后会阴痛的护理干预方法及远期效果。方法：对我科18例妇产科术后会阴痛患者进行奇神经节阻滞治疗前及治疗后采用精心规范的护理措施。结果：18例患者顺利接受奇神经节阻滞治疗,通过治疗前后的细致规范护理,无1例感染及严重并发症发生,疼痛缓解理想,治疗效果显著。结论：对奇神经节阻滞治疗妇产科术后会阴痛的患者实施规范妥当的护理措施,具有明显增强远期治疗效果的临床意义。