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41.
I. Y. Shvera A. M. Cherniavsky W. Yu. Ussov M. P. Plotnikov A. A. Sokolov V. M. Shipulin V. I. Chernov 《European journal of nuclear medicine and molecular imaging》1995,22(2):132-138
In this study we aimed to work out a quantitative prognostic index for preoperative assessment of brain technetium-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission tomography (SPET) in patients referred for urgent carotid endarterectomy due to acute obstructive disease of the internal carotid artery (ICA) and neurological deficit. To this end we compared data from preoperative SPET studies with the postinterventional changes in neurological status in 20 patients (17 males, three females; mean age 53 years, SD 4 years) with acute ischaemic cerebral disorders induced by obstruction of the ICA. Carotid obstruction was diagnosed by ultrasound B-mode study. All patients underwent urgent carotid endarterectomy from the ICA. Patients were divided into two groups in accordance with the results of postoperative follow-up: group A comprised patients with significant (more than 3 points) postoperative improvement in neurological condition as quantified by the Canadian Neurological Scale (11 patients); group B consisted of patients with minimal improvement or deterioration (nine, three of whom died). All patients were studied preoperatively by99mTc-HMPAO SPET. The volume of nonperfused tissue (VS, cm3) was quantified using the Mountz technique. Hypoperfused volume (V
hypoperf, cm3) in the affected hemisphere was calculated as the total volume of voxels with99mTc-HMPAO uptake <90% of the contralateral symmetric voxels. Discriminant prognostic function was calculated by discriminant analysis as:PF = 0.072×VS + 29.46×(VS/V
hypoperf). Patients with preoperativePF values <8.20 demonstrated postoperative improvement in neurological status, while the group withPF>8.90 comprised patients who demonstrated minimal improvement or deterioration. PF values in the range 8.20–8.90 carried an indefinite prognosis. We conclude that the preoperative99mTc-HMPAO SPET can be used for the selection of patients in whom improvement in neurological status may be expected after urgent surgical correction of acute extracranial obstruction of the ICA. 相似文献
42.
K. Arima Minako Nakamura Nobuhiko Sunohara Masafumi Ogawa Midori Anno Yoko Izumiyama Shigeo Hirai Kazuhiko Ikeda 《Acta neuropathologica》1997,93(6):558-566
Coiled bodies and interfascicular threads are conspicuous white matter abnormalities of brains of patients with progressive
supranuclear palsy (PSP). Both structures are argyrophilic and immunoreactive for the microtubule-binding protein tau. This
report concerns the ultrastructural localization of interfascicular threads and their relationship to coiled bodies in five
PSP patients. We showed for the first time that abnormal tubules with a 13- to 15-nm diameter and fuzzy outer contours were
the common structures of coiled bodies in the oligodendroglial perikarya and of interfascicular threads. Moreover, the tubules
were immunolabeled by anti-tau antibodies. The abnormal tau-positive tubules of interfascicular threads were located in the
inner loop of the myelin sheath. Our study further indicated that the thread-like structures in the white matter comprised,
at least in part, oligodendroglial processes, and that they were also present in gray matter. We consider that the formation
of coiled bodies in the perikarya and of interfascicular threads represents a common cytoskeletal abnormality of the oligodendroglia
of PSP patients. Moreover, even though the white matter alterations of PSP resemble those of corticobasal degeneration, there
are certain ultrastructural differences in the abnormal oligodendroglial tubules of the two diseases.
Received: 4 October 1996 / Accepted: 6 December 1996 相似文献
43.
目的:观察偏瘫患者早期床上训练的效果。方法:对58例脑血管意外致偏瘫患者随机分成2组:观察组30例,护理中指导早期床上体操训练;对照组28例,按常规护理。以上、下肢肌力和日常生活活动能力(ADL)为评价指标,于训练开始时、训练4周、训练8周各评价1次。结果:观察组训练4周、8周时患侧上肢肌力以及ADL水平明显增加,与对照组比较有显著差异(P<001)。患侧下肢肌力训练4周及8周时均增加,与对照组比较,4周时无明显差异(P>005),8周时有显著性差异(P<001)。结论:对早期偏瘫患者实施床上功能训练,不仅可以提高患者的生命质量,而且可以减少、甚至解除患者及家属的经济和精神负担。 相似文献
44.
急性脑梗塞患者血清肿瘤坏死因子水平变化的观察 总被引:7,自引:0,他引:7
采用双抗体夹心ELISA法对30例正常对照和36例急性脑梗塞患者血清肿瘤坏死因子(TNF)水平进行了检测。结果显示:急性脑梗塞组血清TNF水平显著高于正常对照组,血清TNF水平变化与脑梗塞容积大小密切相关,恢复期血清TNF水平显著降低。结果提示,TNF参与了脑梗塞发生后病理变化过程,检测血清TNF对判定脑梗塞容积大小有一定的临床意义。 相似文献
45.
Kazumichi Yamada Satoshi Goto Taro Oyama Makoto Yoshikawa Shinji Nagahiro Yukitaka Ushio 《Acta neuropathologica》1995,89(2):172-177
The present study concerns the vulnerability of striatal interneurons immunopositive for the Ca2+-binding protein calretinin to ischemic neuronal injury. An immunohistochemical study was carried out on the striata of rats which had undergone transient middle cerebral artery occlusion. Two weeks after the ischemia, there was a marked reduction in the number of calretinin-positive neurons in the ipsilateral ischemic lesion, although the striatal interneurons positive for parvalbumin, which are a neuronal population distinct from the calretinin-immunoreactive cells in the striatum, were spared in the insulted areas. The present data indicate that the striatal calretinin-positive neurons are less resistant to transient ischemia, suggesting that there may exist vulnerability differences among the striatal interneurons in ischemia-induced neuronal injury. 相似文献
46.
Summary A simple technique of stereotactic craniotomy and intraoperative lesion localisation that uses the Brown-Robert-Wells (BRW) stereotactic frame is presented. The method optimises craniotomy placement and facilitates localisation of small intracerebral lesions. Using the system, 16 patients have had resection of intracranial neoplasms from deep and/or eloquent areas of the brain with no neurological morbidity. 相似文献
47.
研究深低温停循环(DHCA)与逆行脑灌注(RCP)时脑组织自由基的变化。健康杂种犬14只,随机等分为DHCA组和RCP组,在停循环前(A点)、DHCA/RCP30分(B点)、DHCA/RCP60分(C点)DHCA/RCP90分(D眯)和复温再灌注30分(E点)取脑皮层lg,检测丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果见两组在A点MDA和SOD无差别。在B、C、D、E点,DHCA组MDA 相似文献
48.
Erika G. Gisel 《Occupational therapy international》1994,1(4):209-232
This review addresses the current state of knowledge in oral sensorimotor therapy for children with neurological impairments and ingestive problems. Comprehensive assessment of the child with dysphagia looks at the interaction of oral performance and growth. These domains include eating efficiency, oral-motor skills, oral sensory evaluation, classification of the severity of an eating problem, interaction of respiration and ingestion, aspiration, positioning for feeding, social skills assessment, careload and assessment technologies. Oral sensorimotor therapy improves eating but not drinking skills in children 3–12 years of age. Weight gain is sufficient so that children maintain their growth channel but they do not show catchup growth. Many factors thought to contribute to better ingestive performance need further study, such as jaw and lip control in association with drinking. The earliest possible identification of infants at risk for eating impairments needs to be rigorously pursued. Such an approach offers hope that the later growth deterioration now seen in children with eating impairments may be prevented. Finally, the effect of positioning and the use of eating equipment to promote self-feeding need further study. 相似文献
49.
50.
T. Erhan Cosan Baki Adapinar Hamdi Cakli M. Kezban Gurbuz 《European archives of oto-rhino-laryngology》2006,263(4):327-330
The case of a child injured by a knitting needle penetrating transorbitally and intracranially, resulting in carotid cavernous fistula and pontine injury, is reported. After receiving medical and endovascular treatment, the only remaining abnormal neurological manifestation was right peripheral facial nerve palsy. The clinical sequences of events and the demonstration of a pontine lesion leading to peripheral facial palsy are presented. Facial nuclear injury with a penetrating trauma is an extremely rare condition. It is important to identify the anatomical regions injured in penetrating traumas. The lesions must be identified by computerized tomography, magnetic resonance imaging, clinical and laboratory investigation. 相似文献