Diving physiology and pathophysiology

Summary. Divers have worked at 500 m depth in the sea and have reached 700 m in simulated chamber dives. A prerequisite for this has been extensive physiological studies of the body's reactions to pressure and pressure changes. This paper reviews such physiological and pathophysiological studies with emphasis on recent developments.     

Intracerebral haemorrhage as a manifestation of Lyme Neuroborreliosis?

Lyme Neuroborreliosis (LNB) has repeatedly been reported to cause cerebral vasculitis. However, there is no reliable information about the incidence of cerebral vessel affection. The majority of reports deal with ischaemic consequences, and there are a few reports of subarachnoid haemorrhage (SAH). We report a case of otherwise unexplained intracerebral haemorrhage (ICH) where clinical and laboratory tests have shown LNB. Late stage LNB might not only cause ischaemic, but haemorrhagic stroke as well.     

Hyperaemia in rat neocortex produced by acute exposure to methylenedioxymethamphetamine

Cerebral blood flow and glucose utilization were measured in rat neocortex, hippocampus and striatum following methylenedioxymethamphetamine injection (5 mg/kg, i.v.), using the tracers [¹⁴C]iodoantipyrine and [¹⁴C]2-deoxyglucose, respectively. In control rats, blood flow was coupled to glucose metabolism, but in methylenedioxymethamphetamine-treated rats, marked hyperperfusion was measured in frontal and parietal cortex with no change in glucose use. This suggests that methylenedioxymethamphetamine has the potential to disrupt cerebrovascular control.     

川芎素对大鼠脑缺血再灌注时突触后致密物质-95活性的影响

应用神经行为学评估、脑梗死容积测量和Western blot分析,探讨研究阿魏酸钠(SF)的神经保护作用及其对局灶性脑缺血损伤时突轴后致密物质-95(PSD-95)活性的影响,证实SF明显改善再灌注24 h神经功能缺陷和减少脑梗死容积,显著增强再灌注后PSD-95表达,表明SF可能通过加强PSD-95活性来改善缺血性损伤.     

感染患者血清可溶性细胞间粘附分子含量的变化及其对脑梗死的影响

目的：探讨感染合并脑梗死患者血清可溶性细胞间粘附分子（sICAM-1)的变化及临床意义。方法：采用双抗体（ELISA）法测定50例感染合并脑梗死患者血清中sICAM-1的含量，并与30例脑梗死患者和30例健康人对照。结果：感染合并脑梗死患者急性期血清sICAM-1的水平明显高于对照组。结论：感染合并脑梗死时sICAM-1的表达明显升高，sICAM-1水平的增高加重了脑梗死的发生发展。     

Whole-brain 3D perfusion MRI at 3.0 T using CASL with a separate labeling coil.

A variety of continuous and pulsed arterial spin labeling (ASL) perfusion MRI techniques have been demonstrated in recent years. One of the reasons these methods are still not routinely used is the limited extent of the imaging region. Of the ASL methods proposed to date, continuous ASL (CASL) with a separate labeling coil is particularly attractive for whole-brain studies at high fields. This approach can provide an increased signal-to-noise ratio (SNR) in perfusion images because there are no magnetization transfer (MT) effects, and lessen concerns regarding RF power deposition at high field because it uses a local labeling coil. In this work, we demonstrate CASL whole-brain quantitative perfusion imaging at 3.0 T using a combination of strategies: 3D volume acquisition, background tissue signal suppression, and a separate labeling coil. The results show that this approach can be used to acquire perfusion images in all brain regions with good sensitivity. Further, it is shown that the method can be performed safely on humans without exceeding the current RF power deposition limits. The current method can be extended to higher fields, and further improved by the use of multiple receiver coils and parallel imaging techniques to reduce scan time or provide increased resolution.     

出血性脑室铸型的疗效分析

目的 探讨出血性脑室铸型的治疗方法与疗效。方法 分析脑室外引流、尿激酶脑室内注入、气管切开、控制血压以及脑积水的处理等多种治疗手段在治疗脑室铸型过程中的作用及其效果。结果 经过综合治疗完全恢复日常生活者10例(28．6％)，部分恢复日常工作或独立进行家庭生活者13例(37．1％)，生活需要照顾或护理者7例(20％)，死亡5例(14．2％)。结论 对于出血性脑室铸型这类重症病人早期及时的脑室外引流是快速而有效的抢救措施，尿激酶脑室内注入对溶解血凝块，疏通脑室系统行之有效。气管切开对降低死亡率至关重要，控制血压是防止再出血的关键。脑积水的处理是康复过程中需要高度重视的环节。     

Cutaneous basosquamous carcinoma infiltrating cerebral tissue

Basosquamous carcinoma of the skin is a rare malignancy with specific histopathological features of both basal cell carcinoma and squamous cell carcinoma. Some authors believe that basosquamous carcinoma is a variant of basal cell carcinoma, while others suggest that this tumour may behave more aggressively. We present a 44-year-old female patient who was diagnosed with a basosquamous carcinoma histopathologically. She had extensive ulcero-vegetative lesions, involving the anterior half of the scalp, the left orbit and the left side of the face. With this case we aim to emphasize the aggressive nature of basosquamous carcinoma and review the literature.     

Comparison of Asymmetry in Cerebral Blood Flow Between Brain Hemispheres Using Digital Subtraction Angiography

BACKGROUND AND PURPOSE: Recently, endovascular techniques have gained significant therapeutic potential for both treatment and prevention of stroke. Cerebral angiography, which is an essential component of these procedures, has been used to provide morphological information regarding condition of blood vessels. In this study, we propose to determine the possibility of acquiring information regarding cerebral blood flow (CBF) in addition to morphologic information from data routinely available during angiography. METHODS: Digital subtraction angiography sequences were obtained for eight patients having occlusive disease in internal carotid artery (ICA) territories. Two regions-of-interest (ROIs) corresponding to the two brain hemispheres on AP view were delineated. For each image, the average pixel value within each ROI was calculated and used to generate time-density curves. Indices obtained from each curve were compared with each other and with the results obtained from the single photon emission computed tomography (SPECT) studies performed a pre- or postangiography procedure. RESULTS: Comparison between ICA stenosis and cerebral perfusion measurements revealed that cerebral perfusion deficit can be independent of arterial occlusive disease. The indices obtained from the time-density curves exhibit a correlating trend with the results from SPECT studies. However, lack of sufficient sample data prevented any meaningful statistical analysis to be conducted. CONCLUSIONS: We have developed a technique for utilizing the angiographic data for the important task of routinely and easily measuring CBF. Availability of CBF measurements during cerebral angiography may favorably impact upon the appropriate use of endovascular procedures and potentially contribute to the reduction of morbidity and mortality associated with stroke.