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61.
Birgit Herting MD Bettina Beuthien‐Baumann MD Katrin Pöttrich PhD Markus Donix MD Antje Triemer PhD Johannes B. Lampe MD Rüdiger von Kummer MD Karl Herholz MD Heinz Reichmann MD Vjera A. Holthoff MD 《Movement disorders》2007,22(4):490-497
Depressive symptoms are common in patients with neurodegenerative disorders. Imaging studies suggest that a disruption of frontal-subcortical pathways may underlie depression associated with basal ganglia disease. This pilot study tested the hypothesis that frontal dysfunction contributes to depression associated with multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Depressed patients with MSA (n = 11), PSP (n = 9), and age-matched controls (n = 25) underwent measures of cerebral glucose metabolism applying positron emission tomography with (18)F-fluorodeoxyglucose. Regional metabolism in the patient groups was compared to the normal subjects using the voxel-based statistical parametric mapping. Depressive symptom severity (Hamilton Depression Rating) and degree of locomotor disability (Hoehn & Yahr) were assessed in the patient groups. The association between prefrontal metabolism and the occurrence of depressive symptoms and the degree of locomotor disability was investigated. When compared to controls, MSA patients revealed significant metabolic decreases in bilateral frontal, parietal, and cerebellar cortex and in the left putamen. In PSP patients, significant hypometabolism was demonstrated in bilateral frontal cortex, right thalamus, and midbrain. Depression severity but not the patients' functional condition was significantly associated with dorsolateral prefrontal glucose metabolism in both patient groups. The findings of this pilot study support the hypothesis that depressive symptoms in MSA and PSP are associated with prefrontal dysfunction. 相似文献
62.
Ting-Kai Leung Chien-Jui Cheng Chi-Ming Lee Li-Kuo Shen Hung-Jung Wang Ya-Yen Chen 《中华医学杂志(英文版)》2005,118(17):1493-1496
The current report focuses on two patients of the same age who presented similar appearances on initial anteroposterior chest images. Follow-up images showed superoanterior and superoposterior mediastinal lesions. The first patient with noninvasive cystic thymoma was suspected before surgery, while the pathologic diagnosis was intrathoracic phrenic nerve schwannoma. The second patient was with an asymmetric, dumbbell-shaped paravertebral tumor over T3 and T4 on the left side. The preoperative… 相似文献
63.
目前周围神经的组织工程研究热点之一就是研制具有生物活性的神经导管,主要方法是神经导管与雪旺细胞或者神经营养因子相结合来促进周围神经的再生。就复合神经营养因子的神经导管的相关研究进展作一综述。 相似文献
64.
Nobuyuki Oka Teruaki Kawasaki Kotaro Mizutani Hiroshi Sugiyama Ichiro Akiguchi 《Neuropathology》2007,27(6):509-515
Neuromuscular biopsy is still an essential method for diagnosing vasculitic neuropathy, although its diagnostic sensitivity is at most 60%. Our objective was to examine the expression of hypoxia‐inducible factor 1α (HIF‐1α) in peripheral nerves and to evaluate its usefulness in diagnosing vasculitic neuropathy, especially for discrimination from other axonal neuropathies. Forty‐one patients with vasculitic neuropathy consisting of 20 definite, 14 probable and seven possible diagnoses, 15 patients with metabolic neuropathy, five with motor neuron disease and six with chronic inflammatory demyelinating polyneuropathy were included. Nerve biopsy specimens were immunohistochemically examined for HIF‐1α and various cell markers. Distinct immunoreactivity (IR) was observed in nuclei of endoneurial cells in 54% (22/41) of vasculitic patients, while specimens from metabolic neuropathies showed less nuclear IR and the difference of mean density of HIF‐1α‐positive nuclei was significant. Two patients with possible vasculitis who showed HIF‐1α‐positive nuclei in endoneurium, were later confirmed to have vasculitis by skin biopsies. Most of the cells expressing HIF were demonstrated to be Schwann cells. There was a trend in the vasculitic patients with early phase nerve damage to display higher endoneurial HIF‐1α‐IR. HIF‐1α may be an immunohistochemical marker for vasculitic neuropathy, especially when the observed section contains no vasculitic lesions. 相似文献
65.
外消旋聚乳酸复合神经生长因子缓释导管促周围神经再生的形态学研究 总被引:6,自引:2,他引:4
目的 建立外消旋聚乳酸复合神经生长因子(poly-D,L-lactic acid/nerve growth factor,PDLLA/NGF)可吸收性缓释导管桥接修复大鼠坐骨神经缺损的动物模型,观察复合导管对大鼠坐骨神经缺损再生的促进作用。方法利用溶剂挥发法制备PDLLA单纯导管和PDLLA/NGF缓释导管,每根缓释导管含NGF450U。SD大鼠40只随机分成4组,每组10只,切除中段坐骨神经10mm之后分别行自体神经移植(A组)、单纯导管桥接(B组)、单纯导管加一次性给药(C组)、PDLLA/NGF缓释导管桥接(D组)修复坐骨神经,除A组外,均保留10mm缺损。术后3个月观察神经再生情况,比较各组光镜、电镜及图像分析等指标。结果术后3个月导管与周围组织粘连松,并开始降解,但外形仍保持完整。再生神经均顺利通过导管腔,组织学观察A组和D组内神经纤维数目多,大小均匀,成熟良好;B组和C组纤维结缔组织多,神经纤维细小,髓鞘薄。图像分析显示除神经纤维计数D组高于A组外,A组和D组在纤维直径、轴突直径和髓鞘厚度方面差异均无统计学意义(P〉0.05),并明显优于B组和C组(P〈0.05)。结论 PDLLA/NGF缓释导管能够有效促进大鼠坐骨神经缺损再生,组织学观察指标接近自体神经移植。 相似文献
66.
多系统萎缩的临床分型和影像学改变特点分析 总被引:2,自引:0,他引:2
目的探讨多系统萎缩(multiple system atrophy,MSA)的临床表现类型与神经影像学改变新特征(脑桥“十字征”和“壳核裂隙征”)的关系,为临床尽早做出诊断提供依据。方法按照Gilman诊断标准回顾性分析11例MSA患者的临床表现、分型和头颅MRI资料。结果本组诊断为很可能MSA11例,其中橄榄体脑桥小脑萎缩(MSA-C型)8例。2例在发病后3年头颅MRI脑桥“十字征”达Ⅰ期;1例在病后2年达Ⅱ期;3例分别在病后1年、3年、5年达Ⅲ期;另外2例分别在病后2年和7年达Ⅳ期。8例“壳核裂隙征”均为0期。黑质纹状体变性(MSA-P型)2例:1例病后6年脑桥“十字征”0期,“壳核裂隙征”Ⅰ期,另1例发病后9年“壳核裂隙征”Ⅱ期,脑桥“十字征”Ⅳ期。Shy-Drager综合征(MSA-A型)1例:病程5年,MRI检查脑桥“十字征”和“壳核裂隙征”分期均为0期。结论临床表现与头颅MRI检查发现的脑桥“十字征”和“壳核裂隙征”可作为及早识别MSA-C型的神经影像学改变特征,“壳核裂隙征”可作为识别MSA-P型的神经影像学改变特征。 相似文献
67.
甲壳素涂层PGLA神经导管修复兔面神经缺损的实验研究 总被引:6,自引:0,他引:6
目的:探讨甲壳素涂层PGLA神经导管修复兔面神经缺损的效果。方法:成年雄性新西兰兔24只,无菌条件下切断双侧面神经下颊支,制成15mm的兔面神经下颊支缺损模型。左侧用甲壳素涂层聚丙交脂-乙交脂共聚物[poly(L-lactide-co-glycolide),PGLA]神经导管修复;右侧用翻转自体神经修复作为对照。术后5周、10周和14周行大体观察、电生理检查、组织学、电镜观察评价修复效果。结果:术后5周观察到神经导管中有新生轴索通过,再生神经发育不成熟;右侧自体神经修复近段有髓神经纤维均匀疏散分布,远段未见明显再生神经束形成。术后14周左侧再生神经已通过神经导管长入远端,电生理检查结果表明自体神经修复侧再生神经质量优于神经导管修复侧,差异有统计学意义(P<0.01)。自体神经修复再生纤维密度优于神经导管修复侧,差异有统计学意义(P<0.01),但自体神经修复侧近段神经髓鞘部分空泡样变性及脱髓鞘改变,远段再生神经纤维束形成少,面肌联带运动程度较导管修复侧严重。结论:甲壳素涂层PGLA神经导管能有效修复周围神经缺损,有望替代自体神经移植。 相似文献
68.
Nelson Wolosker Guilherme Yazbek José Ribas Milanez de Campos Paulo Kauffman Augusto Ishy Pedro Puech-Leão 《Clinical autonomic research》2007,17(3):172-176
Background Sympathectomy is the treatment of choice for primary hyperhidrosis. One curious occurrence that is difficult to explain from
an anatomophysiological point of view in cases of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of palmar
hyperhidrosis (PH) is the observed improvement in plantar hyperhidrosis (PLH). Nevertheless, current reports on VATS rarely
describe the effect on PLH or just give superficial data. The aim of this study was to prospectively investigate, how surgery
affects PLH in patients with PH and PLH over one-year period.
Methods From May 2003 to January 2004, 70 consecutive patients with combined PH and PLH underwent VATS at the T2, T3, or T4 ganglion
level (47 women and 23 men, with mean age of 23 years).
Results Immediately after the operation, all the patients said they were free from PH episodes, except for two patients (2.8%) who
suffered from continued PH. Compensatory hyperhidrosis (CH) of various degrees was observed in 58 (90.6%) patients after one
year. Only 13 (20.3%) suffered from severe CH. There was a great initial improvement in PLH in 50% of the cases, followed
by progressive regression, such that only 23.4% still presented that improvement after one year. The number of cases without
overall improvement increased progressively (from 17.1% to 37.5%) and the numbers with slight improvement remained stable
(32.9–39.1%). Of the 24 patients with no improvement after one year, 6 patients graded plantar sweating worse.
Conclusion Patients with PH and PLH who undergo VATS to treat their PH present a good initial improvement in PLH that reduces to a lower
level of improvement after the one-year period. 相似文献
69.
目的 探讨近端/远端复合肌肉动作电位振幅比率在术后面神经肿瘤侵犯段功能评估上的价值和对早期面神经修复的指导意义。方法 比较术末面神经近端/远端复合肌肉动作电位振幅比率和术后2周、6个月患侧面神经功能的H-B分级之间的关系。结果 术后6个月面神经H-B分级恢复到Ⅰ-Ⅱ级者,术末近端/远端复合肌肉动作电位振幅比率均>0.3。结论 术末面神经近端/远端复合肌肉动作电位振幅比率是判断术后面神经远期功能,特别是肿瘤侵犯段功能的重要指标,为术中直接修复面神经提供了指导依据。 相似文献
70.