Binswanger's disease in the absence of chronic arterial hypertension

Summary The cerebral changes are described in a woman of 54 who suffered from Binswanger's encephalopathy: there were no signs or symptoms of chronic arterial hypertension. The disease presented as dementia of about 3 years duration. Computed tomography of the brain 2. 5 years before her death showed bilateral widespread hypodense lesions in the cerebral white matter. She died of an asthmatic attack. Autopsy disclosed extensive bilateral degeneration of the central white matter, lacunes and gliosis. Severe obliterative arteriolosclerosis occurred in the meningeal vessels and those supplying the affected parts of the brain. Light microscopy showed that the most severe lesions occurred in the arterioles. Immunohistochemistry demonstrated profound extravasation of plasma proteins chiefly albumin, indicating dysfunction of the blood-brain barrier. Thus, the lesions characteristic of Binswanger's encephalopathy may develop in the absence of chronic arterial hypertension. Additional pathogenic factors, possibly genetic predisposition to vascular injury may play a role in the development of this condition.Supported by grants from the Swedish Medical Research Council, Project No 12X-03020 and 1987 Års Stiftelse för Strokeforskning     

Neural plasticity in vivo: opioid sensitivity of memory develops gradually after a septal lesion

Neuronal plasticity can manifest itself in alterations in the sensitivity of memory to the effects of drugs. After the production of a brain lesion, the memory processing of a passive-avoidance task in mice gradually becomes sensitive to the effect of morphine, i.e., an improvement in retention performance is seen after 6 weeks, but not after 1 or 2 weeks. The results presented demonstrate that, even if they lead to no discernible changes in behaviour, plastic processes can still be detected by means of behavioural tests.     

Cortical projection patterns of magnocellular basal nucleus subdivisions as revealed by anterogradely transportedPhaseolus vulgaris leucoagglutinin

The present paper deals with a detailed analysis of cortical projections from the magnocellular basal nucleus (MBN) and horizontal limb of the diagonal band of Broca (HDB) in the rat. The MBN and HDB were injected iontophoretically with the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L). After immunocytochemical visualization of labeled efferents, the distribution of projections over the cortical mantle, olfactory regions and amygdala were studied by light microscopy. Based on differences in cortical projection patterns, the MBN was subdivided in anterior, intermediate and posterior portions (MBNa, MBNi and MBNp). All subdivisions maintain neocortical projections and are subject to an anterior to posterior topographic arrangement. In the overall pattern, however, the frontal cortex is the chief target. Furthermore, all MBN parts project to various regions of meso- and allocortex, which are progressively more dense when the tracer injection is more anteriorly placed. The most conspicuous finding, however, was a ventrolateral to dorsomedial cortical projection pattern as the PHA-L injection site moved from posterior to anterior. Thus, the posterior MBN projects predominantly to lateral neo- and mesocortex while the anterior MBN sends more fibers to the medial cortical regions. Furthermore, the MBNa is a source of considerable afferent input to the olfactory nuclei and as such should be regarded as a transition to the HDB. The HDB, apart from projecting densely to olfactory bulb and related nuclei, maintains a substantial output to the medial prefrontal cortical regions and entorhinal cortex, as well. Comparison of young vs aged cases indicate that aging does not appear to have a profound influence on cortical innervation patterns, at least as studied with the PHA-L method.     

易误诊为神经肿瘤的一种疾病——肿块型中枢神经系统原发性血管炎

背景与目的：由于缺乏特异性临床和影像表现，肿块型中枢神经系统原发性血管炎（primary angiitris of central nervous system，PACNS）常被误诊为胶质瘤．本文旨在探讨肿块型PACNS的诊断与鉴别诊断。方法：回顾性分析手术治疗的37例肿块型PACNS患者的临床及影像表现。结果：85．3％的患者出现局灶性神经功能减退，55．9％患者有不同程度皮层高级功能减退症状。70．6％的颅内病变累及脑皮层：73．5％患者的正常区域脑血管周围间隙增宽，其中76％出现血管强化；病变出现特征性的“C”形强化。结论：局灶性神经功能和高级功能减退、病变累及皮层和“C”形强化等特征．有助于诊断肿块型PACNS。     

Carcinoma of the thyroid in black patients.

In the period from January 1, 1976 to December 31, 1988, we reviewed the charts of 33 patients treated for carcinoma of the thyroid at Howard University Hospital. The three non-black patients (two Whites and one Pakistani) were excluded from the study. There were 19 females and 11 males. Of the 30 cases elevated, 10 were papillary, 7 were follicular variant of papillary, 8 were follicular, 3 were undifferentiated (anaplastic), and 2 were medullary. Ten patients had either distant metastasis (Hoffman, South Med J 80:741, 1987) or locally advanced disease in the neck (Woolner et al., Am J Surg 102:354, 1961.) at the time of diagnosis. The treatment of these lesions depended on, among other variables, the cell type, the extent of the lesion, and the personal preference of the attending surgeon. Carcinoma of the thyroid remains an uncommon lesion in Black patients. Because of its rarity, the diagnosis may often be delayed and, as a result, patients may first come to attention with a more advanced stage of this disease. To prevent this occurrence, a high index of suspicion must be maintained for all thyroid nodules, and appropriate diagnostic steps taken. Diagnostic and treatment options are discussed.     

骨形态计量学评价低钙对大鼠皮质骨的作用研究

目的 评价低钙饮食对大鼠皮质骨的影响。方法 3月龄SD普通级雄性大鼠40只，随机分为5组。第1、2组饲养1个月，分为正常对照组(1mol，ca1．0％)和极低钙组VLCD(1mol，Ca0．1％)，余下3组饲养3个月，分为正常对照组(3mol，Ca1．0％)、极低钙组VLCD(3mol，Ca0．1％)和低钙组LCD(3mol，Ca0．3％)。各组动物喂养包含对应钙含量的精制饲料，处死前进行双荧光标记。实验结束时，取左侧胫骨中段行骨形态计量学检测。结果 无论是低钙饮食1个月，还是3个月，无论是极度缺钙，还是仅有轻微的钙不足，胫骨中段横截面皮质骨始终未出现显著意义的变化，但骨内膜骨吸收有增加的趋势。结论 低钙对皮质骨作用不明显，这可能与机体在低钙状态下动用骨骼的次序或快慢有关。     

慢性脊髓损伤的实验研究

探讨慢性脊髓损伤的形成原因。方法 选用新西兰白兔36只，随机分为6组，即1天、4月、8月造模组及相应对照组，造模组使用自制捆绑法固定兔于腰椎弯曲位来模仿人类的弯腰运动，通过体感皮层诱发电位及组织形态学等技术进行动态观察。结果 4、8月组造模动物白质出现了髓鞘变薄、水肿，粗大轴突的数量减少，细小的轴突相对增多，诱发电位潜伏期延长等慢性脊髓损伤的病理变化。结论 压迫和牵拉都是造成慢性脊髓损伤的原因。     

Fracture separation of the articular pillar of C5 following brass knuckles trauma

We report the case of a fracture separation of the articular pillar at the lower cervical spine. The trauma, following a brass knuckles, repeats almost in an experimental way the rotation and extension mechanism given in literature for the genesis of such injuries. From the admission in the orthopaedic service to the surgery, the development went in a characteristic way towards a rotatory displacement. Received: 12 July 2002, Accepted: 18 August 2002 Correspondence to: R. Massicot     

Intrahippocampal Injection of Endothelin-1: A New Model of Ischemia-induced Seizures in Immature Rats

Summary:  The goal of this study was to develop a new model of ischemia-induced seizures in immature rats using injection of vasoconstrictor Endothelin-1 (ET-1) into the brain. ET-1 (10, 20, or 40 pmol) was infused into the left dorsal hippocampus of freely moving Wistar rats 12 (P12) and 25 (P25) days old. Animals were then video/EEG-monitored for 100 min and monitoring was repeated 22 h later. Parameters of electrographic seizures (frequency and mean duration) as well as pattern of their behavioral correlates were evaluated. The pattern of behavioral seizures was used to develop model-specific scoring system. Cresyl violet and Fluoro Jade-B-staining were used to evaluate brain damage. Extension of the lesion was correlated with seizure severity. After ET-1-injection, seizures occurred in 83–100% animals of all age-and-dose groups and persisted for 24 h except P12 rats with 10 pmol. There were no differences in average seizure duration (18–40 s) or seizure frequency (3–7 seizures/100 min) among individual dose-groups. Between the 1st and 2nd observation period, total seizure duration decreased in 71% of P12 and 47% of P25 rats. Electrographic seizure activity was most frequently accompanied by clonus, incidence of more severe convulsions (barrel rolling or generalized clonic seizures) increased with dose of ET-1. Morphologic examination did not reveal any dose-related difference in damage severity, hippocampal damage was however more extensive in P12 compared to P25 animals. Seizure severity correlated positively with severity of the damage in both age groups. Our study presents focal injection of ET-1 into the brain as a new and practical model of ischemia-induced seizures in immature rats.     

明显强化孤立肺结节血流模式的临床价值

目的利用4层螺旋CT动态增强技术定量评价不同性质的明显强化孤立肺结节的血流模式并初步评价血管内皮生长因子(VEGF)表达阳性的孤立性肺腺癌血管生成与血流模式定量CT参数的相关性.方法 78例孤立明显强化肺结节(直径≤4 cm,68例恶性,10例活动性炎性),行多层螺旋CT(MSCT)动态增强(以4 ml/s的流率注入对比剂).记录孤立肺结节增强前后各时相的CT值并计算强化值、灌注值,结节-主动脉强化值比.灌注值等于时间-密度曲线最大斜率除以主动脉强化值.其中30例VEGF表达阳性的肺腺癌患者用免疫组织化学测定微血管密度(MVD)并标定VEGF,评价肺腺癌血流模式定量CT参数(强化值、灌注值、结节-主动脉强化值比及平均通过时间)与MVD的相关性.结果恶性结节强化值(35.79±10.76) HU与活动性炎性结节(39.76±4.59) HU差异无显著意义 (t=1.148 , P=0.255).恶性结节的结节-主动脉强化值比(14.27±4.37)%及灌注值(3.02±0.96)ml-1·min-1·kg-1均低于活动性炎性结节(18.51±2.71)%,(6.34±4.39)ml-1·min-1·kg-1 (t=2.978,P=0.004;t=5.590,P<0.0001).VEGF表达阳性的肺腺癌强化值(33.06±13.57)HU、结节-动脉强化值比(14.25±4.92)%及灌注值(2.97 ±0.56) ml-1·kg-1·min-1与MVD(70.15±20.03)条/视野,均呈正相关性(r=0.781, P<0.0001;r=0.688, P<0.0001;r=0.716, P<0.0001).平均通过时间(14.86±5.84)s与MVD无显著相关性(r=0.260, P=0.200).结论恶性与活动性炎性孤立肺结节血流模式不同,恶性结节通过结节-大动脉强化值比和灌注值可有效区别于活动性炎性结节,有助于两者鉴别诊断.肺腺癌强化值、结节-动脉强化值比及灌注值反映了VEGF表达阳性的肺腺癌的MVD.强化值、结节-动脉强化及灌注值可作为VEGF相关的肺腺癌血管生成的指标.