Inter-ictal assay of peripheral circulating inflammatory mediators in migraine patients under adjunctive cervical non-invasive vagus nerve stimulation (nVNS): A proof-of-concept study

Objective

To assay peripheral inter-ictal cytokine serum levels and possible relations with non-invasive vagus nerve stimulation (nVNS) responsiveness in migraineurs.

早期肝癌中端粒酶活化与细胞增殖相关性研究

目的：研究早期肝癌中端粒酶基因蛋白(hTRT)与细胞增殖核抗原（PCNA）表达及其相关性。方法：在20例早期肝癌中用原位杂交检测hTRT基因,免疫组化方法检测PCNA的表达。结果：hTRT阳性信号检出率80．0％,PCNA强阳性率为55．0％;癌中hTRT阳性信号、PCNA表达强度显著高于癌旁非癌组织（P＜0．05）;癌不则分化组中PCNA表达有显著差异（P＜0．05）;癌中hTRT阳性信号分布有模型和浆型两种形式,其分布形式、 信号强度均与PCNA阳性强度密切相关（P＜0．01）。结论;肝癌发生与细胞增殖密切相关。端粒酶活化是肝癌发生的早期事件,是肝细胞增生和恶性转化所必需,其检出结果对鉴别肿瘤恶变有重要意义。     

小鼠脑损伤后GFAP表达与损伤时间的关系

目的探讨小鼠脑损伤后胶质纤维酸性蛋白（GFAP）在损伤灶周围的大脑皮质及白质的表达和损伤时间的关系。方法将健康KM小鼠48只，按施加的处理不同随机分为4组，分别为正常对照组、手术对照组、死后对照组、损伤组。运用免疫组化的技术方法进行研究以及运用图像分析技术测量GFAP阳性反应的灰度。结果（1）手术对照组及正常对照组、死亡对照组小鼠脑组织内均有低水平GFAP表达，它们之间的差异无统计学意义。（2）机械性脑损伤灶在一定时间后GFAP表达增加，其分布特征与对照组相似。主要分布在损伤灶周围的皮质、白质。（3）GFAP在损伤灶周围皮质、白质的表达曲线非常相似，但在白质的反应更加明显。（4）机械性脑损伤后24h表达显著增加，168h后达高峰，其后数天维持在较高水平。结论脑外伤诱导GFAP在损伤灶表达增加，证明它们参与脑损伤修复。在特定损伤部位它们仅主要在星形胶质细胞中表达，从一个侧面反映星形胶质细胞的分裂增殖活动。同时它们之间也可能与脑损伤后神经元活动的存活及维持其功能活动有关。其表达改变的时序可望作为一个客观指标用于法医学脑损伤所经过时间的推断。     

Three-year prevalence and incidence of diabetes among American Indian youth in Montana and Wyoming, 1999 to 2001

OBJECTIVES: To estimate the prevalence and incidence of type 2 diabetes among American Indian youth. STUDY DESIGN: Medical records were reviewed annually for all patients with diabetes who were <20 years of age at 6 Indian Health Service facilities in Montana and Wyoming. All cases < or =5 years of age or weight per age < or =10th percentile at diagnosis or with islet cell antibodies were considered as probable type 1. Among the remaining cases, probable type 2 diabetes was defined when a child had one or more of the following characteristics: weight per age > or =95th percentile or acanthosis nigricans at diagnosis, elevated C-peptide or insulin, family history of type 2 diabetes; treatment with oral agents with or without insulin or no hypoglycemic therapy after 1 year of follow-up. RESULTS: From 1999 to 2001, 53% of prevalent cases and 70% of incident cases were categorized as probable type 2 diabetes. The average annual prevalence of probable type 1 and type 2 diabetes was 0.7 and 1.3 per 1000. The average annual incidence rates for probable type 1, and type 2 diabetes were 5.8, 23.3 per 100,000. CONCLUSIONS: The incidence of probable type 2 diabetes was approximately 4 times higher than type 1 diabetes among American Indian youth in Montana and Wyoming     

SUNCT Syndrome: Short-Lasting Unilateral Neuralgiform Headache with Conjunctival Injection and Tearing

The SUNCT syndrome refers to Short-lasting Unilateral Neuralgiform headache with Conjunctival injection and Tearing. It is characterized by brief attacks of severe unilateral pain in the orbitotemporal region, associated with ipsilateral cranial autonomic disturbances. All SUNCT patients experience ipsilateral conjunctival injection and lacrimation. Mean age of onset is 50 years with a male predominance. The syndrome is often misdiagnosed as trigeminal neuralgia or cluster headache. Primary and secondary forms exist, the secondary form is most commonly associated with lesions of the posterior fossa or pituitary adenoma. The SUNCT syndrome is refractory to most commonly employed therapies. Lamotrigine has recently been reported as an effective first line therapy.     

Impact of the International Headache Society criteria on the use of neuroimaging for headache diagnosis in a headache clinic

OBJECTIVE: To evaluate the impact of the introduction of the International Headache Society (IHS) criteria on the use of neuroimaging for headache diagnosis in a specialist outpatient center. BACKGROUND: The general indications for neuroimaging in headache are a matter of debate. International Headache Society criteria should improve diagnostic accuracy, consequently reducing the use of expensive diagnostic procedures such as brain CT or MRI scan. METHODS: We reviewed the medical records of all 2739 new patients seen in our center from 1984 to 1996, analyzing the records of those patients who underwent neuroimaging before or after the introduction of the IHS criteria in 1988. RESULTS: There were no differences in the number of CT scans ordered in the period before (6.04%) or after (6.06%) the introduction of the IHS criteria. Only 12 scans revealed significant abnormalities, probably unrelated to headache. CONCLUSIONS: These results suggest that the yield of CT scanning patients seen in a headache clinic is very low, even when alarm signs are present notwithstanding strict adherence to dignostic criteria. An improved definition of secondary forms of headache might help to reduce this adjunctive cost to the care of patients with headache in a headache clinic.     

Possible Identification of Cervicogenic Headache Among Patients With Migraine: An Analysis of 374 Headaches

According to Sjaastad, the pain in cervicogenic headache, a form not recognized by the IHS, is long lasting and always side-locked unilateral. The frequency of side-locked unilateral pain (defined here as no change in side from onset) and other characteristics of cervicogenic headache were investigated in 300 outpatients using information collected on standard forms in structured interviews. Three hundred seventy-four headaches diagnosed according to IHS criteria were identified. Three hundred forty-eight of these headaches were long-lasting (duration of more than 4 hours); migraine (65%) followed by tension-type headache (25%) were the commonest forms. Side-locked unilaterality was present in 29% (101 of 348), and occurred most frequently in migrainous disorders not fulfilling the criteria (25 of 56, 44.6%). This group differed significantly from the other migraine conditions for longer pain duration ( P <0.02) and less frequent nausea, vomiting, photophobia, phonophobia ( P <0.0001), and aggravation by physical activity ( P <0.02). With these characteristics, this group resembled cervicogenic headache. However, in none of these patients was pain triggered by head or neck movements, and the frequency of head or neck trauma did not differ from other headaches. A more precise definition of clinical criteria for cervicogenic headache vs migraine is, therefore, required.     

Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache

To estimate the prevalence of tension-type headache, migraine and other headaches, 1850 schoolchildren, age 7-15 years, from the city of Uppsala, were invited to complete a questionnaire. The response rate was 74.1%. To validate the information from the questionnaires, 131 children and their parents were interviewed. Using the criteria of the International Headache Society, the 1-year prevalence of tension-type headache and migraine was 9.8 and 11.0%, respectively. However, these prevalence rates increased considerably, to 23.0 and 17.0%, respectively, when excluding the criteria defining the number of earlier episodes and duration of headache. The prevalence of headache increased with age, similarly in girls and boys up to 11 years, and thereafter only in girls. The preponderance in teenage girls was even more pronounced for tension-type headache than for migraine. Our results indicate an increase over time in headache prevalence when compared with findings in a study conducted in the same city in 1955.