Rotatorenmanschettenrupturen

Ohne Zusammenfassung      

Effects of unilateral electrical stimulation of various thalamic nuclei on the release of dopamine from dendrites and nerve terminals of neurons of the two nigrostriatal dopaminergic pathways

The role of several motor and intralaminar thalamic nuclei in the regulation of dopamine release from terminals and dendrites of the nigrostriatal dopaminergic neurons was investigated in halothane-anaesthetized cats. For this purpose, the effects of the unilateral electrical stimulation of various thalamic nuclei on the release of newly synthesized [3H]dopamine were simultaneously determined in both substantiae nigrae and caudate nuclei using the push-pull cannula method. The electrical stimulation of the motor nuclei was the only one to induce asymmetric changes in the four structures since [3H]dopamine release was enhanced in the ipsilateral caudate nucleus and reduced in the contralateral structure while opposite responses were observed in the corresponding substantiae nigrae. A reduction of [3H]dopamine release occurred in the four structures or only in the contralateral substantia nigra and caudate nucleus following the stimulation of the parafascicularis nucleus and the adjacent posterior part of the nucleus centrum medianum or of the nucleus centralis lateralis and the adjacent paralaminar part of the nucleus medialis dorsalis, respectively. The stimulation of the anterior part of the nucleus centrum medianum, which in contrast to other thalamic nuclei examined, receives few nigral inputs, selectively enhanced [3H]dopamine release in the contralateral substantia nigra. No significant changes in [3H]dopamine release were seen either in the substantiae nigrae or in the caudate nuclei following the stimulation of midline thalamic nuclei. These results indicate that the motor and intralaminar thalamic nuclei exert multiple and selective influences on the release of dopamine from terminals and/or dendrites of the dopaminergic neurons. They also further support a role of thalamic nuclei in the transfer of information from one substantia nigra to the contralateral dopaminergic neurons. The possible involvement of connections between paired thalamic nuclei was underlined by the observations of evoked potentials in contralateral homologous nuclei following unilateral stimulation of motor, or some intralaminar, nuclei. The present report provides new insights on the mechanisms contributing to the reciprocal and/or bilateral regulations of nigrostriatal dopaminergic pathways.     

Effects of nigral application of muscimol on release of [3H]γ-aminobutyrate and on multi-unit activity in various cat thalamic nuclei

The release of [³H]γ-aminobutyrate (GABA) neosynthesized from [³H]glutamine was estimated in one substantia nigra and in the ipsilateral thalamus of halothane-anesthetized cats by perfusing a [³H]glutamine-enriched physiological medium through a push-pull cannula implanted in the two structures under investigation. After two hours of superfusion, muscimol (10^?6 M) was delivered through the nigral push-pull cannula for 50–60 min and local- and distal-evoked changes of [³H]GABA release were analyzed. In some experiments, changes of global neuronal activity induced by muscimol application were recorded in different thalamic nuclei, using a bipolar electrode. In a few of the above experiments, biochemical and electrophysiological determinations were simultaneously performed in the substantia nigra and the thalamus. The nigral application of muscimol (10^?6 M) induced locally an activation of the substantia nigra reticulata cells, as well as an increase in release of [³H]GABA.Distally, in the thalamus, two types of biochemical and electrophysiological responses were observed according to the localization of the tip of the push-pull cannula or the electrode. (1) An increased release of [³H]GABA and a depression of the global multi-unit cellular activity were obtained in the ventralis medialis-ventralis lateralis, the centralis lateralis and the paracentralis nuclei. These effects could reflect an activation of the GABAergic nigrothalamic neurons projecting to these different thalamic nuclei. (2) In contrast, in the medialis dorsalis paralamellar zone adjacent to the intralaminar nuclei of the thalamus, a decrease of [³H]GABA release and an activation of the multi-unit activity were obtained. These latter results may suggest either a polysynaptic response or the non-GABAergic nature of the nigrothalamic neurons afferent to the medialis dorsalis paralamellar zone.     

显微手术切除中央沟附近大脑实质内病变

探讨在超声引导下经皮胸腔细针吸取活检对肺外周型肿块、肺的弥漫性病变和纵隔肿块细胞学、病理学诊断的临床应用价值。方法：选择６８例影像学检查提示肺外周型肿块、肺弥漫性病变或纵隔肿块,而痰细胞学和支气管镜检查阴性的病例。应用 ＡＬＯＫＡ－ＳＳＤ ６５０实时灰阶超声仪。采用日本１８Ｇ与 ２１Ｇ细针活检。 ６８例全部做细胞涂片,４０例除做涂片外同时吸取组织块做石蜡切片。计算敏感性,特异性,准确性。结果：经细胞学、组织学两种方法诊断恶性肿瘤４３例,仅细胞学诊断为恶性肿瘤４０例,良性病变２８例,其中３例假阴性。细胞学检查敏感度为９３％,特异性１００％。细胞学总准确率为９５．６％。被检查者无气胸或出血等合并症。结论：该方法简便、迅速、安全且准确。尤其对细支气管肺泡癌的诊断更有帮助。     

非手术治疗并发血管神经损伤的肱骨髁上骨折

７例并发血管、神经损伤的肱骨髁上骨折，其中桡动脉搏动消失２例；桡动脉搏动减弱，甲床再充血时间延长，血循环不良１例；桡神经损伤３例；正中神经损伤１例。均经尺骨鹰嘴牵引非手术治疗达到良好复位，血管、神经伤恢复，无一例因血管、神经伤而引起其它并发症。     

Cell death in the developing retinal ganglion cell layer of the wallaby Setonix brachyurus

The distribution and number of dying cells in the developing retinal ganglion cell layer of the wallaby Setonix brachyurus were assessed by using cresyl violet stained tissue. The density of dying cells has been expressed per 100 live cells for the entire retinal surface, data being presented as a grid of 500 micron squares. For statistical analysis, retinae were divided into 8 regions; dorsal, ventral, nasal, and temporal quadrants, each further divided into center and periphery. This method allowed comparison of the extent of cell death at different retinal locations as the high density area centralis of live cells developed temporal to the optic disk from 60 days onward. Between 30 and 70 days, dying cells were seen across the entire retina; beyond 100 days very few were seen. Initially, there was a significantly higher incidence of dying cells in the central retina compared to the periphery, whereas from 50 days this situation was reversed. Analysis of the central retina before and during area centralis formation consistently indicated a significantly lower number of dying cells per 100 live cells in temporal compared to other retinal quadrants. This differential pattern suggests that cell death lowers live cell densities less in the emerging area centralis than elsewhere, and therefore must play a part in establishing live cell density gradients. However, we cannot exclude the possibility that other factors are also instrumental. Indeed, factors such as areal growth (Beazley et al., in press) presumably operate at later stages since live cell density gradients continue to be accentuated even after cell death is complete. Numbers of dying cells peaked by 50 days, reaching approximately 1% of the live cell population. At this stage, counts were also maximal for live cells with values up to 30% above the adult range.     

Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA

Geniculate neuralgia is a rare cause of craniofacial pains. The anterior inferior cerebellar artery is the offending vessel which compress nervus intermedius in the patients with typical geniculate neuralgia. We report a patient whose pain was atypical for either geniculate neuralgia and trigeminal neuralgia. At operation the anterior inferior cerebellar artery was coursing with the nerves and was separated. After the decompression the pain resolved immediately.     

Erstes kontinuierliches Nerven-Monitoring in der Schilddrüsenchirurgie

Zusammenfassung. Ein neuartiges „all in one“ Monitoringsystem für den N. laryngeus recurrens (NLR) erlaubt sowohl eine kontinuierliche, atraumatische überwachung des NLR als auch eine in situ Detektion des Nerven. Patienten und Methode: Das System basiert auf einem Doppelballontubus mit integrierten Oberfl?chenelektroden zur transtrachealen Stimulation und Ableitung des Erfolgsorgans. Fakultativ kann über eine elektrische Stimulationsnadel der NLR im OP-Feld identifiziert werden. Die Signalverarbeitungs-Software stellt eine Neuentwicklung unserer Arbeitsgruppe dar und führt eine Echtzeit-Signalanalyse mit akustischer Rückkoppelung durch. 55 Patienten wurden in die klinische Zulassungsstudie eingebracht, 35 Prim?reingriffe, 20 Sekund?reingriffe, davon 10 Halsausr?umungen. Ergebnisse: Die Plazierung des EMG-Tubus ist mit der Routineintubation abgeschlossen und erfordert keinen zus?tzlichen Zeitbedarf. Das System ist au?erhalb des OP Feldes lokalisiert und beeintr?chtigt daher nicht den OP Ablauf. Die akustische Rückkoppelung wurde von allen 8 Operateuren als hilfreich und nicht st?rend beurteilt. Die phoniatrische und HNO-?rztliche Analyse erbrachte keine permanenten Beeintr?chtigungen. Schlu?folgerung: Das neue kontinuierliche Monitoringsystem erm?glicht erstmals eine atraumatische nebenwirkungsfreie Dauerüberwachung des NLR. Es ist einfach anzuwenden, arbeitet au?erhalb des OP-Gebiets und ist so sensitiv, da? auch reversible Irritationen erkannt werden k?nnen.      

Familial occipital and nervus intermedius neuralgia in a Swiss family

Familial trigeminal neuralgia has been reported in 1–2% of cases consistent with an autosomal dominant inheritance. We present a Swiss family with several members suffering from occipital and nervus intermedius neuralgia alone or in combination. We suggest that peripheral sensory anastomoses or central convergence of afferent pathways could explain neuralgia affecting two cranial nerves. The pedigree has two main characteristics: (1) affected individuals in two generations and (2) in the first generation the father is affected, in the second generation all women are affected, and none of the men. This is suggestive of an X-linked dominant or an autosomal dominant mode of inheritance.