Abnormal SEP reflects dysfunction of the medial lemniscus and posterior cervical cord. These structures are likely to be affected in Chiari malformation. Therefore, SEP abnormalities may provide valuable information i...Abnormal SEP reflects dysfunction of the medial lemniscus and posterior cervical cord. These structures are likely to be affected in Chiari malformation. Therefore, SEP abnormalities may provide valuable information in patients with CM. However, the consistency of SEP abnormality or normality with the damage is a matter of research. Knowing whether median nerve somatosensory evoked potential (SEP) is useful in revealing subclinical damage in patients with Chiari malformation is important in the treatment and follow-up plan of the disease. The aim of this study was to investigate the relationship between median nerve SEP values and the severity of cerebellar ectopia in patients with Chiari type 1 malformation. Median nerve SEP values were obtained from 30 healthy individuals and 146 individuals with Chiari malformation. The cerebellar ectopia degree and McRae line length were measured. SEP values were not significantly different between groups. The McRae line was found to be significantly shorter in the control group than in the Chiari malformation group (p = 0.031). There was no correlation between the degree of cerebellar ectopia and the length of the McRae line (r = 0.002, p = 0.979). Neither cerebellar ectopy degree nor McRae line length had a relationship with SEP values (r = -0.153, p = 0.066;r = -0.056, p = 0.500, respectively). There was no difference in cerebellar ectopy degree or SEP values between the groups with cerebellar ectopy with and without a syrinx (p = 0.899;p = 0.080, respectively). Likewise, McRae line length was not found to be related to the presence of a syrinx (p = 0.139). Median nerve SEP examination was not beneficial for diagnosing asymptomatic-oligosymptomatic Chiari malformation as a subclinical injury, whether accompanied by syringomyelia or not.展开更多
BACKGROUND: Studies have shown that latency changes of some elements in a somatosensory evoked potential (SEP) and motor evoked potential (MEP) can reflect electrical activity of cerebral cortical neurons and conducti...BACKGROUND: Studies have shown that latency changes of some elements in a somatosensory evoked potential (SEP) and motor evoked potential (MEP) can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE: To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS: Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS: A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups (n = 9), including three ischemia groups (12, 24 and 72 hours of ischemia) and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion (MCAO) in the left hemisphere. MAIN OUTCOME MEASURES: SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS: The latency of positive wave 1 (P1), negative wave 1 (N1) and positive wave 2 (P2) waves in SEP, and latency of negative wave 1, 2 (N1, N2) waves in MEP were significantly prolonged with increasing ischemic duration following MCAO (P < 0.01), but cerebral blood flow was significantly decreased (P < 0.05, or P < 0.01). CONLUSION: Ischemic stroke prolongs the latency of SEP waves (P1, N1, P2) and MEP waves (N1, N2), and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute ischemic stroke.展开更多
BACKGROUND: Somatosensory evoked potential (SEP) has become a method with higher sensitivity and specificity than electroencephalogram in detecting the brain function and the region, range and degree of ischemia. Howe...BACKGROUND: Somatosensory evoked potential (SEP) has become a method with higher sensitivity and specificity than electroencephalogram in detecting the brain function and the region, range and degree of ischemia. However, the effects of ligustrazine on SEP is still not clear. OBJECTIVE: To study the protective effects of ligustrazini injection on cerebral ischemiareperfusion injury. DESIGN: Auto-control study, random grouping. SETTING: Qilu Hospital of Shandong University. MATERIALS: The experiment was completed in the Cerebral Functional Room of Qilu Hospital Affiliated to Shandong University from March 2002 to June 2004. A totally of 24 healthy Harbin rabbits were randomly divided into blank control group (n=8), model control group (n=8) and ligustrazine treatment group (n=8). Hydrochloric ligustrazine injection, 40 mg/2 mL each ampoule, was provided by the Third Pharmaceutical Factory of Beijing (certification: 93035236273). The main component was hydrochloric ligustrazine and the chemical name was 2, 3, 5, 6-tetramethyl pyrazine hydrochloride. METHODS: ① Modeling method: The bilateral common carotid artery ligation was adopted to make the model. ② Index of cerebral functional lesion evaluated with SEP during ischemia-reperfusion: DISA 2000C neuromyoeletrometer provided by Dantec Electronics Ltd, Denmark was used to detect SEP. ③ Interventional process: Blank control group: The latencies and amplitudes of SEP were measured before injection with 1.5 mg/kg ligustrazine and at the points of 15 minutes, 20 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after injection. Ligustrazine treatment group: Rabbits were injected with 1.5 mg/kg ligustrazine, and those of model control group were injected the same volume of saline. Thirty minutes later, the bilateral common carotid artery of the rabbits all had been ligated for 30 minutes, and then reperfused for 120 minutes. The latencies and amplitudes of SEP were measured before injection, before ligation, at the points of 1 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes and 30 minutes after ligation, and at the points of 5 minutes, 10 minutes, 15 minutes, 20 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after reperfusion. ④ Evaluating criteria: Normal values of P-wave latencies and amplitudes were (19.34±3.18) ms and (4.55±1.43) μV. Average value before injection in blank control group and average values before injection, after injection and before ligation in ischemia-reperfusion group were regarded as control criteria to evaluate changes of Pwave latencies and amplitudes after experiment. MAIN OUTCOME MEASURES: P-wave latencies and amplitudes of SEP in the three groups. RESULTS: A total of 24 rabbits were involved in the final analysis without any loss. ① Blank control group: The P-wave latencies delayed markedly at each time point after injection. Compared with that before injection, there was a significant difference (P < 0.05-0.01). The P-wave amplitudes did not fluctuate noticeably all the time after injection, but significantly decreased when compared with those before injection (P < 0.05-0.01). ② Ischemia-reperfusion group: The P-wave latencies delayed and amplitudes decreased in the rabbits with cerebral ischemiareperfusion at all points of time during cerebral ischemia-reperfusion, and there was significant difference when compared with the levels before ischemia (P < 0.05). When ligustrazine was injected, the latencies and amplitudes changed less, and as compared with the levels before ischemia, the difference was not significant (P > 0.05). CONCLUSION: ① Ligustrazine can inhibit P-wave latencies and amplitudes of SEP of normal rabbits. ② Ligustrazine can improve P-wave latencies and amplitudes of SEP of rabbits with cerebral ischemia-reperfusion injury.展开更多
Somatosensory evoked potentials(SEPs)have been widely used to assess neurological function in clinical practice.A good understanding of the association between SEP signals and neurological function is helpful for prec...Somatosensory evoked potentials(SEPs)have been widely used to assess neurological function in clinical practice.A good understanding of the association between SEP signals and neurological function is helpful for precise diagnosis of impairment location.Previous studies on SEPs have been reported in animal models.However,few studies have reported the relationships between SEP waveforms in animals and those in humans.In this study,we collected normal SEP waveforms and decomposed them into specific time–frequency components(TFCs).Our results showed three stable TFC distribution regions in intact goats and rats and in humans.After we induced spinal cord injury in the animal models,a greater number of small TFC distribution regions were observed in the injured goat and rat groups than in the normal group.Moreover,there were significant correlations(P<0.05)and linear relationships between the main SEP TFCs of the human group and those of the goat and rat groups.A stable TFC distribution of SEP components was observed in the human,goat and rat groups,and the TFC distribution modes were similar between the three groups.Results in various animal models in this study could be translated to future clinical studies based on SEP TFC analysis.Human studies were approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster(approval No.UM 05-312 T/975)on December 5,2005.Rat experiments were approved by the Committee on the Use of Live Animals in Teaching and Research of Li Ka Shing Faculty of Medicine of the University of Hong Kong(approval No.CULART 2912-12)on January 28,2013.Goat experiments were approved by the Animal Ethics Committee of Affiliated Hospital of Guangdong Medical University(approval No.GDY2002132)on March 5,2018.展开更多
Introduction: Many women think about reduction mammaplasty for different reasons. The effect of surgery on the beast sensibility is one of the greatest concerns after reconstructive reductive breast surgery through it...Introduction: Many women think about reduction mammaplasty for different reasons. The effect of surgery on the beast sensibility is one of the greatest concerns after reconstructive reductive breast surgery through its affect on patient’s social life and psychological health. The dermatomal somatosensory evoked potential (D-SEP) is a new method to quantitatively evaluate breast sensibility. Patients and Methods: Twenty-five women enrolled in this study presenting with breast enlargement, underwent mammary reduction by using the inferior pyramidal breast reduction technique using the same operative technique described by Robbins with some modifications. All D-SEP amplitudes and latencies were calculated preoperatively and then were reassessed six and twelve months post-surgery in each breast. Result: The results revealed that there is a significant difference in the D-SEP latency pre- and post-operatively. The statistically significant decrease in latency and the breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. There is also a significant increase in the D-SEP amplitude pre- and post-operatively. The negative and statistically significant increase in amplitude with the decrease in breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. Conclusion: This study concluded that breast sensibility will improve after breast reduction as indicated by significant reduction of D-SEP latencies and increase of its amplitudes. Our results confirm an inverse relationship between breast size and sensibility, with improvement in sensibility after breast reduction.展开更多
The spinal cord is at risk of injury during spinal surgery.If intraoperative spinal co rd injury is identified early,irreve rsible impairment or loss of neurological function can be prevented.Different types of spinal...The spinal cord is at risk of injury during spinal surgery.If intraoperative spinal co rd injury is identified early,irreve rsible impairment or loss of neurological function can be prevented.Different types of spinal cord injury result in damage to diffe rent spinal cord regions,which may cause diffe rent somatosensory and motor evoked potential signal res ponses.In this study,we examined electrophysiological and histopathological changes between contusion,distra ction,and dislocation spinal cord injuries in a rat model.We found that contusion led to the most severe dorsal white matter injury and caused considerable attenuation of both somatosensory and motor evoked potentials.Dislocation resulted in loss of myelinated axons in the lateral region of the injured spinal cord along the rostrocaudal axis.The amplitude of attenuation in motor evoked potential responses caused by dislocation was greater than that caused by contusion.After distraction injury,extracellular spaces were slightly but not significantly enlarged;somatosensory evoked potential res ponses slightly decreased and motor evoked potential responses were lost.Correlation analysis showed that histological and electrophysiological findings we re significantly correlated and related to injury type.Intraope rative monitoring of both somatosensory and motor evoked potentials has the potential to identify iatrogenic spinal cord injury type during surgery.展开更多
BACKGROUND Acute spinal subdural haematoma(ASSH)is a rare and potentially devastating condition with a variable prognosis.Previously described subdural haematomas were thought to have occurred spontaneously or be rela...BACKGROUND Acute spinal subdural haematoma(ASSH)is a rare and potentially devastating condition with a variable prognosis.Previously described subdural haematomas were thought to have occurred spontaneously or be related to major or minor iatrogenic or traumatic injuries caused by surgery,spinal puncture or epidural anaesthesia.Other contributing pathologies have been described,such as intradural tumours or spinal arteriovenous malformations.ASSH has also been associated with anticoagulation therapy,haemostatic abnormalities and risk factors such as pregnancy.To the best of our knowledge,this case study described the first reported occurrence of an ASSH during spinal surgery in a paediatric patient.The patient was not known to have any coagulopathies,and no obvious vascular lesions were documented.The surgical procedure did not directly involve the dura mater,and no evident intraoperative dural tears were found.CASE SUMMARY We reported and discussed a case of ASSH complicating a posterior spinal instrumented fusion during surgery for paediatric congenital scoliosis.This condition has not been previously described.We made recommendations for facing such an occurrence,explored its aetiology in the context of malformation and discussed the benefits of neuromonitoring during scoliosis correction and the management protocol.We conducted a PubMed literature review for cases of paediatric ASSH and other closely related disorders.We reviewed recommendations regarding neuromonitoring and treatment management in such cases.CONCLUSION ASSH is a rare complication of posterior spinal instrumented fusion.Published cases are more often associated with anticoagulation therapy or coagulopathy.Neuromonitoring is strongly recommended to detect and assess neurological status,thus enabling rapid diagnosis and treatment and facilitating early spinal decompression and a return to a normal neurological status.展开更多
Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic res...Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.展开更多
文摘Abnormal SEP reflects dysfunction of the medial lemniscus and posterior cervical cord. These structures are likely to be affected in Chiari malformation. Therefore, SEP abnormalities may provide valuable information in patients with CM. However, the consistency of SEP abnormality or normality with the damage is a matter of research. Knowing whether median nerve somatosensory evoked potential (SEP) is useful in revealing subclinical damage in patients with Chiari malformation is important in the treatment and follow-up plan of the disease. The aim of this study was to investigate the relationship between median nerve SEP values and the severity of cerebellar ectopia in patients with Chiari type 1 malformation. Median nerve SEP values were obtained from 30 healthy individuals and 146 individuals with Chiari malformation. The cerebellar ectopia degree and McRae line length were measured. SEP values were not significantly different between groups. The McRae line was found to be significantly shorter in the control group than in the Chiari malformation group (p = 0.031). There was no correlation between the degree of cerebellar ectopia and the length of the McRae line (r = 0.002, p = 0.979). Neither cerebellar ectopy degree nor McRae line length had a relationship with SEP values (r = -0.153, p = 0.066;r = -0.056, p = 0.500, respectively). There was no difference in cerebellar ectopy degree or SEP values between the groups with cerebellar ectopy with and without a syrinx (p = 0.899;p = 0.080, respectively). Likewise, McRae line length was not found to be related to the presence of a syrinx (p = 0.139). Median nerve SEP examination was not beneficial for diagnosing asymptomatic-oligosymptomatic Chiari malformation as a subclinical injury, whether accompanied by syringomyelia or not.
基金the National Natural Science Foundation of China, No. 30300075China Postdoctoral Science Foundation, No. 20080440995Sichuan Science Fund for Out-standing Youths, No. 05ZQ026-020
文摘BACKGROUND: Studies have shown that latency changes of some elements in a somatosensory evoked potential (SEP) and motor evoked potential (MEP) can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE: To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS: Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS: A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups (n = 9), including three ischemia groups (12, 24 and 72 hours of ischemia) and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion (MCAO) in the left hemisphere. MAIN OUTCOME MEASURES: SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS: The latency of positive wave 1 (P1), negative wave 1 (N1) and positive wave 2 (P2) waves in SEP, and latency of negative wave 1, 2 (N1, N2) waves in MEP were significantly prolonged with increasing ischemic duration following MCAO (P < 0.01), but cerebral blood flow was significantly decreased (P < 0.05, or P < 0.01). CONLUSION: Ischemic stroke prolongs the latency of SEP waves (P1, N1, P2) and MEP waves (N1, N2), and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute ischemic stroke.
基金Technological Developing Plan of Science and Technology Bureau of Shandong Province, No. 032050116
文摘BACKGROUND: Somatosensory evoked potential (SEP) has become a method with higher sensitivity and specificity than electroencephalogram in detecting the brain function and the region, range and degree of ischemia. However, the effects of ligustrazine on SEP is still not clear. OBJECTIVE: To study the protective effects of ligustrazini injection on cerebral ischemiareperfusion injury. DESIGN: Auto-control study, random grouping. SETTING: Qilu Hospital of Shandong University. MATERIALS: The experiment was completed in the Cerebral Functional Room of Qilu Hospital Affiliated to Shandong University from March 2002 to June 2004. A totally of 24 healthy Harbin rabbits were randomly divided into blank control group (n=8), model control group (n=8) and ligustrazine treatment group (n=8). Hydrochloric ligustrazine injection, 40 mg/2 mL each ampoule, was provided by the Third Pharmaceutical Factory of Beijing (certification: 93035236273). The main component was hydrochloric ligustrazine and the chemical name was 2, 3, 5, 6-tetramethyl pyrazine hydrochloride. METHODS: ① Modeling method: The bilateral common carotid artery ligation was adopted to make the model. ② Index of cerebral functional lesion evaluated with SEP during ischemia-reperfusion: DISA 2000C neuromyoeletrometer provided by Dantec Electronics Ltd, Denmark was used to detect SEP. ③ Interventional process: Blank control group: The latencies and amplitudes of SEP were measured before injection with 1.5 mg/kg ligustrazine and at the points of 15 minutes, 20 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after injection. Ligustrazine treatment group: Rabbits were injected with 1.5 mg/kg ligustrazine, and those of model control group were injected the same volume of saline. Thirty minutes later, the bilateral common carotid artery of the rabbits all had been ligated for 30 minutes, and then reperfused for 120 minutes. The latencies and amplitudes of SEP were measured before injection, before ligation, at the points of 1 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes and 30 minutes after ligation, and at the points of 5 minutes, 10 minutes, 15 minutes, 20 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after reperfusion. ④ Evaluating criteria: Normal values of P-wave latencies and amplitudes were (19.34±3.18) ms and (4.55±1.43) μV. Average value before injection in blank control group and average values before injection, after injection and before ligation in ischemia-reperfusion group were regarded as control criteria to evaluate changes of Pwave latencies and amplitudes after experiment. MAIN OUTCOME MEASURES: P-wave latencies and amplitudes of SEP in the three groups. RESULTS: A total of 24 rabbits were involved in the final analysis without any loss. ① Blank control group: The P-wave latencies delayed markedly at each time point after injection. Compared with that before injection, there was a significant difference (P < 0.05-0.01). The P-wave amplitudes did not fluctuate noticeably all the time after injection, but significantly decreased when compared with those before injection (P < 0.05-0.01). ② Ischemia-reperfusion group: The P-wave latencies delayed and amplitudes decreased in the rabbits with cerebral ischemiareperfusion at all points of time during cerebral ischemia-reperfusion, and there was significant difference when compared with the levels before ischemia (P < 0.05). When ligustrazine was injected, the latencies and amplitudes changed less, and as compared with the levels before ischemia, the difference was not significant (P > 0.05). CONCLUSION: ① Ligustrazine can inhibit P-wave latencies and amplitudes of SEP of normal rabbits. ② Ligustrazine can improve P-wave latencies and amplitudes of SEP of rabbits with cerebral ischemia-reperfusion injury.
基金supported by the National Natural Science Foundation of China,No.81871768(to YH)the Natural Science Foundation of Tianjin of China,No.18JCYBJC29600(to HYC)High Level-Hospital Program,Health Commission of Guangdong Province of China,No.HKUSZH201902011(to YH).
文摘Somatosensory evoked potentials(SEPs)have been widely used to assess neurological function in clinical practice.A good understanding of the association between SEP signals and neurological function is helpful for precise diagnosis of impairment location.Previous studies on SEPs have been reported in animal models.However,few studies have reported the relationships between SEP waveforms in animals and those in humans.In this study,we collected normal SEP waveforms and decomposed them into specific time–frequency components(TFCs).Our results showed three stable TFC distribution regions in intact goats and rats and in humans.After we induced spinal cord injury in the animal models,a greater number of small TFC distribution regions were observed in the injured goat and rat groups than in the normal group.Moreover,there were significant correlations(P<0.05)and linear relationships between the main SEP TFCs of the human group and those of the goat and rat groups.A stable TFC distribution of SEP components was observed in the human,goat and rat groups,and the TFC distribution modes were similar between the three groups.Results in various animal models in this study could be translated to future clinical studies based on SEP TFC analysis.Human studies were approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster(approval No.UM 05-312 T/975)on December 5,2005.Rat experiments were approved by the Committee on the Use of Live Animals in Teaching and Research of Li Ka Shing Faculty of Medicine of the University of Hong Kong(approval No.CULART 2912-12)on January 28,2013.Goat experiments were approved by the Animal Ethics Committee of Affiliated Hospital of Guangdong Medical University(approval No.GDY2002132)on March 5,2018.
文摘Introduction: Many women think about reduction mammaplasty for different reasons. The effect of surgery on the beast sensibility is one of the greatest concerns after reconstructive reductive breast surgery through its affect on patient’s social life and psychological health. The dermatomal somatosensory evoked potential (D-SEP) is a new method to quantitatively evaluate breast sensibility. Patients and Methods: Twenty-five women enrolled in this study presenting with breast enlargement, underwent mammary reduction by using the inferior pyramidal breast reduction technique using the same operative technique described by Robbins with some modifications. All D-SEP amplitudes and latencies were calculated preoperatively and then were reassessed six and twelve months post-surgery in each breast. Result: The results revealed that there is a significant difference in the D-SEP latency pre- and post-operatively. The statistically significant decrease in latency and the breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. There is also a significant increase in the D-SEP amplitude pre- and post-operatively. The negative and statistically significant increase in amplitude with the decrease in breast size demonstrated indicates that the sensibility improved after breast reduction surgery both at six and twelve months. Conclusion: This study concluded that breast sensibility will improve after breast reduction as indicated by significant reduction of D-SEP latencies and increase of its amplitudes. Our results confirm an inverse relationship between breast size and sensibility, with improvement in sensibility after breast reduction.
基金supported by the National Natural Science Foundation of China,No.81871768(to YH)Natural Science Foundation of Tianjin,China,No.18JCYBJC29600(to HYC)High Level-Hospital Program,Health Commission of Guangdong Province,China,No.HKUSZH201902011(to YH)。
文摘The spinal cord is at risk of injury during spinal surgery.If intraoperative spinal co rd injury is identified early,irreve rsible impairment or loss of neurological function can be prevented.Different types of spinal cord injury result in damage to diffe rent spinal cord regions,which may cause diffe rent somatosensory and motor evoked potential signal res ponses.In this study,we examined electrophysiological and histopathological changes between contusion,distra ction,and dislocation spinal cord injuries in a rat model.We found that contusion led to the most severe dorsal white matter injury and caused considerable attenuation of both somatosensory and motor evoked potentials.Dislocation resulted in loss of myelinated axons in the lateral region of the injured spinal cord along the rostrocaudal axis.The amplitude of attenuation in motor evoked potential responses caused by dislocation was greater than that caused by contusion.After distraction injury,extracellular spaces were slightly but not significantly enlarged;somatosensory evoked potential res ponses slightly decreased and motor evoked potential responses were lost.Correlation analysis showed that histological and electrophysiological findings we re significantly correlated and related to injury type.Intraope rative monitoring of both somatosensory and motor evoked potentials has the potential to identify iatrogenic spinal cord injury type during surgery.
文摘BACKGROUND Acute spinal subdural haematoma(ASSH)is a rare and potentially devastating condition with a variable prognosis.Previously described subdural haematomas were thought to have occurred spontaneously or be related to major or minor iatrogenic or traumatic injuries caused by surgery,spinal puncture or epidural anaesthesia.Other contributing pathologies have been described,such as intradural tumours or spinal arteriovenous malformations.ASSH has also been associated with anticoagulation therapy,haemostatic abnormalities and risk factors such as pregnancy.To the best of our knowledge,this case study described the first reported occurrence of an ASSH during spinal surgery in a paediatric patient.The patient was not known to have any coagulopathies,and no obvious vascular lesions were documented.The surgical procedure did not directly involve the dura mater,and no evident intraoperative dural tears were found.CASE SUMMARY We reported and discussed a case of ASSH complicating a posterior spinal instrumented fusion during surgery for paediatric congenital scoliosis.This condition has not been previously described.We made recommendations for facing such an occurrence,explored its aetiology in the context of malformation and discussed the benefits of neuromonitoring during scoliosis correction and the management protocol.We conducted a PubMed literature review for cases of paediatric ASSH and other closely related disorders.We reviewed recommendations regarding neuromonitoring and treatment management in such cases.CONCLUSION ASSH is a rare complication of posterior spinal instrumented fusion.Published cases are more often associated with anticoagulation therapy or coagulopathy.Neuromonitoring is strongly recommended to detect and assess neurological status,thus enabling rapid diagnosis and treatment and facilitating early spinal decompression and a return to a normal neurological status.
基金This study was supported in part by grants from Zhejiang province medical and health technology achievement Funding project(2018ZH044)Zhejiang province medical and health science and technology project.(2020KY317)+1 种基金Zhejiang province natural science foundation(LQ19H170001)2019-2021 period key discipline construction plan funded project of traditional Chinese medicine in Jiaxing city(2019 XK-A07).
文摘Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.
