<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Bilateral frontal lobes cerebral contusion and laceration is one unique...<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Bilateral frontal lobes cerebral contusion and laceration is one unique brain injury in neurosurgery department. It is characteristic of recessive attacking and develops quickly. The unilateral cerebral falx incision is a new minimally invasive surgery </span><span style="font-family:Verdana;">that </span><span style="font-family:""><span style="font-family:Verdana;">can solve bilateral frontal lobes cerebral contusion and laceration in one surgery. However, it has some limitations in removal of contralateral frontal hematoma and hemostasis due to the limited field of view under the microscope. The unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy can acquire a good illumination and field of view. This is beneficial to complete removal of contralateral hematoma, effective hemostasis and retaining brain tissue functions to the maximum extent. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> The patient, a 55-year-old man, was hospitalized for “consciousness disorder by 12 h because of car accident”. </span><b><span style="font-family:Verdana;">Physical Examination: </span></b><span style="font-family:Verdana;">Coma, GCS score of E1V2M5, bilateral pupil diameter of 2 mm, presence of light response, contusion of scalp at the left top, peripheral dysphoria and bilateral Bartter syndrome negative. The patient has a history of non-traumatic cerebral stroke 3 years ago.</span><b><span style="font-family:Verdana;"> Head CT: </span></b><span style="font-family:Verdana;">Longitudinal fracture of frontal parietal occipital bone, bilateral frontal lobes contusion and laceration, subarachnoid hemorrhage. </span><b><span style="font-family:Verdana;">Diagnosis:</span></b><span style="font-family:Verdana;"> Bilateral frontal lobes contusion and laceration, longitudinal fracture of frontal parietal occipital bone, subarachnoid hemorrhage and hematoma of scalp. In emergency treatment, unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy was performed. The surgery has achieved satisfying effect. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">This case realized the goal of removing contralateral frontal hematoma through unilateral craniotomy under a neuroendoscopy. Due to the clear field of view, it retained extracerebral layer structures of contralateral olfactory nerve protection frontotemporal completely. Moreover, this surgical technique is conducive to intraoperative recognition of pericallosal</span><span style="background:yellow;"> </span><span style="font-family:Verdana;">arteries and lateral fractured blood vessels. It also involves protection, which conforms to the minimally invasive philosophy. The proposed surgical technology can eliminate contralateral frontal hematoma under a good field of view. However, it is suggested not to manage with the further operation on patients who have brain swelling and difficulties in exposure of cerebral falx. These patients need to determine causes of brain swelling and choose bilateral craniectomy if necessary. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">Unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy is a new application of minimally invasive philosophy in craniocerebral injury operation. It still needs further clinical verifications and experience accumulation.展开更多
AIM: To study glutamine synthetase (GS) activity and glutamate uptake in the hippocampus and frontal cortex (FC) from rats with prehepatic portal vein hypertension. METHODS: Male Wistar rats were divided into shamoper...AIM: To study glutamine synthetase (GS) activity and glutamate uptake in the hippocampus and frontal cortex (FC) from rats with prehepatic portal vein hypertension. METHODS: Male Wistar rats were divided into shamoperated group and a portal hypertension (PH) group with a regulated stricture of the portal vein. Animals were sacrificed by decapitation 14 d after portal vein stricture. GS activity was determined in the hippocampus and FC. Specific uptake of radiolabeled L-glutamate was studied using synaptosome-enriched fractions that were freshly prepared from both brain areas. RESULTS: We observed that the activity of GS increased in the hippocampus of PH rats, as compared to control animals, and decreased in the FC. A significant decrease in glutamate uptake was found in both brain areas, and was more marked in the hippocampus. The decrease in glutamate uptake might have been caused by a deficient transport function, signif icantly and persistent increase in this excitatory neurotransmitter activity. CONCLUSION: The presence of moderate ammonia blood levels may add to the toxicity of excitotoxic glutamate in the brain, which causes alterations in brain function. Portal vein stricture that causes portal hypertension modif ies the normal function in some brain regions.展开更多
BACKGROUND:cAMP-response element binding protein(CREB) is a key modulator of various signaling pathways.CREB activation initiates a series of intracellular signaling pathways that promote neuronal survival. OBJECTIVE:...BACKGROUND:cAMP-response element binding protein(CREB) is a key modulator of various signaling pathways.CREB activation initiates a series of intracellular signaling pathways that promote neuronal survival. OBJECTIVE:To investigate the regulatory effects of basic fibroblast growth factor(bFGF) on cerebral neuronal CREB expression following ischemia/reperfusion injury. DESIGN,TIME AND SETTING:An immunohistochemical detection experiment was performed at the Department of Anatomy,Shenyang Medical College,between October 2006 and April 2008. MATERIALS:A total of 60 healthy,adult,Wistar rats were randomly divided into three groups: sham-operated(n=12),ischemia/reperfusion(n=24),and bFGF-treated(n=24).Rabbit anti-rat CREB(1:100) and biotin labeled goat anti-rabbit IgG were purchased from the Wuhan Boster Company,China.MetaMorph-evolution MP5.0-BX51 microscopy imaging system was provided by China Medical University,China. METHODS:Rat models of cerebral ischemia/reperfusion injury were developed using the suture method for right middle cerebral artery occlusion.Two-hour ischemia was followed by reperfusion. Rats from the bFGF-treated and ischemia/reperfusion groups were intraperitoneally administered endogenous bFGF(500 IU/mL,2 000 IU/kg) or an equal amount of physiological saline.Rats from the sham-operated group underwent a similar surgical procedure,without induction of ischemia/reperfusion injury and drug administration. MAIN OUTCOME MEASURES:After 48-hour reperfusion,hippocampal and parietal cortical neuronal CREB expression was detected by immunohistochemistry,and the absorbance of hippocampal CREB-positive products was determined using MetaMorph-evolutionMP5.0-BX51 microscopy imaging system. RESULTS:The sham-operated group exhibited noticeable CREB expression in hippocampal and parietal cortical neurons.In the ischemia/reperfusion group,the CREB expression was discrete and neurons were poorly arranged.The bFGF-treated group exhibited increased CREB expression and better neuronal arrangement compared with the ischemia/reperfusion group.The mean absorbance of CREB-immunoreactive products in the hippocampus and parietal cortex was significantly higher in the ischemia/reperfusion group than in the sham-operated group(P<0.05),and significantly higher in the bFGF-treated group than in the ischemia/reperfusion group(P<0.05). CONCLUSION:bFGF significantly upregulates CREB expression in hippocampal and parietal cortical neurons following ischemia/reperfusion injury.展开更多
BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correlati...BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period, and to try to find out a method which can quantitatively evaluate learning ability. DESIGN: Case observation, and correlation analysis. SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College. PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Department of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3)years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives. METHODS: When the patients were at convalescent period, their learning and memory ability were measured with " clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale, temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis. MAIN OUTCOME MEASURES: Correlation of rCBF in different brain regions and learning memory ability in patients with cerebral infarction. RESULTS: ① The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of good learning memory function group were significantly higher than those of poor learning memory function group (P < 0.05). ②In the good learning memory function group, rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex were significantly positively correlated with memory scale scores(r = 0.961, 0.926, 0.954, 0.907, P < 0.05), and also in the poor learning memory function group (r = 0.979, 0.976, 0.991, 0.953, P < 0.05). CONCLUSION: The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of patients with cerebral infarction are significantly positively correlated with memory scale scores. Predicting learning memory ability of patients by quantitative determination of rCBF provides a quantitative and objective method for evaluating learning memory ability.展开更多
While it is known that the brain perceives color and motion asynchronously, the specific locations in which the brain binds signals remain unknown. This study distinguishes subjective perception of the capability to b...While it is known that the brain perceives color and motion asynchronously, the specific locations in which the brain binds signals remain unknown. This study distinguishes subjective perception of the capability to bind features and the objective accuracy in feature binding. The stimuli were the same for individual subjects, consisting of random dots (red and green, or yellow and blue) moving either vertically or horizontally. Subjects responded to questions regarding the color or the direction of motion of the dots (objective judgment) and rated their capability in performing the task (subjective judgment). The imaging results of contrasting subjective judgment showed that the activation of the anterior rostral cingulate cortex (rACC) and inferior frontal gyrus (Brodmann area [BA] 45/47) during incapable-of-binding responses, compared with the capable-of-binding responses. It is suggested that the rACC is for uncertainty of subjective judgment and BA 45/47 is for the increased burden on working memory. In contrast, there was no imaging results of contrasting the correct and incorrect responses (i.e., objective judgment), and neither was there for the interaction between subjective and objective judgment. The results of conservative conjunction analysis indicated common and shared brain areas for the 2 distinctive binding situations (the correct and capable-of-binding vs the incorrect and incapable-of-binding), including increased activity in the intraparietal lobe (IPL) and the junction areas of the posterior rostral ACC (dACC) and the prefrontal areas, but decreased activity in the medial portion of the IPL, suggesting that feature binding requires maintaining attention. These results clearly isolated subjective judgment from objective judgment and support the view that maintaining attention is involved in feature binding of color and motion.展开更多
文摘<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Bilateral frontal lobes cerebral contusion and laceration is one unique brain injury in neurosurgery department. It is characteristic of recessive attacking and develops quickly. The unilateral cerebral falx incision is a new minimally invasive surgery </span><span style="font-family:Verdana;">that </span><span style="font-family:""><span style="font-family:Verdana;">can solve bilateral frontal lobes cerebral contusion and laceration in one surgery. However, it has some limitations in removal of contralateral frontal hematoma and hemostasis due to the limited field of view under the microscope. The unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy can acquire a good illumination and field of view. This is beneficial to complete removal of contralateral hematoma, effective hemostasis and retaining brain tissue functions to the maximum extent. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> The patient, a 55-year-old man, was hospitalized for “consciousness disorder by 12 h because of car accident”. </span><b><span style="font-family:Verdana;">Physical Examination: </span></b><span style="font-family:Verdana;">Coma, GCS score of E1V2M5, bilateral pupil diameter of 2 mm, presence of light response, contusion of scalp at the left top, peripheral dysphoria and bilateral Bartter syndrome negative. The patient has a history of non-traumatic cerebral stroke 3 years ago.</span><b><span style="font-family:Verdana;"> Head CT: </span></b><span style="font-family:Verdana;">Longitudinal fracture of frontal parietal occipital bone, bilateral frontal lobes contusion and laceration, subarachnoid hemorrhage. </span><b><span style="font-family:Verdana;">Diagnosis:</span></b><span style="font-family:Verdana;"> Bilateral frontal lobes contusion and laceration, longitudinal fracture of frontal parietal occipital bone, subarachnoid hemorrhage and hematoma of scalp. In emergency treatment, unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy was performed. The surgery has achieved satisfying effect. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">This case realized the goal of removing contralateral frontal hematoma through unilateral craniotomy under a neuroendoscopy. Due to the clear field of view, it retained extracerebral layer structures of contralateral olfactory nerve protection frontotemporal completely. Moreover, this surgical technique is conducive to intraoperative recognition of pericallosal</span><span style="background:yellow;"> </span><span style="font-family:Verdana;">arteries and lateral fractured blood vessels. It also involves protection, which conforms to the minimally invasive philosophy. The proposed surgical technology can eliminate contralateral frontal hematoma under a good field of view. However, it is suggested not to manage with the further operation on patients who have brain swelling and difficulties in exposure of cerebral falx. These patients need to determine causes of brain swelling and choose bilateral craniectomy if necessary. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">Unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy is a new application of minimally invasive philosophy in craniocerebral injury operation. It still needs further clinical verifications and experience accumulation.
基金Supported by Grant B013 from the University of Buenos Aires, Argentina and PIP 5869 from National Research Council of Argentina
文摘AIM: To study glutamine synthetase (GS) activity and glutamate uptake in the hippocampus and frontal cortex (FC) from rats with prehepatic portal vein hypertension. METHODS: Male Wistar rats were divided into shamoperated group and a portal hypertension (PH) group with a regulated stricture of the portal vein. Animals were sacrificed by decapitation 14 d after portal vein stricture. GS activity was determined in the hippocampus and FC. Specific uptake of radiolabeled L-glutamate was studied using synaptosome-enriched fractions that were freshly prepared from both brain areas. RESULTS: We observed that the activity of GS increased in the hippocampus of PH rats, as compared to control animals, and decreased in the FC. A significant decrease in glutamate uptake was found in both brain areas, and was more marked in the hippocampus. The decrease in glutamate uptake might have been caused by a deficient transport function, signif icantly and persistent increase in this excitatory neurotransmitter activity. CONCLUSION: The presence of moderate ammonia blood levels may add to the toxicity of excitotoxic glutamate in the brain, which causes alterations in brain function. Portal vein stricture that causes portal hypertension modif ies the normal function in some brain regions.
基金Scientific Research Foundation of Liaoning Provincial Education Department for Higher Education Institutions, No.05L442
文摘BACKGROUND:cAMP-response element binding protein(CREB) is a key modulator of various signaling pathways.CREB activation initiates a series of intracellular signaling pathways that promote neuronal survival. OBJECTIVE:To investigate the regulatory effects of basic fibroblast growth factor(bFGF) on cerebral neuronal CREB expression following ischemia/reperfusion injury. DESIGN,TIME AND SETTING:An immunohistochemical detection experiment was performed at the Department of Anatomy,Shenyang Medical College,between October 2006 and April 2008. MATERIALS:A total of 60 healthy,adult,Wistar rats were randomly divided into three groups: sham-operated(n=12),ischemia/reperfusion(n=24),and bFGF-treated(n=24).Rabbit anti-rat CREB(1:100) and biotin labeled goat anti-rabbit IgG were purchased from the Wuhan Boster Company,China.MetaMorph-evolution MP5.0-BX51 microscopy imaging system was provided by China Medical University,China. METHODS:Rat models of cerebral ischemia/reperfusion injury were developed using the suture method for right middle cerebral artery occlusion.Two-hour ischemia was followed by reperfusion. Rats from the bFGF-treated and ischemia/reperfusion groups were intraperitoneally administered endogenous bFGF(500 IU/mL,2 000 IU/kg) or an equal amount of physiological saline.Rats from the sham-operated group underwent a similar surgical procedure,without induction of ischemia/reperfusion injury and drug administration. MAIN OUTCOME MEASURES:After 48-hour reperfusion,hippocampal and parietal cortical neuronal CREB expression was detected by immunohistochemistry,and the absorbance of hippocampal CREB-positive products was determined using MetaMorph-evolutionMP5.0-BX51 microscopy imaging system. RESULTS:The sham-operated group exhibited noticeable CREB expression in hippocampal and parietal cortical neurons.In the ischemia/reperfusion group,the CREB expression was discrete and neurons were poorly arranged.The bFGF-treated group exhibited increased CREB expression and better neuronal arrangement compared with the ischemia/reperfusion group.The mean absorbance of CREB-immunoreactive products in the hippocampus and parietal cortex was significantly higher in the ischemia/reperfusion group than in the sham-operated group(P<0.05),and significantly higher in the bFGF-treated group than in the ischemia/reperfusion group(P<0.05). CONCLUSION:bFGF significantly upregulates CREB expression in hippocampal and parietal cortical neurons following ischemia/reperfusion injury.
基金the Grant from Bureau of Science and Technology of Jining City, No.2004JH006
文摘BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period, and to try to find out a method which can quantitatively evaluate learning ability. DESIGN: Case observation, and correlation analysis. SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College. PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Department of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3)years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives. METHODS: When the patients were at convalescent period, their learning and memory ability were measured with " clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale, temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis. MAIN OUTCOME MEASURES: Correlation of rCBF in different brain regions and learning memory ability in patients with cerebral infarction. RESULTS: ① The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of good learning memory function group were significantly higher than those of poor learning memory function group (P < 0.05). ②In the good learning memory function group, rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex were significantly positively correlated with memory scale scores(r = 0.961, 0.926, 0.954, 0.907, P < 0.05), and also in the poor learning memory function group (r = 0.979, 0.976, 0.991, 0.953, P < 0.05). CONCLUSION: The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of patients with cerebral infarction are significantly positively correlated with memory scale scores. Predicting learning memory ability of patients by quantitative determination of rCBF provides a quantitative and objective method for evaluating learning memory ability.
文摘While it is known that the brain perceives color and motion asynchronously, the specific locations in which the brain binds signals remain unknown. This study distinguishes subjective perception of the capability to bind features and the objective accuracy in feature binding. The stimuli were the same for individual subjects, consisting of random dots (red and green, or yellow and blue) moving either vertically or horizontally. Subjects responded to questions regarding the color or the direction of motion of the dots (objective judgment) and rated their capability in performing the task (subjective judgment). The imaging results of contrasting subjective judgment showed that the activation of the anterior rostral cingulate cortex (rACC) and inferior frontal gyrus (Brodmann area [BA] 45/47) during incapable-of-binding responses, compared with the capable-of-binding responses. It is suggested that the rACC is for uncertainty of subjective judgment and BA 45/47 is for the increased burden on working memory. In contrast, there was no imaging results of contrasting the correct and incorrect responses (i.e., objective judgment), and neither was there for the interaction between subjective and objective judgment. The results of conservative conjunction analysis indicated common and shared brain areas for the 2 distinctive binding situations (the correct and capable-of-binding vs the incorrect and incapable-of-binding), including increased activity in the intraparietal lobe (IPL) and the junction areas of the posterior rostral ACC (dACC) and the prefrontal areas, but decreased activity in the medial portion of the IPL, suggesting that feature binding requires maintaining attention. These results clearly isolated subjective judgment from objective judgment and support the view that maintaining attention is involved in feature binding of color and motion.
