强直电刺激大鼠海马、中部颞叶新皮质诱发癫癇模型中电振荡与癫癇发生的关系研究

在急性、慢性在体大鼠及离体脑片癫癇模型上观察EEG、深部电图、神经元网络及单个神经元的电活动,研究中枢同步化电振荡行为在癫癇发生中的重要作用.实验结果表明:离体脑片(n=40)上强直电刺激海马Schaeffer侧枝,32.5% CA1神经元全细胞记录呈现3～100 Hz膜电位振荡,这种电振荡能促进细胞外场电位癫癇活动形式的转化.急性癫癇模型上(n=10,in vivo),反复强直电刺激海马或中部颞叶新皮质可诱发海马区4～7 Hz和中部颞叶新皮质20 Hz(n=11)深部电图电振荡.慢性强直电刺激大鼠背侧海马(n=12)或中部颞叶新皮质(n=11),7～8 d后出现这些脑区和EEG电振荡活动的频率及幅度的增加.巨大EEG节律性电振荡活动成为电图和癫癇行为性发作的先兆.说明过度激活海马-内嗅皮质-颞叶新皮质产生的同步化电振荡可能是颞叶癫癇发生的重要原因之一.     

强直电刺激大鼠海马-颞叶新皮质神经通路致癫癎放电中突触传递可塑性及其癫癎 靶行为的表达研究(英文)

强直电刺激诱发大鼠急、慢性在体和离体脑片癫疒间模型。观察癫疒间电活动的突触可塑性以及癫疒间发作的行为表达特征。结果表明 :慢性癫疒间 大鼠原发性湿狗样抖的频率先增加后减少及潜伏期逐步缩短 ,并相继出现继发性湿狗样抖和“点燃”效应 ,称之为行为改变的可塑性 ,即“长时程”效应 ;急性在体癫疒间模型上反复强直电刺激海马 ,颞叶新皮质区细胞外场电位原发性后放的潜伏期逐渐缩短及幅度逐级增大 ,此效应在脑室内微量注射东莨菪碱后逐渐消失 ;离体脑片上强直电刺激海马 Schaeffer侧枝 ,CA1神经元膜电位原发性后放电及阵发性爆发放电的潜伏期明显缩短 ,表现为突触传递的“长时程增强”。推测癫疒间发作行为的可塑性变化可能是复杂神经网络多级突触传递长时程效应的整体靶行为表现。     

强直电刺激大鼠海马,中部颞叶新皮质诱发癫痫模型中电振？…

在急性,慢性在体大鼠及体脑片癫痫模型上观察ＥＥＧ、深部电图、神经元网络及单个神经元的电活动,研究中枢同步电振荡行为为在癫痫发生中的重要作用。实验结果表明：离体脑片上强直电刺激海马Ｓｃｈａｅｆｆｅｒ侧枝,３２．５％ＣＡ１神经元全细胞记录呈现３－１００Ｈｚ膜电位振荡,这种电振荡能促进细胞外场电位癫痫活动形式的转化。急性癫痫模型上（ｎ＝１０,ｉｎ ｖｉｖｏ）反复强直电刺激海马或中部颞叶新皮质可诱发海马区     

强直电刺激大鼠海马-颞叶新皮质神经通路致癫放电中突触传递可塑性及其癫靶行为的表达研究

强直电刺激诱发大鼠急、慢性在体和离体脑片癫模型.观察癫电活动的突触可塑性以及癫发作的行为表达特征.结果表明:慢性癫大鼠原发性湿狗样抖的频率先增加后减少及潜伏期逐步缩短,并相继出现继发性湿狗样抖和"点燃”效应,称之为行为改变的可塑性,即"长时程”效应;急性在体癫模型上反复强直电刺激海马,颞叶新皮质区细胞外场电位原发性后放的潜伏期逐渐缩短及幅度逐级增大,此效应在脑室内微量注射东莨菪碱后逐渐消失;离体脑片上强直电刺激海马Schaeffer侧枝,CA1神经元膜电位原发性后放电及阵发性爆发放电的潜伏期明显缩短,表现为突触传递的"长时程增强”.推测癫发作行为的可塑性变化可能是复杂神经网络多级突触传递长时程效应的整体靶行为表现.     

立体定向方法建立大鼠红藻氨酸颞叶癫疒间模型及其脑电活动的实验研究

目的探讨采用立体定向技术建立大鼠颞叶癫癎模型的方法,并对发作后的脑电活动进行研究。方法用立体定向方法在20只SD大鼠的右侧海马注射红藻氨酸,用视频监测大鼠的行为学变化;在双侧海马、额叶皮质、杏仁核置入深部电极,对大鼠脑电活动进行长期记录。结果根据Racine行为学分级法,Ⅴ级6只,Ⅳ级10只,Ⅲ级3只,Ⅱ级1只;深部电极描记出起源于海马并向额叶皮质、杏仁核等传导癫疒间样波;病理变化提示长期癫疒间发作会导致海马锥体细胞逐渐缺失、坏死。结论用立体定向技术建立大鼠红藻氨酸颞叶癫疒间模型是一种可靠、经济和实用的方法。起源于海马并向额叶皮质、杏仁核等传导的癫疒间样波是颞叶癫疒间模型的神经电生理基础。     

单侧慢性海马电刺激治疗颞叶癫疒间的疗效观察

目的初步探讨单侧慢性海马电刺激治疗颞叶癫疒间的疗效。方法选取经过术前评估认为不适宜行前颞叶切除术的5例颞叶癫疒间病人。癫疒间灶均位于左侧颞叶,其中3例致疒间灶对侧颞叶存在结构性病损,1例对侧颞叶存在功能性异常,1例颞叶病灶累及优势半球侧语言功能区。进一步定位评估单侧颞叶致疒间灶起源,立体定向下向致疒间侧海马头部植入刺激电极,术后进行慢性电刺激,观察控制癫疒间发作的效果及不良反应。结果刺激器埋植术后及慢性电刺激开启后未见明显不良反应。术后随访14~24个月,发作次数平均减少75%1例,50%3例,无明显改善1例。结论对于部分不适合进行前颞叶切除手术的难治性颞叶癫疒间病人,慢性海马电刺激是一项可供选择的治疗方法。     

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’2006全国癫疒间诊疗新进展研讨会通知研讨会暨第四届全国功能神经外科宣武讲习班将于2006年9月2日￣8日在北京举行,本期重点内容为癫疒间诊疗的新技术和新进展,由李勇杰教授和王玉平教授主讲。会议主要内容:①美国癫疒间中心组织结构与分级标准;②癫疒间病和癫疒间发作的最新国际分类;③EEG基础、皮质EEG、脑深部EEG和录相EEG;④颅内电极应用技术与策略;⑤皮质电刺激、诱发电位以及多导生理记录的应用;⑥磁共振新技术与致疒间灶的发现;⑦癫疒间外科治疗的策略和术式;⑧额、顶、颞叶癫疒间的发作特点和手术治疗;⑨无病灶性癫疒间和功…     

颅内视通路多发节细胞胶质瘤癫疒间的手术治疗

目的总结颅内视通路多发节细胞胶质瘤癫疒间的诊治经验。方法回顾性分析2例以癫疒间发作为首发症状的颅内视通路多发节细胞胶质瘤病例资料。MRI均显示左侧视通路(视交叉、视束、外侧膝状体)多发性病灶。术前评估为左侧颞叶癫疒间,均在术中唤醒下实施裁剪式左侧前颞叶(含杏仁核、海马)切除,同时切除部分视通路病变,其中1例术中部分切除视交叉病变。结果术后病人视野缺损均不同程度加重。术后病理报告为颞叶局灶性皮质发育不良,海马硬化,节细胞胶质瘤。术后癫疒间控制分别达到Engel分级Ⅱa级和Ⅰa级。结论节细胞胶质瘤属良性神经元胶质细胞混合性肿瘤(WHOⅠ级),最常见症状为癫疒间发作。视通路节细胞胶质瘤极罕见,颞叶癫疒间+视通路多发病灶是特征性临床表现。手术治疗应以控制癫疒间发作为主要目的,无需过多切除非致疒间性的肿瘤灶而加重视觉功能缺失。     

颞叶癫癎21例手术治疗分析

目的探讨颞叶癫癎的外科治疗方法及效果.方法 21例颞叶癫癎患者,术前均行EEG、MRI检查,其中6例行PET检查,经定侧定位后,行手术治疗.其中13例行标准前颞叶切除术,5例行病灶切除+致癎灶切除,3例行选择性海马杏仁核切除.术中应用皮层电极或深部电极进行监测;神经导航下海马钙化切除1例.结果术后无明显并发症,均取得满意近期效果.结论海马硬化是颞叶癫癎发生的主要原因;手术是治疗颞叶癫癎的重要手段,且疗效满意.     

涉及中央区难治性癫(癎)的外科治疗

目的 探讨涉及中央区难治性癫(癎)的手术治疗.方法 3例患者术前除常规致癫(癎)灶评估外,还应用fMRI作皮质功能区定位.术中通过皮层EEG(ECoG)对致癫(癎)灶定位,通过皮层诱发电位(SEP)及皮质电刺激定位脑功能区,对位于功能区以外的致疒间灶行切除性手术,功能区内的致疒间灶行软脑膜下横行纤维切断术.结果 术后无神经功能障碍,术后3月,2例病人无癫(癎)发作,1例偶有部分性发作;术后8月,1例无发作,1例偶有部分性发作,1例减少75%发作. 结论术前功能区评估、术中电生理监测有助于保护皮质重要功能和提高手术癫(癎)控制率.     

Fibrous xanthomas and xanthosarcomas of the meninges and the brain

Summary Three cases of intracranial fibrous xanthomas and a case of multicentric cerebral xanthosarcoma are reported. All three fibrous xanthomas developed in the temporal area of boys in their early teens, one was within the leptomeninges (without dural attachment), the other two involved meninges and the superficial portions of the temporal lobe itself. These tumors were characterized by mono- and multinucleated cells with morphological features of histiocytes, Touton type giant cells and a storiform pattern in areas of spindleshaped tumor cells.Because of cellular atypism, giant cells and mitotic figures such tumors may suggest the diagnosis of glioblastoma multiforme but the absence of glial fibers, negative Cajal impregnation, presence of reticulin fibers in close proximity to tumor cells and the morphological similarity to the bizarre cells found in atypical xanthofibromas of the skin and soft tissues help to establish the diagnosis. Since the menigeal forms are probably derived from local meningeal mesenchyme, occasional abortive whorls and pseudopsammoma bodies may be encountered, the overall picture, however, is very different from meningiomas. Two patients had a 2.5 and a 12 year long symptomfree survival, respectively. The third boy had a local recurrence 14 months after initial removal which was excised and the patient is presently doing well.The xanthosarcoma first developed in the right frontal lobe of a 26 year old woman. This tumor was almost exclusively made up of various sized anaplastic cells filled with birefringent lipids. It is suggested that this tumor which had a diffuse network of reticulin, had originated from primitive adventitial cells. It was histologically more malignant than the first three and the patient died within a year after removal of the frontal lobe tumor, from a second mass in the cerebellum. The relationship of this tumor to glioblastomas and to other types of giant cell sarcomas is discussed.This paper was presented in part at the 6th International Congress of Neuropathology in Paris, France, on August 31, 1970.     

Spinal projections of the locus coeruleus and the nucleus subcoeruleus in the Harlan and the Sasco Sprague-Dawley rat

The descending projections of the locus coeruleus (LC) and the nucleus subcoeruleus (SC) to the lumbar spinal cord were examined in rats from two vendors using retrograde transport of fluorescent latex beads. There was a vendor difference observed which agrees with previous findings. The differential dorsal horn and ventral horn projections of the Harlan and the Sasco Sprague-Dawley rats, reported by Fritschy and Grzanna, and Clark and Proudfit were confirmed. In the Harlan rat more cells were labeled in the LC following injections in the dorsal horn. In contrast, in the Sasco rat, more cells were labeled in the LC from injections in the ventral horn. Although, in all studies, the LC in rats from these vendors projected to some extent to both the dorsal and the ventral horn. A difference in labeling was noted also for the depth of placement of the tracer in the dorsal horn. When the site of injection was in the nucleus proprius, a predominately contralateral projection of the LC was noted. In contrast, when horseradish peroxidase (HRP) gel implants were placed to include the superficial laminae, the cells in the LC were labeled predominately ipsilaterally. The SC has a major projection to the dorsal horn in the Harlan rats while cells in the SC were predominately labeled following ventral horn injections in the Sasco rats. These cells send mostly ipsilateral projections to the dorsal and ventral horn of the spinal cord. Double labeled studies confirmed that 91% of LC and 86% of SC neurons projecting to the spinal cord were noradrenergic. The present results confirmed a difference in the descending catecholamine projections of rats purchased from different vendors. These strain differences may prove useful in studies of motor and sensory systems.     

Imaging and modelling of digestion in the stomach and the duodenum

Gastroduodenal physiology is traditionally understood in terms of motor-secretory functions and their electrical, neural and hormonal controls. In contrast, the fluid-mechanical functions that retain and disperse particles, expose substrate to enzymes, or replenish the epithelial boundary with nutrients are little studied. Current ultrasound and magnetic resonance imaging allows to visualize processes critical to digestion like mixing, dilution, swelling, dispersion and elution. Methodological advances in fluid mechanics allow to numerically analyse the forces promoting digestion. Pressure and flow fields, the shear stresses dispersing particles or the effectiveness of bolus mixing can be computed using information on boundary movements and on the luminal contents. These technological advances promise many additional insights into the mechanical processes that promote digestion and absorption.     

Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A

Investigates the construct validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C) by comparing its sensitivity and specificity with another self-report measure of social anxiety, the Social Anxiety Scale for Adolescents (SAS-A). Participants were 252 adolescents (124 males and 128 females) 13-17 years old. Adolescents completed the SPAI-C and the SAS-A and were interviewed using the Anxiety Disorders Interview Schedule for DSM-IV: Child Version (ADIS-IV:C). Parents were also interviewed and composite diagnoses were formed. Youth were classified as socially phobic or non-anxious based on these composite diagnoses. By comparing clinical cutoff scores with diagnostic group classification, the sensitivity and the specificity of the SPAI-C and SAS-A were compared. Results indicated that the SPAI-C was a more sensitive measure than the SAS-A (61.5% vs. 43.6%) providing evidence of the scale's construct validity. The two measures were similar with regard to specificity (82.7% for both). Implications of these results for assessment and research are discussed.