Spinal epidural hematoma. Report of a case and review of the literature

We report the case of a thoracic epidural hematoma at the T7-T9 level which occurred after placement of spinal epidural catheter for continuous anaesthesia in acute pancreatitis. The male patient felt a sudden back pain after six days of successful analgesia and became paraplegic 24 hours afterwards. An emergency laminectomy and removal of the hematoma were performed; however, the patient recovered only incompletely.We discuss the clinical signs and symptoms of spinal epidural hematoma as well as its diagnostics and therapy. The controversial views from the literature concernings its etiology are critically reviewed.     

医源性胆管狭窄X线表现

本文报道了１３例医源性胆管狭窄，分析其影像表现。特点为：环形狭窄；线样狭窄，包括规则的和不规则的线样狭窄；闭塞性狭窄；胆管闭塞和胆管中断分离。ＥＲＣＴ和ＰＣＴ对狭窄的形态，位置及长度显示优于ＣＴ和ＵＳ。     

放射性肝纤维化过程的定量研究

经＾６０Ｃｏγ线照射大鼠肝区，通过光镜、电镜和图像分析仪、宣研究了照后１年肝脏的病理改变。结果表明，３０Ｇｙ组在照射后１年内逐渐发生了放射性肝纤维化病变。在肝纤维化发生过程中，肝细胞内糖原颗凿含量进行性减少，间质中胶原纤维含量进行性增加，网状纤维于照射１－３个月呈进行性增加。     

The effect of MS-818, a pyrimidine compound,on the regeneration of peripheral nerve fibers of mice after a crush injury

One of the pyrimidine compounds, 2-piperadino-6-methyl-5-oxo-5,6-dihydro(7H)pyrrolo[3,4-d]pyrimidine (MS-818), has neurotropic effects in vitro. Therefore, we studied the effect of MS-818 on the regeneration of the peroneal nerve in C57BL/6J mice after a crush injury. Two test groups, which received a daily intraperitoneal injection of 5 mg/kg or 10 mg/kg MS-818, respectively, were compared with controls, which received daily intraperitoneal injections of physiological saline, over a 14-day period. The maximum foot-width ratio (crushed side/uncrushed side) was obtained on days 1, 8 and 14 after the crush injury, and the various morphometric parameters were evaluated at both 5 and 10 mm distal to the proximal portion of the crush site. The significant effects of MS-818 included a larger maximum foot width (P<0.04) and a greater number of unmyelinated axons per nerve at both levels (P<0.003) in both test groups than in controls. MS-818 had no significant effects on body weight, the increase of total transverse fascicular area after the crush injury, the total number of myelinated fibers with their size distributions, or the number of nuclei of Schwann cells and macrophages. Therefore, we conclude that MS-818 promotes axonal sprouting and elongation after a crush injury in mice.     

Dorsal and ventral dopaminergic innervation of the spinal cord: Functional implications

Several studies have demonstrated that a descending dopaminergic pathway innervates the dorsal and the intermediate gray matter of the spinal cord and have suggested that this pathway is involved in pain modulation and in the control of autonomie functions. Other studies have also demonstrated the presence of dopamine (DA) and DA metabolites as well as of DA receptors in the ventral cord. There is also evidence for the implication of DA in the control of motor functions at the spinal level. The occurrence of a dopaminergic innervation in the ventral horn has been, however, disputed until recently. But recent work has demonstrated that the motoneural cell groups in the ventral horn (lamina IX) are a target for descending dopaminergic fibers. In addition, the possibility that DA is a mediator of primary afferent fibers has also been postulated. Finally, the occurrence of dopaminergic cell bodies has been suggested in the spinal cord. This indicates that DA is probably implicated in a complex manner in spinal functions. In the present paper the possible involvement of DA in sensory and in motor functions at spinal level will be discussed in view of neurochemical observations made in polyarthritic rats, in which pain-related behavior and reduction of locomotor activity associated with a marked decrease in mobility, are observed.     

Cervical intramedullary cavernous angioma with MRI-proven haemorrhages

Summary Two contrasting cases of cervical intramedullary cavernous angioma in young female patients are reported. One patient had a 3-year course of step-wise progressive tetraparesis; at each of the five events intramedullary bleeding from a cryptic vascular malformation at C6–7 level was diagnosed by MRI. The other patient presented with one episode which led to MRI diagnosis of a vascular malformation at the C2 level. Both patients eventually underwent complete surgical excision of the angioma with subsequent steady improvement of the neurological deficit.     

神经干细胞移植治疗缺氧缺血性脑损伤的实验研究

目的 研究神经干细胞移植治疗缺氧缺血性脑损伤的可行性。方法 取孕龄为12－16天的母鼠，从胎脑中分离神经细胞，进行培养、鉴定。用出生7天的SD大鼠的新生鼠制作缺氧缺血性脑损伤的动物模型，7天后接受神经干细胞移植（移植组，n＝16只），同时设置对照组，只注射磷酸缓冲液（对照组，n=8只），8－10周后，作Y迷宫实验检测大鼠的学习能力和记忆能力。取脑组织作免疫组织化学检查。结果 从大鼠胎脑中成功培养出神经干细胞，培养条件下呈悬浮状态生长，形成神经球，绝大多数的细胞表达神经干细胞的标志物神经巢蛋白（nestin）。接爱神经干细胞移植组大鼠的学习能力、记忆能力和对照组相比，有明显提高，差异具有显著性（P＜0.05）。接受神经干细胞移植大鼠组织中可见存活的移植细胞，并和宿主脑组织融合在一起。结论 在体外培养条件下，可从胎脑组织中培养出神经干细胞，移植到缺氧缺血性脑损伤大鼠脑内后，细胞与宿主的脑组织融合在一起，动物的学习、记忆能力有改善。移植神经干细胞是治疗缺氧缺知性脑损伤的有效方法之一。     

高热惊厥214例临床分析

本文分析了214例高热惊厥,结果为:检出率4.35％;男女之比为1.61:1;好发年龄为6个月～6岁(93.5％);首发年龄为6个月～4岁(89.9％);惊厥发作时体温多在39℃以上(74.6％);惊厥发作多在发热后12h内(72.4％);每次热病中惊厥发作1～3次(99.5％);惊厥持续时间多在15min内(91.0％);致惊厥发作的热性疾病以上呼吸道感染为最多;214例中63例复发,其中2例转癫痫,61例尚未发现智力低下或其他异常。从2例转癫痫的临床及脑电图看,提示惊厥发作愈重,持续时间愈长,转癫痫的可能性愈大。     

rhGM—CSF对小鼠口腔粘膜损伤的防治作用

目的：观察rhGM-CSF对TMX致实验性小鼠口腔粘膜损伤的疗效。方法：按随机分组原则将501只昆明种小白鼠分成8组，分别在相应时间给予不同药物（MTX，CF或rhGM-CSF）的处理因素，于第1－10天光镜下观察小鼠口腔粘膜的病理改变和积分情况。结果：IDMTX致口腔粘膜损伤病变率（45％－63％）和积分率（19．4％－56％）较其它组高，且死亡率很低（小于5％）；IDMTX＋GM0（或GM2）组的口腔粘膜损伤病变率（30．53％和30．99％）和积分率（19．47％和17．25％）比IDMTX组（55．56％和36．31％）明显减少，且溃疡严重程度较轻，二者相差显著（P＜0．01）。结论：IDMTX致小鼠口腔粘膜损伤模型可以用于粘膜损伤的研究；rhGM-CSF可以减少MTX致小鼠口腔粘膜损伤，并促进粘膜损伤恢复。