简介:AbstractBackground:Patients with temporal lobe epilepsy (TLE) originating from different seizure onset zones had distinct electrophysiological characteristics and surgical outcomes. In this study, we aimed to investigate the relationship between the origin and prognosis of TLE, and the stereoelectroencephalography (SEEG) features.Methods:Thirty patients with TLE, who underwent surgical treatment in our functional neurosurgery department from January 2016 to December 2017, were enrolled in this study. All patients underwent anterior temporal lobectomy after an invasive preoperative evaluation with SEEG. Depending on the epileptic focus location, patients were divided into those with medial temporal lobe seizures (MTLS) and those with lateral temporal lobe seizures (LTLS). The Engel classification was used to evaluate operation effectiveness, and the Kaplan-Meier analysis was used to detect seizure-free duration.Results:The mean follow-up time was 25.7 ± 4.8 months. Effectiveness was 63.3% for Engel I (n = 19), 13.3% for Engel II, 3.3% for Engel III, and 20.0% for Engel IV. According to the SEEG, 60.0% (n = 18) had MTLS, and 40.0% (n = 12) had LTLS. Compared with the MTLS group, the operation age of those with LTLS was significantly greater (26.9 ± 6.9 vs. 29.9 ± 12.5 years, t = -0.840, P = 0.009) with longer epilepsy duration (11.9 ± 6.0 vs. 17.9 ± 12.1 years, t = -1.801, P = 0.038). Patients with MTLS had a longer time interval between ictal onset to seizure (67.3 ± 59.1 s vs. 29.3 ± 24.4 s, t = 2.017, P = 0.008). The most common SEEG ictal pattern was a sharp/spike-wave rhythm in the MTLS group (55.6%) and low-voltage fast activity in the LTLS group (58.3%). Compared with the LTLS group, patients with MTLS had a more favorable prognosis (41.7% vs. 77.8%, P = 0.049). Post-operative recurrence was more likely to occur within three months after the operation for both groups, and there appeared to be a stable longterm outcome.Conclusion:Patients with MTLS, who accounted for three-fifths of patients with TLE, showed a more favorable surgical outcome.
简介:Epilepsyisacommonneurologicaldisorder,anditselectrophysiologycharacteristicisabnormallyhighexcitabilityandsynchronizationoftheneuralactivity.Thispaperfocusesonthestudyofmedialtemporallobeepilepsywithhippocampalsclerosis.Thehippocampusplaysanimportantroleinshort-termmemory.However,littleisknownabouttheconnectivitybetweenhippocampalstructuresandadjacentbrainregions.Thefunctionalandstructuralconnectivitybetweenpatientsandcontrolswasinvestigatedbyusingthetechniquesoffunctionalmagneticresonanceimaginganddiffusiontensorimaginginthepaper.ThreepairsofROIsrelatedtoworkingmemoryfromBOLD-fMRIdatawerechosen.TheseROIswereregistratedfromMNIspacetoindividualspaceandthefiberbundlebetweentwoROIsweretracedintheDTIimages.TheresultsshowthatthenumberoffiberbundleofpatientsreduceamongtheseROIs,suchaslefthippocampusandrighthippocampus,lefthippocampusandleftthalamus,lefthippocampusandleftfrontallobeandsoon.AndthenumberoffiberbundleofpatientsincreaseamongtheseROIs,suchasleftthalamusandrightthalamus,righthippocampusandrightthalamus.AndtheFAvaluesofthefiberbundlesofpatientsinsomeregionsrelatedtolefthippocampusdecrease.Thecauseofabnormalfunctionalandstructuralconnectionsduetothedamageofhippocampusinmedialtemporallobeepilepsyisstudiedfromanewperspective.
简介:这研究的目的是为把用不同技术比较修改Nesbit过程的结果神经与血管的捆(NVB)到正确腹的先天的阴茎弯曲(CPC)。捆在21用中间、侧面的解剖技术被动员(组1)并且13(组2)病人分别地。在中间的技术,uck's扁带在阴茎的背面的方面被打开,深背面的静脉在弯曲的最突出的地点被移开,钻石形的tunicaalbuginea(TA)从阴茎的中线被切除。在侧面的技术,捆在5和7o’在尿道上面用uck's扁带的一个纵的侧面的切口被动员;经由一条双边的途径的钟位置。弯曲的本地化和度用联合intracavernous注射刺激测试或从patients’被评估;相片。弯曲的吝啬的耐心的年龄和度在组之间是类似的。吝啬的操作时间为组2是更长的(P=0.01)。在组1,九个病人(42.8%)要求了一钻石切除,(47.6%)10要求了二钻石切除,(9.5%)二要求了超过二切除;在组2,六个病人(46.2%)要求二钻石切除和七个病人(53.8%)要求了超过二钻石切除(P=0.019)。在阴茎弄短的差别,阴茎弄直和龟头的麻木不是统计上重要的。为修改Nesbit过程的捆的中间的解剖减少TA的钻石形的移动的数字并且因此弄短与它的侧面的对应物比较的操作时间。
简介:Thehumanbrainisknowntobeinfluencedbyenvironmentalstimuli(Feeneyetal.,1982;Kaplan,1988).Therefore,researchonthebrainactivationpatternbyexternalstimulihasbeenanimportanttopicinneuroscience(Kaplan,1988).Chewinggumhasbeenknowntohaveapositiveeffectoncognition,includingalertness,attention,cognitiveprocessingspeed,
简介:Nestin+neuronshavebeenshowntoexpresscholineacetyltransferase(ChAT)inthemedialseptum-diagonalbandofBrocainadultrats.Thisstudyexploredtheprojectionofnestin+neuronstotheolfactorybulbandthetimecourseofnestin+neuronsinthemedialseptum-diagonalbandofBrocainadultratsduringinjuryrecoveryafterolfactorynervetransection.Thisstudyobservedthatallnestin+neuronsweredouble-labeledwithChATinthemedialseptum-diagonalbandofBroca.Approximately53.6%ofnestin+neuronswereprojectedtotheolfactorybulbandco-labeledwithfastblue.Alargenumberofnestin+neuronswerenotpresentineachregionofthemedialseptum-diagonalbandofBroca.Nestin+neuronsinthemedialseptumandverticallimbofthediagonalbandofBrocashowedobviouscompensatoryfunction.Thenumberofnestin+neuronsdecreasedtoaminimumlaterthannestin–/ChAT+neuronsinthemedialseptum-diagonalbandofBroca.Theresultssuggestthatnestin+cholinergicneuronsmayhaveacloserconnectiontoolfactorybulbneurons.Nestin+cholinergicneuronsmayhaveastrongertolerancetoinjurythanNestin–/ChAT+neurons.Thedifferencebetweennestin+andnestin–/ChAT+neuronsduringtherecoveryprocessrequiresfurtherinvestigations.
简介:BACKGROUND:Ithasbeenshownthatginsenoside,theeffectivecomponentofginseng,canenhanceexpressionofcholineacetyltransferase,aswellasbrain-derivedneurotrophicfactor(BDNF)anditsreceptortyrosinekinaseB(TrkB),incholinergicneuronsofthebasalforebrain.OBJECTIVE:ToqualitativelyandquantitativelyverifytheinfluenceofginsenosideonexpressionofBDNFanditsreceptor,TrkB,inthemedialseptumofagedrats,andtoprovideamolecularbasisforclinicalapplication.DESIGN,TIMEANDSETTING:Acontraststudy,whichwasperformedintheDepartmentofAnatomy,ChinaMedicalUniversity,andtheDepartmentofAnatomy,ShenyangMedicalCollegebetweenDecember2005andMay2007.MATERIALS:Thirty-five,healthy,female,SpragueDawleyratswereselectedforthisstudy.Ginsenoside(81%purity)wasprovidedbyJilinJi’anWantaiChineseMedicineFactory;anti-BDNFantibody,anti-TrkBantibody,andtheirkitswereprovidedbyWuhanBosterCompany.METHODS:Atotalof35ratsweredividedintothreegroups:young(fourmonthsold),aging(26monthsold),andginsenoside.Ratsintheginsenosidegroupwereadministeredginsenoside(25mg/kg/d)between17monthsand26months.MAINOUTCOMEMEASURES:ImmunohistochemistryandinsituhybridizationwereusedtomeasureexpressionofBDNFandTrkBinthemedialseptumofagedrats,andthedetectedresultswereexpressedasgrayvalues.RESULTS:①Qualitativedetection:usingmicroscopy,degenerativeneuronswerevisibleinthemedialseptumintheaginggroup.However,neuronalmorphologyintheginsenosidegroupwassimilartoneuronsintheyounggroup.②Quantitativedetection:themeangrayvalueofBDNF-positiveandTrkB-positiveproductsintheaginggroupweresignificantlyhigherthanintheyounggroup(t=3.346,4.169,P<0.01);however,themeangrayvalueintheginsenosidegroupwassignificantlylowerthanintheaginggroup(t=2.432,2.651,P<0.01).CONCLUSION:GinsenosidecanincreaseexpressionofBDNFandTrkBinth
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简介:AbstractBackground:Three-dimensional (3D) fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively.Methods:We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors' location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated.Results:The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = 0.772, P < 0.001). The scoring system had good predictive capacity with an accuracy of 69.60%.Conclusions:We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging.Trial registration:Retrospectively registered
简介:AbstractIntertrochanteric fractures have become a severe public health problem in elderly patients. Proximal femoral nail anti-rotation (PFNA) is a commonly used intramedullary fixation device for unstable intertrochanteric fractures. Pelvic perforation by cephalic screw is a rare complication. We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture. The patient underwent surgery with PFNA as the intramedullary fixation device. Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation. We performed a cemented total hip arthroplasty as the savage procedure. At the latest follow-up of 12 months after total hip arthroplasty, the patient had no pain or loosening of the prosthesis in the left hip. Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device, especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation. The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.
简介:AbstractBackground:The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial. The purpose of this study was to compare differences in the efficacy of a novel nail (medial support nail [MSN-II]) and proximal femoral nail anti-rotation (PFNA-II) in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association [AO/OTA] 31-A3.1) using finite-element analysis.Methods:Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model. Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site.Results:The femoral stress, implant stress and fracture site displacement of MSN-II was less than that of PFNA-II. The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II. The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa, respectively. The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models, respectively.Conclusions:Compared with PFNA-II for inter-trochanteric fracture (AO/OTA 31-A3.1), MSN-II which was designed with a triangular stability structure can provide better biomechanical stability. The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.