Pathologic changes of the palatopharyngeal muscles in adult patients with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the pathology of palatopharyngeal muscle obtained from patients with obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>The samples from both groups were studied under HE, nicotinamide adenine dinucleotide-tetrazolium reductase (NADH- TR), modified Gomori trichrome (MGT) and adenosine triphosphatase (ATPase) staining. There were 36 cases of OSAHS who received uvulopalatopharyngoplasty in the experimental group (including 6 mild, 6 moderate and 24 severe cases). There were 6 patients with chronic tonsillitis but without OSAHS as matched control group. Both groups were diagnosed by PSG.</p><p><b>RESULTS</b>Centralized located nuclei and obvious variability of the size of fiber types were observed in both groups. The occurrence rate of the former were 1/6 in control group and 52.8% (19/36) in OSAHS, while the rate of the latter were 4/6 and 58.3% (21/36)respectively. A large number of fibers in both groups (control group 5/6, OSAHS group 28/36) presented an irregularly distributed staining for oxidative activity reaction in NADH stain.Endomysium connective tissue proliferation, a lobular or motheaten appearance, target-like fibers, ragged red fiber (RRF) and muscle necrosis were only observed in OSAHS group.While it was more common in serious OSAHS patients. Dominance of type 1 fibers were observed in matched control group in ATPase stain. Clusters of type 2 fibers or clusters of both type fibers were observed in OSAHS, especially more common in serious OSAHS. There was a predominance of the type 2 fibers in some OSAHS patients.</p><p><b>CONCLUSIONS</b>The observation of HE and special muscular stain identified that palatopharyngeal muscle of OSAHS patients had pathological lesion. The pathological changes included muscular lesion and abnormal distribution of different fiber types, the rate of type 1 fiber which maintained the opening of upper air way decreased.</p>

Rhabdomyolysis related to statin and seizures: report of 3 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical features and prognosis of rhabdomyolysis related to seizure attacks and use of statin.</p><p><b>METHODS</b>The medical records of 3 patients with established diagnosis of rhabdomyolysis were analyzed and the related literatures were reviewed.</p><p><b>RESULTS</b>All the 3 patients had seizure attacks and/or used statin before the onset of rhabdomyolysis. Two of the patients complained of back pain, and all the 3 patients had dark-colored urine. Serum levels of creatine kinase (CK) were markedly increased by over 50 times above the normal upper limit. CK level kept increasing even after proper interventions, till reaching the peak level about 3 days later. The patients improved rapidly with full recovery thereafter, and CK became normal in 2 weeks. None of the patients had renal failure.</p><p><b>CONCLUSION</b>Seizure attacks and use of statin are common risk factors for non-traumatic rhabdomyolysis. Caution needs to be taken when prescribing statin to patients with recent seizure attacks. Special attention should be given to such early symptoms as muscle pain, weakness and dark-colored urine, and CK level monitoring is advisable in such cases.</p>

Modified neurological tests for evaluating the severity of cerebral infarction and estimating the infarct area in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To test the reliability of quantitative neurological tests in evaluating the neurological deficits in rat models of cerebral ischemia.</p><p><b>METHODS</b>Forty male SD rats (7 to 9 weeks old) were subjected to transient (1 h) middle cerebral artery occlusion (MCAO) to induce cerebral infarction and 9 received sham operation only. The motor and sensory functions of the rats were measured before and 1, 3, 7 and 14 days after MCAO by accelerating rotarod test and modified adhesive removal test. Fourteen days later, the rats were sacrificed for histological examination, and the lesion size was determined by Winroof image analysis. The neurological deficits of the rats with different lesion sizes and at different time points were analyzed.</p><p><b>RESULTS</b>According to the infarct size, the rats after MCAO were divided into two subgroups with large lesions [(68.56+/-12.54)%] affecting both the cortical area and basal ganglia and small lesions [(12.45+/-9.06)%] affecting the basal ganglia. Significant differences in the results of modified adhesive removal test and rotarod test were found between the two groups, and a liner relationship was noted between the lesion size and the results of the neurological tests.</p><p><b>CONCLUSION</b>The modified quantitative neurological tests can reliably evaluate the severity of the infarction and estimate the infarct size in rats with cerebral infarction.</p>