Stereotactic aspiration and thrombolysis of spontaneous intracerebellar hemorrhage / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Spontaneous intracerebellar hemorrhage (SCH) accounts for 10% of intracerebral hemorrhages. Up to now stereotactic aspiration and thrombolysis of SCH was less reported. The aim of this study was to assess the effect and feasibility of the method, and to refine the clinical protocol.</p><p><b>METHODS</b>Eighteen patients with SCH were treated by stereotactic aspiration and thrombolysis and reviewed in this report. The 3-mm axial stereotactic computed tomography slices throughout the hematoma were obtained. Those images were then transferred to the workstation. The trajectory of catheter was designed to go through the main axis of the hematoma. Under local anesthesia a catheter was directed stereotactically into the hematoma through a burr hole. Hematoma thrombolysis and clot drainage was followed by instillation of urokinase (10,000 U) every 12 hours. The catheter was removed when the majority of hematoma was evacuated.</p><p><b>RESULTS</b>Initial SCH volume was reduced by an average of 86% and the average final hematoma volume was 2.8 ml. At 3-month follow-up, 13 patients (72%) had achieved good recovery. At 6-month follow-up, 12 patients (67%) had achieved good recovery.</p><p><b>CONCLUSION</b>Stereotactic aspiration and thrombolysis of SCH was a simple, feasible and effective method to treat moderate and some benign SCH that less respond to medical treatment.</p>

Prospective study on associations between levels of total cholesterol, triglyceride and risk of ischemic and hemorrhagic strokes / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore associations between levels of total cholesterol (TC), triglyceride (TG) and incidence of ischemic and hemorrhagic strokes in populations.</p><p><b>METHODS</b>Baseline investigations on stroke-related risk factors and physical examinations were performed in 10 093 (> 35 years) stroke-free urban community residents from 5 cities in China during May to July in 1987, follow-up investigations on stroke events were made during 1998 to 2000. The hazard ratios and 95% confidence intervals (CI) of ischemic and hemorrhagic strokes in middle, high tertiles of baseline TC or TG levels were compared with low baseline tertile residents using the Cox regression model.</p><p><b>RESULTS</b>There were 491 first strokes during the 8-years cohort follow-up. Compared with the low tertile, risk of ischemic stroke in the middle and high tertiles of TC level was increased by 61% (HR: 1.61, 95%CI: 1.14-2.27) and 58% (HR: 1.58, 95%CI: 1.12-2.22) after adjustments for DBP, age, sex and other variables in the Cox proportional hazards model. Compared with the low tertile, risk of ischemic stroke in the high tertile of TG level was increased by 43% (HR: 1.43, 95%CI: 1.02-2.00). However, risk of hemorrhagic stroke in the middle and high tertiles of TC level decreased by 12% (HR: 0.88, 95%CI: 0.64-1.22) and 33% (HR: 0.67, 95%CI: 0.48-0.95) compared with the low tertile.</p><p><b>CONCLUSIONS</b>Elevated serum TC and TG are independent risk factors for risk of ischemic stroke. However, low TC was related with increased risk of hemorrhagic stroke.</p>

Stereotactic localization and visualization of the subthalamic nucleus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The subthalamic nucleus (STN) is widely recognized as one of the most important and commonly targeted nuclei in stereotactic and functional neurosurgery. The success of STN surgery depends on accuracy in target determination. Construction of a digitalized atlas of STN based on stereotactic MRI will play an instrumental role in the accuracy of anatomical localization. The aim of this study was to investigate the three-dimensional (3D) target location of STN in stereotactic space and construct a digitalized atlas of STN to accomplish the visualization of the STN on stereotactic MRI, thus providing clinical guidance on the precise anatomical localization of STN.</p><p><b>METHODS</b>One hundred and twenty healthy people volunteered to be scanned by 1.5 Tesla MRI scanning with 1-mm-thick slice in the standard stereotactic space between 2005 and 2006. One adult male was selected for 3D reconstruction of STN. The process of 3D reconstruction included identification, manual segmentation, extraction, conservation and reconstruction.</p><p><b>RESULTS</b>There was a significant correlation between the coordinates and age (P < 0.05). The volume of left STN was significantly larger than the right STN, and there was a significant negative correlation between volume and age (P < 0.05). The surface of the STN nucleus after 3D reconstruction appeared smooth, natural and realistic. The morphological feature of STN on the individual brain could be visualized directly in 3D. The 3D reconstructed STN could be rotated, zoomed and displayed at any direction in the stereotactic space. The anteroposterior diameter of the STN nucleus was longer than the vertical and transverse diameters in 3D space. The 3D reconstruction of STN manifested typical structure of the "dual lens".</p><p><b>CONCLUSIONS</b>The visualization of individual brain atlas based on stereotactic MRI is feasible. However, software for automated segmentation, extraction and registration of MR images need to be further developed.</p>

Microstructural observation of epileptic neurons in vitro by atomic force microscopy / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the microstructure of the cell membrane of epileptic neurons using atomic force microscopy (AFM).</p><p><b>METHODS</b>Model of epileptic neurons was established by subjecting the neurons culture for 14 days in vitro to magnesium-free media treatment for 3 h. Patch clamp technique was applied to record the electrophysiological activity of the epileptic neurons. AFM was performed to observe and measure the microstructure of the cell membrane of the epileptic neuron.</p><p><b>RESULTS</b>After a 3-hour treatment with magnesium-free media, the epileptic neurons displayed sustained epileptiform discharge, which continued after the neurons were returned to normal medium culture on day 14. Under AFM scanning size of 80 microm x 80 microm and 2 microm x 2 microm, no obvious difference in the morphology of the cell membrane was noted between epileptic and normal neurons; under the scanning size of 500 nm x 500 nm, small pits occurred in the cell membrane in both groups, but no significant difference was found in the dimension of the pits between the two groups (the diameter and depth of the pits was 114.86-/+9.33 nm and 5.71-/+0.69 nm in epileptic neurons, and 116.4-/+9.13 nm and 5.69-/+0.71 nm in the control neurons, respectively, P>0.05).</p><p><b>CONCLUSION</b>AFM provides a new method for observing neuronal membrane microstructure at nanometer resolutions. No significant alterations occur in the membrane of the neurons after a 3-hour magnesium-free media treatment.</p>