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1.
Arq. ciências saúde UNIPAR ; 27(1): 291-312, Jan-Abr. 2023.
Article in Portuguese | LILACS | ID: biblio-1414871

ABSTRACT

Esse trabalho busca relatar o processo de confecção de peças anatômicas para o ensino da anatomia humana a partir de material cadavérico fetal. Os discentes do curso de medicina da Universidade Federal do Paraná (UFPR) ­ Campus Toledo participaram do programa de voluntariado acadêmico e deram atenção especial aos aspectos técnicos do processo de dissecação, bem como a experiência subjetiva desse procedimento como ferramenta de aprendizado ativo. O procedimento foi realizado na sala de preparação de cadáver da UFPR ­ Campus Toledo, utilizando instrumental de dissecação e cadáveres humanos fetais com 20, 17 e 14 semanas de idade gestacional, direcionado de modo a expor as partes constituintes do sistema neural. Foram confeccionadas peças de cérebro, cerebelo, tronco encefálico, medula espinal, nervos espinais e suas estruturas associadas. Os voluntários envolvidos foram capazes de produzir material de estudo de qualidade através da dissecação e fortalecer seu conhecimento em anatomia humana e aptidão manual. Também foi dada atenção à importância e às limitações do processo de dissecação como estratégia de aprendizado em cursos da área de saúde. pôde ser observado que a dissecação pode fazer parte de uma formação completa e bem estruturada dos discentes, que por sua vez irão integrar a sociedade e a academia. Além disso, a exposição da topografia neural fetal pode servir de referencial para posteriores estudos que venham a utilizar essas informações.


This work aims to report the confection process of anatomic pieces for teaching human anatomy from fetal cadaveric material. The students of the medicine course of Universidade Federal do Paraná (UFPR) ­ Campus Toledo, took part in the academic volunteer program and paid special attention to the technical aspects of the dissection process, as well as the subjective experience of this procedure as an active learning tool. The procedure was performed at the cadaver preparation room of the UFPR ­ Campus Toledo, using dissection tools and human fetal corpses of 20, 17 and 14 weeks of gestational ages, directed so as to expose the constituent parts of the neural system. Pieces of the brain, cerebellum, brainstem, spinal cord, spinal nerves, and its associated structures were made. The involved voluntaries were able to produce quality study material through dissection, and strengthen their knowledge in human anatomy and manual skill. Attention was also given to the importance and limitations of the dissection process as a learning strategy in health courses. it was observed that dissection can be part of a complete and well-structured training of students, who in turn will integrate society and academia. In addition, the exposure of fetal neural topography can serve as a reference for further studies that use this information


Este trabajo tiene como objetivo relatar el proceso de confección de piezas anatómicas para la enseñanza de la anatomía humana a partir de material cadavérico fetal. Los alumnos del curso de medicina de la Universidade Federal do Paraná (UFPR) - Campus Toledo, participaron del programa de voluntariado académico y prestaron especial atención a los aspectos técnicos del proceso de disección, así como a la vivencia subjetiva de este procedimiento como herramienta de aprendizaje activo. El procedimiento fue realizado en la sala de preparación de cadáveres de la UFPR - Campus Toledo, utilizando herramientas de disección y cadáveres de fetos humanos de 20, 17 y 14 semanas de edad gestacional, dirigidos de forma a exponer las partes constitutivas del sistema neural. Se realizaron piezas del cerebro, cerebelo, tronco encefálico, médula espinal, nervios espinales y sus estructuras asociadas. Los voluntarios participantes pudieron elaborar material de estudio de calidad mediante la disección y reforzar sus conocimientos de anatomía humana y habilidad manual. También se prestó atención a la importancia y las limitaciones del proceso de disección como estrategia de aprendizaje en los cursos de salud. Se observó que la disección puede formar parte de una formación completa y bien estructurada de los estudiantes, que a su vez integrarán la sociedad y el mundo académico. Además, la exposición de la topografía neural fetal puede servir de referencia para estudios posteriores que utilicen esta información.


Subject(s)
Humans , Male , Female , Dissection/education , Fetus/anatomy & histology , Nervous System/anatomy & histology , Spinal Cord/anatomy & histology , Volunteers/education , Brain/anatomy & histology , Cerebellum/anatomy & histology , Dura Mater/anatomy & histology , Education, Medical, Undergraduate , Neuroanatomy
2.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 721-726, 2023.
Article in Chinese | WPRIM | ID: wpr-981659

ABSTRACT

OBJECTIVE@#To summarize the research progress of stem cell transplantation in treating spinal cord injury (SCI) at different stages based on the pathophysiological mechanism of SCI.@*METHODS@#The relevant research literature at home and abroad was extensively reviewed to explore the impact of transplantation timing on the effectiveness of stem cell transplantation in treating SCI.@*RESULTS@#Researchers performed different types of stem cell transplantation for subjects at different stages of SCI through different transplantation approaches. Clinical trials have proved the safety and feasibility of stem cell transplantation at acute, subacute, and chronic stages, which can alleviate inflammation at the injured site and restore the function of the damaged nerve cells. But the reliable clinical trials comparing the effectiveness of stem cell transplantation at different stages of SCI are still lacking.@*CONCLUSION@#Stem cell transplantation has a good prospect in treating SCI. In the future, the multi-center, large sample randomized controlled clinical trials are needed, with a focus on the long-term effectiveness of stem cell transplantation.


Subject(s)
Humans , Hematopoietic Stem Cell Transplantation , Neurons , Recovery of Function/physiology , Spinal Cord , Spinal Cord Injuries/surgery , Stem Cell Transplantation
3.
China Journal of Chinese Materia Medica ; (24): 3848-3854, 2023.
Article in Chinese | WPRIM | ID: wpr-981517

ABSTRACT

This study aims to investigate the neuroprotective effect of tetramethylpyrazine on mice after spinal cord injury and its mechanism. Seventy-five female C57BL/6 mice were randomly divided into 5 groups, namely, a sham operation group, a model group, a tetramethylpyrazine low-dose group(25 mg·kg~(-1)), a tetramethylpyrazine medium-dose group(50 mg·kg~(-1)), and a tetramethylpyrazine high-dose group(100 mg·kg~(-1)), with 15 mice in each group. Modified Rivlin method was used to establish the mouse model of acute spinal cord injury. After 14 d of tetramethylpyrazine intervention, the motor function of hind limbs of mice was evaluated by basso mouse scale(BMS) and inclined plate test. The levels of inflammatory cytokines tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-1β(IL-1β) in the spinal cord homogenate were determined by enzyme-linked immunosorbent assay(ELISA). Hematoxylin-eosin(HE) staining was used to observe the histology of the spinal cord, and Nissl's staining was used to observe the changes in the number of neurons. Western blot and immunofluorescence method were used to detect the expression of glial fibrillary acidic protein(GFAP) and C3 protein. Tetramethylpyrazine significantly improved the motor function of the hind limbs of mice after spinal cord injury, and the BMS score and inclined plate test score of the tetramethylpyrazine high-dose group were significantly higher than those of the model group(P<0.01). The levels of TNF-α, IL-6, and IL-1β in spinal cord homogenate of the tetramethylpyrazine high-dose group were significantly decreased(P<0.01). After tetramethylpyrazine treatment, the spinal cord morphology recovered, the number of Nissl bodies increased obviously with regular shape, and the loss of neurons decreased. As compared with the model group, the expression of GFAP and C3 protein was significantly decreased(P<0.05,P<0.01) in tetramethylpyrazine high-dose group. In conclusion, tetramethylpyrazine can promote the improvement of motor function and play a neuroprotective role in mice after spinal cord injury, and its mechanism may be related to inhibiting inflammatory response and improving the hyperplasia of glial scar.


Subject(s)
Rats , Mice , Female , Animals , Rats, Sprague-Dawley , Neuroprotective Agents/pharmacology , Tumor Necrosis Factor-alpha/metabolism , Interleukin-6 , Mice, Inbred C57BL , Spinal Cord Injuries/genetics , Spinal Cord/metabolism
4.
Neuroscience Bulletin ; (6): 466-478, 2023.
Article in English | WPRIM | ID: wpr-971586

ABSTRACT

Multiple sclerosis (MS) is regarded as a chronic inflammatory disease that leads to demyelination and eventually to neurodegeneration. Activation of innate immune cells and other inflammatory cells in the brain and spinal cord of people with MS has been well described. However, with the innovation of technology in glial cell research, we have a deep understanding of the mechanisms of glial cells connecting inflammation and neurodegeneration in MS. In this review, we focus on the role of glial cells, including microglia, astrocytes, and oligodendrocytes, in the pathogenesis of MS. We mainly focus on the connection between glial cells and immune cells in the process of axonal damage and demyelinating neuron loss.


Subject(s)
Humans , Multiple Sclerosis , Neuroglia , Inflammation/pathology , Brain/pathology , Spinal Cord/pathology
5.
Neuroscience Bulletin ; (6): 213-244, 2023.
Article in English | WPRIM | ID: wpr-971539

ABSTRACT

Nerve regeneration in adult mammalian spinal cord is poor because of the lack of intrinsic regeneration of neurons and extrinsic factors - the glial scar is triggered by injury and inhibits or promotes regeneration. Recent technological advances in spatial transcriptomics (ST) provide a unique opportunity to decipher most genes systematically throughout scar formation, which remains poorly understood. Here, we first constructed the tissue-wide gene expression patterns of mouse spinal cords over the course of scar formation using ST after spinal cord injury from 32 samples. Locally, we profiled gene expression gradients from the leading edge to the core of the scar areas to further understand the scar microenvironment, such as neurotransmitter disorders, activation of the pro-inflammatory response, neurotoxic saturated lipids, angiogenesis, obstructed axon extension, and extracellular structure re-organization. In addition, we described 21 cell transcriptional states during scar formation and delineated the origins, functional diversity, and possible trajectories of subpopulations of fibroblasts, glia, and immune cells. Specifically, we found some regulators in special cell types, such as Thbs1 and Col1a2 in macrophages, CD36 and Postn in fibroblasts, Plxnb2 and Nxpe3 in microglia, Clu in astrocytes, and CD74 in oligodendrocytes. Furthermore, salvianolic acid B, a blood-brain barrier permeation and CD36 inhibitor, was administered after surgery and found to remedy fibrosis. Subsequently, we described the extent of the scar boundary and profiled the bidirectional ligand-receptor interactions at the neighboring cluster boundary, contributing to maintain scar architecture during gliosis and fibrosis, and found that GPR37L1_PSAP, and GPR37_PSAP were the most significant gene-pairs among microglia, fibroblasts, and astrocytes. Last, we quantified the fraction of scar-resident cells and proposed four possible phases of scar formation: macrophage infiltration, proliferation and differentiation of scar-resident cells, scar emergence, and scar stationary. Together, these profiles delineated the spatial heterogeneity of the scar, confirmed the previous concepts about scar architecture, provided some new clues for scar formation, and served as a valuable resource for the treatment of central nervous system injury.


Subject(s)
Mice , Animals , Gliosis/pathology , Cicatrix/pathology , Spinal Cord Injuries , Astrocytes/metabolism , Spinal Cord/pathology , Fibrosis , Mammals , Receptors, G-Protein-Coupled
6.
Acta Academiae Medicinae Sinicae ; (6): 346-350, 2023.
Article in Chinese | WPRIM | ID: wpr-981275

ABSTRACT

Wernekink commissure syndrome is a rare midbrain syndrome with bilateral cerebellar dysfunction,eye movement disorder,and palatal myoclonus.Few cases of this syndrome have been reported in China,let alone those combined with hallucinations and involuntary groping.This paper reports the diagnosis and treatment of a case of Wernekink commissure syndrome with hallucinations and involuntary groping,aiming to enrich the knowledge about this disease for clinicians.


Subject(s)
Humans , Mesencephalon , Ocular Motility Disorders/diagnosis , Spinal Cord , Syndrome , Hallucinations
7.
Acta Physiologica Sinica ; (6): 475-485, 2023.
Article in Chinese | WPRIM | ID: wpr-981022

ABSTRACT

Pain is a multi-dimensional emotional experience, and pain sensation and pain emotion are the two main components. As for pain, previous studies only focused on a certain link of the pain transmission pathway or a certain key brain region, and there is a lack of evidence that connectivity of brain regions is involved in pain or pain regulation in the overall state. The establishment of new experimental tools and techniques has brought light to the study of neural pathways of pain sensation and pain emotion. In this paper, the structure and functional basis of the neural pathways involved in the formation of pain sensation and the regulation of pain emotion in the nervous system above the spinal cord level, including thalamus, amygdala, midbrain periaqueductal gray (PAG), parabrachial nucleus (PB) and medial prefrontal cortex (mPFC), are reviewed in recent years, providing clues for the in-depth study of pain.


Subject(s)
Humans , Pain , Neural Pathways/physiology , Periaqueductal Gray/physiology , Brain , Spinal Cord/physiology , Magnetic Resonance Imaging
8.
Acta Physiologica Sinica ; (6): 231-240, 2023.
Article in Chinese | WPRIM | ID: wpr-981000

ABSTRACT

Persistent neurogenesis exists in the subventricular zone (SVZ) of the ventricles and the subgranular zone (SGZ) of the dentate gyrus of the hippocampus in the adult mammalian brain. Adult endogenous neurogenesis not only plays an important role in the normal brain function, but also has important significance in the repair and treatment of brain injury or brain diseases. This article reviews the process of adult endogenous neurogenesis and its application in the repair of traumatic brain injury (TBI) or ischemic stroke, and discusses the strategies of activating adult endogenous neurogenesis to repair brain injury and its practical significance in promoting functional recovery after brain injury.


Subject(s)
Adult , Animals , Humans , Brain/physiopathology , Hippocampus/physiopathology , Mammals/physiology , Neurogenesis/physiology , Brain Hemorrhage, Traumatic/therapy , Ischemic Stroke/therapy , Recovery of Function , Spinal Cord/physiopathology
9.
Neuroscience Bulletin ; (6): 929-946, 2023.
Article in English | WPRIM | ID: wpr-982431

ABSTRACT

A decline in the activities of oxidative phosphorylation (OXPHOS) complexes has been consistently reported in amyotrophic lateral sclerosis (ALS) patients and animal models of ALS, although the underlying molecular mechanisms are still elusive. Here, we report that receptor expression enhancing protein 1 (REEP1) acts as an important regulator of complex IV assembly, which is pivotal to preserving motor neurons in SOD1G93A mice. We found the expression of REEP1 was greatly reduced in transgenic SOD1G93A mice with ALS. Moreover, forced expression of REEP1 in the spinal cord extended the lifespan, decelerated symptom progression, and improved the motor performance of SOD1G93A mice. The neuromuscular synaptic loss, gliosis, and even motor neuron loss in SOD1G93A mice were alleviated by increased REEP1 through augmentation of mitochondrial function. Mechanistically, REEP1 associates with NDUFA4, and plays an important role in preserving the integrity of mitochondrial complex IV. Our findings offer insights into the pathogenic mechanism of REEP1 deficiency in neurodegenerative diseases and suggest a new therapeutic target for ALS.


Subject(s)
Mice , Animals , Amyotrophic Lateral Sclerosis/metabolism , Superoxide Dismutase-1/metabolism , Superoxide Dismutase/metabolism , Mice, Transgenic , Spinal Cord/pathology , Mitochondria/physiology , Disease Models, Animal
10.
Neuroscience Bulletin ; (6): 645-658, 2023.
Article in English | WPRIM | ID: wpr-982413

ABSTRACT

To understand how the nervous system develops from a small pool of progenitors during early embryonic development, it is fundamentally important to identify the diversity of neuronal subtypes, decode the origin of neuronal diversity, and uncover the principles governing neuronal specification across different regions. Recent single-cell analyses have systematically identified neuronal diversity at unprecedented scale and speed, leaving the deconstruction of spatiotemporal mechanisms for generating neuronal diversity an imperative and paramount challenge. In this review, we highlight three distinct strategies deployed by neural progenitors to produce diverse neuronal subtypes, including predetermined, stochastic, and cascade diversifying models, and elaborate how these strategies are implemented in distinct regions such as the neocortex, spinal cord, retina, and hypothalamus. Importantly, the identity of neural progenitors is defined by their spatial position and temporal patterning factors, and each type of progenitor cell gives rise to distinguishable cohorts of neuronal subtypes. Microenvironmental cues, spontaneous activity, and connectional pattern further reshape and diversify the fate of unspecialized neurons in particular regions. The illumination of how neuronal diversity is generated will pave the way for producing specific brain organoids to model human disease and desired neuronal subtypes for cell therapy, as well as understanding the organization of functional neural circuits and the evolution of the nervous system.


Subject(s)
Humans , Neural Stem Cells/physiology , Neurons/physiology , Brain , Spinal Cord , Embryonic Development , Cell Differentiation/physiology
11.
China Journal of Orthopaedics and Traumatology ; (12): 519-524, 2023.
Article in Chinese | WPRIM | ID: wpr-981726

ABSTRACT

OBJECTIVE@#To observe the analgesic effect of Tuina by pressing and kneading the Huantiao (GB30) acupoint on rats with chronic constriction injury (CCI) and to explore the analgesic mechanism of Tuina on sciatica rats.@*METHODS@#Thirty-two SPF male SD rats weighing 180 to 220 g were randomly divided into fore groups:blank group (without any treatment), sham group (only exposed without sciatic nerve ligating), model group (sciatic nerve ligating) and Tuina group (manual intervention after lsciatic nerve ligating). The CCI model was prepared by ligating the right sciatic nerve of the rats, on the third day of modeling, the rats in the Tuina group were given pressing and kneading the Huantiao (GB30) point for 14 days, and the changes of paw withdrawal threshold(PWT), paw withdrawal latency(PWL) were measured before and on the 1st, 3rd, 7th, 10th, 14th and 17th days after modeling. The changes of sciatic functional index(SFI) were measured before and on the 1st and 17th day after modeling. The morphological changes of the sciatic nerve were observed by hematoxylin-eosin(HE) staining;and the differences in NF-κB protein expression in the right dorsal horn of the spinal cord of rats were detected.@*RESULTS@#Following modeling, there was no significant difference in PWT, PWL and SFI between the blank group and the sham group (P>0.05), but the PWT, PWL and SFI of the model group and the Tuina group decreased significantly (P<0.01). After manual intervention, the pain threshold of rats in Tuina group increased. On the 8th day of manual intervention (the 10th day after modeling), PWT in Tuina group increased significantly compared with that in model group (P<0.01). On the 5th day of manual intervention (the 7th day after modeling), the PWL of the massage group was significantly higher than that of the model group (P<0.01). The pain threshold of rats in Tuina group continued to rise with the continuous manipulation intervention. After 14 days of manipulative intervention, the sciatic nerve function index of rats in the Tuina group increased significantly(P<0.01). Compared with the blank group and sham group, the myelinated nerve fibers of sciatic nerve in the model group were disordered and the density of axons and myelin sheath was uneven. Compared with the model group, the nerve fibers of rats in the Tuina group were gradually continuous and the axons and myelin sheath were more uniform than those in the model group. Compared with the blank group and sham group, the expression of NF-κB protein in the right spinal dorsal horn of the model group was significantly increased(P<0.01). Compared with the model group, the expression of NF-κB protein in the right spinal dorsal horn of rats in Tuina group decreased significantly(P<0.01).@*CONCLUSION@#Pressing and kneading the Huantiao (GB30) point restores nerve fiber alignment;and improves the PWT、PWL and SFI in the CCI model by decreasing NF-κB p65 protein expression in the spinal dorsal horn. There fore, Tuina demmstrates an analgesic effect and improves the gait of rats with sciatica.


Subject(s)
Rats , Male , Animals , Rats, Sprague-Dawley , Sciatica/therapy , NF-kappa B/metabolism , Acupuncture Points , Spinal Cord Dorsal Horn/metabolism , Spinal Cord , Massage
12.
Chinese Journal of Traumatology ; (6): 2-7, 2023.
Article in English | WPRIM | ID: wpr-970972

ABSTRACT

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.


Subject(s)
Child , Humans , Spinal Cord Injuries/complications , Spinal Cord
13.
Chinese Journal of Traumatology ; (6): 8-13, 2023.
Article in English | WPRIM | ID: wpr-970963

ABSTRACT

Pediatric and adult spinal cord injuries (SCI) are distinct entities. Children and adolescents with SCI must suffer from lifelong disabilities, which is a heavy burden on patients, their families and the society. There are differences in Chinese and foreign literature reports on the incidence, injury mechanism and prognosis of SCI in children and adolescents. In addition to traumatic injuries such as car accidents and falls, the proportion of sports injuries is increasing. The most common sports injury is the backbend during dance practice. Compared with adults, children and adolescents are considered to have a greater potential for neurological improvement. The pathogenesis and treatment of pediatric SCI remains unclear. The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion, hyperextension, longitudinal distraction and ischemia. We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery. In addition, the complications of pediatric SCI are also worthy of attention. New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis. This article reviews the epidemiology, pathogenesis, imaging, clinical characteristics, treatment and complications of SCI in children and adolescents. Although current treatment cannot completely restore neurological function, patient quality of life can be enhanced. Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.


Subject(s)
Adult , Child , Humans , Adolescent , Diffusion Tensor Imaging/methods , Quality of Life , Spinal Cord Injuries/therapy , Prognosis , Athletic Injuries , Spinal Cord/pathology
14.
Rev. bras. ortop ; 57(4): 697-701, Jul.-Aug. 2022. graf
Article in English | LILACS | ID: biblio-1394871

ABSTRACT

Abstract A 26-year-old previously healthy patient who, at the age of 18 years, began progressive loss of distal strength, rest tremor, and muscle atrophy in the left upper limb. Upon examination, the patient presented moderate distal atrophy, degree 4 in muscular strength, and minipolymioclonus. Electromyoneurography revealed (EMNG) chronic preganglionic bilateral involvement of bilateral C7/C8/T1, worse on the left, with signs of active C8/T1 denervation. A cervical spine magnetic resonance imaging (MRI) scan showed spondylodiscal degenerative changes with central protrusions in C4-C5, C6-C7, and right central in C5-C6, which touched the dural sac. The anteroposterior diameter of the medulla in neutral position, in the C5-C6 plane, was of 5.1 mm. There was a reduction of the spinal cord caliber to 4.0 mm after the dynamic maneuver of forced flexion of the spine, as well as signal increase in the anterior horns. The clinical findings and those of the complementary tests were compatible with Hirayama disease (HD), a rare benign motor neuron disease that affects cervical spinal segments and is most prevalent in men, with onset in the early 20s. Unilateral and slowly progressive weakness is typical, but self-limited. Sensory disturbances, and autonomic and upper motor neuron signals are rare. Management is usually conservative, with the use of a soft cervical collar. Although rare, HD should be considered in young patients with focal asymmetric atrophy in the upper limbs. The early diagnosis of HD depends on the degree of suspicion, as well as on the cooperation and communication among the various specialties involved in the investigation.


Resumo Paciente de 26 anos, previamente hígido, que, aos 18 anos, iniciou perda progressiva de força distal, tremor de repouso, e atrofia muscular no membro superior esquerdo. Ao exame, apresentou atrofia moderada, distal, força muscular de grau 4, e minipolimioclonus. A eletroneuromiografia (ENMG) revelou comprometimento pré-ganglionar crônico de C7/C8/T1 bilateral pior à esquerda, com sinais de desnervação ativa em C8/T1. A ressonância magnética (RM) de coluna cervical mostrou alterações degenerativas espondilodiscais com protrusões centrais em C4-C5, C6-C7, e central direita em C5-C6, que tocavam o saco dural. O diâmetro anteroposterior da medula na posição neutra, no plano de C5-C6, era de 5,1 mm. Houve redução do calibre da medula para 4,0 mm após a manobra dinâmica de flexão forçada da coluna, e aumento de sinal nos cornos anteriores. Os achados clínicos e os dos exames complementares eram compatíveis com doença de Hirayama (DH), uma doença benigna rara dos neurônios motores, que afeta os segmentos espinhais cervicais e é mais prevalente em homens e de início próximo aos 20 anos. É típica a fraqueza unilateral e lentamente progressiva, porém autolimitada. Perturbações sensoriais, sinais autonômicos e do neurônio motor superior são raras. O manejo geralmente é conservador, com uso de colar cervical macio. Apesar de rara, a DH deve ser considerada em pacientes jovens que apresentam atrofias assimétricas focais de membros superiores. O diagnóstico precoce de DH depende do grau de suspeição, e da cooperação e comunicação entre as diversas especialidades envolvidas na investigação.


Subject(s)
Humans , Adult , Spinal Cord/pathology , Magnetic Resonance Imaging , Muscular Atrophy/diagnostic imaging , Spinal Muscular Atrophies of Childhood/diagnostic imaging
15.
Rev. bras. ortop ; 57(3): 521-523, May-June 2022. graf
Article in English | LILACS | ID: biblio-1388024

ABSTRACT

Abstract Idiopathic hypertrophic pachymeningitis is rare cause of neurological symptoms with myelopathy due to spinal cord compression. We report a case of pachymeningitis, which was manifested primarily by tetraparesis after low-energy trauma and recurrence the myelopathy symptoms after 5 years of surgery. The patient, a 19-year-old woman, was subjected to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed an unspecific inflammatory process with extensive fibrosis of the dura mater. These findings, associated with the exclusion of other causes, suggest idiopathic hypertrophic pachymeningitis.


Resumo A paquimeningite hipertrófica idiopática é uma causa rara de sintomas neurológicos apresentando mielopatia por compressão da medula espinhal. Relatamos um caso de paquimeningite com manifestação primária de tetraparesia após trauma de baixa energia e recorrência dos sintomas de mielopatia 5 anos após a cirurgia. A paciente, uma mulher de 19 anos, foi submetida a extensa investigação sem evidências de qualquer doença de base. Uma biópsia da meninge revelou processo inflamatório inespecífico com extensa fibrose da dura máter, também visualizado no período perioperatório. Esses achados, associados à exclusão de outras causas, sugerem o diagnóstico de paquimeningite hipertrófica idiopática.


Subject(s)
Humans , Female , Adult , Spinal Cord/pathology , Spinal Cord Compression , Hypertrophy , Meningitis/physiopathology
16.
Arq. bras. neurocir ; 41(1): 90-93, 07/03/2022.
Article in English | LILACS | ID: biblio-1362095

ABSTRACT

Intramedullary schwanommas are rare, and most cases are reported in cervical region. Less than 20 dorsal intramedullary schwanommas have been reported till date in literature. This is due to their cell of origin, the Schwann cell, which is not normally found within the parenchyma of the brain and spinal cord; therefore it is not surprising that these lesions are rare. We report a rare solitary dorsal intramedullary schwanomma in a young adult patient who presented with paraplegia.


Subject(s)
Humans , Female , Adult , Spinal Cord Neoplasms/surgery , Neurilemmoma/surgery , Neurilemmoma/pathology , Spinal Cord/surgery , Spinal Cord/pathology , Spinal Cord Neoplasms/diagnostic imaging , Diagnosis, Differential , Laminectomy/methods , Neurilemmoma/diagnostic imaging
18.
Journal of Central South University(Medical Sciences) ; (12): 431-442, 2022.
Article in English | WPRIM | ID: wpr-928987

ABSTRACT

OBJECTIVES@#There are clinical reports of nerve injury caused by ropivacaine. The mechanism for nerve injury induced by ropivacaine has not been fully clarified. This study aims to investigate the changes of pain threshold and L3 spinal cord genomics at 6 h and 24 h after intrathecal injection of 0.5% and 1.0% ropivacaine, and to explore the underlying mechanisms for nerve injury caused by ropivacaine.@*METHODS@#A total of 30 male Sprague Dawley rats weighing 220-260 g were successfully implanted with microspinal catheter. The rats were randomly divided into 5 groups (each n=6): a control group (given saline), a ropivacaine group 1 and a ropivacaine group 2 (both given 1% ropivacaine), a ropivacaine group 3 and a ropivacaine group 4 (both given 0.5% ropivacaine). The rats received continuous intrathecal injection of corresponding drugs at 8.3 μL/h for 24 h via an implanted intrathecal catheter followed by 24 h-pause of injection for the ropivacaine group 2, the ropivacaine group 4 and the control group, 6 h-pause of injection for the ropivacaine group 1 and the ropivacaine group 3. For each group, the observation of behavioral change and the paw withdrawal mechanical threshold (PWMT) was conducted immediately after the injection and again after the pause of injection. After the PWMT observation, the rats were dissected to acquire L3 spinal cords. Illumina sequencing was applied to construct gene libraries. Then the statistical methods were used to find out differentially expressed genes between the groups. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway analysis were conducted for those genes. Real-time RT-PCR was used to determine different expressions of some of those genes.@*RESULTS@#Compared with control group, the PWMT got higher in the ropivacaine group 1-4 and was positively correlated with concentration, negatively correlated with discontinuation duration. Compared with control group, the ropivacaine group 1 had 488 differentially expressed genes, of which 456 were up-regulated and 32 were down-regulated; the ropivacaine group 2 had 1 194 differentially expressed genes, of which 1 092 were up-regulated and 102 were down-regulated; the ropivacaine group 3 had 518 differentially expressed genes, of which 384 were up-regulated and 134 were down-regulated; and the ropivacaine group 4 had 68 differentially expressed genes, of which 46 were up-regulated and 22 were down-regulated. GO enrichment analysis and KEGG signaling pathway analysis showed that most of these differentially expressed genes were related to signaling pathways of inflammatory response.@*CONCLUSIONS@#After intrathecal injection of 0.5% ropivacaine and 1.0% ropivacaine for 24 h, the differentially expressed genes in L3 spinal cord of rats are mainly related to signaling pathways of inflammatory response.


Subject(s)
Animals , Male , Rats , Genomics , Injections, Spinal , Rats, Sprague-Dawley , Ropivacaine , Spinal Cord/metabolism
19.
Ribeirão Preto; s.n; 2022. 107 p. ilus, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1524477

ABSTRACT

A Lesão de Medula Espinhal (LME) é um trauma com efeitos devastadores na vida dos indivíduos. Estima-se que mais de 130.000 pessoas sejam afetadas por LME, a cada ano, em todo o mundo. Aproximadamente, 45% de todas as lesões são completas, deixando apenas uma pequena chance de recuperação funcional. As complicações ocasionadas pela LME influenciam a qualidade de vida dos indivíduos, aumentam as demandas de cuidados e os encargos sociais e econômicos de saúde. Este é um estudo metodológico, que teve o objetivo de construir e validar instrumento baseado no Core Set resumido da CIF, para indivíduos com lesão medular aguda traumática. Essa pesquisa foi aprovada pelo Comitê de Ética e desenvolvida nas seguintes etapas: 1 - Elaboração do instrumento a partir do Core set resumido da CIF para lesão medular aguda: "Elaboração e Validação de Instrumento baseado no Core Set resumido da Classificação Internacional da Funcionalidade para indivíduos com Lesão Medular Aguda"; 2- Validação do instrumento e coleta de dados pelos juízes; 3- Aplicação do pré-teste. O instrumento para validação de face e conteúdo composto por 15 categorias que integraram os componentes da CIF: funções do corpo (6), estrutura do copo (2), atividades e participação (2), fatores ambientais e fatores pessoais (5). A validade de conteúdo do instrumento foi feita por um comitê de vinte e dois juízes. Dos 22 juízes, 18 (81,8%) eram do sexo feminino e 4 (18,2%) do sexo masculino. A maioria era constituída por jovens, com média entre 40±10 anos, sendo que 3 participantes (13,6%) tinham idade entre 20 e 29 anos, 8 (36,4%) de 30 e 39 anos, 7 (31,8%) entre 40 e 49 anos, 3 (13,6%) 50 e 59 anos e 1 (4,5%) 60 e 69 anos. Cerca de 95,5 % relataram participar, nos últimos 2 anos, de eventos científicos na área temática da pesquisa, 13 (59,1%) realizavam estudos sobre a CIF e 14 (63,6%) a utilizavam na sua prática clínica. Todas as categorias obtiveram uma concordância de IVC >0,80, sendo assim, o instrumento, pode ser considerado validado. Na maioria das categorias, os juízes fizeram sugestões que visavam às modificações de termos, para serem substituídos ou reformulados, e os qualificadores repontuados, de acordo com os percentuais da CIF. Após consenso entre os pesquisadores foram realizadas as alterações sugeridas e elaborada a versão final do instrumento, com aplicação do pré-teste. O instrumento validado poderá contribuir para prática clínica dos profissionais da saúde, no processo de avaliação da funcionalidade dos indivíduos com lesão medular aguda


Spinal Cord Injury (SCI) is a trauma with devastating effects on the lives of individuals. It is estimated that more than 130,000 people are affected by SCI each year worldwide. Approximately 45% of all injuries are complete, leaving only a small chance of functional recovery. The complications caused by SCI influence the quality of life of individuals, increase the demands for care, and increase the social and economic burden of health care. This is a methodological study, which aimed to construct and validate an instrument based on the summarized ICF Core Set for individuals with traumatic acute spinal cord injury. This research was approved by the Ethics Committee and developed in the following stages: 1 - Development of the instrument from the summarized ICF core set for acute spinal cord injury: "Development and validation of an instrument based on the summarized core set of the International Classification of Functioning for individuals with acute spinal cord injury"; 2 - Validation of the instrument and data collection by the judges; 3 - Application of the pre-test. The instrument for face and content validation consisted of 15 categories that integrated the ICF components: body functions (6), body structure (2), activities and participation (2), environmental factors and personal factors (5). The content validity of the instrument was done by a committee of twenty-two judges. Of the 22 judges, 18 (81.8%) were female and 4 (18.2%) were male. The majority were young, averaging 40±10 years, with 3 participants (13.6%) aged 20-29 years, 8 (36.4%) 30-39 years, 7 (31.8%) 40-49 years, 3 (13.6%) 50-59 years, and 1 (4.5%) 60-69 years. About 95.5% reported participating, in the last 2 years, of scientific events in the thematic area of the research, 13 (59.1%) carried out studies about the ICF and 14 (63.6%) used it in their clinical practice. All categories obtained a CVI agreement >0.80, thus, the instrument can be considered validated. In most of the categories, the judges made suggestions that aimed at the modification of terms, to be replaced or reformulated, and the qualifiers were re-assessed, according to the ICF percentages. After consensus was reached among the researchers, the suggested changes were made and the final version of the instrument was prepared, with the application of the pre-test. The validated instrument may contribute to the clinical practice of health professionals in the process of evaluating the functionality of individuals with acute spinal cord injury


Subject(s)
Humans , Spinal Cord , Spinal Cord Injuries , International Classification of Functioning, Disability and Health , Reproducibility of Results
20.
Article in Spanish | LILACS, BINACIS | ID: biblio-1378016

ABSTRACT

Introducción: La lesión traumática de la médula espinal es la principal causa de discapacidad motora en el mundo, y representa una prioridad para la Organización Mundial de la Salud. Se estudió, a nivel estructural y bioquímico, el efecto de la hipotermia sobre la expresión de la CIRBP (proteína activada por frío) en el asta anterior de la médula de ratas Sprague-Dawley albinas macho de 60 días, planteándola como terapéutica posible. Materiales y Métodos:Se dividió a 24 ratas en dos grupos: normotermia a 24 °C (n = 6) e hipotermia a 8 °C (n = 18), durante 180 min, sacrificadas a las 12, 24 y 48 h después del tratamiento. Se utilizó Western blot e inmunohistoquímica para la CIRBP. Resultados:Se observó un aumento progresivo de la expresión de la CIRBP de 12 a 48 h en las motoneuronas del asta anterior. Los valores fueron estadísticamente significativos entre los grupos de 24 h y 48 h comparados con los de los controles. Conclusiones: Este modelo experimental resultó eficaz, accesible y económico para generar hipotermia sistémica y abre un abanico de estrategias terapéuticas. El aumento en la expresión de las proteínas inducibles por frío en la médula espinal de ratas permite, por primera vez, estudiar el beneficio que aporta la hipotermia a nivel molecular, lo que resulta de suma importancia para estudios de terapéuticas en las lesiones medulares. Nivel de Evidencia: I


Introduction: Traumatic spinal cord injury is the main cause of motor disability in developed and underdeveloped countries, being a priority interest to the WHO. The effect of hypothermia on the expression of CIRBP (cold-activated protein) in the anterior grey column of 60-day-old male albino Sprague-Dawley rats was studied at the structural and biochemical levels and proposed as a possible therapeutic approach. Materials and Methods: 24 rats were randomly divided into two groups; normothermia (n = 6), at 24° C, and hypothermia, (n = 18) at 8° C for 180 minutes and euthanized at 12, 24, and 48 h post-treatment. Western blot and immunohistochemistry for CIRBP were used. Results: A progressive increase in the expression of CIRBP was observed from 12 to 48 hours, with statistically significant values after 24 and 48 hours compared to controls. Conclusion: This experimental model demonstrated efficacy, accessibility, and economy to generate systemic hypothermia, which provides a novel range of therapeutic strategies. The increase in the expression of cold-inducible proteins in the rats' spinal cords allows us to study the benefit of hypothermia at the molecular level for the first time, being of utmost importance for therapeutic studies in spinal cord injuries. Level of Evidence: I


Subject(s)
Animals , Rats , Spinal Cord , Spinal Cord Injuries , Heterogeneous-Nuclear Ribonucleoproteins , Hypothermia
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