The application progress of PET-MRI new technique / 中国医学装备

Even though multimodal imaging system has already been applied in clinic, the PET-MRI still is a revolutionary progress of medical imaging, and it is a landmark after PET-CT imaging equipment. MRI not only can solve the limitations of CT, but also can provide abundant morphology and function information; at the same time, PET also play important role in the diagnosis of tumor, nervous system diseases and cardiovascular disease; and in the treatment decision, treatment effect evaluation and prognosis evaluation when it is applied in research of physiological and disease state at the levels of molecular activity and metabolism of human body. With the rapid development of science and technology, this article has summarized the imaging technology and clinical application of PET-MRI in recent years.

Research progress of Gαi/o-coupled receptor-mediated supersensitization of adenylyl cyclase / 药学学报

Persistent activation of most Gαi/o-coupled receptors resulted in enhanced activity of adenylyl cyclase (AC) and subsequent cyclic adenosine monophosphate (cAMP) accumulation within cells, and this phenomenon has generally been referred to as supersensitization of AC. It represents a cellular adaptive response that has been widely believed to be the cause of drug dependence. Supersensitization of AC might have an important impact during the processes of many central nervous system (CNS) disorder diseases, such as schizophrenia and depression, due to altered cell functions. This article provides an overview of the history and present status in our understanding of Gαi/o-coupled receptor-mediated supersensitization of AC, as well as discussion of the problems and future perspective.

Clinical analysis on 9 cases of nervous system disorder caused by Heat stroke / 中国神经精神疾病杂志

Objective To summarize the clinical characteristics , nerve electrophysiological features , imaging manifestations and prognosis of nervous system disorder caused by heat stroke. Methods A retrospective study was un?dertaken on clinical, nerve electrophysiological and imaging characteristics and prognosis of 9 patients who had heat Stroke and received treatment during July and August in 2010 and 2013 at the Second Hospital of Shandong University. Results There were seven males and two females, aged from 47 to 87 years, among 9 patients. All cases are admitted within 6 hours and their Core body temperature were 39.8℃~42.5℃. Patients had disturbance of consciousness and multi?ple organ dysfunction including acute cerebral infarct in 2 cases, peripheral neuropathy in 3 cases, acute respiratory fail?ure in 2 cases, pulmonary infection in 9 cases, disseminated intravascular coagulation in 1 case ,acute myocardial injury in 8 cases, arrhythmia in 3 cases, rhabdomyolysis in 3 cases, acute liver damage in 8 cases, of acute kidney injury in 6 cases, upper gastrointestinal bleeding in 4 cases, metabolic acidosis in 1 case, metabolic alkalosis in 2 cases , electrolyte disorder in 9 cases and quadriplegia in 3 cases. Brain magnetic resonance imaging showed diffuse brain swelling in 6 cas?es and the acute asymmetric lacunar infarction in 2 cases. All patients are treated with cooling , rehydration , anticoagula?tion , reduction of the intracranial pressure and symptomatic treatment. One case died and the condition of remaining cas?es were improved. At one-year follow-up, the symptoms were almost cured in 2 cases, significantly improved in 4 cases with disability degree in grade 1~2, moderately improved in 1 case with disability degree in grade 3, remained unchanged in 1 case with disability degree of grade 5. Conclusion Heat stroke can cause conscious disorder and multiple organ fail?ure .The central nervous system lesions are often presented with diffuse swelling or/and lacunar infarction and presented with peripheral nerve injury in some cases, leaving persistent neurological deficits .

Cefepime-induced encephalopathy without renal impairment

Cefepime is an extended-spectrum, fourth-generation cephalosporin that has been widely used for approved indications such as febrile neutropenia. Common adverse events of cefepime include headache, skin rash, gastrointestinal problems, and fever. However, encephalopathathy caused by cefepime has been sporadically reported worldwide over the last decade. We experienced a rare case of cefepime-induced encephalopathy. A 75-year-old man with a 30-year history of chronic obstructive pulmonary disease was admitted to the medical intensive care unit under a diagnosis of pneumonia. Initial antibiotic therapy was started with piperacillin/sulbactam and ciprofloxacin. His condition was improved with this treatment. About 2 months later, his condition was aggravated again, with mild fever and purulent sputum. Intravenous cefepime was selected on the basis of antibiotic susceptibility to Pseudomonas aeruginosa isolated from his sputum. However, his mentality became drowsy 48 hours after cefepime adminstration. He showed tremors and right facial paralysis. Neurologic examination for motor power and sensory function revealed normal findings. Laboratory tests, including serum electrolytes, glucose, osmolality, and ammonia, gave normal results. Brain magnetic resonance imaging showed chronic ischemic and atropic changes, and an electroencephalography revealed triphasic waves. The administration of cefepime was stopped, and his symptoms started to improve within 48 hours. Electroencephalography results became normalized, and he completely recovered within 48 hours after discontinuation of cefepime.

Motor and functional evaluation of patients with spastic paraplegia, optic atrophy, and neuropathy (SPOAN) / Avaliação motora e funcional de pacientes com paraplegia espástica, atrofia óptica e neuropatia (SPOAN)

Spastic paraplegia, optic atrophy, and neuropathy (SPOAN) is an autosomal recessive complicated form of hereditary spastic paraplegia, which is clinically defined by congenital optic atrophy, infancy-onset progressive spastic paraplegia and peripheral neuropathy. In this study, which included 61 individuals (age 5-72 years, 42 females) affected by SPOAN, a comprehensive motor and functional evaluation was performed, using modified Barthel index, modified Ashworth scale, hand grip strength measured with a hydraulic dynamometer and two hereditary spastic paraplegia scales. Modified Barthel index, which evaluate several functional aspects, was more sensitive to disclose disease progression than the spastic paraplegia scales. Spasticity showed a bimodal distribution, with both grades 1 (minimum) and 4 (maximum). Hand grip strength showed a moderate inverse correlation with age. Combination of early onset spastic paraplegia and progressive polyneuropathy make SPOAN disability overwhelming.

A paraplegia espástica, atrofia óptica e neuropatia (SPOAN) é uma forma complicada de paraplegia espástica de herança autossômica recessiva, caracterizada por atrofia óptica congênita, paraplegia espástica progressiva de início na infância e neuropatia periférica. Este estudo avaliou o desempenho motor e funcional de 61 indivíduos com SPOAN (5 a 72 anos), por meio do índice de Barthel modificado, a escala modificada de Ashworth, da avaliação da força de preensão das mãos com dinamômetro hidráulico de Jamar e escalas de paraplegia espástica hereditária. O índice de Barthel modificado, que investiga aspectos funcionais, mostrou-se mais sensível para avaliar a progressão da doença do que as escalas de paraplegia espástica. A espasticidade apresentou distribuição bimodal, com o grau 1 (mínimo) e 4 (máximo). A força de preensão mostrou correlação inversa moderada com a idade. A combinação de paraplegia espástica de início precoce com polineuropatia progressiva faz da SPOAN uma condição incapacitante.

Characteristics of Swallowing Disorder in Pediatric Patients with Central Nervous System Disorders: Comparing to Central Nervous System Intact Patients with Gastro-intestinal Disorders

OBJECTIVE: To evaluate common symptoms and severities of swallowing disorders in pediatric patients with a central nervous system disorder. METHOD: Twenty six pediatric patients with age ranging from 1 month to 3 years who had complained feeding and swallowing difficulties were studied. The subjects were divided into two groups according to the presence or absence of a central nervous system disorder. After taking the history and physical examination, a bedside swallowing test and a videofluoroscopic swallowing study were done. The parameters of oral preparatory phase, oral phase and pharyngeal phase were evaluated. RESULTS: In the bedside swallowing test, the patients with a central nervous system disorder showed a significantly higher incidence of decreased swallowing reflex, postural abnormality, tendency of poor secretion control and absent gag reflex. In the videofluoroscopic swallowing study, patients with a central nervous system disorder showed delayed oral transport time, poor oral control, pharyngeal triggering, aspiration, nasal regurgitation and esophageal reflux. Compared to the patients without a central nervous system disorder, the patients with a central nervous system disorder showed a significantly higher incidence of decreased pharyngeal peristalsis and delayed pharyngeal triggering. The patients with a central nervous system disorder also showed a more profound swallowing disorder than that of the patients without a central nervous system disorder, having more chances of a non-oral feeding than those without a central nervous system disorder. CONCLUSION: The children with a swallowing disorder and central nervous system disordershowed the different features from those without a central nervous system disorder in the bedside swallowing test and videofluoroscopic swallowing study. So that a complete swallowing evaluation including the videofluoroscopic a swallowing study will be helpful to children with swallowing disorder and central nervous system disorder for the evaluation and treatment of pharyngeal stage swallowing dysfunction.

The value of computerized axial tomography of the brain in children with central nervous system disorders

No abstract available.

The value of computerized axial tomography of the brain in children with central nervous system disorders

No abstract available.