Magnetic Resonance Imaging Studies of Neurodegenerative Disease: From Methods to Translational Research / 神经科学通报·英文版

Neurodegenerative diseases (NDs) have become a significant threat to an aging human society. Numerous studies have been conducted in the past decades to clarify their pathologic mechanisms and search for reliable biomarkers. Magnetic resonance imaging (MRI) is a powerful tool for investigating structural and functional brain alterations in NDs. With the advantages of being non-invasive and non-radioactive, it has been frequently used in both animal research and large-scale clinical investigations. MRI may serve as a bridge connecting micro- and macro-level analysis and promoting bench-to-bed translational research. Nevertheless, due to the abundance and complexity of MRI techniques, exploiting their potential is not always straightforward. This review aims to briefly introduce research progress in clinical imaging studies and discuss possible strategies for applying MRI in translational ND research.

Correlation between cephalic circumference at birth and ocular alterations in patients with microcephaly potentially associated with Zika Virus infection

SUMMARY INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.

RESUMO: INTRODUÇÃO: O vírus Zika (ZIKV) é um arbovírus isolado pela primeira vez no ano de 1947, sendo transmitido para o homem pelo mosquito Aedes aegypti. No Brasil foi detectado pela primeira vez em maio de 2015. Desde então, ZIKV foi identificado como o agente etiológico da doença exantemática aguda no Brasil, e neuropediatras do Recife deram o sinal de alerta sobre uma epidemia de microcefalia, tendo o Ministério da Saúde do Brasil confirmado a associação entre ZIKV e malformações congênitas e síndromes neurológicas. O olho, sendo uma extensão do cérebro em desenvolvimento, tem sido examinado em pacientes com microcefalia e história materna de infecção por ZIKV. MÉTODO: Foram analisados, por meio de prontuário médico, 20 pacientes recém-nascidos, portadores de microcefalia, cujas mães tiveram presumidamente Zika vírus durante a gestação. A estatística não paramétrica Qui-Quadrado foi utilizada para verificar a associação entre perímetro cefálico e alteração ocular, no nível de significância de 0,0001. RESULTADOS: A significância de P=0,000 no valor da estatística não paramétrica de Qui-Quadrado foi menor do que o valor de α = 0,0001, demonstrando que podemos afirmar que, em um nível de 0,0001, há uma associação entre o perímetro cefálico e a alteração ocular. CONCLUSÃO: Apesar de ainda serem escassos os conhecimentos sobre a evolução natural da doença, as evidências atuais são fortes o suficiente para estabelecermos a relação causal entre a infecção pelo ZIKV durante a gravidez e o aumento da frequência da microcefalia e alterações oculares graves que levam à baixa severa da visão dessas crianças.

Research Progress on Biomechanics of Craniocerebral Injury in Children / 法医学杂志

In the researches of biomechanics for child craniocerebral injury, the research progress of performance parameter detection for brain, skull, cranial suture and dura mater, and the finite element model construction for child's head were reviewed. Meanwhile, the shortcomings of the established finite element model construction of child's head were analyzed. Thus, it is necessary to strengthen the material properties parameter detection of child's head, and establish the relevant database, so as to lay the foundation for establishing an accurate finite element model of child's head.

Therapeutic applications of botulinum neurotoxins in head and neck disorders

The aim of this article is to review the mechanism of action, physiological effects, and therapeutic applications of botulinum neurotoxins in the head and neck area. An extensive literature search was performed using keywords. The resulting articles were analyzed for relevance in four areas: overview on botulinum neurotoxins, the role of botulinum neurotoxins in the management of salivary secretory disorders, the role of botulinum neurotoxins in the management of facial pain, and the role of botulinum neurotoxins in head and neck movement disorders. Institutional review board approval was not needed due the nature of the study. Botulinum neurotoxin therapy was demonstrated to be a valuable alternative to conventional medical therapy for many conditions affecting the head and neck area in terms of morbidly, mortality, and patient satisfaction with treatment outcomes. Botulinum neurotoxin therapy provides viable alternatives to traditional treatment modalities for some conditions affecting the head and neck region that have neurological components. This therapy can overcome some of the morbidities associated with conventional therapy. More research is needed to determine the ideal doses of botulinum neurotoxin to treat different diseases affecting the head and neck regions

Linfoma no hodgkin de células de manto: relato de caso raro y la presentación a los profesionales de la salud de la importancia de un diagnóstico precoz / Lymphoma, mantle cell lymphoma: case report and presentation weird to health professionals of the importance of early diagnosis

Después del carcinoma epidermoide, los linfomas representan el segundo grupo de neoplasias que comprometen la región de la cabeza y cuello, la exploración de este tema es importante en función de la elevada incidencia en los últimos años especialmente los linfomas no Hodgkin. Este linfoma se puede presentar en la región de cabeza y cuello de diversas formas, con compromiso ganglionar y/o extraganglionar, el sitio más común en la región de cabeza y cuello, es el anillo de Waldeyer, seguido por la órbita y anexos, senos paranasales, glándulas salivales, cavidad bucal, laringe y tiroides. En el siguiente trabajo vamos a presentar un caso clínico y en el abordar la necesidad de el conocimiento de el odontólogo-cirujano y demás profesionales de la salud sobre la lesión, con el fin de posibilitar un diagnostico precoz, contribuyendo para un mejor pronostico, prolongar tiempo de vida y mejorar la calidad de vida para este paciente

After the squamous cell carcinoma, lymphomas represent the second group of neoplasms of the head and neck region. Explore this issue proved to be important because the increase of incidence in recent years, especially non-Hodgkin lymphomas. This lymphoma can occur in the head and neck in different ways, with nodal involvement and / or extranodal. When the extranodal site most common in head and neck is the ring of Waldeyer, followed by orbit and attachments, paranasal sinuses, salivary glands, oral cavity, larynx and thyroid. This study sought to present a case report and address the need for knowledge of the dentists and other health professionals about the injury, so that they can make the diagnosis earlier and thus could contribute to a better prognosis, longer survival and better quality of life for this patient

Maniobra digital para localización del nervio recurrente descripción de la técnica Montezuma y Wilper / Digital maneuver for the localization of recurrent nerve Wilper and Montezuma technique description

En el siguiente trabajo tratamos de dar a conocer una maniobra que desde hace varios años venimos utilizando en el servicio de cabeza y cuello, con lo que respecta a la localización del nervio laríngeo recurrente en la cirugía del tiroides tanto en los casos malignos como benigno y en aquellos casos de bocio grado II, III o bocios voluminosos, y carcinoma tiroideos, lo cuales cambian la localización anatómica en el trayecto del nervio de igual manera la disposición anatómica de no recurrir. Se realiza un estudio en una muestra descriptiva tomada para este trabajo de 80 casos solamente, durante 10 años en lo que venimos practicamos la técnica, con pacientes de ambos sexos y diferentes edades. Se procedió a realizar la incisión clásica de cervicotomía anterior, se hace la diéresis hasta liberar los lóbulos tiroideos luego se localiza con palpación digital la escotadura crico tiroidea de cada lado de la laringe donde se encuentra el ligamento suspensorio tiroideo de Berry y membrana cricotiroidea, se diseca una área de 2 cm x 2 cm dicha zona y se ve la penetración de una o dos ramas del nervio recurrentelaríngeo tanto en los casos que recurre como en los no recurrentes. Concluimos que en todos los casos fueron encontrados el nervio ya sea como único o varias de sus ramas en este punto anatómico de reparo

The damage to the recurrent laryngeal nerve is most feared complication by the surgeon of all those that can affect patients undergoing surgery for thyroid and the parathyroid glands. In this paper we try to give a maneuver known that for several years we have been using the service head and neck, with regard to the location of laryngeal recurrent nerve thyroid surgery in both malignant and benign cases most important in cases of goiter grade II, III or bulky goiter and thyroid carcinoma, which changes the anatomical location on the route of laryngeal recurrent nerve, just as the anatomical disposition of non-use. We were studied in a sample descriptive taken for this study of 80 cases only, for 10 years in what we have practiced the technique, patients of both sexes and different ages. We preceded to perform a cervical incision anterior classic, the umlaut is to release the lobes, then located with palpation cricothyroid notch on each side of the larynx where the suspensor ligament of Berry thyroid and cricothyroid membrane is dissected an area of 2 cm x 2 cm that area and is the penetration of one or two branches of recurrent laryngeal nerve, both in the case used as non-recurring. We conclude that in all cases were found either as single recurrent laryngeal nerve or more of its branches at this point anatomical repair

Role of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic head lesions, Egyptian experience

Pancreatic carcinoma is one of the leading cancer morbidity and mortality worldwide. Endoscopic Ultrasound [EUS] provides good direct visualization of the pancreas and EUS-FNA raises the accuracy for diagnosing pancreatic malignancies. US-FNA is another established method for diagnosing pancreatic malignancies. To determine the Role of Percutaneous US-FNA and EUS-FNA in diagnosis of pancreatic lesions. 131 patients with pancreatic masses were included in the study and sub-classified into 2 groups according to the imaging tool used, US-FNA [group I] and EUS-FNA [group II]. Using the appropriate statistical tools, sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV] and diagnostic accuracy were calculated for both groups. It was 88.2%, 93.9%, 96.8%, 97.5% and 90.1% respectively in group I. It was 77.8%, 100%, 100%, 75% and 86.7% respectively in group II. US-FNA/EUS-FNA are safe reliable tools for diagnosis of pancreatic lesions

Lipomatose simétrica benigna e pelagra, associadas ao alcoolismo / Benign symmetrical lipomatosis and pellagra associated with alcoholism

A 42-year-old male patient, alcoholic, presented showing signs of tumors in the neck and around the shoulders, scaly, erythematous-violaceous lesions and some bullous lesions in sun-exposed areas of upper and lower limbs. Based on clinical features, laboratory tests and imaging studies we have established the diagnosis of pellagra associated with benign symmetrical lipomatosis, both justified by chronic alcoholism. Treated with intravenous B-complex and oriented about the importance of alcohol withdrawal, the patient showed complete remission of skin lesions, but with no change in the lipomatosis.

Paciente masculino, 42 anos, etilista crônico, apresentando quadro de tumorações em região cervical e ao redor dos ombros, lesões eritemato-violáceas, descamativas e algumas lesões bolhosas, nas áreas fotoexpostas dos membros superiores e inferiores. Baseado no quadro clínico e nos exames complementares, foi estabelecido o diagnóstico de pelagra associada à lipomatose simétrica benigna, sendo ambos os quadros justificados pelo etilismo crônico. Tratado com reposição de complexo B intravenoso e orientado quanto à importância da abstinência alcoólica, apresentou remissão completa do quadro cutâneo, porém sem alteração da lipomatose.

[Arteriovenous malformations: study about 54 patients]

Background: Arteriovenous malformation [AVM] are vascular anomalies that may threaten functional and vital prognosis

The aim of this study was to assess the management of Arteriovenous malformation

Methods: it is retrospective study about 54 patients, having AVM, collected over a 7-year period

Results: Sex ratio M/F was 1.25; average age at the diagnosis was 25.4 years. Puberty, pregnancy and trauma, were the most important favoring factors for the development of AVM. Location was the head in 75% of the cases. Doppler ultrasound was the most indicated examination to confirm the diagnosis

In over than 70% of our patients, therapeutic abstention and follow-up were indicated. In the other cases, embolixation, with or without surgery was the treatment. A patient died of massive haemorrhage

Treatment is necessary in complicated AVM. Follow-up [if abstention or after treatment] is mainly based on clinical and Doppler data

Conclusions: AVM are anomalies that may be serious and their management must be multidisciplinary to allow better therapeutic indications

Head and neck posttransplant lymphoproliferative disorders [PTLD]: a literature review

Nowadays transplantation is widely used to manage end organ failure, the way that saves patient's lives and increases their survival rate. But it has some complications such as posttransplant malignancies; one of them is posttransplant lymphoproliferative disorder [PTLD]. PTLD is more prevalent in children than in adults and it occurs from months to years after transplantation with the peak of 3-7 months. The incidence of PTLD after heart-lung transplantation is the most [9.4%] and after kidney transplantation is the least [1%]. The common sites of PTLD involvement include abdominal region [32%], bone marrow [25%] and other sites including head and neck [43%]. PTLD is related with immunosuppression caused by administration of immunosuppressive agents and is mostly accompanied by the proliferation of Epstein-Barr virus. Clinical presentation of PTLD varies from a self limiting mononucleosis to a generalized lymphoid infiltration or even a lymphoma. Management of PTLD includes reduction of immunosuppression, using anti CD20 antibody, antiviral drugs, chemothrapy and radiotherapy which are not so efficient. It's prognosis is poor and has 54% mortality rate. Clinical features of PTLD in head and neck region are cervical lymphadenopathy, generalized gingival hyperplasia with erythema, swelling, cyanotic foci and chronic mucosal ulcers; so this neccessitizes referring of a patient with such signs and symptoms or other suspicious conditions in the head and neck to a dentist for early diagnosis and biopsy. This article reviews PTLD with emphasis on oral manifestations and head and neck involvement

Clinical approach to the child with a large head.

Majority of children has head size that is appropriate for age and gender. But a few have either too small or too large head at birth or may be of postnatal acceleration. Abnormality of head circumferences is determined by brain size, including any malformations and space occupying lesions, cerebrospinal fluid (CSF) and blood volume, presence of subdural fluid and thickness of skull bones and overlying tissue scalp. Macrocephaly is used when the head size exceeds the mean by more than two standard devotions of age and gender. Macrocephaly is seen in association with several cranioskeletal dysplastic conditions.

Angioedema of head and neck complicating the use of ACE inhibitors

To study the clinical manifistations and to assess our management of cases of angioedema of head and neck precipitated by the use of Angiotensin - Converting enzyme [ACE] inhibitors. Design and setting: This is a retrospective analysis of 42 consecutive cases with angioedema of head and neck seen and managed at the teaching hospitals of the University of Ottawa, between 1991 and 1995. Twnenty four cases were associated with the use of ACE inhibitors. Subjects:Female patients constituted 69% and males 31%. There was a male to female ratio of 1.0:2.2. The mean age of the patients was 64 years. More than two thirds of the patients [62%] presented as a first episode. The tongue was most commonly affected. Other affected areas included the lips,oro-pharynx, supraglottis and soft palate. ACE's were used in 24 [57%] cases. All cases treated medically responded to therapy which included the use of anti-histamine, steroids and sometimes subcutaneous epinephrine. Admission to intensive care unit [ICU] were required in 12 [28.6%] patients and endotracheal intubation was required in 3 [7%] cases. Fiberoptic Nasolaryngoscopy [FNLS] was utilized in the assessment of 21 patients [50%]. No mortality was recorded. Angiotensin - Converting Enzyme [ACE] inhibitors are relatively common cause of angioedema of head and neck. Treatment to keep the airway open during the acute phase is essential to prevent death

Cefalea en el niño / Headache in children

La cefalea se define como la sensación dolorosa de la cabeza que puede ser difusa o circunscrita, de intensidad y causas variables con o sin concomitante. Es un síntoma frecuente en la edad pediátrica. Los niños se quejan de dolor de cabeza en un porcentaje similar a los adultos y puede persistir hasta la edad adulta. Diversos autores han reportado que una gran cantidad de niños han padecido de cefalea en algún momento de su vida, estimándose que a los 7 años un 35 por ciento y a los 15 años el 75 por ciento ha tenido algún momento de su vida, estimándose que a los 7 años un 35 por ciento y a los 15 años el 75 por ciento ha tenido algún episodio de cefalea

Evaluación de la sutura monocryl / Evaluation of the monocryl suture

Se hace un estudio de las propiedades de la sutura monocryl evaluando 37 pacientes a quienes se les practicaron diversas técnicas quirúrgicas