RESUMO
Deep brain stimulation (DBS) is a reversible treatment for chorea-acanthocytosis (ChAc). Its safety and efficacy remain elusive due to the low prevalence of ChAc. We aimed to investigate the safety and efficacy of DBS for ChAc by systematically reviewing literature through PubMed and EMBASE. Inclusion criteria were reports on the efficacy or safety of DBS for ChAc and English language articles, and exclusion criteria were other movement disorders, non-human subjects, and studies without original data. Most studies were published as case reports, and we therefore pooled these cases in one cohort. Twenty studies with 34 patients were included. The mean age of symptom onset was 29.3 years (range, 17-48). The median follow-up was 12 months (range, 2-84). Twenty-nine patients underwent GPi-DBS, two received STN-DBS, and one underwent Vop-DBS. Electrodes were implanted into the ventralis oralis complex of the thalamus and the pallidal in two patients. Symptoms seemed to be easier relieved in chorea (88.5%) and dystonia (76.9%) but dysarthria of most patients (85.7%) was no response after DBS. The Unified Huntington's Disease Rating Scale-Motor Score was used to assess the efficacy of DBS in 25 patients; the mean score decreased from 43.2 to 22.3 and the median improvement rate was 46.7%. Of 24 patients with data on adverse events, complications occurred in 9 patients (37.5%; mostly transient and mild events). DBS is a promising treatment for ChAc with satisfactory efficacy and safety based on the review. Pallidal and thalamic DBS have been applied in ChAc; GPi-DBS seems to be more widely used.
Assuntos
Estimulação Encefálica Profunda , Distonia , Neuroacantocitose , Distonia/terapia , Globo Pálido , Humanos , Neuroacantocitose/terapia , Resultado do TratamentoRESUMO
Typically, cardiac maxomas arise from the interatrial septum at the border of the fossa ovalis in the left atrium, whereas atypical right atrial myxoma, especially with spontaneous rupture, is extremely rare. Here we report the diagnostic evaluation and successful surgical resection of an atypical myxoma with spontaneous rupture arising from the posterior wall of the right atrium in a 34-year-old male.
Assuntos
Neoplasias Cardíacas/complicações , Ruptura Cardíaca/etiologia , Mixoma/complicações , Adulto , Procedimentos Cirúrgicos Cardíacos/métodos , Diagnóstico Diferencial , Ecocardiografia , Átrios do Coração , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirurgia , Ruptura Cardíaca/diagnóstico , Ruptura Cardíaca/cirurgia , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Mixoma/diagnóstico , Mixoma/cirurgiaRESUMO
OBJECTIVE: To examine the metabolic and behavioral changes of monkeys with MPTP induced Parkinson's disease. METHODS: Four healthy monkeys were injected with diluted MPTP solution continuously through peripheral veins. The behavioral changes of the monkeys were monitored with the Parkinson disease scale for monkeys. 18FDG-PET-CT scans for the whole brain were obtained before and 3 months after the injection of MPTP. The pathological and glucose metabolic changes of the brains were examined. RESULTS: The animal model of Parkinson's disease was successfully established in all 4 monkeys, showing typical parkinsonian syndromes of bradykinesia, rigidity and hypokinesia. Changes in high nervous activities such as apathetic and less aggressive behaviors were also observed. Their scores of Parkinson disease scale exceeded 20. The parkinsonian syndromes were relieved after the administration of sinemet. The 18FDG-PET-CT scans showed significant glucose reduction after the MPTP injection within and outside of the basal ganglion area. CONCLUSION: The metabolic changes of brains in the monkeys with Parkinson's disease are not limited to the basal ganglion area, which may be an important mechanism for the non-motor symptoms.
Assuntos
Encéfalo/metabolismo , Glucose/metabolismo , Doença de Parkinson Secundária/metabolismo , 1-Metil-4-Fenil-1,2,3,6-Tetra-Hidropiridina , Animais , Modelos Animais de Doenças , Fluordesoxiglucose F18 , Haplorrinos , Masculino , Doença de Parkinson Secundária/induzido quimicamente , Tomografia por Emissão de PósitronsRESUMO
OBJECTIVE: To evaluate the effectiveness and complications of gamma knife surgery for treating pituitary adenomas. METHODS: Retrospective analyses of 217 cases of pituitary adenomas (from July 2004 to November 2008) were performed in Sichuan university's West China Hospital. The patients were treated with an average dose of 26.3 Gy (range 11-33 Gy) and 45%-75% isodose line. Data from serial saddle area MRI and blood endocrine hormone tests were examined. RESULTS: Of the 191 patients being followed up, 95.2% had their tumors effectively controlled. All non-functional pituitary adenoma were controlled, with the size of tumor shrinking significantly in an average of 11.4 months after gamma knife surgery. About functional pituitary adenoma were controlled, with the size of tumor shrinking significantly in an average of 18.6 months. Pituitary hypofunction occurred in 11.5% of patients after the surgery. No patient experienced exacerbation of poor eyesight and visual field after gamma knife surgery. CONCLUSION: Gamma knife can effectively control tumor growth and is a safe and effective treatment for pituitary adenoma.
Assuntos
Adenoma/cirurgia , Neoplasias Hipofisárias/cirurgia , Radiocirurgia , Adenoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Hipofisária , Neoplasias Hipofisárias/patologia , Complicações Pós-Operatórias/epidemiologia , Radiocirurgia/efeitos adversos , Radiocirurgia/instrumentação , Dosagem Radioterapêutica , Adulto JovemRESUMO
In this paper, polychlorinated biphenyl (PCB), organochlorine pesticide (OCP) and pyrethroid pesticides in peach was investigated by comparing their residual level in peach juice, pulps and peels using dispersive liquid-liquid microextraction based on solidification of floating organic droplet (DLLME-SFO) combined with gas chromatography-electron capture detection (GC-ECD). Extraction conditions such as the type of extractant, volume of extractant and dispersant, salt effect and extraction time were optimized. For juice samples, the linearity of the method was obtained in the range of 10-2000 ng L(-1),with determination coefficients>0.99. The limits of detection (LOD) of the method were ranged between 2.8 and 18.5 ng L(-1). For pulp and peel samples, the developed method is linear over the range assayed, 1-20 µg kg(-1),with coefficients also >0.99. The relative recoveries of compounds analyzed from juice, pulp and peel samples were in the range of 73-106% with a relative standard deviation between 2.6 and 11.8%. The proposed method was applied to the simultaneous analysis of residues in real peach juice, pulp and peel samples. As a result, there were no target analytes found in peach juices and pulps while 3.3 µg kg(-1) cyhalothrin and 3.5 µg kg(-1) fenvalerate were found in peels. The experiment results revealed that the pyrethroid residues just deposited on the peels of the fruits, but did not move into pulps and juices.